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Cited by 48Anxiety, Depression, Psychometrics, Treatment, Cognitive ProcessesMental Health Research TopicsChild and Adolescent Psychosocial and Emotional Development

Difficulties in emotion regulation in treatment-seeking alcoholics with and without co-occurring mood and anxiety disorders.

Open access
Bradizza, Clara M., Brown, Whitney C., Ruszczyk, Melanie U., Dermen, Kurt H., Lucke, Joseph F., Stasiewicz, Paul R.·2018·Addictive Behaviors
DOI 10.1016/j.addbeh.2017.12.033PMC PMC5807148
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Abstract

Emotion regulation difficulties (ERD) are known to underlie mental health conditions including anxiety and depressive disorders and alcohol use disorder (AUD). Although AUD, mood, and anxiety disorders commonly co-occur, no study has examined the association between these disorders and ERD among AUD outpatients. In the current study, emotion regulation (ER) scores of AUD individuals with no co-occurring mental health condition were compared to the ER scores of individuals who met diagnostic criteria for co-occurring mood and/or anxiety disorders. Treatment-seeking AUD individuals (N=77) completed measures of emotion regulation, alcohol use and psychological functioning prior to beginning a 12-week outpatient cognitive-behaviorally oriented alcohol treatment program. Individuals were classified as having no co-occurring mood or anxiety disorder (AUD-0, n=24), one co-occurring disorder (AUD-1, n=34), or two or more co-occurring disorders (AUD-2, n=19). Between-group differences in emotion regulation, quantity/frequency of alcohol consumption, positive and negative affect, affective drinking situations, negative mood regulation expectancies, distress tolerance, alexithymia, trait mindfulness, and psychological symptom severity were examined. Compared with the AUD-0 group, the AUD-2 group reported significantly greater ERD, psychiatric distress and alcohol consumption, more frequent drinking in response to negative affect situations, greater interference from negative emotions, and less use of mindfulness skills. The AUD-1 group differed from AUD-0 group only on the DERS lack of emotional awareness (Aware) subscale. Emotion regulation scores in the AUD-0 group were comparable to those previously reported for general community samples, whereas levels of ERD in the AUD-1 and AUD-2 were similar to those found in other clinical samples. Implications for the inclusion of ER interventions among AUD patients who might most benefit from such an intervention are discussed.

Integrity signals

Registry

Crossref · 10.1016/j.addbeh.2017.12.033

Cites

65 of 65 references verified0 citation errors · 0 not checkable

Statistics

Nothing to recompute.

Claims the paper makes

6 of 46 cited sources checked · 2 supported · 0 flagged · accuracy not yet measured

  • Premisecitation

    Among non-clinical samples or samples of normal controls, the DERS total score ranges from the mid 50s on the low end to the mid 70s on the high end.

    “our review of the literature indicates that among non-clinical samples or samples of normal controls, the total score ranges from the mid 50’s on the low end to the mid 70’s on the high end (Gratz & Tull, 2015; Kuo & Linehan, 2009; Fox et al, 2007).”
    Quote in the paperSubstantial claim1 of 3 sources checked
    • cites Gratz & Tull, 2015

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

    • cites Kuo & Linehan, 2009 source

      The Results section (Self-Report Measures; page unavailable) says the study measured total DERS scores in normal controls and refers to Table 3, but the passages from our copy do not give their scores. Searches for the control-group DERS total and values in the mid 50s or mid 70s did not locate the claimed range. (LLM, conf=0.70)

      Experimental — accuracy not yet measured
    • cites Fox et al, 2007 source
  • Interpretationcitation

    For participants in the AUD-2 group, the mean DERS score of 104 corresponds to average scores reported in studies of individuals diagnosed with generalized anxiety disorder and PTSD symptoms at a severity level consistent with a diagnosis of PTSD.

