Alethea Desrosiers

Mindfulness and emotion regulation in depression and anxiety: common and distinct mechanisms of action.

The current study seeks to investigate the mechanisms through which mindfulness is related to mental health in a clinical sample of adults by examining (1) whether specific cognitive emotion regulation strategies (rumination, reappraisal, worry, and nonacceptance) mediate associations between mindfulness and depression and anxiety, respectively, and (2) whether these emotion regulation strategies operate uniquely or transdiagnostically in relation to depression and anxiety.

Mapping Mindfulness Facets Onto Dimensions of Anxiety and Depression

Mindfulness has been associated with anxiety and depression, but the ways in which specific facets of mindfulness relate to symptoms of anxiety and depression remains unclear. The purpose of the current study was to investigate associations between specific facets of mindfulness (e.g., observing, describing, nonjudging, acting with awareness, and nonreactivity) and dimensions of anxiety and depression symptoms (e.g., anxious arousal, general distress-anxiety, general distress-depression, and anhedonic depression) while controlling for shared variance among variables. Participants were 187 treatment-seeking adults. Mindfulness was measured using the Five Facet Mindfulness Questionnaire and symptoms of depression and anxiety were measured using the Mood and Anxiety Symptom Questionnaire. Bivariate correlations showed that all facets of mindfulness were significantly related to all dimensions of anxiety and depression, with two exceptions: describing was unrelated to general distress-anxiety, and observing was unrelated to all symptom clusters. Path analysis was used to simultaneously examine associations between mindfulness facets and depression and anxiety symptoms. Significant and marginally significant pathways were retained to construct a more parsimonious model and model fit indices were examined. The parsimonious model indicated that nonreactivity was significantly inversely associated with general distress anxiety symptoms. Describing was significantly inversely associated with anxious arousal, while observing was significantly positively associated with it. Nonjudging and nonreactivity were significantly inversely related to general distress-depression and anhedonic depression symptomatology. Acting with awareness was not significantly associated with any dimensions of anxiety or depression. Findings support associations between specific facets of mindfulness and dimensions of anxiety and depression and highlight the potential utility of targeting these specific aspects of mindfulness in interventions for anxiety and mood disorders.

Observing nonreactively: a conditional process model linking mindfulness facets, cognitive emotion regulation strategies, and depression and anxiety symptoms.

BACKGROUND Mindfulness-based interventions for depression and anxiety emphasize the importance of observing present moment experience, but observing has often been positively related to anxiety and unrelated to depression symptoms. The current study sought to better understand the conditions and mechanism through which observing relates to symptoms by examining six conditional process models in which (1) nonreactivity moderates the direct effect of observing on symptoms of anxiety and depression symptoms and (2) nonreactivity moderates the indirect effect of observing on anxiety and depression via cognitive emotion regulation strategies (i.e., rumination, worry, and reappraisal). METHODS A clinical sample of 189 adults with anxiety and depressive disorders completed the Five Facet Mindfulness Questionnaire, Mood and Anxiety Symptom Questionnaire, Penn State Worry Questionnaire, Ruminative Responses Scale, and Emotion Regulation Questionnaire. RESULTS Conditional process models showed that nonreactivity significantly moderated the direct effect of observing on symptoms of depression, but not anxiety. Additionally, nonreactivity significantly moderated the indirect effect of observing on symptoms of depression through rumination and reappraisal, but not worry. For anxiety, nonreactivity significantly moderated the indirect effect of observing on symptoms through worry and rumination, but not reappraisal. LIMITATIONS Causal interpretations of results are limited. CONCLUSION Findings suggest that the relationship between observing and symptoms of depression and anxiety depends on the capacity to observe nonreactively, which may influence symptoms directly and indirectly through cognitive emotion regulation strategies. Findings raise important implications for tailoring mindfulness-based treatments for anxiety and depression symptoms.

