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The Role of Affect in Psychosocial Treatments for Substance Use Disorders

  • Emotion and Addiction (K Morie, Section Editor)
  • Published:
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Abstract

Purpose of Review

This paper provides a narrative review of studies published over the past 5 years that have examined the role of affect, including both affective symptoms and affective disorders, in psychosocial treatments for substance use disorder.

Recent Findings

A growing body of literature suggests that affective symptoms and affective disorders may moderate substance use disorder treatment efficacy, mediate the effects of treatment on substance use outcomes, and may be directly changed by substance use disorder treatment.

Summary

Substance use disorders and affective disorders commonly co-occur, and both affect and affective disorders are associated with substance use disorder treatment outcomes. Future research should continue to examine affect as a moderator, mediator, and outcome of substance use disorder treatments. In particular, new studies that are designed to test precision medicine hypotheses would greatly expand our understanding of the role of affective symptoms and disorders in substance use disorder treatment.

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References

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

  1. Sacks JJ, Gonzales KR, Bouchery EE, Tomedi LE, Brewer RD. 2010 National and state costs of excessive alcohol consumption. Am J Prev Med. Elsevier Inc. 2015;49:e73–9.

    Article  PubMed  Google Scholar 

  2. Strassels SA. Economic burden of prescription opioid misuse and abuse. J Manag Care Pharm Academy of Managed Care Pharmacy (AMCP). 2009;15:556–62.

    Article  PubMed  Google Scholar 

  3. Whiteford HA, Degenhardt L, Rehm J, Baxter AJ, Ferrari AJ, Erskine HE, et al. Global burden of disease attributable to mental and substance use disorders: findings from the global burden of disease study 2010. Lancet Lancet Publishing Group. 2013;382:1575–86.

    Article  PubMed  Google Scholar 

  4. Orrok BG. Alcoholics anonymous: the story of how many thousands of men and women have recovered from alcoholism. JAMA. 1989;261:3315.

    Article  Google Scholar 

  5. Butelman ER, Kreek MJ. Medications for substance use disorders (SUD): emerging approaches. Expert Opin Emerg Drugs. 2017;22:301–15.

    Article  PubMed  PubMed Central  Google Scholar 

  6. He RH, An H, Zheng YR, Tao R. Cognitive-behavioral therapy. Adv Exp Med Biol. Springer New York LLC. 2017:321–9.

  7. Maisto SA, Hallgren KA, Roos CR, Witkiewitz K. Course of remission from and relapse to heavy drinking following outpatient treatment of alcohol use disorder. Drug Alcohol Depend. 2018;187:319–26.

    Article  PubMed  PubMed Central  Google Scholar 

  8. Witkiewitz K, Marlatt GA. Relapse prevention for alcohol and drug problems: that was zen, this is tao. Am Psychol. 2004;59:224–35.

    Article  PubMed  Google Scholar 

  9. Paul ES, Sher S, Tamietto M, Winkielman P, Mendl MT. Towards a comparative science of emotion: affect and consciousness in humans and animals. Neurosci Biobehav Rev Pergamon. 2019;108:749–70.

    Article  PubMed  Google Scholar 

  10. Davis L, Uezato A, Newell JM, Frazier E. Major depression and comorbid substance use disorders. Curr Opin Psychiatry. 2008;21:14–8.

    Article  PubMed  Google Scholar 

  11. Vorspan F, Mehtelli W, Dupuy G, Bloch V, Lépine JP. Anxiety and substance use disorders: co-occurrence and clinical issues. Curr Psychiatry Rep. Current Medicine Group LLC. 2015;17:4.

    Article  PubMed  Google Scholar 

  12. Stasiewicz PR, Maisto SA. Two-factor avoidance theory: the role of negative affect in the maintenance of substance use and substance use disorder. Behav Ther. 1993;24:337–56.

