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BackgroundReward deprivation has been implicated in major depressive disorder and severe substance abuse, but its potential relation to alcohol use disorder (AUD) symptoms in non-treatment-seeking young adult drinkers is less clear. Depression is often comorbid with alcohol misuse, so relations of AUD with reward deprivation might be due in part to the presence of depressive symptoms in young adults. Behavioral economic theory views addiction as a state that is related in part to deficits in drug-free rewards, and therefore requires an investigation into whether reward deprivation has a direct relation to alcohol misuse that is, at least partially, independent of mood.MethodsThis study evaluates the contribution of 2 facets of reward deprivation (reward availability and experience) to alcohol use, AUD symptoms, and depression in a sample of young adult heavy episodic drinkers. Data were collected from 392 undergraduates (60.4% female, 85.1% Caucasian) who reported recent heavy drinking (83.7% with at least 1 AUD symptom).ResultsLow reward availability (environmental suppression) was significantly associated with both DSM-5 AUD symptoms and alcohol-related problems after controlling for age, gender, depressive symptomatology, and drinking level.ConclusionsThis study provides support for behavioral economic models that emphasize reward deprivation as a unique risk factor for AUD that is independent of mood and drinking level. Limited access to natural rewards may be a risk and/or maintaining factor for AUD symptoms in college student drinkers.

Despite the growing opioid epidemic in the US, few studies have identified theoretically based risk factors for non-medical prescription opioid (NMPO) use among young adults. The goal of the current study was to evaluate the behavioral economic hypotheses that NMPO use would be associated with lower levels of reinforcement from substance-free activities and future time orientation. Participants were 71 undergraduate students (62% women, 52.1% Caucasian, 35.2% African American) who either reported past-year NMPO use or demographically similar control participants with no past-year drug use. Participants provided information on alcohol and drug use, completed three measures of substance-free reinforcement (time allocation to exercise and academic activities, hedonic response to substance-free pleasant images, and self-report anhedonia), and a measure of future orientation, at baseline, 6-month, and 12-month followup. Consistent with nationwide trends, most NMPO users also reported use of marijuana (94%) and alcohol (80%). Compared to no drug use, NMPO use was associated with lower time allocation to academic activities, lower hedonic response to pleasant images, greater self-reported anhedonia, and lower future orientation across the 12-month study period. Among NMPO users, greater positive hedonic response to substance-free pleasant images predicted less alcohol use at 12-month follow-up, and greater baseline future orientation predicted less marijuana and NMPO use at 12-month follow-up. These findings provide partial support for behavioral economic models that link substance misuse to diminished levels of substance-free reinforcement and lower consideration of the future. Keywords Substance-free reward * Behavioral economics * Non-medical use of prescription opioids, College students report high levels of alcohol and drug use; 63.1% of US college students report past-month alcohol use, 34.4% report past-year marijuana use, 20.8% report past-year illicit drug use [...]

Understanding and addressing violence among intimate partners requires sound assessment of their communication patterns. In prior research, the 35-item, self-report Communication Patterns Questionnaire (CPQ) has been used to assess communication patterns in violent relationships. To date, psychometric analysis of the CPQ has been examined only among nonviolent couples; no studies have examined the psychometric properties of this measure in a sample of survivors of intimate partner violence (IPV). Using confirmatory factor analysis, the present study evaluated the factor structure of the CPQ in a sample of women survivors of IPV who sought mental health assessments at a university research clinic. Analyses suggested that a modified three-factor solution (constructive communication [CC], self-demand/partner withdraw [SDPW], partner demand/self-withdraw [PDSW]) provided good fit in our sample. Internal consistency estimates for each of the modified scales were acceptable and exceeded reported coefficients in prior IPV studies. Significant bivariate correlations among modified scales, and between communication patterns and aggressive behaviors, provided initial validity evidence for the CPQ scales in our sample. We found CC to be negatively associated with partner psychological aggression, PDSW to be positively associated with all forms of partner aggression and respondent psychological aggression, and SDPW to be positively associated with respondent physical and psychological aggression. The results of this study indicate that the CPQ may be an appropriate measure for assessing communication patterns in violent relationships; however, modified scoring procedures should be used. We contextualize our results within existing models of IPV and address clinical, cultural, and contextual issues in communication patterns assessment. [ABSTRACT FROM AUTHOR]

