Existing evidence shows that chemsex practice can contribute to adverse health outcomes. However, the presence of addictive disorders based on DSM-5 criteria remains underexplored in this population. The present study aimed to assess the overall prevalence and associated factors of substance use disorders (SUDs) and chemsex addiction among individuals engaged in chemsex, using an online self-report questionnaire. The sample included 132 French adults having engaged in chemsex within the previous 12 months. Sociodemographic characteristics, substance use patterns, DSM-5 criteria for substance use disorders and DSM-5 criteria adapted to assess chemsex addiction, associated consequences, and sexual practices were collected. Univariate analyses and logistic regression models were conducted to explore factors associated with substance and chemsex-related addictions. The most frequently used substances were synthetic cathinones, followed by GHB/GBL and stimulants. Addictive disorders were highly prevalent, particularly cathinone use disorder and addiction to chemsex practice, which were associated with increased negative consequences, notably mental health problems and suicidal ideation. The presence of cathinone use disorder was associated with GHB/GBL use disorder, loss of control over sexual behavior, craving for sex, and chemsex addiction. Both cathinone use disorder and craving for sex significantly predicted chemsex addiction. This study highlights the importance of assessing addictive disorders in the context of chemsex by integrating both substance and behavioral addictions, given the strong interconnection between substance use and sexuality. Multidimensional and integrated treatment approaches are needed to adequately prevent and manage specific addictive patterns and associated risk-taking behaviors among individuals engaged in chemsex.
Online addictive behaviors are common among adolescents and may reflect efforts to cope with inner emptiness, loneliness, or emotional pain. These behaviors suggest a deeper form of emotional disconnection that existing constructs do not fully capture. To address this gap, the present study developed the Sense of Absence Scale (SoAS), a measure designed to assess adolescents' experiences of inner void, relational invisibility, and reduced engagement in daily life. Participants included 1,555 non-clinical adolescents aged 14-18 years. Psychometric analyses included Exploratory Graph Analysis (EGA), Confirmatory Factor Analysis (CFA), and Item Response Theory (IRT). Additionally, we examined correlations between the SoAS and several external self-report measures assessing loneliness, hope, suicidal ideation, and online addictive behaviors to consider convergent and nomological validity. EGA indicated a stable item structure, which was confirmed by the CFA (χ2(77) = 588.35, p < .01, CFI = .96, TLI = .95, RMSEA = .050). IRT analyses showed strong discrimination and high reliability (α ≈ .97). The seven point response format provided the best fit. Convergent validity was high within SoAS items and moderately strong with emptiness. Higher SoAS scores were strongly related to emptiness and mental pain, moderately associated with suicidal ideation, loneliness, and online addictive behaviors, and negatively related to hope and self-compassion. The SoAS has psychometric support among a general population of adolescents. Future studies should examine its functioning in clinical populations and its potential in intervention development.
Cannabis use is associated with increased risk for suicidality. However, the directionality of this association and the role of shared familial influences-such as genetics and environment-remains uncertain. Further, despite higher rates of cannabis use and suicidality endorsement in clinical samples, research in these populations is limited. This study examines cross-sectional and prospective associations between cannabis use and suicidality in a sample characterized by earlier cannabis initiation and heavier use than typically reported, while accounting for shared familial influences. Adolescent sibling groups were recruited from Denver and San Diego (N = 1,261); at least one sibling was recruited from a substance use treatment program, alternative school, or juvenile probation. Participants completed clinical interviews assessing substance use and suicidality at three waves (2001--2019). Cannabis use frequency was examined as a predictor of suicidality using multilevel models accounting for shared familial influences and within-family clustering. Covariates included alcohol, tobacco, other substance use, age, and sex. Reverse associations and exploratory models assessing tobacco as a predictor were also examined. Cannabis use was not associated with suicidality (all p's > 0.05). Exploratory analyses suggested a possible association between tobacco and suicidality (e.g., Wave 1 within-family effect: OR = 1.037, p = 0.016), though these associations were largely reduced to non-significance after accounting for other substance use. Findings in this high-risk clinical sample are inconsistent with literature linking cannabis use to suicidality in community samples. Results underscore the need for further research on the association between general and polysubstance use risk and suicidality.
