Whole person recovery from substance use disorder: a call for research examining a dynamic behavioral ecological model of contexts supportive of recovery

Addiction Research & Theory, Journal Year: 2024, Volume and Issue: 33(1), P. 1 - 12

Published: April 1, 2024

Abstinence has long been considered the defining feature of recovery from substance use disorder, with a focus on individual level factors associated abstinence rather than identifying and socioecological that support recovery. This paper proposes greater consideration dynamic behavioral ecological influences offers an expanded contextualized approach to understanding promoting predicting pathways. Conceptual empirical bases are summarized moving beyond research, treatment, policy agendas narrowly as fundamental change agent in emphasize changes primary outcome metric. A model is presented expands scope recovery-relevant variables include dynamically-varying contexts variously or hinder along functional contextual variables. Examining behavior patterns through time changing environmental community neighborhood-level social determinants health critical for developing multi-level interventions promote change. Molar perspectives needed understand how influenced by broader features addition determinants. provides concrete recommendations pursuit this broadened research agenda. Individual pathology-based approaches disorder too focused. review calls temporally extended contribute harmful systemic necessary sustain

Language: Английский

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Problem Recognition as A Discrete Concept for Change Processes in Problematic Alcohol Use

Current Addiction Reports, Journal Year: 2025, Volume and Issue: 12(1)

Published: Feb. 19, 2025

Alcohol problem recognition reflects the extent to which a person with any level of problematic alcohol use (PAU), including hazardous use, acknowledges associated risks/harms as potentially/actually relative degree objectivity. Notably, is typically low amongst people PAU not engaged in treatment or support. This review evaluates existing measures and related concepts such ambivalence, readiness change, motivation, cognitive biases other self-evaluative appraisal processes. has been operationalised via various but often conflated theoretically distinct concepts. Limited conceptual work examines nature discrete concept its function relation behaviour change outcomes key variables. Problem proposed an important process that warrants further development testing for advancing understanding processes across spectrum.

Language: Английский

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Reducing Stigma and Enhancing Care for People Who Use Alcohol

Journal of Health Service Psychology, Journal Year: 2025, Volume and Issue: unknown

Published: March 13, 2025

Language: Английский

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Mindful attention promotes control of brain network dynamics for self-regulation and discontinues the past from the present

Proceedings of the National Academy of Sciences, Journal Year: 2023, Volume and Issue: 120(2)

Published: Jan. 3, 2023

Mindful attention is characterized by acknowledging the present experience as a transient mental event. Early stages of mindfulness practice may require greater neural effort for later efficiency. self-regulate behavior and focalize present, but this understanding lacks computational explanation. Here we used network control theory model how external inputs—operationalizing effort—distribute changes in activity evoked during mindful across white matter network. We hypothesized that individuals with controllability, thereby efficiently distributing inputs, effectively behavior. further brain regions utilize input exhibit shorter intrinsic timescales activity. Shorter characterize quickly discontinuing past processing to present. tested these hypotheses randomized controlled study primed participants either mindfully respond or naturally react alcohol cues fMRI administered text reminders measurements consumption 4 wk postscan. found controllability moderated consumption. regulation cues, compared one’s own natural reactions, reduced craving, craving did not differ from baseline group. reactions group, involved more-effortful dynamics cognitive subnetworks. This persisted group More-effortful states had than less effortful states, offering an explanation promotes being

Language: Английский

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Animal models of compulsion alcohol drinking: Why we love quinine-resistant intake and what we learned from it

Frontiers in Psychiatry, Journal Year: 2023, Volume and Issue: 14

Published: March 24, 2023

Alcohol Use Disorder (AUD) ranks among the most prevalent mental disorders, extracting ~$250 billion/year in US alone and producing myriad medical social harms. Also, number of deaths related to problem drinking has been increasing dramatically. Compulsive alcohol drinking, characterized by intake that persists despite negative consequences, can be particularly important a major obstacle treatment. With people suffering from AUD during past years, there is critical need understand neurobiology compulsive drives for alcohol, as well development novel pharmacological therapies. Here we discuss rodent compulsion-like (CLAD) models, focusing on two widely used adverse stimuli model responding, quinine adulteration footshook-resistant intake. For both cases, goal uncover behavior patterns brain circuits underlie drive even face consequences. We caveats, benefits, potential mechanisms, models consequence-resistant responding more generally, especially highlight some advantages quinine-resistance over footshook-resistance. Further, since this review contributes Special issue focused Molecular Aspects Drug Use, our new findings showing how noradrenergic system CLAD responding. In particular, comment importance α1 β adrenergic receptors (ARs) targets treating AUD.