Intimate partner violence (IPV) against women, particularly those living in poverty who have multiple marginalized identities, is a significant public health issue. IPV is associated with numerous mental health concerns including depression, hopelessness, and suicidal behavior. The present study examined the ecological determinants of these mental health outcomes in a high-risk sample of 67 low-income, African American women survivors of IPV. Based on an ecological framework that conceptualizes individuals as nested in multiple, interactive systems, we examined, longitudinally, the main and interactive effects of self-reported neighborhood disorder and social support from family members and friends on participants' mental health (i.e., self-reported depressive symptoms, hopelessness, and suicide intent). In multiple regression analyses, neighborhood disorder interacted with social support from family members to predict depressive symptoms and hopelessness over time. Neighborhood disorder also interacted with social support from friends to predict hopelessness and suicide intent over time. High levels of social support buffered against the dangerous effects of neighborhood disorder on depressive symptoms, hopelessness, and suicide intent; at low levels of social support, there was no significant association between neighborhood disorder and those mental health outcomes. Neighborhood disorder and social support did not yield significant main effects. These findings underscore the importance of interventions that target individuals, families, and communities (e.g., community empowerment programs). Group interventions may also be important for low-income, African American women survivors of IPV, as they can help survivors establish and strengthen relationships and social support. [ABSTRACT FROM AUTHOR]

Consistent themes in the constructivist supervision of counseling and psychotherapy include the fostering of supervisee reflexivity, perspective taking, and capacity to generate alternative conceptualizations and interventions. In keeping with these objectives, we describe a technique for deepening therapists' reflection on their interchanges with clients through “questioning their questions” and the clients' responses to them. We further illustrate the procedure in the supervision of a therapist in training who (a) analyzed in writing a series of six question-and-answer cycles pertaining to a client, (b) considered the larger implications of the interaction for the therapeutic relationship with this client, (c) received supervisory feedback on his journaling, and (d) offered a final reflexive comment on the procedure. We conclude with a few thoughts about variations on the technique to enhance its relevance in different supervisory settings. [ABSTRACT FROM PUBLISHER]

Background: Psychotherapy noncompletion rates for veterans and their families are high. This study sought to (a) measure noncompletion rates of such patients at a university-based treatment center, (b) compare veteran and family member attrition rates, (c) identify dropout predictors, and (d) explore clinicians' perspectives on treatment noncompletion., Method: Using quantitative and qualitative approaches, we analyzed demographic and clinical characteristics of 141 patients (90 military veterans; 51 family members) in a university treatment center. We defined dropout as not completing the time-limited therapy contract. Reviewing semistructured interview data assessing clinicians' perspectives on their patients' dropout, three independent raters agreed on key themes, with interrater coefficient kappa range .74 to 1., Results: Patient attrition was 24%, not differing significantly between veterans and family members. Diagnosis of major depression (MDD) and exposure-based therapies predicted noncompletion, as did higher baseline Hamilton Depression Rating Scale (HDRS) total scores, severe depression (HDRS > 20), lack of Beck Depression Inventory weekly improvement, and history of military sexual trauma. Clinicians mostly attributed noncompletion to patient difficulties coping with intense emotions, especially in exposure-based therapies., Conclusion: Noncompletion rate at this study appeared relatively low compared to other veteran-based treatment centers, if still unfortunately substantial. Patients with comorbid MDD/PTSD and exposure-based therapies carried greater noncompletion risk due to the MDD component, and this should be considered in treatment planning. Ongoing discussion of dissatisfaction and patient discontinuation, in the context of a strong therapeutic alliance, might reduce noncompletion in this at-risk population. (PsycInfo Database Record (c) 2022 APA, all rights reserved).