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11-12-2019 | ORIGINAL PAPER

Novel Associations Among Trauma, Mindfulness, and Impaired Control Over Alcohol Use

Auteurs: Tessa Frohe, Robert F. Leeman, JeeWon Cheong, Daniel A. Belton, Julie A. Patock-Peckham

Gepubliceerd in: Mindfulness | Uitgave 3/2020

Abstract

Objective

Two thirds of adults experience at least one lifetime traumatic incident. Specifically, childhood traumas (physical neglect, emotional neglect, physical abuse, emotional abuse, and sexual abuse) are associated with increased alcohol use. According to the self-medication hypothesis, alcohol is used to alleviate upsetting thoughts and memories. This may lead to greater impaired control over alcohol use (i.e., a breakdown of an intention to limit drinking). Utilizing mindfulness reduces maladaptive responses to trauma. Trauma and difficulties maintaining control (generally) have been examined with mindfulness as a mediator; however, control over alcohol use specifically, has not.

Methods

We analyzed data from a cross-sectional, student survey (N = 847, 49% female) utilizing path modeling. We examined mindfulness and impaired control over alcohol use as potential mediators between trauma and alcohol outcomes (i.e., drinks per drinking day [DPDD] and alcohol-related problems).

Results

Emotional neglect (EN) was the strongest predictor among five facets of trauma. Higher EN related to lower mindfulness (β = − 0.22; SE = 0.05; p ≤ 0.001) and greater impaired control over alcohol (β = 0.11; SE = 0.06; p = 0.05). Finally, EN was related to higher DPDD, mediated by mindfulness and impaired control over alcohol use (standardized indirect effect = 0.006; 95% CI, 0.002, 0.012).

Conclusion

These findings suggest potential mediating pathways from childhood trauma to alcohol-related outcomes via mindfulness and greater impaired control over alcohol use. Current research informs efforts to promote mindfulness interventions to reduce alcohol use and related problems among college students, especially those who have experienced childhood traumas and may experience elevated impaired control over alcohol use.

vorige artikel Mindfulness: Attenuating Self-Referential Processing and Strengthening Other-Referential Processing

volgende artikel A Brief Scale to Measure Caring for Bliss: Conceptualization, Initial Development, and Validation

Allem, J. P., Soto, D. W., Baezconde-Garbanati, L., & Unger, J. B. (2015). Adverse childhood experiences and substance use among Hispanic emerging adults in Southern California. Addictive Behaviors, 50, 199–204. https://doi.org/10.1016/j.addbeh.2015.06.038.CrossRefPubMedPubMedCentral

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders DSM-5® (5th ed.). Arlington: American Psychiatric Pub.CrossRef

Arnekrans, A. K., Calmes, S. A., Laux, J. M., Roseman, C. P., Piazza, N. J., Reynolds, J. L., et al. (2018). College students’ experiences of childhood developmental traumatic stress: resilience, first-year academic performance, and substance use. Journal of College Counseling, 21(1), 2–14. https://doi.org/10.1002/jocc.12083.CrossRef

Baer, R. A., Smith, G. T., & Allen, K. B. (2004). Assessment of mindfulness by self-report: the Kentucky inventory of mindfulness skills. Assessment, 11(3), 191–206. https://doi.org/10.1177/1073191104268029.CrossRefPubMed

Baer, R. A., Smith, G. T., Hopkins, J., Krietemeyer, J., & Toney, L. (2006). Using self-report assessment methods to explore facets of mindfulness. Assessment, 13(1), 27–45. https://doi.org/10.1177/1073191105283504.CrossRefPubMed

Baslet, G., & Hill, J. (2011). Case report: brief mindfulness-based psychotherapeutic intervention during inpatient hospitalization in a patient with conversion and dissociation. Clinical Case Studies, 10(2), 95–109. https://doi.org/10.1177/1534650110396359.CrossRef

Bernstein, D. P., Stein, J. A., Newcomb, M. D., Walker, E., Pogge, D., Ahluvalia, T., et al. (2003). Development and validation of a brief screening version of the childhood trauma questionnaire. Child Abuse & Neglect, 27(2), 169–190. https://doi.org/10.1016/S0145-2134(02)00541-0.CrossRef

Boughner, E., Thornley, E., Kharlas, D., & Frewen, P. (2016). Mindfulness-related traits partially mediate the association between lifetime and childhood trauma exposure and PTSD and dissociative symptoms in a community sample assessed online. Mindfulness, 7(3), 672–679. https://doi.org/10.1007/s12671-016-0502-3.CrossRef

Brady, K. T., & Back, S. E. (2012). Childhood trauma, posttraumatic stress disorder, and alcohol dependence. Alcohol Research: Current Reviews, 34(4), 408.