Reports the notice of retraction of "Preventing tobacco and alcohol use among high school students through a hybrid online and in-class intervention: A randomized controlled trial" by Christopher Williams, Kenneth W. Griffin, Sandra M. Sousa and Gilbert J. Botvin (Psychology of Addictive Behaviors, 2025[Sep], Vol 39[6], 528-540; see record 2025-86677-001). The published paper reported an incorrect registration number for https://clinicaltrials.gov/. When comparing the correct https://clinicaltrials.gov/ trial registration (NCT03219190) and the published article, there were several discrepancies between the protocol as reported in the published paper and the appropriate https://clinicaltrials.gov/ registry, which deviated from accepted standards for the reporting of RCTs. The outcomes reported in the published article were not specified as primary or secondary outcomes of the trial. The Allocation (randomized) sample size (n = 1804) was markedly less than the registered Anticipated sample size of n = 3000. The age range for the population listed in the https://clinicaltrials.gov/ registration (11-14 years old) was younger than the average age of participants in the published paper (mean age = 15.2). (The following abstract of the original article appeared in record 2025-86677-001.) Objective: School-based health promotion programs can have a positive effect on behavioral and social outcomes among adolescents. Yet, limited classroom time and suboptimal program implementation can reduce the potential impact of these interventions. In the present randomized trial, we tested the effectiveness of a classroom-based substance use prevention program that was adapted for hybrid implementation. The hybrid adaptation included eight asynchronous e-learning modules that presented didactic content and eight classroom sessions designed to facilitate discussion and practice of refusal, personal self-management, and general social skills. Nineteen high schools were randomly assigned to intervention or control conditions. Students (N = 1,235) completed confidential online pretest and posttest surveys to assess the effects of the intervention on tobacco and alcohol use and life skills. The sample was 50.7% female and 35.5% non-White with a mean age of 15.2 years. Analyses revealed significant program effects on current cigarette smoking, alcohol use, drunkenness, and intentions for future use. There were also program effects for communication, media resistance, anxiety management, and refusal skills. Taken together, these findings suggest that hybrid approaches can produce robust prevention effects and may help reduce barriers to the widespread adoption and implementation of evidence-based prevention programs. (PsycInfo Database Record (c) 2026 APA, all rights reserved).
Reward learning can contribute to addictive behaviors by shaping attention and action selection. While reward-associated stimuli are known to capture attention, it remains unclear whether such learning can also guide behavior without stimulus-outcome contingency awareness. This study examined whether implicitly learned reward associations influence both attention and action selection, and how these effects relate to risky alcohol use. Eighty university students (40 low-risk and 40 high-risk drinkers) completed a Pavlovian-to-instrumental transfer task combined with an emotional attentional blink paradigm. During learning, conditioned stimuli and responses were probabilistically paired with monetary rewards. Awareness of stimulus-outcome contingencies was assessed at the individual level, using the Bayesian Awareness Categorization Technique. Reward-related influences on attention and response selection were then tested in a transfer phase. We observe no evidence of Pavlovian-to-instrumental transfer in either participants aware or unaware of reward contingencies. Similarly, reward associations did not modulate attention. The absence of effects in both aware and unaware participants makes it difficult to determine whether Pavlovian influences on attention and behavior are truly absent or simply not detectable under the current task conditions. However, exploratory analyses show that high-risk drinkers present greater preference for high-probability, low-value responses in the transfer phase. The observed preference for high-probability rewards in high-risk drinkers may reflect altered reward sensitivity. Together, these findings underscore the importance of evaluating reward-driven attentional and behavioral biases under well-controlled conditions and highlight the value of publishing null results to refine theoretical models of Pavlovian influences in addiction.