    “For participants in the AUD-2 group, the mean DERS score of 104 corresponds to average scores reported in studies investigating emotion regulation difficulties in samples of individuals diagnosed with generalized anxiety disorder (Roemer et al., 2009; Salters-Pedneault et al., 2006) and PTSD symptoms at a severity level consistent with a diagnosis of PTSD (McDermott et al., 2009; Tull, Barret, et”
    Quote in the paperNot a substantial claim1 of 3 sources checked
    • cites Roemer et al., 2009 source
    • cites Salters-Pedneault et al., 2006 source
    • cites McDermott et al., 2009 source

      The Methods (Measures; page unavailable) identify a group whose PTSD symptom scores met a cutoff for probable PTSD, and the Results (Primary Analyses; page unavailable) report greater overall DERS difficulties in that group. The passages available from our copy do not give its mean DERS score, so they cannot establish the claimed numerical comparison with the AUD-2 mean of 104. The generalized-anxiety-disorder comparison is attributed to other citations, not McDermott et al. (LLM, conf=0.78)

      Experimental — accuracy not yet measured
  • Premisecitation

    In the Stage 1a/1b treatment development study, an emotionally-focused treatment supplement was developed and added to standard CBT for alcohol use disorder.

    “in the Stage 1a/1b treatment development study, we developed an emotionally-focused treatment supplement that was added to standard CBT for alcohol use disorder (Stasiewicz et al., 2013).”
    Quote in the paperSubstantial claim1 of 1 sources checked
    • cites Stasiewicz et al., 2013 source
  • Findingown data

    In treatment-seeking alcohol use disorder outpatients, those with exactly one co-occurring mood or anxiety disorder differed from those with no co-occurring disorder only on the DERS lack of emotional awareness subscale.

    “The AUD-1 group differed from AUD-0 group only on the DERS lack of emotional awareness (Aware) subscale.”
    Quote in the paperSubstantial claim
  • Findingown data

    On the BSI Global Severity Index, there was a statistically significant difference between the AUD-0 and AUD-2 groups (p = .022).

    “statistically significant differences on the GSI (p = .022), PSDI (p = .029) and the PST (p = .038) indices”
    Quote in the paperSubstantial claim
    • Rests on an assumption: The MINI diagnoses accurately identify DSM-IV alcohol dependence and co-occurring mood or anxiety disorders in this sample.
  • May combine two claims. 32
  • Classified as probably not a substantial claim. 38
  • The quote only partly states this claim. 1

  • May combine two claims.

    Premisecitation

    Emotion regulation is linked to negative mood regulation expectancies, distress tolerance, alexithymia, mindfulness, and psychiatric symptom severity.

    “Emotion regulation has demonstrated relationships with a number of psychological variables known to impact drinking and relapse to alcohol use during and following treatment. These include negative mood regulation expectancies (Kassel, Bornovalova & Mehta, 2006), distress tolerance (Jeffries, McLeish, Kramer et al., 2016), alexithymia (Stasiewicz, Bradizza, Gudlieski, et al., 2012), mindfulness (S”
    Quote in the paperSubstantial claim1 of 3 sources checked
    • cites Kassel, Bornovalova & Mehta, 2006 source
    • cites Jeffries, McLeish, Kramer et al., 2016

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

    • cites Stasiewicz, Bradizza, Gudlieski, et al., 2012 source

  • Classified as probably not a substantial claim. May combine two claims.

    Premisecitation

    For some patients with alcohol use disorder, addressing emotion regulation difficulties could be an effective and efficient way to improve treatment results and lower relapse risk.

    “For some AUD patients, targeting emotion regulation difficulties may be an effective and efficient strategy for improving treatment outcomes and decreasing relapse risk (Barlow, Allen, & Choate, 2004; Stasiewicz et al., 2013).”
    Quote in the paperSubstantial claim1 of 2 sources checked
    • cites Barlow, Allen, & Choate, 2004 source
    • cites Stasiewicz et al., 2013 source

      The Discussion reports that adding affect regulation training to CBT reduced drinking in alcohol-dependent patients who often drank in negative emotional situations. The Introduction links poor affect regulation to relapse risk, but the study does not establish that the approach is efficient or directly show a reduction in relapse risk. (LLM, conf=0.86)

      Experimental — accuracy not yet measured
    • Rests on an assumption: Having a co-occurring mood or anxiety disorder is linked to more severe alcohol use disorder and a higher chance of relapse.

