Anxiety sensitivity,distress tolerance,and discomfort intolerance in relation to coping and conformity motives for alcohol use and alcohol use problems among young adult drinkers

Anxiety sensitivity, distress tolerance, and discomfort intolerance have been identified as important factors related to alcohol use motives and alcohol-related problems. Yet, these variables are highly correlated and little work has delineated whether these psychological vulnerability factors are differentially related to alcohol use motives and problems. To fill this gap in the existing literature, the present study evaluated whether anxiety sensitivity, distress tolerance, and discomfort intolerance were differentially related to high-risk alcohol use motives (i.e., coping and conformity motives) and alcohol use problems among 224 young adult, current drinkers (52.3% women; M_age = 21.18, SD = 7.08). Results indicated that distress tolerance, but not anxiety sensitivity or discomfort intolerance, was significantly related to coping motives for alcohol use. Additionally, anxiety sensitivity, but not distress tolerance or discomfort intolerance, was significantly related to conformity motives for drinking. For both sets of analyses, the observed significant effects were evident above and beyond the variance accounted for by alcohol consumption level, smoking rate, negative affectivity, and non-criterion alcohol use motives. Additionally, discomfort intolerance and anxiety sensitivity each predicted alcohol use problems; effects were not attributable to negative affectivity, cigarettes smoked per day, or shared variance with distress tolerance. Findings are discussed in relation to the role of emotional sensitivity and intolerance in terms of the motivational bases for alcohol use and alcohol use problems among young adult drinkers.     

The association between distress tolerance and cannabis use-related problems: the mediating and moderating roles of coping motives and gender

Recent research has linked distress intolerance to a greater incidence of cannabis use-related problems. Additionally, individuals reporting coping motives for cannabis use might be particularly vulnerable to use-related problems, and tendencies to use coping motives may be influenced by gender. The current study sought to extend the literature by examining the role of distress tolerance on cannabis use-related problems and the potential influences of coping motives for use and gender. Participants were 118 cannabis-using adults (Mage = 29.84). As hypothesized, highly distress intolerant individuals reported more cannabis-use related problems. Further, coping motives mediated the relationship between distress tolerance and cannabis use-related problems, and this effect was more powerful for women than for men. The current study adds to our understanding of the impact of distress tolerance and problematic patterns of cannabis use.     

The association between perceived distress tolerance and cannabis use problems,cannabis withdrawal symptoms,and self-efficacy for quitting cannabis: The explanatory role of pain-related affective distress

Rates of cannabis use and related problems continue to rise, ranking as the third most common substance use disorder in the United States, behind tobacco and alcohol use. Past work suggests that perceived distress tolerance is related to several clinically significant features of cannabis use (e.g., coping-oriented use). However, there has been little exploration of the mechanisms that may underlie relations between perceived distress tolerance and cannabis use problems, withdrawal severity, and self-efficacy for quitting. The current study sought to examine the experience of pain, which frequently co-occurs with cannabis use (Ashrafioun, Bohnert, Jannausch, & Ilgen, 2015), as an underlying factor in the relation between perceived distress tolerance and cannabis related problems among 203 current cannabis-using adults (29.2% female, M = 37.7 years, SD = 10.2, 63% African American). Results indicated that perceived distress tolerance via pain related affective distress significantly predicted the severity of cannabis use problems (Pm = 0.60), degree of cannabis withdrawal (Pm = 0.39), and lower self-efficacy for quitting cannabis (Pm = 0.36). Future work may usefully explore the role of pain-related affective distress as a mechanistic factor in the context of perceived distress tolerance-cannabis relations.     