Bramm, S. M., Cohn, A. M., & Hagman, B. T. (2013). Can preoccupation with alcohol override the protective properties of mindful awareness on problematic drinking? Addictive Disorders and Their Treatment, 12, 19–27. https://doi.org/10.1016/j.surg.2006.10.010.CrossRefPubMed

Bravo, A. J., Boothe, L. G., & Pearson, M. R. (2016). Getting personal with mindfulness: a latent profile analysis of mindfulness and psychological outcomes. Mindfulness, 7(2), 420–432. https://doi.org/10.1007/s12671-015-0459-7.CrossRef

Brett, E. I., Espeleta, H. C., Lopez, S. V., Leavens, E. L., & Leffingwell, T. R. (2018). Mindfulness as a mediator of the association between adverse childhood experiences and alcohol use and consequences. Addictive Behaviors, 84, 92–98. https://doi.org/10.1016/j.addbeh.2018.04.002.CrossRefPubMed

Britton, W. B., Shahar, B., Szepsenwol, O., & Jacobs, W. J. (2012). Mindfulness-based cognitive therapy improves emotional reactivity to social stress: results from a randomized controlled trial. Behavior Therapy, 43(2), 365–380. https://doi.org/10.1016/j.beth.2011.08.006.CrossRefPubMed

Carr, C. P., Martins, C. M. S., Stingel, A. M., Lemgruber, V. B., & Juruena, M. F. (2013). The role of early life stress in adult psychiatric disorders: a systematic review according to childhood trauma subtypes. The Journal of Nervous and Mental Disease, 201(12), 1007–1020. https://doi.org/10.1097/NMD.0000000000000049.CrossRefPubMed

Carvajal, F., & Lerma-Cabrera, J. M. (2015). Alcohol consumption among adolescents—implications for public health. America, 16(8.86), 13–47. https://doi.org/10.5772/58930.CrossRef

Chiesa, A., & Serretti, A. (2014). Are mindfulness-based interventions effective for substance use disorders? A systematic review of the evidence. Substance Use & Misuse, 49(5), 492–512. https://doi.org/10.3109/10826084.2013.770027.CrossRef

Conger, J. J. (1956). Reinforcement theory and the dynamics of alcoholism. Quarterly Journal of Studies on Alcohol, 17, 296–305.PubMed

D’Andrea, W., Ford, J., Stolbach, B., Spinazzola, J., & van der Kolk, B. A. (2012). Understanding interpersonal trauma in children: why we need a developmentally appropriate trauma diagnosis. American Journal of Orthopsychiatry, 82(2), 187. https://doi.org/10.1111/j.1939-0025.2012.01154.x.CrossRefPubMed

Dalenberg, C. J., Brand, B. L., Gleaves, D. H., Dorahy, M. J., Loewenstein, R. J., Cardena, E., et al. (2012). Evaluation of the evidence for the trauma and fantasy models of dissociation. Psychological Bulletin, 138(3), 550. https://doi.org/10.1037/a0027447.CrossRefPubMed

Davis, J. L., Petretic-Jackson, P. A., & Ting, L. (2001). Intimacy dysfunction and trauma symptomatology: long-term correlates of different types of child abuse. Journal of Traumatic Stress, 14(1), 63–79. https://doi.org/10.1023/A:100783553.CrossRef

Ducharme, J., Koverola, C., & Battle, P. (1997). Intimacy development: the influence of abuse and gender. Journal of Interpersonal Violence, 12(4), 590–599. https://doi.org/10.1177/088626097012004007.CrossRef

Duncan, R. D. (2000). Childhood maltreatment and college drop-out rates. Journal of Interpersonal Violence, 15, 987–995. https://doi.org/10.1177/088626000015009005.CrossRef

Efron, B., & Tibshirani, R. J. (1993). An introduction to the bootstrap. New York: Chapman and Hall/CRC.CrossRef

Fernandez, A. C., Wood, M. D., Stein, L. A., & Rossi, J. S. (2010). Measuring mindfulness and examining its relationship with alcohol use and negative consequences. Psychology of Addictive Behaviors, 24, 608–616. https://doi.org/10.1037/a0021742.CrossRefPubMedPubMedCentral

Fisher, B. S., Cullen, F. T., & Turner, M. G. (2000). The sexual victimization of college women. Research report 182369. Washington, DC: U.S. Dept. of Justice, National Institute of Justice.