  • May combine two claims.

    Interpretationcitation

    Individuals with AUD and only one comorbid disorder (AUD-1) had a mean DERS total score (M = 87.8), above the normal range and corresponding to levels found among clinical samples of self-harming college students, individuals diagnosed with social anxiety disorder, and treatment-seeking individuals with cocaine use disorder.

    “individuals with an AUD and only one comorbid disorder (AUD-1) had a mean DERS total score (M = 87.8), above the “normal” range and corresponding to levels found among clinical samples of self-harming college students (Gratz & Chapman, 2007; Gratz & Roemer, 2008), individuals diagnosed with social anxiety disorder (Kuo & Linehan, 2009) and treatment-seeking individuals with cocaine use disorder (”
    Quote in the paperNot a substantial claim1 of 3 sources checked
    • cites Gratz & Chapman, 2007 source
    • cites Gratz & Roemer, 2008 source
    • cites Kuo & Linehan, 2009 source

      Split into 2 atoms — 0 confirmed, 2 partially supported, 0 disputed, 0 misattributed, 0 unverifiable. Expand the claim to see per-atom verdicts.

      Experimental — accuracy not yet measured

  • May combine two claims.

    Findingown data

    Over the 6 months before baseline, the entire sample reported an average of 9.46 (SD = 6.16) drinks per drinking day and 27.5% (SD = 21.1) days abstinent.

    “participants reported an average of 9.46 (SD = 6.16) drinks per drinking day and 27.5% (SD = 21.1) of days abstinent.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    The mean DERS total and subscale scores for the AUD-1 group were not statistically significantly different from those of the AUD-0 group, except for the DERS Aware scale, indicating comparable emotional functioning for the AUD-0 and AUD-1 groups.

    “However, the mean DERS total and subscale scores for the AUD-1 group were not statistically significantly different than those of the AUD-0 group, with the exception of the DERS Aware scale, indicating comparable emotional functioning for the AUD-0 and AUD-1 groups.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    On the MAAS total score, there were no significant differences between the AUD-0 group and either the AUD-2 or AUD-1 group.

    “Group comparisons of the Mindful Attention and Awareness Scale (MAAS) Total score using a Student’s t-test indicated no significant differences between the AUD-0 group and either the AUD-2 or AUD-1 group.”
    Quote in the paperNot a substantial claim
    • Rests on an assumption: The MINI diagnoses accurately identify DSM-IV alcohol dependence and co-occurring mood or anxiety disorders in this sample.

  • May combine two claims.

    Findingown data

    On the Toronto Alexithymia Scale total score and subscales, there were no significant differences between the AUD-0 group and either the AUD-2 or AUD-1 group.

    “Group comparisons of the Toronto Alexithymia Scale Total score and subscales using the Student’s t-test indicated no significant differences between the AUD-0 group and either the AUD-2 or AUD-1 group.”
    Quote in the paperNot a substantial claim
    • Rests on an assumption: The MINI diagnoses accurately identify DSM-IV alcohol dependence and co-occurring mood or anxiety disorders in this sample.

  • Probably not a substantial claim: may not pass S1 (asserted), S3 (load-bearing), S4 (based).

    Study design and conductnone given

    Emotion regulation was assessed solely by self-report.

    “Lastly, emotion regulation was assessed solely by way of self-report.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S2 (checkable).

    Interpretationreasoning

    Learning more about emotion regulation difficulties in people with alcohol use disorder could help identify subgroups that are more likely to have these difficulties and thus more likely to benefit from adding an emotion regulation intervention to standard alcohol treatment.