Transdiagnostic processes linking anxiety symptoms and substance use problems among adolescents

Numerous anxiety syndromes co-occur with substance use problems in adolescents, though the mechanisms underlying these comorbidities are not well understood. There are 3 transdiagnostic processes—anxiety sensitivity (fear of anxiety-related sensations), distress tolerance (capacity to withstand emotional distress), and negative urgency (propensity to respond impulsively to negative emotion)—that have been implicated in various anxiety and substance use problems. To examine whether anxiety sensitivity, distress tolerance, and negative urgency statistically mediated relations between symptoms of 3 different anxiety disorders (social anxiety, generalized anxiety, and panic disorders) and alcohol and cannabis use problems, cross-sectional analysis of high school students in Los Angeles (N = 3002) was assessed via paper and pencil questionnaires. When mediators were entered simultaneously, negative urgency accounted for a significant 33 to 85% of the covariance between anxiety symptomatology and substance use problems over and above the other trandiagnostic processes. This pattern was consistent across all 3 anxiety syndromes and both alcohol and cannabis problems. Anxiety sensitivity and distress tolerance did not account for positive associations between anxiety symptoms and substance use problems. Negative urgency may be an important mechanism underlying the relationship between various types of anxiety and substance use problems in adolescence, and thus represents a possible target for preventive interventions targeting adolescent anxiety and substance use.     

The Role of Acculturation and Alcohol Problems on Frequency of Cannabis Use Among Latinas at Risk of an Alcohol-Exposed Pregnancy

Background: Along with alcohol, cannabis is one of the most commonly used substances among women of childbearing age. Recent studies indicate detrimental effects of prenatal cannabis use. Because many women use these substances before realizing they are pregnant, these serious health consequences for women and their offspring are of great concern. Despite the recent upsurge in cannabis use, little is known about individual and sociocultural factors that may contribute to risk of a cannabis-exposed pregnancy, particularly among Latinas of child-bearing age also at risk of an alcohol-exposed pregnancy (AEP). Objectives: Examine the relationships of acculturation, alcohol use, alcohol problems, and psychological distress with frequency of cannabis use among adult Latinas at risk of an AEP. Methods: The hypothesized model included 76 Latinas and was analyzed using path analysis. The study used baseline data from a randomized controlled trial of an intervention targeting risky drinking and tobacco use among women at risk of an AEP in primary care clinics. Results: Greater acculturation was associated with more frequent cannabis use and greater psychological distress. There was a positive indirect relationship between acculturation and alcohol use and alcohol problems through psychological distress. Greater alcohol problems were associated with more frequent cannabis use. Greater psychological distress and alcohol use were indirectly related to more frequent cannabis use through alcohol problems. Conclusions: Findings underscore the critical role of acculturation and alcohol-related problems in cannabis use frequency and have relevant implications for preventive efforts addressing cannabis use among Latinas at risk of an AEP.     

Depression and Substance Use: Towards the Development of an Emotion Regulation Model of Stigma Coping

The comorbidity between depression and substance use problems is well-documented, yet little research has investigated how stigma associated with one's depression might relate to alcohol and drug use. The current study examined the association between depression-related stigma and substance use coping and considered the role of emotion dysregulation (i.e., difficulty in monitoring, evaluating, and modulating one's emotional reactions) as a mechanism underlying this association. A sample of individuals who self-identified as having current or remitted depression (N = 218) completed self-report measures of depression-related stigma, emotion dysregulation, and tendency to rely on alcohol or drugs to cope with psychological distress. Depression-related stigma was positively associated with emotion dysregulation, which was in turn associated with a greater tendency to engage in substance use coping. These findings provide initial support for the role of stigma as a contributor to maladaptive coping responses, such as substance use, among people living with depression. Further, they underscored the potential utility of targeting emotion dysregulation in stigma coping and substance abuse prevention intervention efforts.     

