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Environmental reward (ER) is an established mechanism contributing to depression. Given the high prevalence of depression in China and Taiwan, it is important to develop measures that facilitate the examination of cultural similarities and differences in ER. The reward probability index (RPI) assesses ER through items measuring individual access to rewarding (Reward Probability) and aversive (Environmental Suppressor) events. The purpose of the current study is to translate the RPI into Chinese (C-RPI) and to study cultural difference in ER by examining structural- and item-level differences in RPI functioning. A total of 930 college students were recruited from China (n = 300), Taiwan (n = 300), and the United States (n = 330). Confirmatory factor analysis was used to study the configural invariance of the RPI and C-RPI. Item response theory-based differential item functioning (DIF) testing was used to study item level differences in functioning between the RPI and C-RPI. Results overall support the established RPI structure in all three regions. Most Reward Probability items exhibit no DIF across cultures, while most Environmental Suppressor items exhibit DIF across cultures. Findings highlight cultural difference in ER constructs and cultural factors contributing to the observed DIF. The assessment and clinical implications of the findings are also discussed. [ABSTRACT FROM AUTHOR]

Abstract: Aims: To compare outcomes for a behavioral activation group treatment for substance use [life enhancement treatment for substance use (LETS ACT)] versus a time and group size‐matched control condition delivered in a residential treatment setting. Design: Single‐site two‐arm parallel‐group randomized clinical trial with follow‐up assessment at 3, 6 and 12 months post‐treatment. Setting: Residential substance use treatment facility in the United States. Participants: Participants were 263 adults [mean age 42.7 (11.8); 29.5% female; 95.4% African American; 73.2% court mandated] whose insurance dictated 30‐day (65.9%) or 90‐day (34.1%) treatment duration. Intervention and comparator: LETS ACT (n = 142) is a treatment developed originally for depression and modified for substance use. It teaches participants to increase positively reinforcing value‐driven activities in order to counter depression and relapse. The control group [supportive counseling (SC); n = 121] received time and group size‐matched supportive counseling. Treatment was delivered in five or eight 1‐hour sessions depending on patient length of stay. Measurements: Percentage abstinent at follow‐up, percentage of substance use days among those reporting use, depressive symptoms [Beck Depression Inventory (BDI)] and adverse consequences of drug use [Short Inventory of Problems—Alcohol and Drug (SIP‐AD)]. Findings: LETS ACT had significantly higher abstinence rates at 3 months [odds ratio (OR) = 2.2, 95% confidence interval (CI) = 1.3–3.7], 6 months (OR = 2.6, 95% CI= 1.3–5.0) and 12 months (OR = 2.9, 95% CI = 1.3–6.1) post‐treatment compared with SC. LETS ACT participants reported significantly fewer adverse consequences from substance use at 12 months post‐treatment [B = 4.50, standard error (SE) = 2.17, 95% CI = 0.22–8.78]. Treatment condition had no effect on percentage substance use days among those who resumed use or on change in depressive symptoms; the latter decreased over time only in those who remained abstinent after residential treatment irrespective of condition (B = 0.43, SE = 0.11, 95% confidence interval = 0.22–0.65). Conclusions: A behavioral activation group treatment for substance use (LETS ACT) appears to increase the likelihood of abstinence and reduce adverse consequences from substance use up to 12 months post‐treatment. [ABSTRACT FROM AUTHOR]

Research suggests that an overwhelming majority of college students gamble, with between 2–9% of U.S. students meeting DSM-IV criteria for pathological gambling. Despite the prevalence of gambling among college students, accurate and easily implemented methods for the assessment of gambling involvement among college students are lacking. Thus, the purpose of the current study was to establish the psychometric properties of a measure of gambling attitudes and beliefs (GABS) and demonstrate this measure's association with gambling frequency and an established gambling screen among 374 U.S. male college students during 1995–1997. Using techniques based in modern test theory (e.g., Rasch model), we identified a set of 10 items that reliably rank-ordered students in relation to their positive attitudes and beliefs about gambling. Further, the resulting 10 items accounted for variance in gambling behavior beyond that provided by a more standard consequences-based assessment measure. Use of this measure for the improvement of gambling assessment in college students is recommended. [ABSTRACT FROM AUTHOR]

Only a small minority of people with substance use disorders (SUDs) receive treatment. A focus on abstinence is pervasive in SUD treatment, defining success in both research and practice, and punitive measures are often imposed on those who do not abstain. Most adults with SUD do not seek treatment because they do not wish to stop using substances, though many also recognize a need for help. This narrative review considers the need for increased research attention on nonabstinence psychosocial treatment of SUD – especially drug use disorders – as a potential way to engage and retain more people in treatment, to engage people in treatment earlier, and to improve treatment effectiveness. We describe the development of nonabstinence approaches within the historical context of SUD treatment in the United States, review theoretical and empirical rationales for nonabstinence SUD treatment, and review existing models of nonabstinence psychosocial treatment for SUD among adults to identify gaps in the literature and directions for future research. Despite significant empirical support for nonabstinence alcohol interventions, there is a clear gap in research examining nonabstinence psychosocial treatment for drug use disorders. Future research must test the effectiveness of nonabstinence treatments for drug use and address barriers to implementation. • Abstinence-only treatment excludes most adults with substance use disorder. • Nonabstinence treatment may improve engagement, retention, and effectiveness. • There is a gap in research examining nonabstinence psychosocial drug treatment. • Future work is needed to test effectiveness of nonabstinence treatments for drug use. • Addressing barriers to implementing nonabstinence treatment is also vital. [ABSTRACT FROM AUTHOR]