Research on young adult alcohol use often overlooks the influence of specific social network members on daily alcohol use. This pilot study combined egocentric social network methods with a daily diary design to examine how network members influence drinking at the day level. Participants (N = 21) identified six social network members they frequently drank with and saw in person and then reported on these individuals in a 21-day study. Daily reports captured self-reported alcohol use and social network members presence and alcohol use from the previous day. Across 417 morning reports, participants drank on 77 days (18.5%), consuming an average of 2.36 drinks (SD = 1.70) on those days. Linear mixed-effects models showed that being with a given network member who was drinking was associated with consuming 1.75 more drinks than the participant's average. Network members who contributed to higher alcohol use were more likely to be people the participant intended to drink with in the future and who had frequently consumed alcohol in the past month, regardless of whether it was with the participant. The findings from this pilot study provide preliminary evidence that the drinking of and anticipating future drinking with certain network members contributes to greater alcohol use and suggests that interventions could use personalized feedback to help individuals recognize the network members who facilitate heavier drinking.
Behavioral addictions are increasingly common among adolescents and young adults, especially in the context of digital and compulsive behaviors. This study examined whether emotion dysregulation mediates the relationship between insecure attachment representations and behavioral addiction risk. A total of 418 undergraduate students (59.1 % female; M = 20.00, SD = 1.51; age range = 18-22 years) completed self-report measures on attachment style, emotion regulation, and behavioral addiction. Multiple regressions and mediation analyses were conducted. Results indicated that insecure attachment-particularly Preoccupation with Relationships and Need for Approval-was linked to greater behavioral addiction risk. This association was partly explained by emotion dysregulation, suggesting that difficulties in managing emotions heighten the impact of insecure attachment on maladaptive behaviors. These findings highlight the contribution of early relational vulnerabilities and emotion dysregulation deficits to behavioral addiction risk in emerging adulthood and suggest emotion regulation as a key target for prevention.
This repeated cross-sectional study examined trends and behavioral correlates of excessive screen time among Swedish adolescents across 2017, 2020 and 2023. Specifically, this study examined 1) temporal trends of variables used, 2) correlates of pooled screen time, and 3) correlates of specific screen modalities (gaming, social media, and film/TV viewing). Data were collected from n=8,300 upper secondary school students in Jönköping County (n=2,319 in 2017; n=3,056 in 2020; n=2,925 in 2023). Measures used included risk behaviors (e.g., alcohol, smoking), physical activity, psychosocial trust, exposure to violence and victimization, sleep duration, psychosomatic symptoms, absenteeism and living arrangement. General linear models (GLM; UNIANOVA) were conducted, adjusting for relevant covariates. Alcohol use, smoking, shorter sleep duration, higher psychosomatic symptoms, and school absenteeism were associated with higher pooled screen time, whereas physical activity, female gender, and living with both parents were associated with lower pooled screen time. Across modality-specific analyses, shorter sleep duration, lower physical activity, living without both parents, and school absenteeism were consistently associated with higher screen use across gaming, social media, and film/TV viewing, while substance-use and gender associations varied by modality. Sleep, physical activity, family structure, and school absenteeism appear to be robust correlates across screen modalities, supporting the importance of targeting these factors in adolescent health promotion and digital media guidance. These findings highlight the need for parents, researchers, and health professionals to pay closer attention to adolescents' digital media use.
A common feature of contemporary sports-betting apps is 'instant cash-out', which allows users to settle a bet early in exchange for a discounted immediate payout. Despite high prevalence and links with gambling-related harm, relatively little is known about how personality traits associated with gambling, such as impulsivity, predict instant cash-out usage. To address this question, we recruited 145 general-population adult participants (69 men, 66 women, 10 non-binary or undisclosed; Mage = 36.3, SD = 10.7; participants resided in Australia, Canada, Ireland, New Zealand, the UK, or the USA) to complete five self-report questionnaires related to impulsivity, as well as the Problem Gambling Severity Index (PGSI), and a validated cognitive task measuring individual differences in cash-out frequency. We then assessed how cash-out frequency in the behavioral task was associated with both self-reported impulsivity and PGSI. We found that cash-out frequency was negatively correlated both with PGSI scores and with a number of impulsivity-related traits including Dysfunctional Impulsivity, Lack of Premeditation, Positive Urgency, Sensation Seeking, and Fun Seeking. An exploratory factor analysis revealed that higher scores on a latent 'Dysfunctional Impulsivity' factor were negatively associated with cash-out frequency overall, whereas higher scores on an 'Inhibition and Inflexibility' factor predicted higher cash-out frequency specifically for bets with a low win probability. Taken together, results suggest that instant cash-out may primarily appeal to less impulsive people and those with lower PGSI scores. This raises the possibility that instant cash-out may specifically facilitate increased gambling behaviors among people with less prior experience of gambling.