    “A greater understanding of emotion regulation difficulties among AUD individuals may lead to the identification of subgroups that are more likely to report such difficulties and therefore more likely to benefit from the addition of an emotion regulation intervention into existing alcohol treatment.”
    Quote in the paperNot a substantial claim
    • Rests on an assumption: Before this study, no research had tested how alcohol use disorder, mood disorders, and anxiety disorders relate to emotion regulation difficulties in outpatient alcohol use disorder samples.
    • Rests on an assumption: The link between individual difference factors and emotion regulation difficulties in people with alcohol use disorder is not well understood.
    • Rests on an assumption: No known study has looked at emotion regulation difficulties and psychological functioning in treatment-seeking alcohol use disorder patients who do and do not have co-occurring mood or anxiety disorders.

  • May combine two claims.

    Premisecitation

    People with alcohol use disorders and people with affective disorders each show more problems across several measures of emotional functioning.

    “In separate literatures, individuals with alcohol use disorders and those with affective disorders have been shown to demonstrate greater deficiencies on multiple indices of emotional functioning (Witkiewitz, & Marlatt, 2004; Joorman & Stanton, 2016).”
    Quote in the paperSubstantial claim0 of 2 sources checked
    • cites Witkiewitz, & Marlatt, 2004 source
    • cites Joorman & Stanton, 2016

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation

    Among people with alcohol use disorder, about 18.9% also have a mood disorder and about 17.1% also have an anxiety disorder.

    “Epidemiological evidence indicates that among individuals diagnosed with an AUD, 18.9% are diagnosed with a mood disorder and 17.1% with an anxiety disorder (Grant, Stinson, Dawson et al., 2004).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Grant, Stinson, Dawson et al., 2004 source

  • May combine two claims.

    Premisecitation

    Emotion regulation difficulties are a core feature of anxiety disorders and depressive disorders.

    “Emotion regulation difficulties (ERD) are known to underlie mental health conditions including anxiety and depressive disorders and alcohol use disorder (AUD).”
    • Also stated in: § 1. Introduction · plain
      “These two diagnostic categories, which are defined, in part, by chronic emotion regulation difficulties (Gross & Levenson, 1997; Kring & Werner, 2004; Lynch, Robins, Morse & Krause, 2001), share high rates of comorbidity with AUDs.”
    Quote in the paperSubstantial claim0 of 3 sources checked
    • cites Gross & Levenson, 1997 source
    • cites Kring & Werner, 2004

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

    • cites Lynch, Robins, Morse & Krause, 2001 source

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductown data

    In the current sample, the Toronto Alexithymia Scale had good internal consistency for the overall scale and for its subscales.

    “Internal consistency in the current sample was good for the overall scale (α = .82) and subscales (αs = .61 – .77).”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Study design and conductcitation

    The Positive and Negative Affect Scale has demonstrated good internal consistency for both its positive affect and negative affect scales and has demonstrated validity.

    “This measure has demonstrated good internal consistency for both the positive affect (α = .89) and negative affect (α = .85) scales and has demonstrated validity (Watson et al., 1988).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Watson et al., 1988 source

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Study design and conductown data

    In the current sample, the Distress Tolerance Scale had good internal consistency for the overall scale and for its subscales.

    “Internal consistency in the current sample was good for the overall scale (α = .88) and for subscales (αs =.70 – .77).”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Study design and conductcitation

    The Difficulties in Emotion Regulation Scale has demonstrated good internal consistency and validity.

    “This measure has demonstrated good internal consistency (α = .93) and validity (Gratz & Roemer, 2004).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Gratz & Roemer, 2004 source

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductown data

    In the current sample, the Negative Mood Regulation Expectancies Questionnaire had good internal consistency.

    “Internal consistency in the current sample was good (α = .88).”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Student's t-test is well-known to be robust against non-normality.

    “which is well-known to be robust against non-normality (Rasch & Guiard, 2004).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Rasch & Guiard, 2004

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation

    The Mindful Attention Awareness Scale has demonstrated good internal consistency (α = .87) and validity.

    “This measure has demonstrated good internal consistency (α = .87) and validity (Brown & Ryan, 2003).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Brown & Ryan, 2003 source

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductnone given

    The University at Buffalo Institutional Review Board reviewed and approved the study before data collection began.