Relations Between Parental Distress Intolerance,Adolescent Motives for Cigarette Use,and Adolescent Cigarette Smoking Levels

Background: A relatively large body of evidence indicates that coping motives for cigarette smoking are associated with a number of problematic outcomes (e.g., greater smoking frequency) among adolescents. Evidence also indicates that lower distress tolerance (or higher distress intolerance) is related to higher levels of coping motives for cigarette smoking among adults and adolescents. Therefore, it is critical to improve our understanding of factors that may increase the likelihood of smoking to cope among adolescents. In addition, evidence suggests that a number of parenting behaviors may affect adolescent smoking behavior. No work to date, however, has examined the relation between parental distress intolerance and adolescent smoking motives, or adolescent smoking behavior. Objective/methods: The current study involving adolescents (n?=?46) and one of their parents aimed to address this gap in the literature by examining the association between parent-reported parental distress intolerance, self-reported adolescent motives for cigarette use, and self-reported adolescent cigarette smoking levels. Results: Results indicated that parental distress intolerance was related to greater adolescent coping motives for cigarette smoking, but not to other motives for adolescent cigarette use. Furthermore, results indicated that parental distress intolerance was indirectly associated with higher adolescent cigarette smoking levels through adolescent coping motives for cigarette smoking. Conclusions: Parental distress intolerance is associated with coping motives for adolescent cigarette smoking. This suggests parental emotional factors may be associated with adolescent cigarette use.     

Multisubstance Use Among Treatment-Seeking Smokers: Synergistic Effects of Coping Motives for Cannabis and Alcohol Use and Social Anxiety/Depressive Symptoms

Objective: This study examined the impact of coping motives for cannabis and alcohol use on the relation between social anxiety/depressive symptoms and severity of substance use for alcohol, tobacco, and cannabis among treatment-seeking smokers who also use cannabis and alcohol. Methods: The sample included 197 daily cigarette smokers (M_Age 34.81 years, SD = 13.43) who reported using cannabis and alcohol. Results: Hierarchical multiple regression analyses were conducted wherein separate models were constructed for each dependent variable. Among individuals with higher social anxiety, alcohol coping motives were associated with heavier drinking, and this was more pronounced among those low in depressive symptoms. Similarly, those at greater risk for nicotine dependence were anxious individuals with lower depressive symptoms who endorse coping-oriented motives for using cannabis. Further, among those with higher social anxiety, cannabis coping motives were associated with marginally greater drinking, particularly for those high in depressive symptoms. Conclusions: The present findings support the perspective that among multisubstance users, the interplay between social anxiety, depressive symptoms, and coping-oriented motives for using one substance (e.g., cannabis or alcohol) may pose difficulties in refraining from other substances (e.g., tobacco). This observation highlights the importance of tailoring multisubstance treatments to specific needs of multiusers for whom single-substance interventions may be less effective. Findings also support previous work exploring the benefits of concurrently treating co-occurring substance use and lend credence to the perspective that motivation to use substances for coping reasons is of central theoretical and clinical relevance.     

Anxiety sensitivity components in relation to alcohol and cannabis use,motives, and problems in treatment-seeking cigarette smokers

Anxiety sensitivity (AS)— fear of anxiety symptoms and their potential negative consequences—has been implicated in the development of substance use problems and motivation to use substances for coping with distress, though the AS components (physical, cognitive, and social concerns) have not been studied extensively in relation to alcohol- and cannabis-related variables. In a cross-sectional design, self-report measures of AS and alcohol and cannabis use, motives, and problems were administered to 364 treatment-seeking cigarette smokers with a history of alcohol and cannabis use. In both adjusted and unadjusted analyses, linear regression models indicated that AS cognitive concerns are related to cannabis-use conformity motives, alcohol-use coping motives, and alcohol problems; AS physical and cognitive concerns are related to greater cannabis problems specifically in males; and AS social concerns are associated with greater social, coping, enhancement, and conformity drinking motives. AS cognitive and physical concerns were also related to greater alcohol and cannabis problems, respectively, in subsamples limited to 214 current alcohol users and 170 current cannabis users. Together with prior work, current findings suggest that it may be beneficial to focus more on addressing AS cognitive concerns in individuals with tobacco-alcohol problem comorbidity, whereas it may be beneficial to focus on addressing both AS physical and cognitive concerns in males with tobacco-cannabis problem comorbidity. In addition, cigarette smokers high in AS social concerns may benefit from relaxation training to lessen their social anxiety as well as behavioral activation to enhance their positive affect.     