Problematic Internet use (PIU) is a public health concern in children and adolescents and is associated with physical (e.g., musculoskeletal pain, headache) and mental health problems (e.g., depression, emotional instability). Kagawa Prefecture in Japan introduced a residential treatment camp for adolescent PIU in 2022; however, previous studies on its effectiveness lacked control groups and longitudinal follow-ups. This study evaluated the short-term effects of the treatment camp on Internet addiction severity and mental health indicators using a non-randomized controlled design. This pilot non-randomized controlled study was conducted between July and November 2024, with grade 5-9 students and their parents. The intervention group (n = 22) attended a 7-day residential camp, whereas the control group (n = 106) did not. Baseline assessments were conducted in July or August, and follow-up surveys three months post intervention. Students' Internet addiction, attachment style, mental health, self-efficacy, and lifestyle habits were measured. Parents' mental health and parenting styles were also measured. Intervention-group students had higher Internet addiction and mental health scores than control-group students at baseline. Post-intervention, intervention-group students showed greater improvements in Internet addiction (Δmedian =  - 9.5 vs. - 2.0) and mental health (Δmedian =  - 4 vs. 0), while intervention-group parents demonstrated a greater reduction in negative parenting behaviors (Δmedian =  - 6 vs. 0). This pilot non-randomized controlled study suggests short-term improvements in camp attendees' IAT scores and depressive symptoms at 3-month follow-up. A 12-month follow-up is planned to evaluate the longer-term sustainability of these findings.
Adolescent substance use (SU) is a prevalent public health issue in the United States. Understanding how known risk factors such as harsh parenting and externalized anger may impact youth SU is crucial for structuring primary prevention efforts and interventions. This study examines the relationship between harsh parenting and both current SU and SU severity. We assess whether, and to what extent, externalized anger mediates the relationship between harsh parenting and the two SU outcomes. Two waves of a biannual prospective cohort study administered to adolescents between 10-16 years of age were used to test mediation models for SU outcomes. The sample was 44.5% female, 87.2% White, and 95.7% non-Hispanic. Significant direct effects (p < 0.05) were observed between harsh parenting and externalized anger (Stand. β = 0.27); harsh parenting and current SU (Stand. β = 0.11); and externalized anger and current SU (Stand. β = 0.33). Significant indirect effects were also observed between harsh parenting and current SU (Stand. β = 0.09) and between harsh parenting and SU severity (Stand. β = 0.06). Results indicate a total effect between harsh parenting and adolescent SU of Stand. β = 0.198; about 44% of which is attributed to mediation via externalized anger. While no significant direct effect between harsh parenting and SU severity was found, significant mediation effects (Stand. β = 0.06) were found for the role of externalized anger. While harsh parenting is known to affect adolescent SU directly, we found that this relationship is emphasized by the presence of externalized anger. Implications for prevention and interventions are discussed.
Existing treatments for methamphetamine use disorder (MUD) are suboptimal in addressing withdrawal and preventing relapse. Models of addiction have proposed that negative affect plays an influential role in drug craving and relapse. Although Reduced Environmental Stimulation Therapy (REST) has been associated with attenuated negative affect in other psychiatric conditions, it has not been examined as an intervention for MUD. To address this gap, the present study investigated the feasibility, tolerability, and safety of a single session of REST via floatation pool (pool-REST) in treatment-enrolled individuals with MUD. In a within-subject crossover design, participants (n = 78) consented to complete one session each of pool-REST and chair-REST, an active comparator controlling for the effects of simple relaxation and expectation. Feasibility was assessed via completion rate, tolerability via duration of REST utilization, and safety via adverse event incidence. Secondary outcomes were assessed via measurement of self-reported affect, interoceptive sensation, and degree of stimulant craving. 74 % of all recruited participants (n = 58) completed both REST sessions, which were well-tolerated. There were no serious adverse events and participants provided more frequent endorsements of positive versus negative experiences. Although both REST conditions showed significant decreases in ratings of stress/anxiety, negative affect, and stimulant craving, pool-REST was associated with greater increases in positive affect, cardiorespiratory interoceptive awareness, heart rate, and systolic blood pressure than chair-REST. These results demonstrate that REST sessions are feasible, well-tolerated, and safe in individuals with MUD. Randomized control trials are warranted to explore potential salutary effects of pool-REST on MUD remission and recovery.
