Sex Differences in the Association Between Internalizing Symptoms and Craving in Methamphetamine Users

Abstract

Objectives Methamphetamine (MA) users often have substantial psychiatric comorbidities, with nearly a third reporting lifetime mood disorders and over a quarter reporting lifetime anxiety disorders. Female MA users are more likely to endorse depression and anxiety symptoms compared to men. Craving has been related to mood/anxiety symptoms in MA users. To extend the literature on gender differences in MA use disorder, the present study examines the role of gender as a moderator of the relationship between mood/anxiety symptoms and MA craving. Methods Participants (N = 203) were non-treatment seeking, current MA users, recruited from the Los Angeles community for enrollment in a larger pharmacotherapy trial. At the assessment visit, participants completed multiple measures including the Methamphetamine Urge Questionnaire, the Beck Depression Inventory, and the Beck Anxiety Inventory. Results The relationship between depression symptomatology and MA craving was moderated by gender (F = 6.18, p = 0.01), such that the relationship was positive and significant for men (p < 0.001) but was not significant for women. Similarly, gender significantly moderated the relationship between anxiety and MA craving (F = 5.99, p = 0.02), such that the relationship was also positive and significant in men but not in women (p < 0.001). Conclusions These results suggest that men may be more sensitive to the effects of internalizing symptoms on MA craving than women. Given craving's propensity to predict relapse, these initial findings indicate the necessity of treating comorbid psychiatric problems in male MA users, which may in turn assist in the attenuation of craving.

A Review of Risk Factors for Methamphetamine-Related Psychiatric Symptoms

“…Beck Depression Inventory (BDI) is used to assess specific depression symptoms ( 24 – 26 ). Additionally, there are several other assessments used in MAP research, including the Beck Anxiety Inventory (BAI) ( 27 , 28 ), Hamilton Depression Rating Scale (HDRS) ( 29 , 30 ), and other scales ( 31 – 33 ). There is inconsistency in MAP definition when several assessments are compared ( 34 – 36 ).…”

Dark Times: The Role of Negative Reinforcement in Methamphetamine Addiction

“…Among 113 female methamphetamine users participating in a compulsory detoxification program (average detoxification duration of 8.7 ± 4.8 months), craving level positively correlated with negative mood disturbances including fatigue, bewilderment, anxiety, depression, and hostility after controlling for each user's weekly dose of methamphetamine (34). Alternatively, among a sample of 203 non-treatment seeking methamphetamine users, the opposite pattern was observed, wherein depression and anxiety symptoms positively correlated with methamphetamine craving among men, but not women (31). This difference in findings may be related to use status at the time data were collected, given that two studies reported on abstinent users (34,73) and one examined current users (31).…”

“…Alternatively, among a sample of 203 non-treatment seeking methamphetamine users, the opposite pattern was observed, wherein depression and anxiety symptoms positively correlated with methamphetamine craving among men, but not women (31). This difference in findings may be related to use status at the time data were collected, given that two studies reported on abstinent users (34,73) and one examined current users (31). Gender differences have also been observed among self-reported reasons for use.…”

The Higher Parietal Cortical Thickness in Abstinent Methamphetamine Patients Is Correlated With Functional Connectivity and Age of First Usage

“…It is more rapid and provides voxel-wise whole brain results compared to manually segmented brain regions in traditional morphometric approaches ( Ashburner and Friston, 2000 ). Therefore, it has been extensively used in psychiatric disorder studies including substance addiction ( Morales et al, 2012 ; Durazzo et al, 2015 ; Hartwell et al, 2016 ). As another important structural analysis method, surf-based cortical thickness measurement allows the “regional distribution and quantification of gray matter cortical loss to be specifically assessed in contrast to gyral or lobar volumetric studies which combine gray and white matter within regional volumes” ( Rohrer et al, 2009 ).…”