Impulsivities and addictions: a multidimensional integrative framework informing assessment and interventions for substance use disorders

Impulse control is becoming a critical survival skill for the twenty-first century. Impulsivity is implicated in virtually all externalizing behaviours and disorders, and figures prominently in the aetiology and long-term sequelae of substance use disorders (SUDs). Despite its robust clinical and predictive validity, the study of impulsivity is complicated by its multidimensional nature, characterized by a variety of trait-like personality dimensions, as well as by more state-dependent neurocognitive dimensions, with variable convergence across measures. This review provides a hierarchical framework for linking self-report and neurocognitive measures to latent constructs of impulsivity and, in turn, to different psychopathology vulnerabilities, including substance-specific addictions and comorbidities. Impulsivity dimensions are presented as novel behavioural targets for prevention and intervention. Novel treatment approaches addressing domains of impulsivity are reviewed and recommendations for future directions in research and clinical interventions for SUDs are offered. This article is part of the theme issue ‘Risk taking and impulsive behaviour: fundamental discoveries, theoretical perspectives and clinical implications’.

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Use of Occupation-Based Outcome Measure and Strength-Based Self-Report with Persons with Substance Use Disorders: A Prospective Cohort Study

Occupational Therapy in Mental Health ◽

10.1080/0164212x.2021.1875956 ◽

2021 ◽

pp. 1-16

Author(s):

Jeffrey Sargent ◽

Kristin Valdes

Keyword(s):

Substance Use ◽

Cohort Study ◽

Substance Use Disorders ◽

Prospective Cohort Study ◽

Prospective Cohort ◽

Outcome Measure ◽

Self Report ◽

Strength Based

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Substance use, Unlike Dolutegravir, is Associated with Mood Symptoms in People Living with HIV

AIDS and Behavior ◽

10.1007/s10461-021-03272-2 ◽

2021 ◽

Author(s):

Lisa Van de Wijer ◽

Wouter van der Heijden ◽

Mike van Verseveld ◽

Mihai Netea ◽

Quirijn de Mast ◽

...

Keyword(s):

Substance Use ◽

Term Treatment ◽

Assessment Tools ◽

Self Report ◽

People Living With Hiv ◽

Antiretroviral Drug ◽

Long Term Treatment ◽

Living With Hiv ◽

Neuropsychiatric Side Effects

AbstractContradictory data have been reported concerning neuropsychiatric side effects of the first-line antiretroviral drug dolutegravir, which may be partly due to lack of control groups or psychiatric assessment tools. Using validated self-report questionnaires, we compared mood and anxiety (DASS-42), impulsivity (BIS-11), and substance use (MATE-Q) between dolutegravir-treated and dolutegravir-naive people living with HIV (PLHIV). We analyzed 194, mostly male, PLHIV on long-term treatment of whom 82/194 (42.3%) used dolutegravir for a median (IQR) of 280 (258) days. Overall, 51/194 (26.3%) participants reported DASS-42 scores above the normal cut-off, 27/194 (13.5%) were classified as highly impulsive, and 58/194 (29.9%) regularly used recreational drugs. Regular substance use was positively associated with depression (p = 0.012) and stress scores (p = 0.045). We observed no differences between dolutegravir-treated and dolutegravir-naive PLHIV. Our data show that depressed and anxious moods and impulsivity are common in PLHIV and associate with substance use and not with dolutegravir use.

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Recovery-informed Theory: Situating the Subjective in the Science of Substance Use Disorder Recovery

Journal of Recovery Science ◽

10.31886/jors.13.2019.38 ◽

2019 ◽

Vol 1 (3) ◽

pp. 1-15 ◽

Cited By ~ 5

Author(s):

Austin M Brown ◽

Robert D Ashford

Keyword(s):

Substance Use ◽

Substance Use Disorders ◽

Substance Use Disorder ◽

Systems Of Care ◽

Grand Theory ◽

Recovery Strategies ◽

Recovery Capital ◽

New Ideas

As recovery from substance use disorder becomes more than a mere quantifiable outcome, there exists a need to discuss and propose the underlying theoretical constructs that ultimately describe and identify the science of recovery. In this abstract undertaking, we propose an initial formulation of a grand theory of recovery science, built upon the seminal theories of recovery capital, recovery-oriented systems of care, and socioecological theory. This grand theory - labeled recovery-informed theory (RIT) - states that successful long-term recovery is self-evident and is a fundamentally emancipatory set of processes. This paper will discuss, analyze, and explore this theory as it is situated within the larger substance use, misuse, and disorder contexts. The uses, implications, and benefits of RIT as an organizing point of inquiry for recovery science are also discussed. By promoting the role of subjective recovery experience in the formulation of the study of recovery, it may be possible to summon new ideas, metrics, and strategies that can directly address substance use disorders in society. Adopting a recovery-informed understanding as follows from this grand theory may allow individual recovery and wellness trajectories to be explored, adapted, and modified to exemplify person-centered and individualized recovery strategies.

