Research on substance use

This post and the next deal with substance use and abuse. Today we look at correlates. First, Clinchard et al. (2024) published “Family Socioeconomic Status and Adolescent Substance Use: The role of parent–adolescent brain similarity and parental monitoring” in Journal of Family Psychology. Here’s the edited abstract:

Greater neural similarity between parents and adolescents may reduce adolescent substance use. Among 70 parent–adolescent dyads, we tested a longitudinal path model in which family economic environment is related to adolescent substance use, directly and indirectly through parent–adolescent neural similarity and parental monitoring. Neural similarity was measured as parent–adolescent pattern similarity in functional brain connectivity at Time 1. Parents reported socioeconomic status and parental monitoring at Time 1. Adolescents reported parental monitoring at Time 1 and substance use at Time 2. Higher family socioeconomic status was associated with greater neural similarity. Greater neural similarity was associated with lower adolescent substance use, mediated through greater adolescent-perceived parental monitoring. Parent–adolescent neural similarity may attenuate adolescent substance use by bolstering parental monitoring. 

Qu et al. (2023) examine parent-child neural similarity as an extension of both attachment and behavioral research. They add, “Although extensive studies demonstrate the importance of parent-child dyadic similarity at the behavioral, psychological, and physiological levels in fostering children's learning and psychological wellbeing, little is known about parent-child similarity at the neural level until recently.” So, this is an interesting study in using brain scans. It makes sense to me that financial security correlates with neural security. The other findings are promising. Most professionals won’t be able to use brain scans but there are other ways to capture parent-teen similarity. The next study looks at rural settings. Hargons, Benner & Wyman-Bookwalter (2023) published “Identifying and Addressing Barriers to Effective Substance Misuse Treatment in Rural Settings” in Journal of Rural Mental Health. Here are the edited abstract and impact statements:

Those seeking treatment for opioid or substance use disorder (OUD/SUD) often face obstacles, which may be exacerbated in rural areas. Barriers to treatment, such as access, stigma, and policies that no longer reflect the current needs of clients seeking treatment for OUD/SUD, are well-documented. However, barriers once engaged in treatment that impact persistence are relatively unstudied. This study sought to understand the barriers related to effective treatment provision with clients in OUD/SUD treatment, particularly those in rural settings. This exploratory qualitative study consisted of two focus groups with 18 graduate social work and counseling psychology students completing a two-semester practicum at OUD/SUD treatment facilities. The student practitioners were trained in screening, intervention, and treatment services for SUD in rural and underserved locations. Participants reflected on the barriers for clients who sought OUD/SUD treatment and the subsequent impact on treatment efficacy. Three themes emerged, including Substance Use Treatment and Criminalization Policies, Rurality, and COVID-Related Adjustments. Understanding the ongoing support needed for clients to address barriers once engaged in treatment is critical to treatment persistence. Recognizing and addressing the identified barriers, particularly those with macro or community-level impacts, supports the client’s harm reduction, treatment, and recovery needs to better position clients for successful outcomes. 

Identifying and addressing barriers to persistence in OUD/SUD treatment is of critical importance, particularly in rural communities where treatment resources may be limited, yet mortality rates rival those of urban communities. Recognizing and mitigating the identified barriers, particularly those with macro- or community-level impacts, reflects the harm reduction, treatment, and recovery emphasis of public health modeling. 

I thought this was helpful in examining persistence in teen substance use treatment and the barriers rural clients may encounter. The final study looks at PTSD. Freichel et al. (2023) published “Use of Substances to Cope Predicts Posttraumatic Stress Disorder Symptom Persistence: Investigating patterns of interactions between symptoms and its maintaining mechanisms” in Psychological Trauma: Theory, Research, Practice, and Policy.  The edited abstract and impact statements follow:

Posttraumatic stress disorder (PTSD) remains a growing public health challenge across the globe and is associated with negative and persistent long-term consequences. The last decades of research have identified different mechanisms associated with the development and persistence of PTSD, including maladaptive coping strategies, cognitive and experiential avoidance, and positive and negative metacognitions. Despite these advances, little is known about how these different processes interact with specific PTSD symptoms, and how they influence each other over time at the within-person level. Method: Leveraging a large (N > 1,800) longitudinal data set representative of the Norwegian population during the COVID-19 pandemic, this preregistered study investigated these symptom-process interactions over four assessment waves spanning an 8-month period. Results: Our panel graphical vector autoregressive network model revealed the dominating role of substance use to cope in predicting higher levels of PTSD symptoms over time and increases in PTSD symptomatology within more proximal time windows (i.e., within 6 weeks). Threat monitoring was associated with increased suicidal ideation, while threat monitoring itself was increasing upon decreased avoidance behavior, greater presence of negative metacognitions, and higher use of substances to cope. Our findings speak to the importance of attending to different coping strategies, particularly the use of substances as a coping behavior in efforts to prevent PTSD chronicity upon symptom onset. 

Our results showed that substance use as a coping strategy had a dominant role in predicting higher levels of posttraumatic stress disorder (PTSD) symptoms over time, and threat monitoring was associated with increased suicidal ideation. These findings highlight the importance of addressing different coping strategies, particularly the use of substances, to prevent chronic PTSD upon symptom onset. The study provides directions for future research to better understand the complex interactions and temporal pathways leading up to the development and maintenance of PTSD symptomatology.

I liked the emphasis on substance use as a coping strategy and its role in exacerbating PTSD symptoms over time. The next blog post looks at treatment.