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Introduction: Providing doctoral internship stipends below living wages may harm interns, the clinical services they provide, and the field of health service psychology as a whole. This study evaluated the extent to which doctoral psychology internship stipends from the 2021-2022 training year for APA-accredited, APPIC-member programs in the US are consistent with living wages in the geographic region where sites are located. Methods: We obtained data reflecting internship sites’ geographic location and stipends for the 2021-2022 academic year. Using the Massachusetts Institute of Technology Living Wage Calculator, we computed a living wage for the county in which each internship site is located. Descriptive statistics, discrepancies, ratios, and correlations were calculated to reflect the associations between internship sites’ stipends and their local living wages.Results: The mean internship stipend was 31,783 US dollars (USD), which was lower than the mean living wage by 2,091 USD. Stipends ranged widely, from a low of 15,000 to a high of 94,595 USD–reflecting a six-fold difference in wages. Although internship sites in higher cost of living areas paid higher stipends, over two-thirds (67.0%) of sites did not pay a stipend that equaled or exceeded a living wage. Ninety-eight sites (15.3%) had deficits of over 10,000 USD when comparing their stipends to local living wages, with 33,240 USD as the highest deficit.Discussion: Eliminating obstacles to educating health service psychologists by decreasing the financial burden of training will likely have subsequent critical benefits towards bridging the workforce gap between mental healthcare service needs and available providers, ultimately leading to improved population health.

Early recovery from alcohol use disorder (AUD) is commonly associated with high levels of negative affect, stress, and emotional vulnerability, which confer significant relapse risk. Emotion differentiation-the ability to distinguish between discrete emotions-has been shown to predict relapse after treatment for a drug use disorder, but this relationship has not been explored in individuals recovering from AUD.The current study used thrice daily random and up to thrice daily self-initiated ecological momentary assessment surveys (N = 42, observations = 915) to examine whether 1) moments of high affective arousal are characterized by momentary differences in emotion differentiation among individuals in the first year of a current AUD recovery attempt, and 2) individuals' average emotion differentiation would predict subsequent alcohol use measured by the timeline follow-back over a 3-month follow-up period.Multilevel models showed that moments (Level 1) of higher-than-average negative affect (p 0.001) and/or stress (p = 0.033) were characterized by less negative emotion differentiation, while moments of higher-than-average positive affect were characterized by greater positive emotion differentiation (p 0.001). At the between-person level (Level 2), participants with higher stress overall had lower negative emotion differentiation (p = 0.009). Linear regression showed that average negative, but not positive, emotion differentiation was inversely associated with percent drinking days over the subsequent 3-month follow-up period (p = 0.042). Neither form of average emotion differentiation was associated with drinking quantity.We found that for individuals in early AUD recovery, affective states are associated with acute shifts in the capacity for emotion differentiation. Further, we found that average negative emotion differentiation prospectively predicts subsequent alcohol use.

Background Several evidence-based tobacco cessation treatment strategies exist, though significant barriers to cessation remain which must be addressed to improve abstinence rates for sub-populations of those smoking cigarettes. Cannabis co-use among those who use tobacco is common and appears to be increasing among adults in the United States (US). The literature evaluating the impact of cannabis use on tobacco cessation has been mixed and has several important limitations, which precludes development of treatment recommendations specific to individuals who use tobacco and co-use cannabis. To date, no prospective studies have evaluated the impact of cannabis use and severity on tobacco cessation or quantified cannabis use changes during tobacco treatment to assess for concurrent reductions, abstinence, or compensatory (i.e., increased) cannabis use. This study’s aims are to: (1) evaluate tobacco cessation outcomes among participants who co-use cannabis compared to participants only using tobacco, (2) using daily diaries and biochemical verification, assess changes in cannabis use during tobacco treatment, and (3) assess for a dose-dependent impact of cannabis use on tobacco cessation. Method A multi-site, prospective, quasi-experimental 12-week tobacco treatment trial enrolling treatment-seeking adults (ages 18–40; N = 208) from three sites across South Carolina (US) who use tobacco daily and oversampling (2:1) those who co-use cannabis. Participants receive tobacco cessation pharmacotherapy (varenicline) paired with behavioral support, while cannabis use is not addressed as part of treatment. The primary outcome is 7-day point prevalence tobacco abstinence at the week 12 end of treatment visit, measured via biochemical verification and self-report. Secondary outcome measures include changes in cannabis use (via biochemical verification and self-report) during tobacco cessation treatment. Discussion Results from this trial have the potential to inform tobacco treatment among those co-using cannabis, which may require a tailored approach to address the role of cannabis in quitting tobacco. Trial registration The trial is registered with ClinicalTrials.gov: NCT04228965. January 14th, 2020.