Perceived risk associated with tobacco,alcohol and cannabis use among people with and without psychotic disorders

Background

Perceived harmfulness of substances is a key concept of behavioural theories that have been used to explain substance use behaviours. However, perceptions of risk associated with substance use have rarely been examined among people with psychotic disorders. This study examined the relationship between perceived harm and patterns of substance use among people with and without psychotic disorders. It also aimed to identify the factors that may be associated with perceived harmfulness of tobacco, alcohol and cannabis use among these populations.

Methods

Participants were recruited via first year psychology courses, research databases and the social networking service ‘Facebook’. Participants completed a self-report questionnaire either online or on paper which assessed substance use, perceived harmfulness of substance use, history of mental illness, current psychological distress, and exposure to and acceptance of anti-substance use campaigns. A series of linear regressions were conducted to examine key predictors of the perceived harmfulness of tobacco, alcohol and cannabis use.

Results

1046 participants were recruited. Participants were aged 18 to 86 years and 53.2% were female. For tobacco and cannabis, substance use was found to be inversely and significantly related to perceived harm of these substances. In addition, higher risk perceptions for tobacco and cannabis were associated with: being female, perceived effectiveness of anti-substance use campaigns, and less hazardous substance use. Increased age and negative psychosis status were also associated with higher risk perceptions for tobacco, while positive psychosis status was associated with higher risk perceptions for cannabis. Only perceived effectiveness of anti-drinking campaigns was found to be significantly related to perceived harmfulness of alcohol.

Conclusions

These results suggest that demographic, substance use, mental health and public health campaign variables are associated with perceptions of the harmfulness of tobacco, cannabis, and to a lesser extent alcohol, among people with and without mental disorders. While messages regarding the negative consequences associated with cannabis use among people with psychotic disorders may be accepted, there is a continued need to highlight the negative consequences of smoking among people with psychotic disorders.     

Association between psychopathology and substance use among school-going adolescents in Cape Town, South Africa

Limited information exists regarding the association between psychopathology and specific substance use in young people both globally and locally. We examined the association between psychopathology and substance use in high school students to determine the nature of the associations and the role of demographic factors in these associations. Grade 8 (N=480) and Grade 11 (N=459) students from 39 high schools in Cape Town, South Africa, completed a self-administered questionnaire. Psychopathology information was obtained from total scores on the Harvard Trauma Questionnaire, Beck Depression Inventory and the Zung Self-Rating Anxiety Scale. Lifetime prevalence rates were calculated for tobacco, alcohol, cannabis and inhalant use. Associations between psychopathology and substance use were determined using regression analyses and structural equation modeling. On adjusting for demographic characteristics, significant associations were found between PTSD and all substance use, between depression, alcohol, cannabis and inhalant use, and between anxiety and cannabis use. The associations of PTSD and depression with alcohol and cannabis use, and between anxiety and cannabis use, were moderated by grade. Although psychopathology and substance use were associated with each other, these associations occurred in accordance with substance and grade. Roles for gender, age and ethnicity emerged in the associations, but further investigation is recommended to examine these.     

A Comparison of Psychosocial and Cognitive Functioning Between Depressed and Non-Depressed Patients with Cannabis Dependence

ABSTRACT

Cannabis use and depressive disorders are thought to impair cognitive performance and psychosocial functioning. Both disorders co-occurring may compound the negative effects of these diagnoses. In this study, the authors used the California Computerized Assessment Package as the cognitive performance measure and the Addiction Severity Index as the psychosocial functioning measure to compare individuals who were cannabis dependent and either depressed or not depressed (N= 108: 54 cannabis dependent only, 54 cannabis dependent and depressed or dysthymic). As predicted, cannabis dependent individuals with comorbid depression showed more psychosocial impairment than individuals with cannabis dependence alone. However, contrary to the authors’ hypothesis, individuals who were cannabis dependent with comorbid depression showed less cognitive impairment in some California Computerized Assessment Package modules than individuals with cannabis dependence alone. Based on the authors’ results, they concluded that the additive effects of cannabis dependency and depression may only be limited to psychosocial domains and may not extend to cognitive functioning.     