    Article  Google Scholar 

  13. Roos CR, Bowen S, Witkiewitz K. Baseline patterns of substance use disorder severity and depression and anxiety symptoms moderate the efficacy of mindfulness-based relapse prevention. J Consult Clin Psychol. American Psychological Association Inc. 2017;85:1041–51.

    Article  PubMed  PubMed Central  Google Scholar 

  14. Kang D, Fairbairn CE, Ariss TA. A meta-analysis of the effect of substance use interventions on emotion outcomes. J Consult Clin Psychol. American Psychological Association Inc. 2019;87:1106–23.

    Article  PubMed  PubMed Central  Google Scholar 

  15. del Barrio V. Diagnostic and statistical manual of mental disorders. Encycl Appl Psychol Three-Volume Set. 5th ed. Washington, DC: American Psychiatric Association; 2004. p. 607–14.

    Google Scholar 

  16. Carroll KM, Kiluk BD. Cognitive behavioral interventions for alcohol and drug use disorders: through the stage model and back again. Psychol Addict Behav NIH Public Access. 2017;31:847–61.

    Article  PubMed  PubMed Central  Google Scholar 

  17. Magill M, Kiluk BD, Mccrady BS, Tonigan JS, Longabaugh R. Active ingredients of treatment and client mechanisms of change in behavioral treatments for alcohol use disorders: progress 10 years later. Alcohol Clin Exp Res. 2015;39:1852–62.

    Article  PubMed  PubMed Central  Google Scholar 

  18. Ray LA, Bujarski S, Grodin E, Hartwell E, Green RJ, Venegas A, et al. State-of-the-art behavioral and pharmacological treatments for alcohol use disorder. Am J Drug Alcohol Abuse Taylor and Francis Ltd. 2019;45:124–40.

    Article  Google Scholar 

  19. Law B, Gullo MJ, Daglish M, Kavanagh DJ, Feeney GFX, Young RM, et al. Craving mediates stress in predicting lapse during alcohol dependence treatment. Alcohol Clin Exp Res Blackwell Publishing Ltd. 2016;40:1058–64.

    Article  PubMed  Google Scholar 

  20. Gullo MJ, Matveeva M, Feeney GFX, Young RMD, Connor JP. Social cognitive predictors of treatment outcome in cannabis dependence. Drug Alcohol Depend Ireland. 2017;170:74–81.

    Article  PubMed  Google Scholar 

  21. Decker SE, Morie KP, Malin-Mayo B, Nich C, Carroll KM. Positive and negative affect in cocaine use disorder treatment: change across time and relevance to treatment outcome. Am J Addict. 2018;27:375–82. Among individuals in computerized cognitive-behavioral therapy for cocaine use disorder, baseline positive affect was associated with less frequent cocaine use during treatment, but baseline negative affect was not associated with cocaine use during treatment. During treatment, weekly negative affect was associated with greater concurrent cocaine use, while weekly positive affect did not predict concurrent cocaine use.

    Article  Google Scholar 

  22. Holzhauer CG, Epstein EE, Hayaki J, Marinchak JS, McCrady BS, Cook SM. Moderators of sudden gains after sessions addressing emotion regulation among women in treatment for alcohol use. J Subst Abus Treat. 2017;83:1–9. In a study comparing female-specific cognitive-behavioral therapy for alcohol use disorder to gender-neutral cognitive-behavioral therapy, women who had higher baseline depression and anxiety were more likely to experience a steep decrease in drinking following sessions addressing negative affect regardless of treatment condition. These sudden gains translated to lower drinking frequency following treatment.

    Article  Google Scholar 

  23. Morie KP, Nich C, Hunkele K, Potenza MN, Carroll KM. Alexithymia level and response to computer-based training in cognitive behavioral therapy among cocaine-dependent methadone maintained individuals. Drug Alcohol Depend Elsevier Ireland Ltd. 2015;152:157–63.

    Article  PubMed  PubMed Central  Google Scholar 

  24. Coates JM, Gullo MJ, Feeney GFX, Young RMD, Dingle GA, Connor JP. Alcohol expectancies pre-and post-alcohol use disorder treatment: clinical implications. Addict Behav. 2018;80:142–9.