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Psychosocial Therapies for Substance Use Disorders

Managing Substance Use Disorder ◽

10.1093/med-psych/9780190926717.003.0005 ◽

2019 ◽

pp. 41-52

Author(s):

Dennis C. Daley ◽

Antoine Douaihy

Keyword(s):

Substance Use ◽

Substance Use Disorders ◽

Psychosocial Interventions ◽

Alcohol Problems ◽

Support Programs ◽

Treatment Programs ◽

Mutual Support ◽

Professional Treatment ◽

Drug Problems

There are many counseling approaches, treatment programs, and psychosocial interventions for individuals with substance use disorders (SUDs). Although some have been shown in clinical trials to be more effective than others, to date there is no single, superior treatment approach appropriate for all clients. While brief treatments have been successful with alcohol problems, longer term treatments are often needed for drug problems. For clients with more severe SUDs, long-term involvement in professional treatment (including medication-assisted therapies), mutual support programs, or both may be needed. This chapter includes a summary of treatment principles and guidelines that can serve as a framework for helping clients with SUDs.

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Accuracy of self-report, biological tests, collateral reports and clinician ratings in identifying substance use disorders among adults with schizophrenia.

Psychology of Addictive Behaviors ◽

10.1037/a0031256 ◽

2013 ◽

Vol 27 (3) ◽

pp. 774-787 ◽

Cited By ~ 13

Author(s):

Sarah L. Desmarais ◽

Richard A. Van Dorn ◽

Brian G. Sellers ◽

M. Scott Young ◽

Marvin S. Swartz

Keyword(s):

Substance Use ◽

Substance Use Disorders ◽

Self Report ◽

Biological Tests

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The effect of substance use disorders on the association between guideline-concordant long-term opioid therapy and all-cause mortality

Drug and Alcohol Dependence ◽

10.1016/j.drugalcdep.2016.08.196 ◽

2017 ◽

Vol 171 ◽

pp. e68

Author(s):

J.R. Gaither ◽

J. Goulet ◽

William Becker ◽

Stephen Crystal ◽

E. Jennifer Edelman ◽

...

Keyword(s):

Substance Use ◽

Substance Use Disorders ◽

Opioid Therapy ◽

All Cause Mortality

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Alcohol and Substance Use Disorders as Predictors of Child to Adult Sexual Revictimization in a Sample of Community Women

Violence and Victims ◽

10.1891/vivi.17.3.319.33662 ◽

2002 ◽

Vol 17 (3) ◽

pp. 319-340 ◽

Cited By ~ 44

Author(s):

Terri L. Messman-Moore ◽

Patricia J. Long

Keyword(s):

Risk Factors ◽

Substance Abuse ◽

Substance Use ◽

Substance Use Disorders ◽

Sexual Victimization ◽

Use Of Force ◽

Self Report ◽

Sexual Revictimization ◽

Verbal Coercion ◽

Different Types

Alcohol- and substance-related diagnoses were examined as factors in child to adult sexual revictimization. Three hundred community women completed interviews and self-report instruments to obtain information regarding victimization and to diagnose substance use disorders (alcohol and substance abuse/dependence). Childhood sexual abuse (CSA) survivors were more likely than nonvictims to meet criteria for both substance use disorders and to report rape (e.g., unwanted intercourse due to threat or use of force, or due to the inability to consent due to the respondent’s alcohol or drug use) and coerced intercourse (e.g., unwanted intercourse due to verbal coercion or misuse of authority by the perpetrator) by acquaintances, strangers, and husbands. In general, both CSA and substance use disorders were predictive of adult sexual victimization, but there were no significant interactions between these factors. Overall, substance use disorders were related to rape for all women; this relationship was not unique to CSA survivors. Alcohol- and substance-related diagnoses predicted rape by all three types of perpetrators, but CSA was predictive of rape only by acquaintances and strangers and not husbands. In contrast, CSA predicted coerced intercourse by all three perpetrators, while alcohol- and substance-related diagnoses predicted coerced intercourse by acquaintances and strangers, but not husbands. Results highlight the need to continue the study of revictimization of CSA survivors, including examination of both rape and sexually coercive experiences by different types of perpetrators. Findings support continued research of substance use disorders as risk factors for sexual victimization among all women.

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Pharmacotherapy for substance use disorders within correctional facilities

10.1093/med/9780199360574.003.0046 ◽

2015 ◽

Author(s):

Sarah E. Wakeman ◽

Josiah D. Rich

Keyword(s):

Substance Use ◽

Substance Use Disorders ◽

Behavioral Interventions ◽

Opioid Dependence ◽

Addiction Treatment ◽

Term Treatment ◽

Opiate Dependence ◽

Opioid Use ◽

Long Term Treatment

Drug addiction treatment is increasingly complex. Only 5% of prisons and 34% of jails offer any detoxification services, and only 1% of jails offer methadone for opioid withdrawal. Even fewer facilities offer medication assisted therapy (MAT) for alcohol or substance use disorders despite the tremendous evidence base supporting the use of medications to treat addiction. Untreated opioid dependence both within corrections and in the community is associated with HIV, Hepatitis C, crime, and death by overdose. Substantial evidence argues that these risks are reduced through long-term treatment with agonist medications such as methadone and buprenorphine. Only a minority of prisoners receive any addiction treatment while incarcerated. Those that do are usually offered behavioral interventions, which when used alone have extremely poor outcomes. Although there are limited studies on the outcomes of drug treatment during incarceration, there are nearly 50 years of evidence documenting the efficacy of methadone given in the community in reducing opioid use, drug-related health complications, overdose, death, criminal activity, and recidivism. Buprenorphine is similarly an effective, safe, and cost-effective long-term treatment for opioid dependence that reduces other opioid use and improves health and quality of life outcomes. There is a growing role for MAT in jails, and to a lesser degree in prisons for the treatment of alcohol and opiate dependence. This chapter presents the current state of evidence based practice in correctional MAT models.

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