International Journal of Behavioral Sciences

International Journal of Behavioral Sciences

Development of Causation Model between Automatic Negative Thoughts and Craving Mediating by Cognitive Emotional Regulation among Methadone Maintained Clients

Document Type : Original Article

Authors
Marziyeh Safarzadeh 1
Mahdi Khanjani 2
Alireza Noroozi 3
1 Department of Psychology, Allameh Tabataba’i University, Tehran, Iran
2 Department of General and Clinical Psychology, Allameh Tabataba’i University, Tehran, Iran
3 Iranian National Center for Addiction Studies, Tehran University of Medical Sciences, Tehran, Iran
10.30491/ijbs.2022.318413.1721
Abstract
Introduction: The purpose of this study was to investigate the causal effects of automatic negative thought on craving mediating by cognitive emotional regulation.
Method: This study had a descriptive and correlational design. The study population consisted of methadone maintained clients of the Iranian National Center for Addiction Studies, Tehran City (n=78) and Mehr-Aein clinic in Rey city (n=42) who referred to treatment centers during February to April 2019. Data were collected through convenient sampling using craving questionnaires including Francken’s Obsessive-compulsive Drug Use Scale and Visual Analog Scale. Other study questionnaires were Cognitive Emotional Regulation Questionnaire and Automatic Negative Thought Scale. For data analysis, we used multivariate linear regression using the structural equation modeling and path analysis using STATA software.
Results: Findings revealed that there are significant correlations between automatic negative thoughts, cognitive emotional regulation and craving (P<0.001). Also, the results of hierarchical regression analysis indicate that cognitive emotional regulation can mediate the relationship between automatic negative thoughts and craving (P< 0.001).
Conclusion: According to the results of this study, it can be concluded that clients who have higher levels of automatic negative thoughts and higher negative strategies of cognitive emotional regulation, experience a higher level of craving. Thus, identifying the level of negative thoughts and cognitive emotion regulation strategies of methadone-treated clients can predict the severity of craving and their leave or retention of the treatment.
Keywords
Craving
Cognitive Emotional Regulation
Automatic Negative Thoughts
  1. Hser Y-I, Mooney LJ, Saxon AJ, Miotto K, Bell DS, Zhu Y, et al. High Mortality Among Patients With Opioid Use Disorder in a Large Healthcare System. J Addict Med. 2017;11(4):315-9. doi:1097/ADM.0000000000000312
  2. Isbell H, Vogel VH. The addiction liability of methadon (amidone, dolophine, 10820) and its use in the treatment of the morphine abstinence syndrome. American Journal of Psychiatry. 1949;105(12):909-14. doi:: 1176/ajp.105.12.909
  3. Ries RK, Fiellin DA, Miller SC, Saitz R. The ASAM principles of addiction medicine: Lippincott Williams&Wilkins;2014.Retrievedfrom https://books.google.com/books?id=j6GGBud8DXcC
  4. Gunne LM, Grönbladh L. The Swedish methadone maintenance program. Social and medical aspects of drug abuse: Springer; 1984. p. 205-13. doi: 10.1007/978-94-011-6320-0_19
  5. Amato L, Davoli M, Perucci CA, Ferri M, Faggiano F, Mattick RP. An overview of systematic reviews of the effectiveness of opiate maintenance therapies: available evidence to inform clinical practice and research. Journal of substance abuse treatment. 2005;28(4):321-9. https://doi.org/10.1016/j.jsat.2005.02.007
  6. Naji L, Dennis BB, Bawor M, Plater C, Pare G, Worster A, et al. A prospective study to investigate predictors of relapse among patients with opioid use disorder treated with methadone. Substance abuse: research and treatment. 2016; 10: SART. S37030. https://doi.org/10.4137%2FSART.S37030
  7. Fareed A, Vayalapalli S, Stout S, Casarella J, Drexler K, Bailey SP. Effect of methadone maintenance treatment on heroin craving, a literature review. Journal of addictive diseases. 2010;30(1):27-38. https://doi.org/10.1080/10550887.2010.531672
  8. O’Brien C. Addiction and dependence in DSM‐V. Addiction. 2011;106(5):866-7. https://doi.org/10.1111/j.1360-0443.2010.03144.x
  9. Bottlender M, Soyka M. Impact of craving on alcohol relapse during, and 12 months following, outpatient treatment. Alcohol and Alcoholism. 2004;39(4):357-61. https://doi.org/10.1093/alcalc/agh073