    “The University at Buffalo Institutional Review Board reviewed and approved the study prior to data collection.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Study design and conductcitation

    The Inventory of Drug Taking Situations - Alcohol version has demonstrated good internal consistency and validity in treatment-seeking samples of people with alcohol dependence.

    “This measure has demonstrated good internal consistency (overall α = .95; subscale αs = .70 – .92) and validity in treatment seeking samples of individuals with alcohol dependence (Annis, Turner & Sklar, 1997).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Annis, Turner & Sklar, 1997

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Study design and conductcitation

    The Timeline Follow-Back is a valid and reliable measure of alcohol consumption.

    “The TLFB has been determined to be a valid and reliable measure of alcohol consumption (see Sobell & Sobell, 1992 for a review).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Sobell & Sobell, 1992 source

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation

    The Brief Symptom Inventory has demonstrated good reliability (α = .87) and validity.

    “This measure has demonstrated good reliability (α = .87) and validity (Abu Ruz, Lennie, Riegel et al., 2010; Derogatis, 1983).”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites Abu Ruz, Lennie, Riegel et al., 2010 source
    • cites Derogatis, 1983 source

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductown data

    In the current sample, the Positive and Negative Affect Scale had good internal consistency for its positive affect and negative affect subscales.

    “Internal consistency in the current sample was good for the positive (α = .84) and negative affect (α = .84) subscales.”
    Quote in the paperNot a substantial claim

  • Classified as probably not a substantial claim.

    Study design and conductcitation

    The Holm method was used to control family-wise Type 1 error for multiple comparisons.

    “The Holm (1979) method was used to control family-wise Type 1 error for multiple comparisons.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites Holm, 1979

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • Classified as probably not a substantial claim. May combine two claims.

    Study design and conductown data

    The empirical data densities were near-symmetric and had no extreme values, so Student's t-test was used for statistical comparisons.

    “Given the near-symmetry and absence of extreme values in all cases, statistical comparisons were conducted by Student’s t-test”
    Quote in the paperSubstantial claim

  • Classified as probably not a substantial claim. May combine two claims.

    Study design and conductcitation

    The Mini International Neuropsychiatric Interview is a valid and reliable measure of DSM-IV psychiatric disorders.

    “The MINI has been shown to be a valid and reliable measure of DSM-IV psychiatric disorders (Sheehan et al., 1998).”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites Sheehan et al., 1998

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Study design and conductown data

    In the current sample, the Inventory of Drug Taking Situations - Alcohol version had good internal consistency for the overall scale and for its three subscales.

    “Internal consistency in the current sample was good for the overall scale (α = .95) and for the three subscales (αs = .86 – .88).”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation

    The Kentucky Inventory of Mindfulness Skills has demonstrated good internal consistency (subscale αs = .82-.91) and validity.

    “This measure has demonstrated good internal consistency (subscale αs = .82 – .91) and validity (Baer, Smith, & Allen, 2004).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Baer, Smith, & Allen, 2004 source

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation

    The Short Alcohol Dependence Data Questionnaire is a unidimensional measure of present-state alcohol dependence that is sensitive to the full range of dependence.

    “The Short Alcohol Dependence Data Questionnaire (Raistrick, Dunbar & Davidson, (1983) is a unidimensional measure of present state alcohol dependence that is sensitive to the full range of dependence.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Raistrick, Dunbar & Davidson, 1983 source

  • Probably not a substantial claim: may not pass S4 (based).

    Study design and conductnone given

    The measures used in this study have shown good to excellent psychometric properties in samples of people diagnosed with alcohol use disorder.

    “Measures chosen have demonstrated good to excellent psychometric properties in samples of individuals diagnosed with an AUD.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductown data

    In the current sample, the Mindful Attention Awareness Scale had good internal consistency (α = .86).

    “Internal consistency in the current sample was good (α = .86).”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductown data

    In the current sample, the Kentucky Inventory of Mindfulness Skills had good internal consistency for all subscales (αs = .81-.90).