    Article  PubMed  Google Scholar 

  25. Epstein EE, McCrady BS, Hallgren KA, Cook S, Jensen NK, Hildebrandt T. A randomized trial of female-specific cognitive behavior therapy for alcohol dependent women. Psychol Addict Behav United States. 2018;32:1–15.

    Article  PubMed  Google Scholar 

  26. Sundström C, Kraepelien M, Eék N, Fahlke C, Kaldo V, Berman AH. High-intensity therapist-guided internetbased cognitive behavior therapy for alcohol use disorder: a pilot study. BMC Psychiatry. England. 2017;17:197.

    Article  PubMed  PubMed Central  Google Scholar 

  27. Hellem TL, Lundberg KJ, Renshaw PF. A review of treatment options for co-occurring methamphetamine use disorders and depression. J Addict Nurs United States. 2015;26:14–23.

    Article  PubMed  PubMed Central  Google Scholar 

  28. Litt MD, Kadden RM, Tennen H, Kabela-Cormier E. Network Support II: Randomized controlled trial of network support treatment and cognitive behavioral therapy for alcohol use disorder. Drug Alcohol Depend Elsevier Ireland Ltd. 2016;165:203–12.

    Article  PubMed  PubMed Central  Google Scholar 

  29. Atance CM, O’Neill DK. Episodic future thinking. Trends Cogn Sci. 2001;5:533–9.

    Article  PubMed  Google Scholar 

  30. Murphy JG, Skidmore JR, Dennhardt AA, Martens MP, Borsari B, Barnett NP, et al. A behavioral economic supplement to brief motivational interventions for college drinking. Addict Res Theory. 2012;20:456–65.

    Article  PubMed  PubMed Central  Google Scholar 

  31. Beck A, Rush J, Shaw B, Emery G. Cognitive therapy of depression. 1st ed. Guilford press. New York: Guilford Press; 1979.

    Google Scholar 

  32. Lewinsohn PM. A behavioral approach to depression, in Innovative treatment methodes of psychopathology. Friedman RJ, Katz MM, editors. Psychol Depress Contemp Theory Res. John Wiley & Sons; 1974;1:88–102.

  33. Jacobson NS, Martell CR, Dimidjian S. Behavioral activation treatment for depression: returning to contextual roots. Clin Psychol Sci Pract. 2006;8:255–70.

    Article  Google Scholar 

  34. Daughters SB, Magidson JF, Anand D, Seitz-Brown CJ, Chen Y, Baker S. The effect of a behavioral activation treatment for substance use on post-treatment abstinence: a randomized controlled trial. Addiction Blackwell Publishing Ltd. 2018;113:535–44.

    Article  PubMed  Google Scholar 

  35. Daughters SB, Braun AR, Sargeant MN, Reynolds EK, Hopko DR, Blanco C, et al. Effectiveness of a brief behavioral treatment for inner-city illicit drug users with elevated depressive symptoms: The Life Enhancement Treatment for Substance Use (LETS Act!). J Clin Psychiatry. Physicians Postgraduate Press Inc. 2008;69:122–9.

    Article  PubMed  Google Scholar 

  36. Magidson JF, Gorka SM, MacPherson L, Hopko DR, Blanco C, Lejuez CW, et al. Examining the effect of the Life Enhancement Treatment for Substance Use (LETS ACT) on residential substance abuse treatment retention. Addict Behav. 2011;36:615–23.

    Article  PubMed  PubMed Central  Google Scholar 

  37. Hunt GM, Azrin NH. A community-reinforcement approach to alcoholism. Behav Res Ther. 1973;11:91–104.

    Article  CAS  PubMed  Google Scholar 

  38. Meyers R, Smith JE. Clinical guide to alcohol treatment: the community reinforcement approach. 1st ed. New York: Guilford Press; 1995.

