A Preliminary Examination of Negative Affect, Emotion Dysregulation, and Risky Behaviors Among Military Veterans in Residential Substance Abuse Treatment

REFERENCES

• Armey, M. F., Crowther, J. H., & Miller, I. W. (2011). Changes in ecological momentary assessment reported affect associated with episodes of nonsuicidal self-injury. Behavior Therapy, 42(4), 579–588.
   PubMed Web of Science ®Google Scholar
• Axelrod, S. R., Perepletchikova, F., Holtzman, K., & Sinha, R. (2011). Emotion regulation and substance use frequency in women with substance dependence and borderline personality disorder receiving dialectical behavior therapy. American Journal of Drug and Alcohol Abuse, 37(1), 37–42.
   PubMed Web of Science ®Google Scholar
• Berking, M., Margraf, M., Ebert, D., Wupperman, P., Hofmann, S. G., & Junghanns, K. (2011). Deficits in emotion-regulation skills predict alcohol use during and after cognitive–behavioral therapy for alcohol dependence. Journal of Consulting and Clinical Psychology, 79(3), 307–318.
   PubMed Web of Science ®Google Scholar
• Bonn-Miller, M. O., Vujanovic, A. A., Boden, M. T., & Gross, J. J. (2011). Posttraumatic stress, difficulties in emotion regulation, and coping-oriented marijuana use. Cognitive Behaviour Therapy, 40(1), 34–44.
   PubMedGoogle Scholar
• Borders, A., McAndrew, L. M., Quigley, K. S., & Chandler, H. K. (2012). Rumination moderates the associations between PTSD and depressive symptoms and risky behaviors in U.S. veterans. Journal of Traumatic Stress, 25(5), 583–586.
   PubMed Web of Science ®Google Scholar
• Bordnick, P. S., & Schmitz, J. M. (1998). Cocaine craving: An evaluation across treatment phases. Journal of Substance Abuse, 10(1), 9–17.
   PubMedGoogle Scholar
• Carter, A. C., Capone, C., & Eaton Short, E. (2011). Co-occurring posttraumatic stress disorder and alcohol use disorders in veteran populations. Journal of Dual Diagnosis, 7(4), 285–299.
   PubMed Web of Science ®Google Scholar
• Chapman, A. L., Rosenthal, M. Z., & Leung, D. W. (2009). Emotion suppression in borderline personality disorder: An experience sampling study. Journal of Personality Disorders, 23(1), 29–47.
   PubMed Web of Science ®Google Scholar
• Cooper, M. L., Agocha, V. B., & Sheldon, M. S. (2000). A motivational perspective on risky behaviors: The role of personality and affect regulatory processes. Journal of Personality, 68(6), 1059–1088.
   PubMed Web of Science ®Google Scholar
• Cooper, M. L., Frone, M. R., Russell, M., & Mudar, P. (1995). Drinking to regulate positive and negative emotions: A motivational model of alcohol use. Journal of Personality and Social Psychology, 69(5), 990–1005.
   PubMed Web of Science ®Google Scholar
• Crepaz, N., & Marks, G. (2001). Are negative affective states associated with HIV sexual risk behaviors? A meta-analytic review. Health Psychology, 20(4), 291–299.
   PubMed Web of Science ®Google Scholar
• Department of Veterans Affairs. (2012). Analysis of VA health care utilization among Operation Enduring Freedom, Operation Iraqi Freedom, and Operation New Dawn veterans, from 1st Qtr FY 2002 through 1st Qtr FY 2012. Washington, DC: Routledge.
   Google Scholar
• Efron, B. (1987). Better bootstrap confidence intervals. Journal of the American Statistical Association, 82(397), 171–185.
   Web of Science ®Google Scholar
• Eisen, S. A., Griffith, K. H., Xian, H., Scherrer, J. F., Fischer, I. D., Chantarujikapong, S., … Tsuang, M. T. (2004). Lifetime and 12-month prevalence of psychiatric disorders in 8,169 male Vietnam war era veterans. Military Medicine, 169(11), 896–902.
