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Positive and negative affect in cocaine use disorder treatment: Change across time and relevance to treatment outcome.

ABSTRACT: BACKGROUND:Cognitive-behavior therapy (CBT) for substance use disorder is empirically supported, and may be associated with change in affect over time. OBJECTIVES:Understanding the role of affect in cocaine use disorder could help to improve CBT outcomes. METHODS:This secondary analysis included 140 adults with cocaine use disorder, 57.9% female, drawn from two randomized controlled studies of web-based cognitive-behavior therapy who completed the Positive and Negative Affect Scale (PANAS) before and during treatment. RESULTS:In mixed-effects regression models, baseline negative affect (NA) scores were not associated with self-reported cocaine use during treatment, but baseline PA scores were associated with less frequent cocaine use (??=?-0.04, p?=?.02). During treatment, NA scores reduced over time in CBT and treatment as usual (??=?-0.27, p?

SUBMITTER: Decker SE

PROVIDER: S-EPMC6309484 | biostudies-literature | 2018 Jun

REPOSITORIES: biostudies-literature

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Positive and negative affect in cocaine use disorder treatment: Change across time and relevance to treatment outcome.

Decker Suzanne E SE Morie Kristen P KP Malin-Mayo Bo B Nich Charla C Carroll Kathleen M KM

The American journal on addictions 20180620

<h4>Background</h4>Cognitive-behavior therapy (CBT) for substance use disorder is empirically supported, and may be associated with change in affect over time.<h4>Objectives</h4>Understanding the role of affect in cocaine use disorder could help to improve CBT outcomes.<h4>Methods</h4>This secondary analysis included 140 adults with cocaine use disorder, 57.9% female, drawn from two randomized controlled studies of web-based cognitive-behavior therapy who completed the Positive and Negative Affe ...[more]

PMID: 29923665

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Project description:BackgroundThe network approach to psychopathology has become increasingly popular. Little research has examined the dynamic network structure of mental disorders, and, to date, no study has investigated the network dynamics of positive affect, negative affect, and physical activity in bipolar disorder. This represents the first study to estimate the dynamic network structure of affect and physical activity in individuals with and without bipolar I disorder.MethodsAn intensive longitudinal design was used to assess positive affect, negative affect, and actigraphy-based estimates of physical activity. The overall sample consisted of 32 adults with bipolar I disorder and 36 healthy control participants. Eligible participants underwent an 8-week assessment period, in which once-per-day ratings of affect and actigraphy estimates were obtained. Participants were re-assessed on baseline measures afterwards. Dynamic network analysis was used to examine the network structure of affect and physical activity over time. Multilevel models were used to examine the relationship between autocorrelation and changes in depression symptoms among participants with bipolar disorder.LimitationsThe network analyses assume stationarity. Future research should consider time-varying multilevel network models to better account for time trends.ResultsThe results of the temporal networks indicated that the directed edges between positive and negative affect were mostly positive among individuals with bipolar I disorder. Among healthy control participants, the directed edges between positive and negative affect were mostly negative in direction. Physical activity, as assessed by daily actigraphy indices, was more densely connected in the healthy control network than the bipolar disorder network. Furthermore, the results indicated that critical slowing down predicted worsening of mood symptoms in the bipolar I disorder group.ConclusionsThis study suggests that certain dynamic patterns of affect may be an underlying process that contributes to the maintenance of bipolar disorder. These results have both theoretical and practical implications.

Project description:AimsTo identify when smoking cessation treatments affect craving, negative affect and anhedonia, and how these symptoms relate to abstinence, to help evaluate the effects of particular intervention components in multi-component treatments and accelerate treatment refinement.DesignSecondary analysis of data from a two-arm randomized controlled trial.SettingSeven primary care clinics in Wisconsin, United States.ParticipantsAdult primary care patients who smoked daily (n = 574).Intervention and comparatorIntervention was abstinence-optimized treatment (A-OT, n = 276) comprising 3 weeks of nicotine mini-lozenges pre-target quit day (TQD), 26 weeks of combination nicotine patch and mini-lozenges post-TQD and extensive psychosocial support. The comparator was recommended usual care (RUC, n = 298), comprising brief counseling and 8 weeks of nicotine patch post-TQD.MeasurementsTime-varying effect models examined dynamic effects of A-OT (versus RUC) on the primary outcomes of nightly cigarette craving, negative affect and anhedonia from 1 week pre- to 2 weeks post-TQD. Exploratory models examined within-person relations between nicotine medication use and same-day symptom ratings. Secondary logistic regression analyses examined associations between post-TQD craving, negative affect and anhedonia and 1-month post-TQD abstinence.FindingsA-OT significantly suppressed pre- and post-TQD craving (β = -0.27 to -0.46 across days) and post-TQD anhedonia (β = -0.24 to -0.38 across days), relative to RUC. Within individuals, using patches was associated with lower negative affect in RUC (β = -0.42 to -0.52), but not in A-OT. Using more mini-lozenges was associated with greater craving (β = 0.04-0.07) and negative affect (β = 0.03-0.05) early, and with lower anhedonia (β = -0.06 to -0.12) later. Greater post-TQD craving (OR = 0.68) and anhedonia (OR = 0.85) predicted lower odds of abstinence 1 month post-TQD.ConclusionTime-varying effect models showed that a multi-component treatment intervention for smoking cessation suppressed significant withdrawal symptoms more effectively than recommended usual care among daily adult smokers motivated to quit. The intervention reduced craving pre- and post-target quit day (TQD) and anhedonia post-TQD.

Dataset Information

Positive and negative affect in cocaine use disorder treatment: Change across time and relevance to treatment outcome.

Publications

Positive and negative affect in cocaine use disorder treatment: Change across time and relevance to treatment outcome.

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