    Google Scholar 

  39. Miller WR, Meyers RJ, Hiller-Sturmhöfel S. The community-reinforcement approach. Alcohol Res Health. 1999;23:116–21.

    CAS  PubMed  PubMed Central  Google Scholar 

  40. Slesnick N, Guo X, Brakenhoff B, Bantchevska D. A comparison of three interventions for homeless youth evidencing substance use disorders: results of a randomized clinical trial. J Subst Abus Treat. Elsevier Inc. 2015;54:1–13.

    Article  Google Scholar 

  41. Garner BR, Hunter SB, Funk RR, Griffin BA, Godley SH. Toward evidence-based measures of implementation: examining the relationship between implementation outcomes and client outcomes. J Subst Abus Treat. Elsevier Inc. 2016;67:15–21.

    Article  Google Scholar 

  42. Petry NM, Martin B, Cooney JL, Kranzler HR. Give them prizes, and they will come: contingency management for treatment of alcohol dependence. J Consult Clin Psychol. 2000;68:250–7.

    Article  CAS  PubMed  Google Scholar 

  43. Higgins ST, Budney AJ, Bickel WK, Foerg FE, Donham R, Badger GJ. Incentives improve outcome in outpatient behavioral treatment of cocaine dependence. Arch Gen Psychiatry. 1994;51:568–76.

    Article  CAS  PubMed  Google Scholar 

  44. Petry NM, Peirce JM, Stitzer ML, Blaine J, Roll JM, Cohen A, et al. Effect of prize-based incentives on outcomes in stimulant abusers in outpatient psychosocial treatment programs: a national drug abuse treatment clinical trials network study. Arch Gen Psychiatry. 2005;62:1148–56.

    Article  PubMed  Google Scholar 

  45. Carroll KM, Nich C, Frankforter TL, Yip SW, Kiluk BD, DeVito EE, et al. Accounting for the uncounted: physical and affective distress in individuals dropping out of oral naltrexone treatment for opioid use disorder. Drug Alcohol Depend Elsevier Ireland Ltd. 2018;192:264–70.

    Article  PubMed  PubMed Central  Google Scholar 

  46. Stotts AL, Vujanovic A, Heads A, Suchting R, Green CE, Schmitz JM. The role of avoidance and inflexibility in characterizing response to contingency management for cocaine use disorders: a secondary profile analysis. Psychol Addict Behav. 2015;29:408–13.

    Article  PubMed  Google Scholar 

  47. Miguel AQC, Madruga CS, Cogo-Moreira H, Yamauchi R, Simões V, Ribeiro A, et al. Contingency management targeting abstinence is effective in reducing depressive and anxiety symptoms among crack cocaine-dependent individuals. Exp Clin Psychopharmacol. 2017;25:466–72. In a recent study, participants with cocaine use disorder who received contingency management and the standard treatment had lower depression and anxiety scores after treatment than those who received standard treatment without contingency management.

    Article  CAS  Google Scholar 

  48. Sancho M, De Gracia M, Rodriguez RC, Mallorqui-Bagué N, Sanchez-Gonzalez J, Trujols J, et al. Mindfulness-based interventions for the treatment of substance and behavioral addictions : a systematic review. Front Psychiatry. 2018;9:95.

    Article  PubMed  PubMed Central  Google Scholar 

  49. Byrne SP, Haber P, Baillie A, Costa DSJ, Fogliati V, Morley K. Systematic reviews of mindfulness and acceptance and commitment therapy for alcohol use disorder: should we be using third wave therapies? Alcohol Alcohol. 2019;54:159–66.

    Article  PubMed  Google Scholar 

  50. Bowen S, Witkiewitz K, Clifasefi SL, Grow J, Chawla N, Hsu SH, et al. Relative efficacy of mindfulness-based relapse prevention, standard relapse prevention, and treatment as usual for substance use disorders. JAMA Psychiatry. 2014;71:547–56.