Follette, V. M. (2014). Mindfulness-oriented interventions for trauma: integrating contemplative practices. New York: Guilford Publications.

Fritz, M., & MacKinnon, D. (2007). Required sample size to detect the mediated effect. Psychological Science, 18(3), 233–239. https://doi.org/10.1111/j.1467-9280.2007.01882.x.CrossRefPubMed

Goodman, R., & Calderon, A. (2012). The use of mindfulness in trauma counseling. Journal of Mental Health Counseling, 34(3), 254–268. https://doi.org/10.17744/mehc.34.3.930020422n168322.CrossRef

Heather, N., Tebbutt, J. S., Mattick, R. P., & Zamir, R. (1993). Development of a scale for measuring impaired control over drinking consumption: a preliminary report. Journal of Studies on Alcohol, 54(6), 700–709. https://doi.org/10.15288/jsa.1993.54.700.CrossRefPubMed

Hersh, M. A., & Hussong, A. M. (2009). The association between observed parental emotion socialization and adolescent self-medication. Journal of Abnormal Child Psychology, 37(4), 493–506. https://doi.org/10.1007/s10802-008-9291-z.CrossRefPubMedPubMedCentral

Hurlbut, S. C., & Sher, K. J. (1992). Assessing alcohol problems in college students. Journal of American College Health, 41(2), 49–58. https://doi.org/10.1080/07448481.1992.10392818.CrossRefPubMed

Kabat-Zinn, J. (1982). An outpatient program in behavioral medicine for chronic pain patients based on the practice of mindfulness meditation: theoretical considerations and preliminary results. General Hospital Psychiatry, 4(1), 33–47. https://doi.org/10.1016/0163-8343(82)90026-3.CrossRefPubMed

Kabat-Zinn, J. (2003). Mindfulness-based interventions in context: past, present, and future. Clinical Psychology: Science and Practice, 10(2), 144–156. https://doi.org/10.1093/clipsy.bpg016.CrossRef

Kahler, C. W., Strong, D. R., Read, J. P., Palfai, T. P., & Wood, M. D. (2004). Mapping the continuum of alcohol problems in college students: a Rasch model analysis. Psychology of Addictive Behaviors, 18(4), 322. https://doi.org/10.1037/0893-164X.18.4.322.CrossRefPubMed

Karam, E. G., Friedman, M. J., Hill, E. D., Kessler, R. C., McLaughlin, K. A., & Koenen, K. C. (2014). Cumulative traumas and risk thresholds: 12-month PTSD in the world mental health (WMH) surveys. Depression and Anxiety, 31, 130–142. https://doi.org/10.1002/da.22169.CrossRefPubMed

Kenny, M. C., & McEachern, A. G. (2000). Prevalence and characteristics of childhood sexual abuse in multiethinic female college students. Journal of Child Sexual Abuse, 9(2), 57–70. https://doi.org/10.1300/J070v09n02_04.CrossRef

Leeman, R. F., Toll, B. A., Taylor, L. A., & Volpicelli, J. R. (2009). Alcohol-induced disinhibition expectancies and impaired control as prospective predictors of problem drinking in undergraduates. Psychology of Addictive Behaviors, 23(4), 553. https://doi.org/10.1037/a0017129.CrossRefPubMedPubMedCentral

Leeman, R. F., Patock-Peckham, J. A., & Potenza, M. N. (2012). Impaired control over alcohol use: an under-addressed risk factor for problem drinking in young adults? Experimental and Clinical Psychopharmacology, 20(2), 92–106. https://doi.org/10.1037/a0026463.CrossRefPubMed

MacKinnon, D. P., Lockwood, C. M., & Williams, J. (2004). Confidence limits for the indirect effect: distribution of the product and resampling methods. Multivariate Behavioral Research, 39(1), 99–128. https://doi.org/10.1207/s15327906mbr3901_4.CrossRefPubMedPubMedCentral

Manly, B. F. (1997). Randomization, bootstrap, and Monte Carlo methods in biology (2nd ed.p. 399). New York: Chapman and Hall/CRC.