This study tested whether Surrender to God (StG), assessed explicitly (self-report) and implicitly (implicit association task), was a predictor of recovery characterized by reduced risk of relapse, reduced Substance Use Disorder (SUD) symptoms, and increased meaning in life. Longitudinal data (N = 177) were collected during treatment at a Christian inpatient SUD treatment facility, with follow-ups at one, six, and twelve months after treatment discharge. We used generalized estimating equations (GEE) analyses with the binary outcome relapse to estimate predictive relationships of explicit and implicit StG after treatment. Additionally, linear mixed model analyses (LMM) were conducted concerning SUD symptoms and meaning in life, with either implicit or explicit StG scores as predictors. The analyses were controlled for baseline scores of SUD symptoms and meaning in life including Bonferroni-Holm correction. Implicit StG predicted decreased odds of relapse (Odds ratio = 0.371, p = 0.001) over the course of one year but not at the one-month follow-up assessment. The reversed pattern was found for explicit StG, which predicted lower chances of relapse up to one month after treatment (Odds ratio = 0.962, p = 0.011) but not at 6 or 12-months assessments. Neither implicit nor explicit StG predicted follow-up SUD symptoms or meaning in life. These results suggest that explicit StG may be useful in predicting short-term relapse, and implicit StG may be useful in predicting longer-term relapse. In the context of religion-based recovery, theory and clinical practice may benefit from including explicit and implicit measures concerning religion and spirituality, such as StG.
This study investigates trends in substance use treatment admissions and overdose patterns across New Jersey counties from 2014 to 2022. Using the Social Vulnerability Index (SVI), we examined how county-level vulnerability differentiates treatment utilization and overdose outcomes. We created a novel, longitudinal data set using data from multiple public sources. Data were obtained and analyzed for all 21 New Jersey counties. Outcome measures included substance use treatment admissions, opioid-specific treatment admissions, overdose deaths, and naloxone administration. Using the SVI, counties were categorized as either high (n = 10) or low (n = 11) social vulnerability. Data analyses were conducted using joinpoint analysis to identify trends over time and variation by social vulnerability status. Significant trends were identified regardless of social vulnerability status for all outcome measures, appearing as upward trends in initial segments and flat or declining trends in latter segments. High vulnerability (compared to low vulnerability) counties demonstrated greater Annual Percentage Change (APC) magnitudes for all outcome measures in the initial segment, similar APCs in the latter segment, and had higher baseline rates and peak rates. Findings demonstrate that county-level social vulnerability status is associated with substance use treatment admissions and overdose patterns. Specifically, high vulnerability counties exhibit consistently higher rates of substance use treatment admissions, naloxone administrations, and overdose deaths. This pattern highlights a need for expanded substance use services along the continuum of care for vulnerable areas and the viability of SVI status as a useful and simple tool for targeting service expansion efforts.
