Experiential avoidance, distress tolerance, and substance use cravings among adults in residential treatment for substance use disorders

Abstract

Substance use cravings are a known predictor of relapse to substance use following treatment for a substance use disorder. Thus, research on factors that may be correlated with cravings, and could then be targeted in substance use treatment, is needed. Both distress tolerance and experiential avoidance, similar but distinct constructs, are independently associated with substance use cravings. However, no known research has examined these constructs as simultaneous predictors of substance use cravings, which may have important implications for treatment. The current study examined this in a sample of men and women in residential substance use treatment (n = 117). The authors used pre-existing data from a larger study where men and women were recruited for participation from a residential substance use treatment facility. The majority of the sample was male (n = 87; 74.3%) and Caucasian (92.2%). The mean age was 41.27 (standard deviation = 10.68). Better distress tolerance and lower experiential avoidance were negatively and significantly associated with alcohol and drug cravings, but only experiential avoidance remained significantly and negatively associated with cravings when both predictors were examined simultaneously. The current findings provide preliminary support for the importance of decreasing experiential avoidance in substance use treatment, which may result in reduced substance use cravings.

Thinking about feeling: Using trait emotional intelligence in understanding the associations between early maladaptive schemas and coping styles

“…(; see Table 2). The presence of EMS does not in itself lead to psychopathology; indeed, there is extensive research demonstrating that EMS exist on a spectrum and are present in the ‘healthy’ population (Dozois, Martin, & Bieling, ; Ehsan & Bahramizadeh, ; Shorey et al ., ; Zhu et al ., ). Rather, the development of psychopathology is, according to Young et al .…”

Feasibility, acceptability and preliminary outcomes of a mindfulness-based relapse prevention program in a naturalistic setting among treatment-seeking patients with alcohol use disorder: a prospective observational study

“…Experiential avoidance is a coping style with the objective of avoiding or suppressing private experience such as emotions and cognitions 20. Patients with substance use disorder (SUD) seem to commonly use this avoidant coping style,21 which has been shown to be associated with the severity of SUD and craving 22. From this perspective, substance use expectancies could be the suppression of a negative inner experience 22.…”

“…Patients with substance use disorder (SUD) seem to commonly use this avoidant coping style,21 which has been shown to be associated with the severity of SUD and craving 22. From this perspective, substance use expectancies could be the suppression of a negative inner experience 22. However, efforts to suppress emotion and thoughts could paradoxically increase their intrusion 23.…”

“…Psychological flexibility has been described as the ability to fully live in the present moment, including the thoughts and emotions it contains, without trying to change it, and, according to the situation, persisting or changing behaviour in the pursuit of objectives 44. Psychological flexibility is considered the opposite of experiential avoidance: the tendency to try to change the frequency or intensity of internal negative events such as cognitions, emotions or sensations, which appears to be associated with substance and alcohol craving 22. Increasing the level of psychological flexibility could be particularly beneficial for addictions, as it increases the ability to accept negative emotions or other unpleasant sensations, such as craving, and moves the patient away from the dysfunctional avoidant coping style.…”

Aberrant Cost–Benefit Integration During Effort-Based Decision Making Relates to Severity of Substance Use Disorders

“…Moreover, theoretical models of SUDs long distinguish between substance use evoked by a desire to avoid negative affect (i.e., avoid tendencies; e.g., Baker, Piper, McCarthy, Majeskie, & Fiore, 2004; Kassel et al, 2007) and substance use evoked by a desire to enhance positive affect (i.e., approach tendencies; e.g., Cheetham, Allen, Yücel, & Lubman, 2010; Volkow et al, 2005). In particular, avoidance motivations especially may be relevant for SUD recovery or relapse (Forster, Finn, & Brown, 2017; Gökbayrak, Paiva, Blissmer, & Prochaska, 2015; Lijffijt, Hu, & Swann, 2014; McCabe, Cranford, & Boyd, 2016; Venniro, Caprioli, & Shaham, 2016), and individuals with heightened avoidance tendencies experience more craving during periods of abstinence and worse treatment outcomes (Baker et al, 2004; Forsyth, Parker, & Finlay, 2003; Shorey et al, 2017).…”