   PubMed Web of Science ®Google Scholar
• Erbes, C. R., Kaler, M. E., Schult, T., Polusny, M. A., & Arbisi, P. A. (2011). Mental health diagnosis and occupational functioning in National Guard/Reserve veterans returning from Iraq. Journal of Rehabilitation Research and Development, 48(10), 1159–1170.
   PubMed Web of Science ®Google Scholar
• Fischer, S., Smith, G. T., Spillane, N., & Cyders, M. A. (2005). Urgency: Individual differences in reaction to mood and implications for addictive behaviors. In A. V. Clark (Ed.), The psychology of mood (pp. 85–107). New York, NY: Routledge.
   Google Scholar
• Flannery, B. A., Poole, S. A., Gallop, R. J., & Volpicelli, J. R. (2003). Alcohol craving predicts drinking during treatment: An analysis of three assessment instruments. Journal of Studies on Alcohol and Drugs, 64(1), 120–126.
   PubMed Web of Science ®Google Scholar
• Foa, E. B., & Kozak, M. J. (1986). Emotional processing of fear: Exposure to corrective information. Psychological Bulletin, 99(1), 20–35.
   PubMed Web of Science ®Google Scholar
• Fortenberry, J. D., Temkit, M., Tu, W., Graham, C. A., Katz, B. P., & Orr, D. P. (2005). Daily mood, partner support, sexual interest, and sexual activity among adolescent women. Health Psychology, 24(3), 252–257.
   PubMed Web of Science ®Google Scholar
• Fritz, M. S., & MacKinnon, D. P. (2007). Required sample size to detect the mediated effect. Psychological Science, 18(3), 233–239.
   PubMed Web of Science ®Google Scholar
• Gratz, K. L. (2006). Risk factors for deliberate self-harm among female college students: The role and interaction of childhood maltreatment, emotional inexpressivity, and affect intensity/reactivity. American Journal of Orthopsychiatry, 76(2), 238–250.
   PubMed Web of Science ®Google Scholar
• Gratz, K. L., & Gunderson, J. G. (2006). Preliminary data on an acceptance-based emotion regulation group intervention for deliberate self-harm among women with borderline personality disorder. Behavior Therapy, 37(1), 25–35.
   PubMed Web of Science ®Google Scholar
• Gratz, K. L., & Roemer, L. (2004). Multidimensional assessment of emotion regulation and dysregulation: Development, factor structure, and initial validation of the Difficulties in Emotion Regulation Scale. Journal of Psychopathology and Behavioral Assessment, 26(1), 41–54.
   Web of Science ®Google Scholar
• Gratz, K. L., & Roemer, L. (2008). The relationship between emotion dysregulation and deliberate self-harm among female undergraduate students at an urban commuter university. Cognitive Behavioral Therapy, 37(1), 14–25.
   PubMedGoogle Scholar
• Gratz, K. L., & Tull, M. T. (2010a). Emotion regulation as a mechanism of change in acceptance- and mindfulness-based treatments. In R. A. Baer (Ed.), Assessing mindfulness and acceptance: Illuminating the theory and practice of change (pp. 105–133). Oakland, CA: Routledge.
   Google Scholar
• Gratz, K. L., & Tull, M. T. (2010b). The relationship between emotion dysregulation and deliberate self-harm among inpatients with substance use disorders. Cognitive Therapy and Research, 34(6), 544–553.
   PubMed Web of Science ®Google Scholar
• Gratz, K. L., & Tull, M. T. (2011). Extending research on the utility of an adjunctive emotion regulation group therapy for deliberate self-harm among women with borderline personality pathology. Personality Disorders: Theory, Research, and Treatment, 2(4), 316–326.
   Web of Science ®Google Scholar
• Gratz, K. L., Tull, M. T., & Levy, R. (2013). Randomized controlled trial and uncontrolled 9-month follow-up of an adjunctive emotion regulation group therapy for deliberate self-harm among women with borderline personality disorder. Psychological Medicine, August 28, 1–14.
   Google Scholar
• Hayes, A. F., & Scharkow, M. (2013). The relative trustworthiness of inferential tests of the indirect effect in statistical mediation analysis: Does method really matter? Psychological Science, 24(10), 1918–1927.