Mermelstein, L. C., & Garske, J. P. (2015). A brief mindfulness intervention for college student binge drinkers: a pilot study. Psychology of Addictive Behaviors, 29(2), 259. https://doi.org/10.1037/adb0000040.CrossRefPubMed

Moore, A., & Malinowski, P. (2009). Meditation, mindfulness and cognitive flexibility. Consciousness and Cognition, 18(1), 176–186. https://doi.org/10.1016/j.concog.2008.12.008.CrossRefPubMed

Morean, M. E., DeMartini, K. S., Foster, D., Patock-Peckham, J., Garrison, K. A., Corlett, P. R., Krystal, J. H., Krishan-Sarin, S., & O’Malley, S. S. (2018). The Self-Report Habit Index: assessing habitual marijuana, alcohol, e-cigarette, and cigarette use. Drug and Alcohol Dependence, 186, 207–214. https://doi.org/10.1016/j.drugalcdep.2018.01.014.CrossRefPubMedPubMedCentral

Murphy, C., & MacKillop, J. (2012). Living in the here and now: interrelationships between impulsivity, mindfulness, and alcohol misuse. Psychopharmacology, 219, 527–536. https://doi.org/10.1007/s00213-011-2573-0.CrossRefPubMed

Muthén, L. K., & Muthén, B. O. (1998–2017). Mplus user’s guide (7th ed.). Los Angeles, CA: Muthén & Muthén.

Muthén, L. K., & Muthén, B. O. (2007). Statistical analysis with latent variables using Mplus. (version 3). Los Angeles: Muthén & Muthén.

Naidu, E. S., Patock-Peckham, J. A., Ruof, A., Bauman, D. C., Banovich, P., Frohe, T., & Leeman, R. F. (2019). Narcissism and devaluing others: an exploration of impaired control over drinking as a mediating mechanism of alcohol-related problems. Personality and Individual Differences, 139, 39–45.CrossRefPubMed

National Institute on Alcohol Abuse and Alcoholism (NIAAA) (2015a). Alcohol facts and statistics. Retrieved from http://www.niaaa.nih.gov/alcohol-health/overview-alcohol-consumption/alcohol-facts-and-statistics. Accessed 15 Mar 2017.

National Institute on Alcohol Abuse and Alcoholism (NIAAA) (2015b). College drinking. Retrieved from http://www.niaaa.nih.gov/alcohol-health/special-populations-co-occurring-disorders/college-drinking. Accessed 15 Mar 2017.

Neziroglu, F., & Donnelly, K. (2013). Dissociation from an acceptance- oriented standpoint. In F. Kennedy, H. Kennerley, & D. Pearson (Eds.), Cognitive behavioural approaches to the understanding and treatment of dissociation (pp. 236–250). New York: Routledge.

Norris, F. H., & Sloan, L. B. (2014). Epidemiology or trauma and PTSD. In M. J. Friedman, T. M. Keane, & P. A. Resick (Eds.), Handbook of PTSD: science and practice (2nd ed., pp. 100–120). New York: Guilford.

Patock-Peckham, J. A., & Morgan-Lopez, A. A. (2006). College drinking behaviors: mediational links between parenting styles, impulse control, and alcohol-related outcomes. Psychology of Addictive Behaviors, 20(2), 117. https://doi.org/10.1037/0893-164X.20.2.117.CrossRefPubMed

Pearson, M. R., Brown, D. B., Bravo, A. J., & Witkiewitz, K. (2015). Staying in the moment and finding purpose: the associations of trait mindfulness, decentering, and purpose in life with depressive symptoms, anxiety symptoms, and alcohol-related problems. Mindfulness, 6, 645–653. https://doi.org/10.1007/s12671-014-0300-8.CrossRef

Roos, C. R., Pearson, M. R., & Brown, D. B. (2015). Drinking motives mediate the negative associations between mindfulness facets and alcohol outcomes among college students. Psychology of Addictive Behaviors, 29, 176–183. https://doi.org/10.1037/a0038529.CrossRefPubMed

Rothman, E. F., Dejong, W., Palfai, T., & Saitz, R. (2008). Relationship of age of first drink to alcohol-related consequences among college students with unhealthy alcohol use. Substance Abuse, 29(1), 33–41. https://doi.org/10.1300/J465v29n01_05.CrossRefPubMed

Rutter, M. (2007). Resilience, competence, and coping. Child Abuse & Neglect, 31(3), 205–209. https://doi.org/10.1016/j.chiabu.2007.02.001.CrossRef

Sanders, S. (1986). The perceptual alteration scale: a scale measuring dissociation. American Journal of Clinical Hypnosis, 29(2), 95–102. https://doi.org/10.1080/00029157.1986.10402691.CrossRefPubMed

Schoorl, M., Van Mil-Klinkenberg, L., & Van Der Does, W. (2015). Mindfulness skills, anxiety sensitivity, and cognitive reactivity in patients with posttraumatic stress disorder. Mindfulness, 6(5), 1004–1011. https://doi.org/10.1007/s12671-014-0364-7.CrossRef