We estimated a network model of trait affect to examine the pattern of associations between emotions. We reasoned that more independence across valences (e.g., enthusiastic-upset) and within valence (e.g., distressed-afraid) would represent a more adaptive affective structure characterized by greater emotion differentiation. The network structure was expected to vary as a function of effortful control and reactivity. We hypothesized effortful control would be associated with weaker associations between and within emotional valences and reactivity would be associated with stronger associations between and within emotional valences (less complexity). Hypotheses were partially supported in a cross-sectional study of 403 young adults. Findings indicated that low effortful control (e.g., low planning and problem solving) was related to stronger associations between emotional valences and reactivity (e.g., impulsivity, distractibility) was associated with stronger associations between negative emotions. This pattern of findings is consistent with a conceptualization of self-regulation characterized by more complex and unique emotional experiences. Unexpectedly, reactivity was associated with lower associations between positive emotions. These mixed findings give a preliminary window into the ways in which the structure of affect varies as a function of two important dimensions of self-regulation.

Risky sexual behaviors are a significant public health concern. Laboratory experiments are necessary to identify causal determinants of risky sexual behavior. However, experiments often rely on analogue sexual risk behavior, assessed by self-reported intentions in response to a sexual scenario. Using behavioral tasks to assess risk taking may be a valuable addition to self-reported intention outcome measures. The Balloon Analogue Risk Task (BART) is a commonly used measure of general risk-taking. However, BART’s associations with sexual risk-taking have been mixed. In this pilot study, we developed a task akin to the BART, the Implicit Sexual Risk Assessment (ISRA), which incorporates sexual stimuli. We hypothesized sexual arousal would increase risk taking on ISRA relative to BART. Using a within-persons experimental design, 79 participants (52% women, mean age = 19.5 (SD = 1.42)) were randomized to condition (i.e., arousal versus neutral) and completed the BART and ISRA tasks. As expected, sexual arousal was associated with increased risk-taking (i.e., adjusted pumps) on ISRA relative to BART. However, this was unexpectedly the result of decreased pumps on BART instead of increased pumps on ISRA. Neither BART nor ISRA were significantly associated with sexual risk behavior or intentions. Null findings are qualified by the fact that sexual arousal was not significantly associated with sexual risk intentions.

IntroductionTobacco/nicotine use is commonly initiated during adolescence or young adulthood, which increases the likelihood of continued use into adulthood and related adverse health outcomes. Despite interest in cessation, achieving and maintaining abstinence is difficult among this population. Cravings are often a barrier to abstinence, which have been associated with intensity of affect at the moment level. Emotion differentiation involves the ability to distinguish between discrete emotion states, and previous work suggests it may moderate the effect of momentary affect on craving, which has never been explored among young adults who are smoking or vaping nicotine.Aims and MethodsIn a sample of young adults (N = 37, observations = 2020, ages 18–25, 51% female, and 78% white) interested in quitting smoking or vaping, we used real-time, naturalistic data capture via mobile phones to examine the interaction of momentary affect and trait emotion differentiation on nicotine craving. Participants were prompted with four surveys per day for 35 days and asked to make a 48-h quit attempt on day 7.ResultsMultilevel models showed moments of higher-than-average momentary negative affect (NA; b = 0.39, p ConclusionsFindings from this exploratory analysis suggest that for young adults engaging in a nicotine quit attempt, greater ability to differentiate NA weakens the momentary association between intense affect and craving.ImplicationsResults of this study show that the ability to differentiate between discrete emotional experiences may protect young adults against nicotine craving during moments of intense affective experience. These preliminary findings suggest that emotion differentiation, a modifiable construct, could be an important treatment target for individuals engaged in treatment for nicotine dependence.