  10. Kavanagh D, Connor J. Craving: A research update: Editorial to a special issue. Addictive behaviors. 2013;38(2):1499-500. https://doi.org/10.1016/j.addbeh.2012.08.001
  11. Kleykamp BA, Weiss RD, Strain EC. Time to reconsider the role of craving in opioid use disorder. JAMA psychiatry. 2019;76(11):1113-4. doi:10.1001/jamapsychiatry.2019.1839
  12. Nosen E, Woody SR. Acceptance of cravings: How smoking cessation experiences affect craving beliefs. Behaviour research and therapy. 2014;59:71-81. https://doi.org/10.1016/j.brat.2014.05.003
  13. Nosen E, Woody SR. Applying lessons learned from obsessions: Metacognitive processes in smoking cessation. Cognitive Therapy and Research. 2009;33(2):241-54. https://psycnet.apa.org/doi/10.1007/s10608-007-9180-8
  14. Tiffany ST. A cognitive model of drug urges and drug-use behavior: role of automatic and nonautomatic processes. Psychological review. 1990;97(2):147. Retrieved from https://www.safetylit.org/week/journalpage.php?jid=3720
  15. Beck A, Alford B. Depression: causes and treatment University of Pennsylvania Press. Philadelphia, PA. 1967.
  16. Saladin ME, Gray KM, Carpenter MJ, LaRowe SD, DeSantis SM, Upadhyaya HP. Gender differences in craving and cue reactivity to smoking and negative affect/stress cues. The American journal on addictions. 2012;21(3):210-20. https://doi.org/10.1111/j.1521-0391.2012.00232.x
  17. Sinha R, Catapano D, O’Malley S. Stress-induced craving and stress response in cocaine dependent individuals. Psychopharmacology. 1999;142(4):343-51. https://doi.org/10.1007/s002130050898
  18. Childress AR, Ehrman R, McLellan AT, MacRae J, Natale M, O’Brien CP. Can induced moods trigger drug-related responses in opiate abuse patients? Journal of substance abuse treatment. 1994;11(1):17-23. https://doi.org/10.1016/0740-5472(94)90060-4
  19. Cooney NL, Litt MD, Morse PA, Bauer LO, Gaupp L. Alcohol cue reactivity, negative-mood reactivity, and relapse in treated alcoholic men. Journal of abnormal psychology. 1997;106(2):243. https://psycnet.apa.org/doi/10.1037/0021-843X.106.2.243
  20. Seo D, Lacadie CM, Tuit K, Hong K-I, Constable RT, Sinha R. Disrupted ventromedial prefrontal function, alcohol craving, and subsequent relapse risk. JAMA psychiatry. 2013;70(7):727-39. doi:10.1001/jamapsychiatry.2013.762
  21. Serre F, Fatseas M, Swendsen J, Auriacombe M. Ecological momentary assessment in the investigation of craving and substance use in daily life: a systematic review. Drug and alcohol dependence. 2015;148:1-20. https://doi.org/10.1016/j.drugalcdep.2014.12.024
  22. Shadur JM, Lejuez CW. Adolescent substance use and comorbid psychopathology: Emotion regulation deficits as a transdiagnostic risk factor. Current addiction reports. 2015;2(4):354-63. https://doi.org/10.1007/s40429-015-0070-y
  23. EJEI J, GHOLAMALI LM, ERAMI H. Comparison of emotional regulation in substance abusers and normal subjects. 2015. Retrieved from https://new.sid.ir/
  24. Garland EL, Hanley AW, Bedford CE, Zubieta J-K, Howard MO, Nakamura Y, et al. Reappraisal deficits promote craving and emotional distress among chronic pain patients at risk for prescription opioid misuse. Journal of Addictive Diseases. 2018;37(1-2):14-22. https://doi.org/10.1080/10550887.2018.1459148
  25. Ghanbarizarandi Z, Hasani J, Mohammadkhani S, Hatami M. The assessment of difficulty in emotion regulation and craving based on the sensitivity of brain-behavioral systems and levels of loneliness. Neuropsychology. 2018;4(13):47-66. Retrieved from Neuropsychology
  26. John OP, Gross JJ. Individual differences in emotion regulation. Handbook of emotion regulation. 2007:351-72. Retrievedfrom https://books.google.com/books?id=j6GGBud8DXcC
  27. Troy AS. Cognitive reappraisal ability as a protective factor: resilience to stress across time and context:UniversityofDenver;2012. https://digitalcommons.du.edu/etd/659
  28. Aldao A, Nolen-Hoeksema S, Schweizer S. Emotion-regulation strategies across psychopathology: A meta-analytic review. Clinical psychology review. 2010; 30(2): 217-37. https://doi.org/10.1016/j.cpr.2009.11.004
  29. Hasani J. The psychometric properties of the cognitive emotion regulation questionnaire (CERQ). Journal of clinical psychology. 2010;2(3):73-84. Retrieved from https://new.sid.ir/