Loneliness is a pervasive public health problem, especially among individuals with problematic substance use (PSU). To date, however, scarce research has examined the prevalence and correlates of loneliness in vulnerable segments of the population, such as US military veterans. Data were analyzed from the National Health and Resilience in Veterans Study, which surveyed a nationally representative sample of US veterans. The Three-Item Loneliness Scale was used to assess clinically significant loneliness (≥6). Multivariable logistic regression and relative importance analyses were conducted to identify correlates of loneliness in 593 veterans with PSU. Nearly half of US veterans with PSU (47.4%) reported clinically significant loneliness. In a multivariable analysis, loneliness was independently associated with being unmarried/unpartnered, greater current psychological distress (depressive and posttraumatic stress symptoms), lifetime suicide attempt, and physical disability, smaller social network size, and lower levels of purpose in life and optimism. In a relative importance analysis, major depressive and posttraumatic stress symptoms (35.4%), smaller social network size (16.7%), and lower purpose in life (15.0%) and optimism (13.6%) explained the majority of the variance in loneliness. Purpose in life also moderated the link between depressive symptoms and loneliness: among veterans with depressive symptoms, those with higher purpose in life had a lower likelihood of loneliness. Nearly half of US veterans with PSU report significant loneliness. Prevention and treatment strategies that address psychological distress, foster meaningful social connections, and enhance veterans' sense of purpose may help mitigate the burden of loneliness in this population.
Over 60% of permanent supportive housing (PSH) residents smoke cigarettes, and over 50% use cannabis. Co-use of tobacco and cannabis may be linked with other substance use. We explored attitudes toward tobacco-free and cannabis-free policies among PSH residents who smoked cigarettes, co-used tobacco and cannabis, or other substances. Between 2022 and 2024, we recruited 400 PSH residents who smoked cigarettes into a cluster-randomized clinical trial (RCT) of a smoke-free home intervention. Using baseline data from the RCT, we created scores reflecting attitudes toward tobacco-free and cannabis-free policies (higher scores reflect more favorable attitudes). We used linear mixed models to examine multivariable associations of these attitudes with predisposing, enabling, and need factors, as well as with intensity of tobacco and cannabis co-use. Participants' mean age was 54.5 years, 62.7% were male, and 41.8% identified as Black or African American. Of the participants, 64.3% used cannabis, 31.5% used amphetamines, and 27.3% used cocaine in the past 30 days. Cocaine use in the past 30 days was associated with less favorable attitudes toward tobacco-free policies (adjusted β: -0.20, 95% CI: -0.37, -0.04). Compared to light co-users of tobacco and cannabis, heavy co-users of tobacco and cannabis had less favorable attitudes toward tobacco-free policies (adjusted β:-0.32, 95% CI: -0.56, -0.07) and cannabis-free policies (adjusted β:-0.58; 95% CI: -0.82,-0.35). Interventions that address the intensity of tobacco and cannabis co-use, the high levels of indoor co-use of tobacco and cannabis, and co-occurring substance use may increase favorable attitudes towards smoke-free policies in PSH.
Objective: Although compulsive internet use reflects interactions between personal vulnerabilities and situational triggers, adolescents' day-to-day screen time patterns, especially in non-Western contexts, remain understudied. We aim to examine temporal patterns of screen time among Moroccan adolescents and their associations with compulsive internet use (CIU) and sociodemographic factors. Methods: This study uses an intensive daily design to capture short-term fluctuations in screen use across a week, identifying weekday-weekend shifts and other dynamics. A total of 334 Moroccan high school students (Mage = 16.02 years, 52 % female) from three public schools in urban and rural areas reported their daily screen time and CIU over seven consecutive days, their platform-specific usage and their scores on the CIUS. Latent class analysis (LCA) was used to identify subgroups with distinct weekly trajectories, and latent growth modeling (LGM) was used to assess temporal change. Linear mixed-effects models tested predictors, including age, sex, CIUS scores, school type, device preference, and primary internet activity. Results: Two distinct usage profiles emerged: steady-low and weekend-high. The weekend-high profile was more common among older girls and showed strong Sunday peaks. Mixed-effects and latent class models showed that higher CIUS scores, being female, and the day of the week (especially Sunday, with an increase of 74 min compared to weekdays) predicted heavier, multi-platform engagement. Conclusions: Moroccan adolescents show heterogeneous temporal patterns of screen use, with compulsive use linked to heavier, weekend-centered engagement. Prevention efforts should target overall exposure and high-risk time windows, especially on weekends.