   PubMed Web of Science ®Google Scholar
• Heatherton, T. F., & Baumeister, R. F. (1991). Binge eating as escape from self-awareness. Psychological Bulletin, 110(1), 86–108.
   PubMed Web of Science ®Google Scholar
• Ilgen, M., McKellar, J., & Tiet, Q. (2005). Abstinence self-efficacy and abstinence 1 year after substance use disorder treatment. Journal of Consulting and Clinical Psychology, 73(1), 1175–1180.
   PubMed Web of Science ®Google Scholar
• Khantzian, E. J. (1997). The self-medication hypothesis of substance use disorders: A reconsideration and recent applications. Harvard Review of Psychiatry, 4(5), 231–244.
   PubMed Web of Science ®Google Scholar
• Kulka, R., Schlenger, W., & Fairbank, J. (1990). Trauma and the Vietnam war generation. New York, NY: Routledge.
   Google Scholar
• Leith, K. P., & Baumeister, R. F. (1996). Why do bad moods increase self-defeating behavior? Emotion, risk tasking, and self-regulation. Journal of Personality and Social Psychology, 71(6), 1250–1267.
   PubMed Web of Science ®Google Scholar
• Linehan, M. M. (1993). Cognitive behavioral treatment of borderline personality disorder. New York, NY: Routledge.
   Google Scholar
• MacKinnon, D. P., Lockwood, C. M., Hoffman, J. M., West, S. G., & Sheets, V. (2002). A comparison of methods to test mediation and other intervening variable effects. Psychological Methods, 7(1), 83–104.
   PubMed Web of Science ®Google Scholar
• Mennin, D. S., Heimberg, R. G., Turk, C. L., & Fresco, D. M. (2005). Preliminary evidence for an emotion dysregulation model of generalized anxiety disorder. Behaviour Research and Therapy, 43(10), 1281–1310.
   PubMed Web of Science ®Google Scholar
• Morris, W. N., & Reilly, N. P. (1987). Toward the self-regulation of mood: Theory and research. Motivation and Emotion, 11(3), 215–249.
   Web of Science ®Google Scholar
• Parrish, B. D. (2007). Dialectical behavior therapy deployed: An aggressive alternative to traditional mental health on the noncontiguous battlefield. U.S. Army Medical Department Journal, July–September, 24–31.
   PubMedGoogle Scholar
• Preacher, K. J., & Hayes, A. F. (2004). SPSS and SAS procedures for estimating indirect effects in simple mediation models. Behavior Research Methods, Instruments, and Computers, 36(4), 717–731.
   PubMedGoogle Scholar
• Segal, Z. V., Williams, J. M. G., & Teasdale, J. D. (2002). Mindfulness-based cognitive therapy for depression: A new approach to relapse prevention. New York, NY: Routledge.
   Google Scholar
• Shapiro, D., Jamner, L. D., Davydov, D. M., & James, P. (2002). Situations and moods associated with smoking in everyday life. Psychology of Addictive Behaviors, 16(4), 342–345.
   PubMed Web of Science ®Google Scholar
• Sinha, R., Fox, H. C., Hong, K. A., Hansen, J., Tuit, K., & Kreek, M. J. (2011). Effects of adrenal sensitivity, stress-and cue-induced craving, and anxiety on subsequent alcohol relapse and treatment outcomes. Archives of General Psychiatry, 68(9), 942–952.
   PubMed Web of Science ®Google Scholar
• Smyth, J. M., Wonderlich, S. A., Heron, K. E., Sliwinski, M. J., Crosby, R. D., Mitchell, J. E., & Engel, S. G. (2007). Daily and momentary mood and stress are associated with binge eating and vomiting in bulimia nervosa patients in the natural environment. Journal of Consulting and Clinical Psychology, 75(4), 629–638.
   PubMed Web of Science ®Google Scholar
• Stice, E. (2002). Risk and maintenance factors for eating pathology: A meta-analytic review. Psychological Bulletin, 128(5), 825–848.