Tobacco, alcohol, cannabis and other illegal drug use among young adults: the socioeconomic context

Background

Low socioeconomic position predicts risk of substance abuse, yet few studies tested the role of preexisting familial and individual characteristics.

Methods

Data come from the TEMPO (Trajectoires Epidémiologiques en Population) study (community sample in France, 1991–2009, n = 1103, 22–35 years in 2009) set up among offspring of participants of an epidemiological study (GAZEL). Past 12-month substance use was assessed in 2009 by self-completed mail survey: regular tobacco smoking, alcohol abuse (AUDIT), cannabis use, problematic cannabis use (CAST), other illegal drug use. Socioeconomic position was defined by educational attainment, occupational grade, employment stability and unemployment. Covariates included demographics (age, sex, relationship status, parenthood), family background (parental income, parental tobacco smoking, parental alcohol use), and juvenile characteristics (psychological problems, academic difficulties) measured longitudinally.

Results

35.8% of study participants were regular smokers, 14.3% abused alcohol, 22.6% used cannabis (6.3% had problematic cannabis use) and 4.1% used other illegal drugs. Except for alcohol abuse, substance use rates were systematically higher in individuals with low, rather than intermediate/high, socioeconomic position (age and sex-adjusted ORs from 1.75 for cannabis use to 2.11 for tobacco smoking and 2.44 for problematic cannabis use). In multivariate analyses these socioeconomic disparities were decreased, but remained statistically significant (except for illegal drugs other than cannabis).

Conclusions

Tobacco smoking, alcohol, cannabis and polysubstance use are common behaviors among young adults, particularly those experiencing socioeconomic disadvantage. Interventions aiming to decrease substance abuse and reduce socioeconomic inequalities in this area should be implemented early in life.     

The role of distress tolerance in the relationship between cognitive schemas and alcohol problems among college students

IntroductionThe current study tested the role of distress tolerance in the relationship between three early maladaptive cognitive schemas (Abandonment, Defectiveness/Shame, and Insufficient Self-Control) and alcohol problems among college students (N = 364). Previous research suggests that maladaptive cognitive schemas may be a risk factor for alcohol-related problems. However, the mechanism underlying this association is unclear. One's tolerance for emotional distress may play an important role in understanding the nature of this association.MethodsWe tested a structural equation model where distress tolerance was expected to explain or moderate associations between early maladaptive schemas and alcohol outcomes.ResultsResults indicated distress tolerance partially mediated the relationships between schemas of Abandonment and Insufficient Self-Control and alcohol problems. Distress tolerance also significantly moderated the relationship between the Defectiveness/Shame schema and alcohol-related problems, reducing the strength of the association.ConclusionsDistress tolerance is a modifiable risk factor and the results of this study support the inclusion of emotional regulation strategies in the prevention and treatment of alcohol problems among young adults.     

Decreased drinking in adults with co-occurring cannabis and alcohol use disorders in a treatment trial for marijuana dependence: Evidence of a secondary benefit?