Hepatitis C seroconversion in methadone maintenance treatment programs in Wuhan, China

BACKGROUND AND AIMS To decrease infectious disease transmission, China is expanding methadone maintenance treatment (MMT). This study evaluated the prevalence of hepatitis C virus (HCV) infection at MMT entry, seroconversion rates after admission and potential risk factors for HCV seroconversion during MMT in Wuhan, China. DESIGN Cross-sectional survey of all patients entering MMT and prospective follow-up of patients HCV seronegative at admission. SETTING All MMT clinics in Wuhan, China. PARTICIPANTS A total of 12 755 opiate-dependent individuals entering MMT between May 2006 and June 2011; 1200 participants HCV seronegative at admission were followed. MEASUREMENTS Serological tests for HCV and self-report data on risk behaviors at MMT admission; urine toxicology results and repeated assessments of serological status and risk behaviors during treatment on patients HCV seronegative at admission. FINDINGS HCV seroprevalence at admission was 72.1% [95% confidence interval (CI) = 71.3-72.9%] and 555/1200 (46.3%, 95% CI = 43.5-49.1%) patients seroconverted to HCV during MMT. The mean time to HCV seroconversion was 3 (95% CI = 2.84-3.07) years with a cumulative seroconversion rate of 34.5 (95% CI = 31.5-36.9) per 100 person-years. Significant predictors of HCV conversion included injection drug use in the past 30 days [relative hazard (RH) 2.0, 95% CI: 1.6 - 2.4, P=0.002] and the rate of opiate-positive urine tests during MMT (RH 2.0, 95% CI = 1.3-3.1, P<0.001). CONCLUSIONS Methadone maintenance treatment patients in Wuhan, China show a high prevalence of hepatitis C virus at admission (72.1%) and a high rate of seroconversion during treatment (46.3%). Seroconversion is associated with continuing injection drug use.

“Love Hurts”: Romantic Attachment and Depressive Symptoms in Pregnant Adolescent and Young Adult Couples

OBJECTIVE The current study investigates the relationship between romantic attachment style and depressive symptoms between both members of pregnant adolescent and young adult couples. METHOD Participants were 296 pregnant young females (mean age = 18.7) and their male partners (mean age = 21.3; 592 total participants) who were recruited from obstetrics and gynecology clinics in Connecticut. The dimensions of avoidant and anxious romantic attachment were assessed using the Experiences in Close Relationships Inventory. Depressive symptoms were measured using the Center for Epidemiological Studies-Depression Scale. RESULTS Results showed that avoidant attachment and anxious attachment were significantly positively related to depressive symptoms. Multilevel modeling for partner effects revealed that anxious attachment and depressive symptoms in partners were significantly positively associated with depressive symptoms CONCLUSION Findings underscore the importance of considering couples-based approaches to supporting the transition to parenthood and developing the necessary self and relationship skills to manage attachment needs and relationship challenges.

Predictors of alcohol-related problems among depressed and non-depressed women

BACKGROUND Depression and alcohol-related problems are often comorbid in women, but not all depressed women have comorbid alcohol-related problems. The current study investigated intrapersonal (drinking expectancies), interpersonal (interpersonal pressure to drink), and familial (mothers and fathers drinking history) predictors of alcohol-related problems among women with and without a major depressive episode in the past year. METHOD Participants were 853 women ages 21-90 from a U.S. national probability sample. Depression diagnosis was determined via interviewer administration of the Diagnostic Interview Schedule (DIS) depression module. Participants completed self-report measures of alcohol-related problems and intrapersonal, interpersonal, and familial predictors of drinking. RESULTS Regression analyses indicated that an episode of depression in the past year, more positive drinking expectancies, greater interpersonal pressure to drink, and higher levels of maternal (but not paternal) drinking predicted alcohol-related problems; moreover, the relationships between alcohol-related problems and maternal drinking, paternal drinking, and interpersonal pressure to drink were significantly stronger among women with an episode of major depression in the past year than among women without an episode. LIMITATIONS Study data was cross-sectional and obtained through self-report, thus limiting causal explanations of results. CONCLUSIONS Findings suggest that depression may enhance the impact of interpersonal and familial risk factors on womens alcohol misuse. Implications of findings for transdiagnostic models of psychopathology and for prevention and treatment of alcohol-related problems in women presenting with depressive symptoms are discussed.

