Affective vulnerability in substance use disorders

McHugh, R Kathryn; Kneeland, Elizabeth T

doi:10.1016/j.copsyc.2019.01.011

Cited by 80Substance Abuse Treatment and OutcomesAnxiety, Depression, Psychometrics, Treatment, Cognitive ProcessesNeurotransmitter Receptor Influence on Behavior

Affective vulnerability in substance use disorders

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McHugh, R Kathryn, Kneeland, Elizabeth T·2019·Current Opinion in Psychology

DOI 10.1016/j.copsyc.2019.01.011PMC PMC6661223

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Abstract

Substances of abuse are characterized by their rewarding effects and engagement of reward pathways in the brain. However, these substances also provide rapid relief of negative affect, and thus are highly negatively reinforcing. Accordingly, negative affectivity and other affective vulnerabilities (factors related to the experience of affect) are strongly linked to problematic substance use and substance use disorders. In this review, we provide a critical overview of the literature on affective vulnerabilities in substance use disorders. We discuss how both the experience of affect (e.g. negative affectivity, stress reactivity) and the interpretation of affect (e.g. distress intolerance, anxiety sensitivity) are pertinent to the development, maintenance, and treatment of substance use disorders.

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Low DT is associated with wide-ranging psychopathology, including SUDs, eating disorders, BPD, depressive disorders, anxiety disorders, obsessive-compulsive disorder, and post-traumatic stress disorder.
“studies have shown low DT (i.e., distress intolerance) to be associated with wide-ranging psychopathology, including SUDs (McHugh and Kneeland, 2019), eating disorders (Lampard et al., 2011a), BPD (Kiselica et al., 2014)”
From Distress tolerance across substance use, eating, and borderline personality disorders: A meta-analysis (2022) · cites this paper as McHugh and Kneeland, 2019
Individuals with low DT would be at increased risk of engaging in the substance use pathway, thus increasing risk towards PSU.
“It follows that individuals who experience distress as unbearable (i.e., individuals with low DT) would be at increased risk of engaging in this pathway towards substance use, thus increasing risk towards PSU (McHugh and Kneeland, 2019).”
From Distress tolerance across substance use, eating, and borderline personality disorders: A meta-analysis (2022) · cites this paper as McHugh and Kneeland, 2019

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[26]Howell AN, Leyro TM, Hogan J Anxiety sensitivity, distress tolerance, and discomfort intolerance in relation to coping and conformity motives for alcohol use and alcohol use problems among young adult drinkers. Addict Behav 2010; 35: 1144– 1147. 20719435 PMC2942953

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Authors: McHugh, R. K., & Kneeland, E. T.
Affiliations: Harvard University (US)
Corresponding author: McHugh, R Kathryn
ORCID: McHugh, R Kathryn
Kneeland, Elizabeth T
Venue: Current Opinion in Psychology
Publisher: Elsevier BV
Published: 2019-12
Volume: 30
Pages: 54-58
ISSN: 2352-250X (ISSN-L)
DOI: 10.1016/j.copsyc.2019.01.011
PMC: PMC6661223
OpenAlex: W2947126747
Cited by: 80
References: 60
Citations by year: 2026: 10 · 2025: 13 · 2024: 17 · 2023: 8 · 2022: 11 · 2021: 12 · 2020: 7 · 2019: 2
FWCI: 1.17
Type: journal article
Language: en
Open access: green
www.ncbi.nlm.nih.gov
Licence: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
www.elsevier.com/legal/tdmrep-license (tdm)
Locations: Current Opinion in Psychology (publishedVersion)
PubMed (publishedVersion)
PubMed Central (acceptedVersion)
Funders: National Institutes of Health (DA035297)
Topics: Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
Life Sciences › Neuroscience › Cellular and Molecular Neuroscience › Neurotransmitter Receptor Influence on Behavior
Keywords: emotional vulnerability, substance use disorders, negative affectivity, stress reactivity, distress intolerance, anxiety sensitivity, negative reinforcement, reward pathways, problematic substance use, addiction treatment
MeSH terms: Affect, Anxiety, Humans, Substance-Related Disorders

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