The purpose of the present study was to investigate whether cannabis dependent users who met criteria for a secondary diagnosis of alcohol use disorder (AUD) would increase their use of alcohol in response to decreasing their use of marijuana in a behavioral treatment trial for cannabis use disorder (CUD). This phenomenon is commonly known as “substance substitution.” Participants were randomly assigned to one of four 9-session treatment conditions with cannabis and alcohol use measured at baseline, posttreatment, and at 4 follow-ups through 14 months. Of those enrolled (n = 198), 27 (13.6%) also met criteria for AUD. Linear mixed models were used to analyze alcohol use over time with cannabis use and time as predictors. Findings demonstrated that there were no associations between declines in cannabis use and changes in alcohol consumption in the full sample. However, among those with CUD who also had AUD, declines in cannabis use significantly predicted concurrent declines in alcohol use (p < .05). This study did not find evidence of substance substitution among individuals receiving treatment for CUD. Contrary to expectations, the results indicated that individuals with AUD were more likely to decrease, rather than increase, their alcohol use when they reduced their marijuana use. Treatment for CUD in this study appeared to result in improvements in substance use generally, at least for those with comorbid AUD.     

Coping via substance use,internal attribution bias,and their depressive interplay: Findings from a three-week daily diary study using a clinical sample

BackgroundThe relationship between depression and coping-oriented substance use is extensively documented; however, the cognitive processes moderating this bidirectional relationship are not well-understood. The present study investigated whether internal attribution bias coupled with a tendency to use drugs and/or alcohol to cope predicts increases in depression and daily-levels of general negative affectivity, sadness, and hostility.MethodSixty-seven adults diagnosed with depression were recruited from out-patient treatment settings (66% female, 81% White, M_age = 31, SD_age = 13.2). Participants completed measures on substance-related coping, depression, attributional style, and daily affect over a three-week period.ResultsSubstance use to cope predicted increases in depression among individuals with high-level internal attribution bias. Further, coping via substance use moderated the relationship between internal attribution bias and daily-level sadness, such that sadness was highest among individuals with a high internal attribution bias coupled with greater levels of coping via substance use. A modest, yet, non-significant upward trend in daily-level hostility was also observed.ConclusionsResults suggested that depressed individuals who habitually perceive themselves as being responsible or blameworthy for negative life events are at an increased risk of worsening depressive symptoms and experiencing greater daily levels of sadness over a relatively brief period of time, particularly, when tending to engage in substance use as a mechanism to cope. This interaction effect can elicit greater daily-level sadness as well. Findings may aid in the identification and treatment of individuals at risk of maintaining or worsening their depressive symptoms.     

LETTERS TO THE EDITOR

Abstract

Limited information exists regarding the association between psychopathology and specific substance use in young people both globally and locally. We examined the association between psychopathology and substance use in high school students to determine the nature of the associations and the role of demographic factors in these associations. Grade 8 (N = 480) and Grade II (N = 459) students from 39 high schools in Cape Town, South Africa, completed a self-administered questionnaire. Psychopathology information was obtained from total scores on the Harvard Trauma Questionnaire, Beck Depression Inventory and the Zung Self-Rating Anxiety Scale. Lifetime prevalence rates were calculated for tobacco, alcohol, cannabis and inhalant use. Associations between psychopathology and substance use were determined using regression analyses and structural equation modeling. On adjusting for demographic characteristics, significant associations were found between PTSD and all substance use, between depression, alcohol, cannabis and inhalant use, and between anxiety and cannabis use. The associations of PTSD and depression with alcohol and cannabis use, and between anxiety and cannabis use, were moderated by grade. Although psychopathology and substance use were associated with each other, these associations occurred in accordance with substance and grade. Roles for gender, age and ethnicity emerged in the associations, but further investigation is recommended to examine these.     

Predictors and consequences of simultaneous alcohol and cannabis use in adolescents

Background/Aims

The simultaneous use of alcohol and cannabis is common among adolescents, but has been little studied. In this study, we examine predictors and consequences of this behavior in a population-based sample of high school students.

Method

Self-reports were obtained from students in Quebec (Canada) followed throughout high school (N = 6589). Logistic regressions were used to test the association between individual, family, and peer-related predictors in grades 7–8 and simultaneous alcohol and cannabis use in grade 10, as well as between simultaneous alcohol and cannabis use in grade 10 and experiencing 3 or more substance-related problems of various types (legal, physical, etc.) in grade 11.