Emerging Drug Use Trends in Kelantan, Malaysia

ABSTRACT The primarily rural and agrarian Kelantan province of Malaysia has high rates of drug use and is characterized by unique sociocultural factors. Combining qualitative and ethnographic methods, we investigated drug use and treatment needs of people who use drugs (PWUD) in rural areas of Kelantan. In February 2014, field visits, participant observation, and focus group discussions (FGDs) with 27 active PWUD were conducted in rural areas surrounding the capital city of Kelantan. The findings indicate a high prevalence of opiate and amphetamine type stimulants (ATS) use in these areas. FGD participants reported initiating drug use at early ages due to peer influences, to relieve boredom, to cope with problems, and a high saturation of villages with other PWUD was reported as a major contributor to their own continued drug use. They reported a trend of drug use initiation at younger ages and increased drug use among females. Participants were interested in treatment; however, their limited knowledge about treatment options and perceived limited availability of services were barriers to treatment seeking. Easy access to drugs, primarily from Thailand and facilitated by the use of mobile phones, resulted in an expanding prevalence of drug use that underscores the need to bolster education and prevention efforts and accessibility of treatment services in Kelantan.

(S)He's Gotta Have It: Emotion Regulation, Emotional Expression, and Sexual Risk Behavior in Emerging Adult Couples

ABSTRACT Emotion regulation and emotional expression may be important factors which contribute to sexual risk behavior among emerging adults, yet research exploring their relation is limited. Further, the influence of a romantic partner is unclear. The current study aims to a) investigate association between emotional difficulties and sexual risk behavior (e.g., sexual compulsivity and sensation-seeking) and b) explore the influence of a romantic partner on individual sexual risk. Participants were 49 couples (n = 98) participating in a randomized control pilot intervention. Results demonstrated that individual and partner emotional difficulties were associated with sexual risk behavior. Results did not vary by gender.

Early Initiation of Amphetamine-Type Stimulants (ATS) Use Associated with Lowered Cognitive Performance among Individuals with Co-Occurring Opioid and ATS Use Disorders in Malaysia

ABSTRACT Amphetamine-type stimulants (ATS) use is increasingly prevalent in Malaysia, including among individuals who also use opioids. We evaluated cognitive functioning profiles among individuals with co-occurring opioid and ATS dependence and their lifetime patterns of drug use. Participants (N = 50) enrolling in a clinical trial of buprenorphine/naloxone treatment with or without atomoxetine completed the Raven’s Standard Progressive Matrices, Rey-Osterrieth Complex Figure Test, Digit Span, Trail Making and Symbol Digit Substitution tasks. Multidimensional scaling and a K-means cluster analyses were conducted to classify participants into lower versus higher cognitive performance groups. Subsequently, analyses of variance procedures were conducted to evaluate between group differences on drug use history and demographics. Two clusters of individuals with distinct profiles of cognitive performance were identified. The age of ATS use initiation, controlling for the overall duration of drug use, was significantly earlier in the lower than in the higher cognitive performance cluster: 20.9 (95% CI: 18.0–23.8) versus 25.2 (95% CI: 22.4–28.0, p = 0.038). While adverse effects of ATS use on cognitive functioning can be particularly pronounced with younger age, potentially related to greater vulnerability of the developing brain to stimulant and/or neurotoxic effects of these drugs, the current study findings cannot preclude lowered cognitive performance before initiation of ATS use.

Emotion Expression and Substance Use in Newly Parenting Adolescents and Young Adults

OBJECTIVE Deficits in emotion expression skills have been associated with alcohol and substance use, but the mechanisms through which these associations occur are not well understood. The current study investigated (a) associations between emotion expression and substance use (i.e., alcohol, cigarettes, and marijuana) in newly parenting adolescents and young adults and (b) whether symptoms of depression and stress mediate these associations in young mothers and fathers. METHODS Participants recruited from obstetrics and gynecology clinics completed the Center for Epidemiological Studies-Depression Scale, Perceived Stress Scale, Emotion Expression Scale for Children, and substance use items. RESULTS Path analysis indicated that lower emotion expression at 6 months postpartum was significantly associated with more alcohol and marijuana use at 12 months postpartum for males but not females. Also among males, stress levels at 6 months postpartum partially mediated associations between emotion expression and alcohol and marijuana use at 12 months postpartum. CONCLUSIONS Findings suggest that poor emotion expression skills are related to more substance use in young fathers, and levels of stress may partially account for this association.