   PubMed Web of Science ®Google Scholar
• Stuewig, J., & Tangney, J. P. (2007). Shame and guilt in antisocial and risky behaviors. New York, NY: Routledge.
   Google Scholar
• Swendsen, J. D., Tennen, H., Carney, M. A., Affleck, G., Willard, A., & Hromi, A. (2000). Mood and alcohol consumption: An experience sampling test of the self-medication hypothesis. Journal of Abnormal Psychology, 109(2), 198–204.
   PubMed Web of Science ®Google Scholar
• Tabachnick, B. G., & Fidell, L. S. (2007). Using multivariate statistics. New York, NY: Routledge.
   Google Scholar
• Thomas, J. L., Wilk, J. E., Riviere, L. A., McGurk, D., Castro, C. A., & Hoge, C. W. (2010). Prevalence of mental health problems and functional impairment among active component and National Guard soldiers 3 and 12 months following combat in Iraq. Archives of General Psychiatry, 67(6), 614–623.
   PubMed Web of Science ®Google Scholar
• Thomsen, C. J., Stander, V. A., McWhorter, S. K., Rabenhorst, M. M., & Milner, J. S. (2011). Effects of combat deployment on risky and self-destructive behavior among active duty military personnel. Journal of Psychiatric Research, 45(10), 1321–1331.
   PubMed Web of Science ®Google Scholar
• Tull, M. T., Barrett, H. M., McMillan, E. S., & Roemer, L. (2007). A preliminary investigation of the relationship between emotion regulation difficulties and posttraumatic stress symptoms. Behavior Therapy, 38(3), 303–313.
   PubMed Web of Science ®Google Scholar
• Tull, M. T., Weiss, N. H., Adams, C. E., & Gratz, K. L. (2012). The contribution of emotion regulation difficulties to risky sexual behavior within a sample of patients in residential substance abuse treatment. Addictive Behaviors, 37(10), 1084–1092.
   PubMed Web of Science ®Google Scholar
• Veilleux, J. C., Skinner, K. D., Reese, E. D., & Shaver, J. A. (2014). Negative affect intensity influences drinking to cope through facets of emotion dysregulation. Personality and Individual Differences, 59, 96–101.
   Web of Science ®Google Scholar
• Watson, D., Clark, L. A., & Tellegen, A. (1988). Development and validation of brief measures of positive and negative affect: The PANAS scales. Journal of Personality and Social Psychology, 54(6), 1063–1070.
   PubMed Web of Science ®Google Scholar
• Weiss, N. H., Gratz, K. L., & Lavender, J. (2015). Factor structure and initial validation of a multidimensional measure of difficulties in the regulation of positive emotions: The DERS-Positive. Behavior Modification. Advance online publication. doi:10.1177/0145445514566504
   PubMed Web of Science ®Google Scholar
• Weiss, N. H., Sullivan, T. P., & Tull, M. T. (2015). Explicating the role of emotion dysregulation in risky behaviors: A review and synthesis of the literature with directions for future research and clinical practice. Current Opinion in Psychology, 3, 22–29.
   PubMed Web of Science ®Google Scholar
• Weiss, N. H., Tull, M. T., Anestis, M. D., & Gratz, K. L. (2013). The relative and unique contributions of emotion dysregulation and impulsivity to posttraumatic stress disorder among substance dependent inpatients. Drug and Alcohol Dependence, 128(1–2), 45–51.
   PubMed Web of Science ®Google Scholar
• Weiss, N. H., Tull, M. T., & Gratz, K. L. (2014). A preliminary experimental examination of the effect of emotion dysregulation and impulsivity on risky behaviors among women with sexual assault-related posttraumatic stress disorder. Behavior Modification, 38(6), 914–939.
   PubMed Web of Science ®Google Scholar
• Weiss, N. H., Tull, M. T., Viana, A. G., Anestis, M. D., & Gratz, K. L. (2012). Impulsive behaviors as an emotion regulation strategy: Examining associations between PTSD, emotion dysregulation, and impulsive behaviors among substance dependent inpatients. Journal of Anxiety Disorders, 26(3), 453–458.
   PubMed Web of Science ®Google Scholar