    “Internal consistency in the current sample was good for all subscales (αs = .81 – .90).”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Study design and conductcitation

    The Negative Mood Regulation Expectancies Questionnaire has shown good internal consistency and validity.

    “This measure has shown good internal consistency (α = .87) and validity (Catanzaro & Mearns, 1990).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Catanzaro & Mearns, 1990 source

  • Probably not a substantial claim: may not pass S2 (checkable). May combine two claims.

    Interpretationreasoning

    Emotionally-focused interventions may be ideally suited for AUD outpatients with multiple co-occurring mood and/or anxiety disorders, but possibly inappropriate for those with no co-occurring or only one co-occurring disorder.

    “the results of this study suggest that these emotionally- focused interventions may be ideally suited for AUD outpatients who meet diagnostic criteria for a multiple co-occurring mood and/or anxiety disorders, but possibly inappropriate for those with no co-occurring or only one co-occurring disorder.”
    Quote in the paperNot a substantial claim

  • Classified as probably not a substantial claim.

    Premisenone given

    There are no published norms for the DERS total score in clinical and non-clinical samples.

    “While there are no published norms for the DERS total score in clinical and non-clinical samples”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Study design and conductcitation

    The Distress Tolerance Scale has demonstrated good internal consistency and validity.

    “This measure has demonstrated good internal consistency (α = .89) and validity (Simons & Gaher, 2005).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Simons & Gaher, 2005 source

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductnone given

    Only Holm-adjusted p-values are reported.

    “Only the Holm-adjusted p-values are reported.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Study design and conductown data

    In the current sample, the Difficulties in Emotion Regulation Scale had good internal consistency for the overall scale and for its subscales.

    “Internal consistency in the current sample was good for the overall scale (α = .92) and also for subscales (αs = .84 – .92).”
    Quote in the paperNot a substantial claim

  • May combine two claims. The quote only partly states this claim.

    Interpretationown data

    The AUD-0 group showed greater overall mindfulness skills, acceptance of present-moment experiences without judgment, and engaging attention fully in activities.

    “indicating greater overall mindfulness skills, acceptance of present-moment experiences without judgment, and engaging attention fully in activities, respectively.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Study design and conductcitation

    The Toronto Alexithymia Scale has demonstrated good internal consistency and validity.

    “This measure has demonstrated good internal consistency (overall α = .84; subscale αs = .62 – .80) and validity (Bagby et al., 1994).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Bagby et al., 1994 source

  • May combine two claims.

    Interpretationown data

    The AUD-2 group had greater overall psychological distress, greater numbers of symptoms, and more severe psychiatric symptoms than the AUD-0 group.

    “indicating greater overall psychological distress, greater numbers of symptoms, and more severe psychiatric symptoms, respectively, among the AUD-2 group as compared with the AUD-0 group.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductown data

    In the current sample, the Brief Symptom Inventory had good internal consistency (α = .97).

    “Internal consistency in the current sample was good (α = .97).”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Premisecitation

    The addition of the emotionally-focused intervention led to greater improvements in drinking, several emotion regulation skills, and negative affect compared to standard CBT for alcohol dependence.

    “The addition of the emotionally-focused intervention led to greater improvements in drinking, several emotion regulation skills, and negative affect as compared to standard CBT for alcohol dependence.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S2 (checkable).

    Interpretationown data

    The results suggest that AUD individuals with multiple comorbid disorders may benefit from the addition of an emotion regulation intervention to standard alcohol treatment.

    “Overall, the results from the current study suggest that AUD individuals with multiple comorbid disorders may benefit from the addition of an emotion regulation intervention to standard alcohol treatment.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Interpretationreasoning

    AUD individuals diagnosed with two or more comorbid mood or anxiety disorders not only experience greater psychiatric symptoms but additionally suffer from higher levels of mood dysregulation.

    “Thus, AUD individuals diagnosed with two or more co-morbid mood or anxiety disorders not only experience greater psychiatric symptoms but additionally, suffer from higher levels of mood dysregulation.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductreasoning

    The study has limitations including secondary data analyses from a parent study that recruited individuals seeking outpatient alcohol treatment.