    Article  PubMed  PubMed Central  Google Scholar 

  51. Garland EL, Schwarz NR, Kelly A, Whitt A, Howard MO. Mindfulness-oriented recovery enhancement for alcohol dependence: therapeutic mechanisms and intervention acceptability. J Soc Work Pract Addict. 2012;12:242–63.

    Article  PubMed  PubMed Central  Google Scholar 

  52. Lee EB, An W, Levin ME, Twohig MP. An initial meta-analysis of acceptance and commitment therapy for treating substance use disorders. Drug Alcohol Depend Elsevier Ireland Ltd. 2015;155:1–7.

    Article  PubMed  Google Scholar 

  53. Wilson AD, Roos CR, Robinson CS, Stein ER, Manuel JA, Enkema MC, et al. Mindfulness-based interventions for addictive behaviors: implementation issues on the road ahead. Psychol Addict Behav. 2017;31:888–96.

    Article  PubMed  PubMed Central  Google Scholar 

  54. Serfaty S, Gale G, Beadman M, Froeliger B, Kamboj SK. Mindfulness, acceptance and defusion strategies in smokers: a systematic review of laboratory studies. Mindfulness (N Y). Mindfulness. 2018;9:44–58.

    Article  PubMed  Google Scholar 

  55. Witkiewitz K, Bowen S, Harrop EN, Douglas H, Enkema M, Sedgwick C. Mindfulness-based treatment to prevent addictive behavior relapse: theoretical models and hypothesized mechanisms of change. Subst Use Misuse. 2014;49:513–24.

    Article  PubMed  PubMed Central  Google Scholar 

  56. Witkiewitz K, Bowen S. Depression, craving, and substance use following a randomized trial of mindfulness-based relapse prevention. J Consult Clin Psychol. 2010;78:362–74.

    Article  PubMed  PubMed Central  Google Scholar 

  57. Roos CR, Bowen S, Witkiewitz K. Baseline patterns of substance use disorder severity and negative affect moderate the efficacy ofmindfulness-based relapse prevention. Alcohol Clin Exp Res. 2017;85:1041–51. Relevant to precision medicine research approaches, this study shows that individuals with higher severity in baseline SUD, depression, and anxiety benefit more from MBRP than CBT in terms of substance use outcomes. Among those with lower baseline SUD and affect severity, there was no difference between these two types of treatment.

    Google Scholar 

  58. Garland EL, Bryan CJ, Finan PH, Thomas EA, Priddy SE, Riquino MR, et al. Pain, hedonic regulation, and opioid misuse: modulation of momentary experience by mindfulness-oriented recovery enhancement in opioid-treated chronic pain patients. Drug Alcohol Depend Elsevier Ireland Ltd. 2017;173:S65–72.

    Article  PubMed  Google Scholar 

  59. Garland EL, Hanley AW, Kline A, Cooperman NA. Mindfulness-oriented recovery enhancement reduces opioid craving among individuals with opioid use disorder and chronic pain in medication assisted treatment: ecological momentary assessments from a stage 1 randomized controlled trial. Drug Alcohol Depend Elsevier. 2019;203:61–5.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  60. Garland EL, Atchley RM, Hanley AW, Zubieta JK, Froeliger B. Mindfulness-oriented recovery enhancement remediates hedonic dysregulation in opioid users: neural and affective evidence of target engagement. Sci Adv. 2019;5:1–12. A study of individuals with opioid misuse receving 8 weeks of MORE groups demonstrated significantly increased positive affective reactivity to natural (non-substance) reward cues. These increases in positive affective reactivity to natural rewards mediated the effect of MORE on opioid misuse outcomes at follow-up, demonstrating that influencing affective processes is an important mechanisms of treatment.

    Article  CAS  Google Scholar 

  61. Garland EL, Roberts-Lewis A, Tronnier CD, Graves R, Kelley K. Mindfulness-oriented recovery enhancement versus CBT for co-occurring substance dependence, traumatic stress, and psychiatric disorders: proximal outcomes from a pragmatic randomized trial. Behav Res Ther. England. 2016;77:7–16.