  30. Szeto EH, Schoenmakers TM, van de Mheen D, Snelleman M, Waters AJ. Associations between dispositional mindfulness, craving, and drinking in alcohol-dependent patients: An ecological momentary assessment study. Psychology of Addictive Behaviors. 2019;33(5):431. https://psycnet.apa.org/doi/10.1037/adb0000473
  31. Krahn DD, Bohn MJ, Henk HJ, Grossman JL, Gosnell B. Patterns of urges during early abstinence in alcohol-dependent subjects. American Journal on Addictions. 2005;14(3): 248-55. https://doi.org/10.1080/10550490590949424
  32. Kuepper R, Oorschot M, Myin‐Germeys I, Smits M, Van Os J, Henquet C. Is psychotic disorder associated with increased levels of craving for cannabis? An Experience Sampling study. Acta psychiatrica scandinavica. 2013;128(6):448-56. https://doi.org/10.1111/acps.12078
  33. Lukasiewicz M, Fareng M, Benyamina A, Blecha L, Reynaud M, Falissard B. Ecological momentary assessment in addiction. Expert review of neurotherapeutics. 2007;7(8):939-50. https://doi.org/10.1586/14737175.7.8.939
  34. Todd M, Armeli S, Tennen H, Carney MA, Ball SA, Kranzler HR, et al. Drinking to cope: a comparison of questionnaire and electronic diary reports. Journal of studies on alcohol. 2005;66(1):121-9. https://doi.org/10.15288/jsa.2005.66.121
  35. Hollon SD, Kendall PC. Cognitive self-statements in depression: Development of an automatic thoughts questionnaire. Cognitive therapy and research. 1980;4(4):383-95. https://doi.org/10.1007/BF01178214
  36. GOLPARVAR M, KAMKAR M, Javadi S. Relation between just world beliefs for self and others with general health, life satisfaction, positive and negative affect and automatic thoughts. 2007. Retrieved from https://new.sid.ir/
  37. Foroozan S. The Effectiveness of Therapeutic Hope on the Automotic Negative Thoughts of Addicts Leaving the City of Rudsar (Persian) [MSc. Thesis]. Tehran: University of Allameh Tabatabai; 2015.
  38. Arianakia E, Hasani J. Impulsivity and cognitive emotion regulation strategies in patients with bipolar-and major depressive disorders. Advances in Cognitive Science. 2014;16(2):1-10. Retrieved from https://icssjournal.ir/index.php?sid=1&slc_lang=en
  39. Garnefski N, Kraaij V. Cognitive emotion regulation questionnaire–development of a short 18-item version (CERQ-short). Personality and individual differences. 2006;41(6):1045-53. https://doi.org/10.1016/j.paid.2006.04.010
  40. Franken IH, Hendriks VM, van den Brink W. Initial validation of two opiate craving questionnaires: the Obsessive Compulsive Drug Use Scale and the Desires for Drug Questionnaire. Addictive behaviors. 2002;27(5):675-85. https://doi.org/10.1016/S0306-4603(01)00201-5
  41. Hassani-Abharian P, Mokri A, Ganjgahi H, Oghabian M-A, Ekhtiari H. Validation for Persian versions of “desire for drug questionnaire” and “obsessive compulsive drug use scale” in heroin dependents. Archives of Iranian Medicine. 2016;19(9):0-. https://doi.org/0161909/aim.0010
  42. Mokri A, Ekhtiari H, Edalati H, Ganjgahi H. Relationship between degree of craving and different dimensions of addiction severity in heroin intravenous users. Iranian Journal of Psychiatry and Clinical Psychology. 2008. Retrieved from https://ijpcp.iums.ac.ir/index.php?sid=1&slc_lang=en
  43. Kober H. Emotion regulation in substance use disorders. 2014. Retrieved from https://psycnet.apa.org/
  44. Terry-McElrath YM, Emery S, Szczypka G, Johnston LD. Potential exposure to anti-drug advertising and drug-related attitudes, beliefs, and behaviors among United States youth, 1995–2006. Addictive behaviors. 2011;36(1-2):116-24. https://doi.org/10.1016/j.addbeh.2010.09.005
  45. Smelson DA, Losonczy MF, Davis CW, Kaune M, Williams J, Ziedonis D. Risperidone decreases craving and relapses in individuals with schizophrenia and cocaine dependence. The Canadian Journal of Psychiatry. 2002;47(7):671-5. https://doi.org/10.1177%2F070674370204700710
  46. Marlatt GA, Donovan DM. Relapse prevention: Maintenance strategies in the treatment of addictive behaviors: Guilford press; 2005. Retrieved from https://books.google.com/?sa=X&ved=0ahUKEwisrojIkc32AhXPqqQKHSerAu4QPAgC

 

 

International Journal of Behavioral Sciences
Volume 16, Issue 1
Spring 2022
Pages 66-75