    “These include secondary data analyses from a parent study that recruited individuals seeking outpatient alcohol treatment.”
    Quote in the paperNot a substantial claim

  • Classified as probably not a substantial claim.

    Premisenone given

    There are currently no recommended DERS cut-off scores for determining the need for a specialized emotion regulation intervention.

    “While there are currently no recommended DERS cut-off scores for determining the need for a specialized emotion regulation intervention”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S2 (checkable).

    Interpretationown data

    Given the findings, it may be that among individuals diagnosed with an AUD, a somewhat higher DERS cutoff score could be used to indicate the need for an emotion regulation intervention.

    “However, given our findings, it may be that among individuals diagnosed with an AUD, a somewhat higher DERS cutoff score could be used to indicate the need for an emotion regulation intervention.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Study design and conductreasoning

    The study sample size (N = 77) is not large, so the power of the study may have been insufficient for some variables.

    “Additionally, the study sample size (N = 77) is not large so that the power of the study may have been insufficient for some variables.”
    Quote in the paperNot a substantial claim

  • Classified as probably not a substantial claim.

    Premisenone given

    The combined intervention was tested against standard CBT plus a health and lifestyles treatment supplement in a sample of individuals who met criteria for DSM-IV alcohol dependence and reported frequent heavy drinking in response to negative affect.

    “This combined intervention was tested against standard CBT plus a health and lifestyles treatment supplement in a sample of individuals who met criteria for DSM-IV alcohol dependence and reported frequent heavy drinking in response to negative affect.”
    Quote in the paperSubstantial claim
51 of 51

  • The paper relies on this without support.

    Before this study, no research had tested how alcohol use disorder, mood disorders, and anxiety disorders relate to emotion regulation difficulties in outpatient alcohol use disorder samples.

    “Although AUD, mood, and anxiety disorders commonly co-occur, no study has examined the association between these disorders and ERD among AUD outpatients.”

  • The paper relies on this without support.

    The link between individual difference factors and emotion regulation difficulties in people with alcohol use disorder is not well understood.

    “Yet, despite the growing interest in emotion regulation as a possible mechanism underlying problematic alcohol use and relapse (Barlow, Allen & Choate, 2004), little is known about the association of individual difference factors and emotion regulation difficulties among individuals with an AUD.”

  • The paper relies on this without support.

    Having a co-occurring mood or anxiety disorder is linked to more severe alcohol use disorder and a higher chance of relapse.

    “One important individual difference factor often associated with greater AUD severity and an increased risk for relapse is the presence of a co-occurring mood or anxiety disorder.”

  • The paper relies on this without support.

    Emotion regulation difficulties are a fundamental feature of alcohol use disorder.

    “Emotion regulation difficulties (ERD) are known to underlie mental health conditions including anxiety and depressive disorders and alcohol use disorder (AUD).”

  • The paper relies on this without support.

    No known study has looked at emotion regulation difficulties and psychological functioning in treatment-seeking alcohol use disorder patients who do and do not have co-occurring mood or anxiety disorders.

    “To date, few studies have assessed emotion regulation among alcohol use disorder patients (Fox, Hong, & Sinha, 2008; Lagerberg et al., 2017), and no known studies have examined emotion regulation difficulties and psychological functioning in treatment-seeking AUD patients with and without co-occurring mood and/or anxiety disorders.”

  • The paper relies on this without support.

    No prior study has reported on the relationships between mental health comorbidity, emotion regulation, and associated alcohol, emotional, and psychological functioning among adults seeking treatment for an alcohol use disorder.

    “This exploratory study is the first known to report on the relationships between mental health comorbidity, emotion regulation and associated alcohol, emotional and psychological functioning among adults seeking treatment for an alcohol use disorder (AUD).”

  • The paper relies on this without support.

    The MINI diagnoses accurately identify DSM-IV alcohol dependence and co-occurring mood or anxiety disorders in this sample.