    Article  PubMed  Google Scholar 

  62. Price CJ, Thompson EA, Crowell SE, Pike K, Cheng SC, Parent S, et al. Immediate effects of interoceptive awareness training through Mindful Awareness in Body-oriented Therapy (MABT) for women in substance use disorder treatment. Subst Abus Taylor & Francis. 2019;40:102–15.

    Article  PubMed  Google Scholar 

  63. Price CJ, Thompson EA, Crowell S, Pike K. Longitudinal effects of interoceptive awareness training through mindful awareness in body-oriented therapy (MABT) as an adjunct to women’s substance use disorder treatment: a randomized controlled trial. Drug Alcohol Depend. Elsevier. 2019;198:140–9.

    Article  PubMed  PubMed Central  Google Scholar 

  64. Zgierska AE, Burzinski CA, Mundt MP, McClintock AS, Cox J, Coe CL, et al. Mindfulness-based relapse prevention for alcohol dependence: findings from a randomized controlled trial. J Subst Abus Treat Elsevier. 2019;100:8–17.

    Article  Google Scholar 

  65. Svanberg G, Munck I, Levander M. Acceptance and commitment therapy for clients institutionalized for severe substance-use disorder: a pilot study. Subst Abus Rehabil. 2017;8:45–51.

    Article  Google Scholar 

  66. McHugh RK, Goodman FR. Are substance use disorders emotional disorders? Why heterogeneity matters for treatment. Clin Psychol Sci Pract. John Wiley & Sons, Ltd (10.1111). 2019;26:e12250.

    Article  Google Scholar 

  67. Grant BF, Stinson FS, Dawson DA, Chou SP, Dufour MC, Compton W, et al. Prevalence and co-occurrence of substance use disorders and independent mood and anxiety disorders: results from the national epidemiologic survey on alcohol and related conditions. Arch Gen Psychiatry. 2004;61:807–16.

    Article  PubMed  Google Scholar 

  68. Vujanovic AA, Meyer TD, Heads AM, Stotts AL, Villarreal YR, Schmitz JM. Cognitive-behavioral therapies for depression and substance use disorders: an overview of traditional, third-wave, and transdiagnostic approaches. Am J Drug Alcohol Abuse England. 2017;43:402–15.

    Article  PubMed  Google Scholar 

  69. Flanagan JC, Jones JL, Jarnecke AM, Back SE. Behavioral treatments for alcohol use disorder and post-traumatic stress disorder. Alcohol Res Curr Rev United States. 2018;39:181–92.

    Google Scholar 

  70. Flanagan JC, Korte KJ, Killeen TK, Back SE. Concurrent treatment of substance use and PTSD. Curr Psychiatry Rep. Current Medicine Group LLC 1. 2016;18:70.

    Article  PubMed  PubMed Central  Google Scholar 

  71. Ruglass LM, Lopez-Castro T, Papini S, Killeen T, Back SE, Hien DA. Concurrent treatment with prolonged exposure for co-occurring full or subthreshold posttraumatic stress disorder and substance use disorders: a randomized clinical trial. Psychother Psychosom. 2017;86:150–61.

    Article  PubMed  Google Scholar 

  72. Hien DA, Lopez-Castro T, Papini S, Gorman B, Ruglass LM. Emotion dysregulation moderates the effect of cognitive behavior therapy with prolonged exposure for co-occurring PTSD and substance use disorders. J Anxiety Disord. 2017;52:53–61. Individuals with co-occurring substance use disorder and posttraumatic stress disorder (PTSD) who had higher baseline emotion dysregulation (i.e., the ability to identify and control emotional reactions) demonstrated greater reductions in PTSD severity in a trauma-focused treatment, as compared with non-trauma-focused relapse prevention and an active monitoring control group.

  73. Roberts NP, Roberts PA, Jones N, Bisson JI. Psychological interventions for post-traumatic stress disorder and comorbid substance use disorder: a systematic review and meta-analysis. Clin Psychol Rev. Elsevier Inc. 2015;38:25–38.