Language: Английский

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Alcohol use disorder criteria exhibit different comorbidity patterns

Addiction, Journal Year: 2023, Volume and Issue: 118(8), P. 1457 - 1468

Published: Jan. 6, 2023

Alcohol use disorder is comorbid with numerous other forms of psychopathology, including externalizing disorders (e.g. conduct disorder) and, to a lesser extent, internalizing conditions depression, anxiety). Much the time, overlap among alcohol and explored at level, assuming that criteria are co-equal indicators even though span varied domains. Emerging evidence suggests there symptom clusters within construct relate differentially important external criteria, psychopathology allied personality traits impulsivity, novelty-seeking). The present study mapped individual onto dimensions.

Language: Английский

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The Genetically Informed Neurobiology of Addiction (GINA) model

Nature reviews. Neuroscience, Journal Year: 2022, Volume and Issue: 24(1), P. 40 - 57

Published: Nov. 29, 2022

Language: Английский

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(Mis)understanding alcohol use disorder: Making the case for a public health first approach

Drug and Alcohol Dependence, Journal Year: 2023, Volume and Issue: 253, P. 111019 - 111019

Published: Nov. 4, 2023

'Alcohol use disorder' (AUD) is used by several contemporary conceptualizations to identify, treat and prevent problems associated with alcohol use. Such encompass diagnostic classifications broader frameworks for policy practice. However, current AUD concepts are subject multiple tensions limitations in capturing responding the complex heterogeneous nature of problems. Further, public understandings heavily divergent from professional remain embedded within an 'alcoholism' master narrative which disease model stereotypes come costs prevention 'recovery'. The persistence a problematic paradigm reflects coalescing forces including cognitive appeal reductionism, motives stigmatize 'other', over-emphasis on as individually located biomedical problem. Public misperceptions matter individual, individual's essence, misconceived notions responsibility control have been bolstered industry interests ascension neuroscience genetics, turn diverting attention importance environmental commercial determinants health effectiveness under-utilized policies. We call stakeholders support efforts prioritize first approach advancing research, treatment order make significant advances treatment. offer recommendations assist shifting understanding scientific responses.

Language: Английский

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An Umbrella Review of the Links Between Adverse Childhood Experiences and Substance Misuse: What, Why, and Where Do We Go from Here?

Substance Abuse and Rehabilitation, Journal Year: 2022, Volume and Issue: Volume 13, P. 83 - 100

Published: Nov. 1, 2022

Background and Objectives: A wealth of research has identified adverse childhood experiences (ACEs; abuse, neglect, violence or disorder in the home) as a strong risk factor for substance misuse. Synthesis existing evidence is critical to shape policy inform directions future research. Existing reviews have focused on specific substances use outcomes (eg, disorder), do not include discussion mechanisms that operate between ACEs The current umbrella review aims synthesize relationship misuse, linking these, identify gaps our knowledge, discuss research, practice, public policy. Methods: Two electronic databases (PsycINFO Medline) were searched published 1998 2022 link Twenty articles met eligibility criteria qualitatively synthesized. Results: Results overwhelmingly demonstrated an elevated misuse disorder, among adolescents adults exposed ACEs. Research explain this highlights multitude potential intervention targets, with stress propelling cascade effects across neurobiological, endocrine, immune, metabolic, nervous systems, impacting psychosocial cognitive functioning. Nonetheless, literature subject limitations surrounding unmeasured cofounders causality, well decontextualizing adversity from broader structural issues influence Research, policy, practice seek holistically understand address within social determinants health crucial. Keywords: experiences, review,

Language: Английский

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Drinkers like us? The availability of relatable drinking reduction narratives for people with alcohol use disorders

Addiction Research & Theory, Journal Year: 2022, Volume and Issue: 31(1), P. 1 - 8

Published: July 18, 2022

Narratives around alcohol are important in determining how people decide who or what qualifies as problematic use. draw on common representations that subject to influences including historical and normative influences. We argue there two dominant narratives relate use disorder (AUD) is identified addressed. The first the historically embedded narrative of alcoholism disease, second more recent positive new sobriety. present an argument these alone do not capture wide heterogeneous experience harms, such a diverse range relatable required reach resonate with broader community AUDs. In particular, we reflect fact both abstinence focused therefore exclude many drinkers willing may need, consider lifelong sobriety reduce their risk harms. ask policy professionals, researchers lived advocates issues support diversifying experiences, goals public health outcomes, stigma reduction alternative routes recovery.

Language: Английский

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