Results

Most predictors in grades 7–8 were associated with simultaneous alcohol and cannabis use in grade 10. Only variables reflecting early-onset substance use involvement — alcohol intoxication, cannabis use, and drug use by close friend(s) — remained predictive in a multivariate model. Simultaneous alcohol and cannabis use was associated with increased substance-related problems in grade 11, above and beyond baseline problems and the concurrent use of the two substances in separate episodes in grade 10.

Conclusions

Simultaneous alcohol and cannabis use 1) is anticipated by multiple psychosocial risk factors which come together with individual and peer substance use in early high school and 2) is independently predictive of subsequent substance-related problems. Providing adolescents with adequate information regarding the potential harm of simultaneous use may be a useful prevention strategy.     

Depression and Anxiety Subgroups Across Alcohol Use Disorder and Substance Use in a National Epidemiologic Study

Abstract

Objective: The high prevalence of alcohol/substance use among individuals with psychiatric disorders elucidates the import of investigations into associations between types and severity of psychiatric symptoms and alcohol/substance use. This study examined the likelihood of alcohol use disorder and substance use among individuals with varying depression and anxiety symptoms and severity thereof. Differences across sex were also examined.

Methods: Using data from the National Epidemiological Survey on Alcohol and Related Conditions, a nationally representative sample from the United States (N?=?43,093), separate logistic regressions estimated the odds of lifetime alcohol use disorder, depressant, stimulant, hallucinogen, and comorbid substance use across psychiatric symptom clusters controlling for age, sex, and ethnicity.

Results: Symptom severity was a more important correlate of alcohol use disorder and substance use than symptom type. In particular, the odds ratio of lifetime use of depressants, stimulants, hallucinogens, or any combination of these types of substances were higher for individuals with either severe depression or severe depression and anxiety relative to a healthy control. Moreover, the odds of having a diagnosis of lifetime alcohol use disorder were higher for individuals with severe symptoms of depression, anxiety, and both depression and anxiety, relative to healthy individuals. Those with mild depression were more likely to engage in substance use than individuals with anxiety alone. Patterns of association among males and females were highly consistent.

Conclusions: The findings highlight an enhanced risk of alcohol and substance use among individuals with severe depression and/or anxiety symptoms above what is seen among individuals with less severe symptomatology. In addition, this study shows a unique risk posed by the presence of depression on substance use. This study offers a framework for future studies to examine the causal mechanisms explaining the connection between psychiatric symptoms and alcohol/substance use.     

Regulate yourself: Emotion regulation and protective behavioral strategies in substance use behaviors

Although research suggests links between emotion regulation strategies and substance use outcomes, little work has examined the relationship between specific strategies (i.e., reappraisal and suppression) and outcomes (i.e., alcohol and cannabis consumption and related problems). To date, no research has examined the association between emotion regulation strategies and protective behavioral strategies used while engaging in substance use. Thus, the current study examined these relations for females and males. Undergraduates (N = 643) completed an online battery of self-report measures. Using structural equation modeling, results indicated improved Emotion Regulation Questionnaire model fit after one item was removed. Reappraisal was negatively associated with alcohol binge frequency and related problems for females, though suppression was negatively related to these outcomes for males. Reappraisal was also negatively associated with cannabis-related problems for males only. Reappraisal was positively associated with all types of protective behavioral strategies use for females, whereas only alcohol-specific serious harm reduction and cannabis protective behavioral strategies were significant for males. Latent variable interactions between reappraisal and protective behavioral strategies were significant for past-month cannabis use and related problems for males and indicated protective behavioral strategies use was more protective against past-month use and cannabis-related problems for those high in reappraisal. Although replication is necessary, these preliminary findings suggest the link between emotion regulation strategies and substance use outcomes among college students is complex and future work may benefit from examining these relations from an emotion regulation flexibility perspective.