    Article  PubMed  Google Scholar 

  74. Najavits LM, Krinsley K, Waring ME, Gallagher MW, Skidmore C. A randomized controlled trial for veterans with PTSD and substance use disorder: creating change versus seeking safety. Subst Use Misuse. Taylor and Francis Ltd. 2018;53:1788–800.

    Article  PubMed  Google Scholar 

  75. Norman SB, Trim R, Haller M, Davis BC, Myers US, Colvonen PJ, et al. Efficacy of integrated exposure therapy vs integrated coping skills therapy for comorbid posttraumatic stress disorder and alcohol use disorder: a randomized clinical trial. JAMA Psychiatry American Medical Association. 2019;76:791–9.

    Article  PubMed  PubMed Central  Google Scholar 

  76. Badour CL, Flanagan JC, Gros DF, Killeen T, Pericot-Valverde I, Korte KJ, et al. Habituation of distress and craving during treatment as predictors of change in PTSD symptoms and substance use severity. J Consult Clin Psychol. American Psychological Association Inc. 2017;85:274–81.

    Article  PubMed  PubMed Central  Google Scholar 

  77. Peck KR, Coffey SF, McGuire AP, Voluse AC, Connolly KM. A cognitive processing therapy-based treatment program for veterans diagnosed with co-occurring posttraumatic stress disorder and substance use disorder: the relationship between trauma-related cognitions and outcomes of a 6-week treatment program. J Anxiety Disord Netherlands. 2018;59:34–41.

    Article  PubMed  Google Scholar 

  78. Meyer EC, Walser R, Hermann B, La Bash H, DeBeer BB, Morissette SB, et al. Acceptance and commitment therapy for co-occurring posttraumatic stress disorder and alcohol use disorders in veterans: pilot treatment outcomes. J Trauma Stress United States. 2018;31:781–9.

    Article  PubMed  Google Scholar 

  79. Vujanovic AA, Wardle MC, Smith LJ, Berenz EC. Reward functioning in posttraumatic stress and substance use disorders. Curr Opin Psychol. Elsevier B.V. 2017;14:49–55.

    Article  PubMed  Google Scholar 

  80. Morley KC, Baillie A, Leung S, Sannibale C, Teesson M, Haber PS. Is specialized integrated treatment for comorbid anxiety, depression and alcohol dependence better than treatment as usual in a public hospital setting? Alcohol alcohol. England. 2016;51:402–9.

    CAS  Google Scholar 

  81. Buckner JD, Zvolensky MJ, Ecker AH, Schmidt NB, Lewis EM, Paulus DJ, et al. Integrated cognitive behavioral therapy for comorbid cannabis use and anxiety disorders: a pilot randomized controlled trial. Behav Res Ther. England. 2019;115:38–45.

    Article  PubMed  Google Scholar 

  82. Wolitzky-Taylor K, Krull J, Rawson R, Roy-Byrne P, Ries R, Craske MG. Randomized clinical trial evaluating the preliminary effectiveness of an integrated anxiety disorder treatment in substance use disorder specialty clinics. J Consult Clin Psychol United States. 2018;86:81–8.

    Article  PubMed  PubMed Central  Google Scholar 

  83. Wolitzky-Taylor K, Drazdowski TK, Niles A, Roy-Byrne P, Ries R, Rawson R, et al. Change in anxiety sensitivity and substance use coping motives as putative mediators of treatment efficacy among substance users. Behav Res Ther. 2018;107:34–41. Decreases in anxiety sensitivity, but not coping motives, mediated the effect of integreated cognitive-behavioral therapy on substance use outcomes for those with co-occurring substance use and anxiety disorders.

    Article  PubMed  Google Scholar 

  84. Conklin LR, Cassiello-Robbins C, Brake CA, Sauer-Zavala S, Farchione TJ, Ciraulo DA, et al. Relationships among adaptive and maladaptive emotion regulation strategies and psychopathology during the treatment of comorbid anxiety and alcohol use disorders. Behav Res Ther England. 2015;73:124–30.