We tested within- and between-person effects of posttraumatic stress disorder (PTSD) symptoms on conduct problems and alcohol intoxication via self-control demands using multilevel structural equation modeling in a longitudinal burst-design study of 251 U.S. veterans who participated in the recent wars in Iraq and Afghanistan. We theorized that experiencing PTSD symptoms engenders efforts to regulate mood, control thoughts, and inhibit or control behavior that is taxing to the individual (i.e., it places demands on self-control) and hypothesized that this process results in subsequent deficits in regulatory control that manifest in heightened intoxication and conduct problems associated with PTSD. At the within-person level, daytime PTSD symptoms, IRR = 1.09, and self-control demands, IRR = 1.12, exhibited within-person associations with nighttime conduct problems over and above nighttime intoxication. Consistent with our hypothesis, daytime increases in self-control demands mediated the associations between daytime PTSD symptoms and subsequent nighttime conduct problems. The indirect effect between daytime PTSD symptoms and nighttime intoxication via self-control demands was nonsignificant. At the between-person level, self-control demands mediated the associations between PTSD symptoms and conduct problems; however, the expected between-person associations with intoxication were nonsignificant. Drinking behavior is related to but cannot fully account for various difficulties in psychosocial functioning associated with PTSD. The present results suggest that dysregulated behavior may, ironically, stem from individuals' concerted efforts to control and manage overwhelming symptoms. Self-control demands may be a common factor that accounts for a broad range of functional impairments associated with PTSD.

OBJECTIVE: To estimate a network model of risk and resilience factors of suicidal ideation among veterans. METHODS: Two network models of suicidal ideation among OIF/OEF/OND veterans (N = 276) incorporated key disorders, traumatic stress, and resilience constructs to contextualize suicidal ideation. RESULTS: Childhood trauma was positively connected with suicidal ideation and harassment and inversely connected with social support and distress tolerance. This exemplifies long-lasting associations between childhood trauma and re-victimization, emotion regulation, and ability to form supportive social relationships. A subsequent model including lower-order facets indicated that combat trauma was predominantly associated with PTSD-intrusion symptoms. CONCLUSIONS: This study highlights the importance of addressing both risk and resilience to reduce suicide risk among veterans and increases understanding of factors that contribute to suicidal ideation.

Risky sexual behaviors are a significant public health concern. Laboratory experiments are necessary to identify causal determinants of risky sexual behavior. However, experiments often rely on analogue sexual risk behavior, assessed by self-reported intentions in response to a sexual scenario. Using behavioral tasks to assess risk taking may be a valuable addition to self-reported intention outcome measures. The Balloon Analogue Risk Task (BART) is a commonly used measure of general risk-taking. However, BART's associations with sexual risk-taking have been mixed. In this pilot study, we developed a task akin to the BART, the Implicit Sexual Risk Assessment (ISRA), which incorporates sexual stimuli. We hypothesized sexual arousal would increase risk taking on ISRA relative to BART. Using a within-persons experimental design, 79 participants (52% women, mean age = 19.5 (SD = 1.42)) were randomized to condition (i.e., arousal versus neutral) and completed the BART and ISRA tasks. As expected, sexual arousal was associated with increased risk-taking (i.e., adjusted pumps) on ISRA relative to BART. However, this was unexpectedly the result of decreased pumps on BART instead of increased pumps on ISRA. Neither BART nor ISRA were significantly associated with sexual risk behavior or intentions. Null findings are qualified by the fact that sexual arousal was not significantly associated with sexual risk intentions.

Self-Discrepancy Theory (Higgins, 1987) predicts that the difference between the ideal and the actual self will be associated with impaired-control-over-drinking (IC; dysregulated drinking beyond one's own limits) as well as alcohol-related-problems. According to Slaney et al. (2001) perfectionism is a multi-faceted personality trait which represents both adaptive (e.g. high-standards) and maladaptive (e.g. discrepancy) aspects. In particular, discrepancy has been associated with poorer coping approaches, which may suggest a Self-Medication route to IC. Yet, to date, no one has examined whether drinking-motives (e.g., social, enhancement, coping and conformity) mediate the relations between discrepancy and high standards and alcohol-outcomes such as IC. We used a structural equation model to test indirect associations of discrepancy and high-standards to both heavy-episodic-drinking and alcohol-related-problems through the mediating mechanisms of drinking-motives and IC. Results supported the distinction between discrepancy and high-standards consistent with the Self-Medication Hypothesis (Hersh & Hussong, 2009). Discrepancy was associated with poorer alcohol-outcomes through greater coping-motives, conformity-motives and IC. In contrast, higher-standards were associated with fewer alcohol-outcomes through less coping-motives, conformity-motives, and IC. This study illustrates the importance of personality factors such as discrepancy in the development of problematic alcohol-use suggesting that it might be a good target for intervention.