Protective Behavioral Strategies (PBS) are cognitive-behavioural strategies that are promising to reduce risky alcohol consumption among students. This research investigates 1) the role of psychosocial determinants of drinking (motives and perceived social norms) as potential barriers to their use, and 2) the protective value of the four‑PBS against risky consumption. Two longitudinal studies (two-waves, one-year interval) in French university students were conducted. Latent Change Score Model (N = 164) tested how changes in psychosocial determinants were related to within-person changes in four PBS use. Cross-Lagged Panel Model (N = 188) examined reciprocal associations between each PBS and typical drinking quantity. Firstly, modifying the manner of drinking strategy (MOD; i.e., inhibiting risky drinking) showed the largest within-person change over one year, increasing as students grew older and decreased in social motives. Secondly, higher MOD use was consistently associated with fewer drinks per occasion, whereas other PBS domains showed mainly same-wave links with drinking. Prior drinking also strongly predicted later consumption, indicating that MOD operates as a protective factor beyond the relative stability of students' drinking patterns. Findings highlight MOD strategy as a priority target for reducing student alcohol consumption. Strengthening MOD may help reduce typical number of drinks, but interventions must also tackle social drinking motives that discourage its use. Student-focused prevention programmes could therefore prioritise presenting MOD as socially acceptable and compatible with enjoyable nights out, helping students to preserve social connection and pleasure while shifting towards safer, more sustainable patterns of alcohol use.
Medications for opioid use disorder (MOUD) are standard of care for opioid use disorder (OUD), but high rates of treatment discontinuation limit their impact on recovery. Nature exposure and engagement holds promise as a potential adjunctive treatment to MOUD through stress reduction and mental health benefits. This study evaluated whether nature exposure influenced MOUD treatment participation by analyzing associations of residential greenness with MOUD discontinuation across a diverse geography in Pennsylvania, while considering interrelated factors-season and community type. We analyzed electronic health records from 2,570 adults receiving MOUD from an outpatient addiction treatment program. Weekly MOUD participation was derived from medication days' supply of buprenorphine or naltrexone. Average weekly greenness (normalized difference vegetation index) was assigned to buffers surrounding participants' residential address. We applied mixed-effects logistic regression of pooled person-weeks in treatment to model the odds of MOUD discontinuation, clustered by patient and with robust standard errors. In models adjusted for sociodemographic factors, residential greenness was not associated with MOUD discontinuation. We observed associations of season with MOUD discontinuation: compared to spring weeks, the odds of MOUD discontinuation were 20-27% higher during summer, fall, and winter weeks. In season-stratified models, we observed a non-linear association of greenness and MOUD discontinuation during the spring season. Understanding factors contributing to MOUD discontinuation is essential to improving recovery outcomes for those with OUD. Findings suggest that passive greenness exposure may have little influence on MOUD participation but identified the potential importance of season on MOUD outcomes.
Studies have shown that emotion dysregulation, depression symptoms, and escapism motives are associated with Gaming Disorder (GD) symptoms. Findings indicate a discrepancy between the World Health Organization (WHO) and the American Psychiatric Association (APA) GD symptoms frameworks. The current study aimed to investigate the serial mediating effect of depression symptoms and coping, escapism and fantasy motives on the relationship between emotion dysregulation and GD symptoms and compare the WHO and APA frameworks. Data was collected through an online survey utilizing validated self-reported measures. The final convenience sample consisted of 678 video game players (68.44 % men [n = 464], 29.65 % women [n = 201], and 1.92 % reported 'other' as gender identification [n = 13]) with an average age of 29.50 years (SD = 8.92). Structural equation modeling (SEM) was used to analyze the mediating effects. The results showed that depression symptoms and a composite measure of coping, escapism, and fantasy motivations, in sequence, fully mediated the relationship between emotion dysregulation and GD symptoms within the WHO framework and partially mediated it within the APA framework. The results indicate that individuals with emotion dysregulation and higher levels of depression symptoms may use video games as an emotion regulation strategy. Managing emotion dysregulation and coping in the context of video games may aid in the clinical course for gaming disorder and co-occurring depression. Future research should utilize longitudinal designs to investigate study variables.