    “Based on the MINI diagnoses, all individuals met DSM-IV criteria for alcohol dependence (AUD) and were assigned to one of three groups”

  • The paper relies on this without support.

    The DERS total score is a valid measure of emotion regulation difficulties.

    “The average Difficulties in Emotion Regulation (DERS) total score for the entire sample was 87.5 (SD = 24.4).”
8 of 8

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

  • Individuals with alcohol use disorders and co-occurring mood or anxiety disorders have higher overall DERS scores than those diagnosed with alcohol use disorder only.

    “it has been found that individuals with alcohol use disorders and co‐occurring mood or anxiety disorders have higher overall DERS scores than those who were only diagnosed with AUD [96].”

    From Emotion regulation in substance use disorders: a systematic review and meta-analysis (2023) · cites this paper as [96]

    The Results (§3.1) report significantly higher total DERS scores for participants with two or more co-occurring disorders than for those with AUD alone. The Discussion (§4) gives a numerically higher mean for participants with one co-occurring disorder, but says their total scores were not significantly different from the AUD-only group. The claim omits that distinction. (LLM, conf=0.88)

    Experimental — accuracy not yet measured

  • Lots of college students are excessively addicted to charming mobile games.

    “it is often found that lots of college students are excessively addicted to charming mobile games [43].”

    From Comparative effectiveness of mind-body exercise versus cognitive behavioral therapy for college students with problematic smartphone use: A randomized controlled trial (2020) · cites this paper as [43]

    The Methods (section 2.1, page unavailable) describe 77 adults seeking treatment for alcohol dependence, not a sample of college students. A search for the claim’s wording and for mobile-game addiction among college students found no passage addressing mobile games or their use by students. (LLM, conf=0.78)

    Experimental — accuracy not yet measured

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

Each contradiction between two passages listed here was confirmed by an independent check.

  • BSI symptom count and intensity are reversed

    Minor

    The results assign greater numbers of symptoms to PSDI and greater symptom severity to PST, in the order listed. The measures section defines PST as the symptom count and PSDI as symptom intensity.

1 of 1

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7 of the 72 references couldn’t be matched to a known paper.

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Related

Authors
Bradizza, C. M., Brown, W. C., Ruszczyk, M. U., Dermen, K. H., Lucke, J. F., & Stasiewicz, P. R.
Affiliations
University at Buffalo, State University of New York (US)
Corresponding author
Bradizza, Clara M.
ORCID
Venue
Addictive Behaviors
Publisher
Elsevier BV
Published
2018-05
Volume
80
Pages
6-13
ISSN
0306-4603 (ISSN-L)
DOI
10.1016/j.addbeh.2017.12.033
PMC
PMC5807148
OpenAlex
W2777671243
Cited by
48
References
72
Citations by year
2026: 2 · 2025: 2 · 2024: 8 · 2023: 2 · 2022: 10 · 2021: 7 · 2020: 6 · 2019: 6 · 2018: 5
FWCI
3.81
Type
journal article
Language
en
Open access
Licence
www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations
  • Addictive Behaviors (publishedVersion)
  • PubMed (publishedVersion)
  • Europe PMC (PubMed Central) (submittedVersion)
  • PubMed Central (submittedVersion)
Funders
National Institutes of Health (R01 AA015064, T32 AA007583)
Topics
  • Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
  • Social Sciences › Psychology › Experimental and Cognitive Psychology › Mental Health Research Topics
  • Social Sciences › Psychology › Clinical Psychology › Child and Adolescent Psychosocial and Emotional Development
Keywords
emotional dysregulation, alcoholism, negative affect, distress tolerance, alexithymia, trait mindfulness, emotional awareness, alcohol consumption
MeSH terms
Self-Control, Adult, Affective Symptoms, Alcoholism, Anxiety Disorders

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Claims read under definition version 3 (extract-v3) on 2026-09-28.

Classified by jev-1.13-20260917 (gold-guideline-v0.2) on 2026-09-28.

Cited sources are checked by gpt-6-sol.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

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