Substance use and associated problems often return following treatment for substance use disorder (SUD), which disproportionally impact Black/African American (AA) individuals. Social support and spiritual well-being are sources of recovery capital identified as particularly important among Black/AA adults. Social support and spiritual well-being are also posited mechanisms in 12-step; thus, this study tested the effects of social support and spiritual well-being on substance use outcomes over time, distinct from 12-step involvement, among Black/AA adults post-SUD treatment. The study hypothesized that social support and spiritual well-being would demonstrate significant interactions with time, respectively, on substance use frequency and substance use consequences, above the effect of 12-step involvement. The study drew data from a study of 262 adults (95.4 % Black/AA) entering residential SUD treatment (NCT#01189552). Assessments were completed at pretreatment and at 3-, 6-, and 12-months posttreatment. Two generalized linear mixed models (GLMM) tested the effects of social support and spiritual well-being, above the effect of 12-step involvement, on substance use frequency and substance use consequences over the course of 12-months posttreatment. Higher spiritual well-being predicted significantly less frequent substance use during recovery (β = 0.00 , p =.03). Greater 12-step involvement predicted significantly fewer substance use consequences during recovery (β = 0.00 , p =.02). In post hoc analyses the effect of spiritual well-being and 12-step involvement dissipated by 3.5- and 6.6-months posttreatment, respectively. The study found no significant effects of social support over time. Spiritual well-being and 12-step involvement are associated with lower substance use and substance use consequences, respectively, in the early months of posttreatment recovery among Black/AA adults. These findings contribute to the growing recovery capital literature informing paths to recovery and sources of support outside of 12-step affiliation. However, these effects diminish over time. • Social support and spiritual well-being are important sources of recovery capital • Higher spiritual well-being was associated with lower substance use frequency • Treatment settings may improve outcomes by helping patients increase spiritual well-being [ABSTRACT FROM AUTHOR]

Abstract: In the United States, substance users who voluntarily (VO) elect to receive treatment and substance users who are court-mandated (CM) to receive treatment typically obtain care within the same facilities. Little is known about the clinical characteristics that differentiate these individuals. The current study provides rates of specific DSM-IV Axis I and Axis II psychiatric and substance use disorders, comorbidities, childhood trauma, motivation, and other clinical and demographic characteristics as a function of referral status, among individuals in residential substance use treatment (463 participants, M age=43.3; 69.7% male; 88.4% African American). Participants were interviewed and diagnosed using the Structure Clinical Interview for DSM-IV and the Diagnostic Interview for Personality Disorders. Within our sample, VO individuals, as compared to CM individuals had significantly higher rates of psychiatric disorders (68.7% versus 55.2%, respectively), including mood disorders, major depressive disorder, generalized anxiety disorder, and borderline personality disorder. Additionally, they were significantly more likely to have alcohol dependence (43.0% versus 20.8%) and cocaine dependence (66.5% versus 48.9%). Elevated rates of comorbidities and childhood abuse were also observed among VO individuals, while motivation did not differ as a function of referral status. Overall, VO individuals appeared to have more severe problems than their CM counterparts which may suggest that they require more intensive or different types of treatment. [Copyright &y& Elsevier]

Distress tolerance (DT) is an established construct contributing to the onset and maintenance of psychopathology in adulthood; however, few studies have examined the role of DT in older adolescent psychopathology. Emerging data suggest that gender and race may influence this relation. Therefore, the current study examined the relation between gender, race, and DT on parent-reported internalizing and externalizing DSM-oriented symptoms among a community sample of 128, 14-18 year old adolescents. Results indicated a moderating effect of gender on affective problems, such that females with low DT, but not males, displayed significantly greater affective problems. Findings also indicated a significant moderating effect of race, such that Caucasians with low DT, but not African Americans, displayed significantly higher somatic, oppositional defiant, and conduct problems. These findings suggest that DT is an important clinical variable in older adolescence, particularly among Caucasians and females., (Copyright © 2013 The Foundation for Professionals in Services for Adolescents. Published by Elsevier Ltd. All rights reserved.)

There is currently limited research on the potential mechanisms underlying the development of antisocial personality disorder (ASPD). One such mechanism, distress tolerance (defined as an individual's behavioral persistence in the face of emotional distress) may underlie the development of ASPD and its associated behavioral difficulties. It was hypothesized that substance users with ASPD would evidence significantly lower levels of distress tolerance than substance users without ASPD. To test this relationship, we assessed 127 inner-city males receiving residential substance abuse treatment with two computerized laboratory measures of distress tolerance. The mean age of the sample was 40.1 years (SD = 9.8) and 88.2% were African American. As expected, multiple logistic regression analyses indicated that distress intolerance significantly predicted the presence of an ASPD diagnosis, above and beyond key covariates including substance use frequency and associated Axis I and II psychopathology. Findings suggest that distress tolerance may be a key factor in understanding the development of ASPD, setting the stage for future studies expanding on the nature of this relationship, as well as the development of appropriate interventions for this at-risk group.