Dual-Process models of self-regulation suggest different facets of self-regulation predict adaptive (e.g., academics, exercise) and maladaptive (e.g., drinking) behaviors. Engagement in these behaviors may ultimately result in automatic habits that either promote or inhibit alcohol use and related problems. This study tested a structural equation model of relationships between self-regulation constructs, health and drinking habits and automaticity, effortful inhibition, and alcohol problems in a college student sample (N = 405). As expected, effortful control was positively associated with health habits, which were positively associated with health automaticity. Automaticity was inversely associated with effortful inhibition. Thus, effortful control was indirectly associated with less effortful inhibition, as hypothesized. Contrary to hypothesis, effortful inhibition was inversely associated with alcohol-related problems, which resulted in a positive indirect association between effortful control and alcohol problems. Reactivity was positively associated with drinking automaticity via drinking habits and positively associated with effortful inhibition and alcohol problems. Results indicate effortful control and reactivity exhibit unique associations with health and drinking habits, automaticity, and effortful inhibition. Results suggest a somewhat paradoxical process whereby effortful control achieves its ends via decreased effort to engage in adaptive behaviors. Validity of using self-report and word association measures of automaticity was supported by the observed associations with predictors and outcomes.

BACKGROUND: Social Learning Theory suggests how one conceptualizes time will be passed from parent to child (Bandura & Walters, 1963). Through the lens of Behavioral Economics Theory (Vuchinich & Simpson, 1998), impaired control may be characterized as consuming alcohol as a form of immediate gratification as a choice over more distal rewards. Because impaired control reflects a self-regulation failure specific to the drinking situation, it may be directly related to time-perspectives. OBJECTIVES: This investigation explored whether or not the indirect influences of perceived parenting styles on alcohol use and related problems is mediated by both facets of time-perspective (e.g. hedonism, present-fatalism, future, past-positive, past-negative) and impaired control over drinking. METHODS: We examined a structural equation model with 391 (207 women; 184 men) college student drinkers. We used an asymmetric bias-corrected bootstrap technique to conduct mediational analyses (MacKinnon, 2008). RESULTS: Higher levels of past-positive time-perspective were indirectly linked to both less alcohol use and fewer alcohol-related problems through less impaired control. In contrast, higher levels of present-fatalism were indirectly linked to more alcohol use through more impaired control. Higher levels of father permissiveness and mother authoritarianism were indirectly linked to both more impaired control and alcohol use through more present-fatalism. In addition, higher levels of father authoritarianism were indirectly linked to more alcohol use through more hedonism. CONCLUSIONS/IMPLICATIONS: Our results support the notion that drinking beyond one’s self-prescribed limits is associated with time-perspectives related to negative aspects of the parent-offspring socialization process, such as fatalism.

This study tested a multilevel structural model of associations between two aspects of self-control (effortful control and reactivity), self-control demands, alcohol consumption, and alcohol problems and related risk behaviors using daily diary data from 196 young adults (4,177 person-days). Self-control demands were hypothesized to be positively associated with alcohol consumption and alcohol problems and related risk behaviors both within- and between-persons. At the between-person level, self-control demands were hypothesized to mediate the association between trait self-control and alcohol problems and related risk behaviors. At the within-person level, self-control demands had a direct positive effect on alcohol problems and related risk behaviors, over and above alcohol consumption. However, contrary to expectation, self-control demands were inversely associated with alcohol consumption. In contrast, self-control demands were positively associated with alcohol consumption at the between-person level and partially mediated the positive effects of reactivity on consumption and alcohol problems and related risk behaviors. That is, reactivity was associated with higher perceived self-control demands, which in turn predicted higher rates of consumption and alcohol problems and related risk behaviors. Effortful control was not significantly associated with alcohol consumption or self-control demands. The pattern of self-control demand effects at the within-person level suggest that young adults are less likely to drink when struggling to manage their day-to-day behavior, yet if they do drink they are more susceptible to negative consequences. Trait effects suggest that individual differences in self-control may be associated with alcohol use patterns in part attributable to development of, and response to, structured daily routines. (PsycINFO Database Record