    Article  PubMed  PubMed Central  Google Scholar 

  85. Anker JJ, Kushner MG, Thuras P, Menk J, Unruh AS. Drinking to cope with negative emotions moderates alcohol use disorder treatment response in patients with co-occurring anxiety disorder. Drug Alcohol Depend Elsevier Ireland Ltd. 2016;159:93–100.

    Article  CAS  PubMed  Google Scholar 

  86. Wolitzky-Taylor K, Niles AN, Ries R, Krull JL, Rawson R, Roy-Byrne P, et al. Who needs more than standard care? Treatment moderators in a randomized clinical trial comparing addiction treatment alone to addiction treatment plus anxiety disorder treatment for comorbid anxiety and substance use disorders. Behav Res Ther. England. 2018;107:1–9.

    Article  PubMed  Google Scholar 

  87. Cui R, Tate SR, Cummins K, Skidmore JR, Brown SA. Chronic physical health problems moderate changes in depression and substance use among dual diagnosed individuals during and after treatment. Subst Use Misuse England. 2015;50:174–83.

    Article  PubMed  Google Scholar 

  88. Babowitch JD, Antshel KM. Adolescent treatment outcomes for comorbid depression and substance misuse: a systematic review and synthesis of the literature. J Affect Disord Netherlands. 2016;201:25–33.

    Article  PubMed  Google Scholar 

  89. Delgadillo J, Gore S, Ali S, Ekers D, Gilbody S, Gilchrist G, et al. Feasibility randomized controlled trial of cognitive and behavioral interventions for depression symptoms in patients accessing drug and alcohol treatment. J Subst Abus Treat United States. 2015;55:6–14.

    Article  Google Scholar 

  90. Thekiso TB, Murphy P, Milnes J, Lambe K, Curtin A, Farren CK. Acceptance and commitment therapy in the treatment of alcohol use disorder and comorbid affective disorder: a pilot matched control trial. Behav Ther England. 2015;46:717–28.

    Article  PubMed  Google Scholar 

  91. Rizvi SJ, Pizzagalli DA, Sproule BA, Kennedy SH. Assessing anhedonia in depression: potentials and pitfalls. Neurosci Biobehav Rev. Elsevier Ltd. 2016:21–35.

    Article  Google Scholar 

  92. Volkow N. Toward precision medicine in addiction treatment. Am J Addict Wiley Blackwell. 2018;27:35–6.

    Article  PubMed  Google Scholar 

  93. Gardner RA, Epstein DH, Preston KL, Phillips KA. Defining and predicting opioid and cocaine treatment response. Subst Use Misuse. 2019;54:2134–43. Baseline characteristics such as length of current employment, time spent on hobbies, relationship status with parent figures, and medical diagnoses indicated whether methadone treatment was more or less effective in participants with heroin or cocaine use disorder.

    Article  PubMed  PubMed Central  Google Scholar 

  94. Sliedrecht W, de Waart R, Witkiewitz K, Roozen HG. Alcohol use disorder relapse factors: a systematic review. Psychiatry Res. 2019;278:97–115.

    Article  PubMed  Google Scholar 

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  1. Department of Psychology, University of New Mexico, Albuquerque, NM, 87131, USA

    Julia E. Swan, Victoria R. Votaw, Elena R. Stein & Katie Witkiewitz

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  1. Julia E. Swan
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  2. Victoria R. Votaw
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Correspondence to Julia E. Swan.

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ERS and VRV were supported by a training grant (T32AA018108) and JES and KW by a research project grant (R01AA022328) from the National Institute on Alcohol Abuse and Alcoholism (NIAAA).

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Swan, J.E., Votaw, V.R., Stein, E.R. et al. The Role of Affect in Psychosocial Treatments for Substance Use Disorders. Curr Addict Rep 7, 108–116 (2020). https://doi.org/10.1007/s40429-020-00304-0

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