Schore, A. N. (2009). Relational trauma and the developing right brain: the neurobiology of broken attachment bonds. In T. Baradon (Ed.), Relational trauma in infancy (pp. 39–67). London: Routledge. https://doi.org/10.1111/j.1749-6632.2009.04474.x.CrossRef

Schore, A. N. (2014). The right brain is dominant in psychotherapy. Psychotherapy, 51(3), 388. https://doi.org/10.1037/a0037083.CrossRefPubMed

Schwandt, M. L., Heilig, M., Hommer, D. W., George, D. T., & Ramchandani, V. A. (2013). Childhood trauma exposure and alcohol dependence severity in adulthood: mediation by emotional abuse severity and neuroticism. Alcoholism: Clinical and Experimental Research, 37(6), 984–992. https://doi.org/10.1111/acer.12053.CrossRef

Stein, D. J., McLaughlin, K. A., Koenen, K. C., Atwoli, L., Friedman, M. J., Hill, E. D., & Kessler, R. C. (2014). DSM-5 and ICD-11 definitions of posttraumatic stress disorder: investigating “narrow” and “broad” definitions. Depression and Anxiety, 31, 494–505. https://doi.org/10.1002/da.22279.CrossRefPubMedPubMedCentral

Stratton, K. J. (2006). Mindfulness-based approaches to impulsive behaviors. The New School Psychology Bulletin, 4(2), 49–71.

Taylor, A. B., MacKinnon, D. P., & Tein, J. (2008). Tests of the three-path mediated effect. Organizational Research Methods, 11(2), 241–269. https://doi.org/10.1177/1094428107300344.CrossRef

Tofighi, D., & MacKinnon, D. P. (2011). RMediation: an R package for mediation analysis confidence intervals. Behavior Research Methods, 43(3), 692–700. https://doi.org/10.3758/s13428-011-0076-x.CrossRefPubMedPubMedCentral

US Department of Health and Human Services (2016). Dietary guidelines for Americans 2015–2020. Washington, DC: U.S. Department of Health and Human Services and U.S. Department of Agriculture.

Van IJzendoorn, M. H., & Schuengel, C. (1996). The measurement of dissociation in normal and clinical populations: meta-analytic validation of the Dissociative Experiences Scale (DES). Clinical Psychology Review, 16(5), 365–382. https://doi.org/10.1016/0272-7358(96)00006-2.CrossRef

Vaughan, C. L., Stangl, B. L., Schwandt, M. L., Corey, K. M., Hendershot, C. S., & Ramchandani, V. A. (2019). The relationship between impaired control, impulsivity, and alcohol self-administration in nondependent drinkers. Experimental and Clinical Psychopharmacology. https://doi.org/10.1037/pha0000247.CrossRefPubMedPubMedCentral

Wardell, J. D., Quilty, L. C., & Hendershot, C. S. (2016). Impulsivity, working memory, and impaired control over alcohol: a latent variable analysis. Psychology of Addictive Behaviors, 30(5), 544. https://doi.org/10.1037/adb0000186.CrossRefPubMedPubMedCentral

Witkiewitz, K., Marlatt, G. A., & Walker, D. (2005). Mindfulness-based relapse prevention for alcohol and substance use disorders. Journal of Cognitive Psychotherapy, 19(3), 211–228. https://doi.org/10.1891/jcop.2005.19.3.211.CrossRef

Witkiewitz, K., Bowen, S., Harrop, E. N., Douglas, H., Enkema, M., & Sedgwick, C. (2014). Mindfulness-based treatment to prevent addictive behavior relapse: theoretical models and hypothesized mechanisms of change. Substance Use & Misuse, 49(5), 513–524. https://doi.org/10.3109/10826084.2014.891845.CrossRef

Zgierska, A., Rabago, D., Chawla, N., Kushner, K., Koehler, R., & Marlatt, A. (2009). Mindfulness meditation for substance use disorders: a systematic review. Substance Abuse, 30(4), 266–294. https://doi.org/10.1080/08897070903250019.CrossRefPubMed

Titel: Novel Associations Among Trauma, Mindfulness, and Impaired Control Over Alcohol Use
Auteurs: Tessa Frohe
Robert F. Leeman
JeeWon Cheong
Daniel A. Belton
Julie A. Patock-Peckham
Publicatiedatum: 11-12-2019
Uitgeverij: Springer US
Gepubliceerd in: Mindfulness / Uitgave 3/2020
Print ISSN: 1868-8527
Elektronisch ISSN: 1868-8535
DOI: https://doi.org/10.1007/s12671-019-01285-6

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