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初级保健中拉丁裔的消极情感性与酒精使用问题:情绪失调的作用

Negative Affectivity and Problematic Alcohol Use Among Latinos in Primary Care: The Role of Emotion Dysregulation.

作者信息

Paulus Daniel J, Bakhshaie Jafar, Lemaire Chad, Garza Monica, Ochoa-Perez Melissa, Valdivieso Jeanette, Velasco Ricardo Valdes, Bogiaizian Daniel, Kauffman Brooke Y, Robles Zuzuky, Neighbors Clayton, Zvolensky Michael J

机构信息

a Department of Psychology , University of Houston , Houston , Texas , USA.

b Legacy Community Health Services , Houston , Texas , USA.

出版信息

J Dual Diagn. 2016 Apr-Jun;12(2):137-47. doi: 10.1080/15504263.2016.1172897. Epub 2016 Apr 11.

Abstract

OBJECTIVE

Latinos are the largest and most rapidly growing racial/ethnic group in the United States. In Latino communities, alcohol is the most widely abused substance, yet there is little empirical understanding of the factors underlying problematic alcohol use among Latinos. The current study explored whether negative affectivity exerted an indirect effect via emotion dysregulation in relation to two alcohol-related outcomes.

METHODS

Participants were 316 Latinos attending a community-based primary care facility (Mage = 39.3, SD = 11.3; 85.4% female; 95.3% first language Spanish), who completed a variety of self-report and interview measures. Mediation analyses evaluated the indirect effect of negative affectivity via emotion dysregulation on problematic drinking and symptoms of alcohol dependence.

RESULTS

While there was no direct or total effect of negative affectivity on either alcohol-related outcome, negative affectivity was significantly associated with both problematic alcohol use and symptoms of dependence via emotion dysregulation. Effect sizes were in the medium range, K(2) = .09 and .10, respectively. Post-hoc multiple mediation analyses evaluated subfactors of emotion dysregulation as mediators of the negative affectivity-alcohol associations. These results suggested that difficulties engaging in goal-directed behavior might be particularly important in explaining the association between negative affectivity and problematic alcohol use/symptoms of dependence. Last, independent mediation analyses evaluated emotion dysregulation subfactors and found that limited access to effective emotion regulation strategies and difficulties engaging in goal-directed behavior were, independently, significant mediators for both outcomes. Nonacceptance of emotional responses may also mediate negative affectivity and problematic drinking. Surprisingly, impulse control difficulties was not a significant mediator in any model.

CONCLUSIONS

These data provide novel insight that among Latinos in primary care, emotion dysregulation is a possible mechanism underlying the indirect relationship between negative affectivity and problematic alcohol use and symptoms of dependence. Results also highlight specific facets of emotion dysregulation as potential targets of intervention. Future research should be longitudinal in nature, be conducted among more representative samples, and utilize measures that will better assess the potential variability in these associations. Results of such work may inform the development of alcohol treatment interventions incorporating the use of adaptive emotion regulation among Latinos in primary care.

摘要

目的

拉丁裔是美国最大且增长最迅速的种族/族裔群体。在拉丁裔社区,酒精是滥用最为广泛的物质,但对于拉丁裔中存在问题的饮酒行为背后的因素,实证研究了解甚少。本研究探讨了消极情感性是否通过情绪失调对两种与酒精相关的结果产生间接影响。

方法

参与者为316名在社区基层医疗设施就诊的拉丁裔(年龄中位数 = 39.3,标准差 = 11.3;85.4%为女性;95.3%的母语为西班牙语),他们完成了各种自我报告和访谈测量。中介分析评估了消极情感性通过情绪失调对问题饮酒和酒精依赖症状的间接影响。

结果

虽然消极情感性对任何一个与酒精相关的结果均无直接或总体影响,但消极情感性通过情绪失调与问题饮酒和依赖症状均显著相关。效应大小处于中等范围,分别为K(2) = 0.09和0.10。事后多重中介分析评估了情绪失调的子因素作为消极情感性与酒精关联的中介。这些结果表明,在解释消极情感性与问题饮酒/依赖症状之间的关联时,难以进行目标导向行为可能尤为重要。最后,独立中介分析评估了情绪失调的子因素,发现获得有效情绪调节策略的机会有限以及难以进行目标导向行为分别是这两种结果的显著中介因素。对情绪反应的不接受也可能介导消极情感性和问题饮酒。令人惊讶的是,冲动控制困难在任何模型中均不是显著的中介因素。

结论

这些数据提供了新的见解,即在基层医疗的拉丁裔中,情绪失调是消极情感性与问题饮酒及依赖症状之间间接关系的一种可能机制。结果还突出了情绪失调的特定方面作为潜在干预靶点。未来的研究应具有纵向性质,在更具代表性的样本中进行,并采用能更好评估这些关联中潜在变异性的测量方法。此类研究的结果可能为制定在基层医疗的拉丁裔中纳入适应性情绪调节的酒精治疗干预措施提供参考。

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