Recent research studies and clinical trials have suggested that psychedelic therapy with psychological support can offer beneficial and synergistic effects in reducing or eliminating substance use disorder (SUD) patterns and symptoms. However, very little is known about SUD healthcare providers' perceptions of the usage of psychedelic-assisted therapy in SUD treatment. The present study assesses biomedical SUD healthcare providers' perceptions and concerns to better understand potential barriers to the effective implementation of psychedelic-based therapies and formulate further recommendations for research efforts surrounding them. This study collected data through a short survey and qualitative semi-structured interviews from nine participants involved in SUD patient treatment and care. Open discussion was encouraged in the interviews which were recorded and transcribed using the Otter app. Data was analyzed using Charmaz's two-step coding process, which identified common themes and specific issues about translating psychedelic-assisted therapy into clinical application. Four interconnected themes were identified: personal responsibility, patient safety and expectations, a call for further research, and societal structures as barriers. The findings of this study indicate that SUD healthcare providers have optimism and openness surrounding psychedelic-assisted therapy and generally view it as a positive treatment. However, this optimism was often followed by concerns for safety, legality, and the providers' role in this treatment. Participants also expressed a critical need for further research with rigorous clinical trials to explore the effectiveness of psychedelics in a therapeutic setting. The results provided in this study act as basis for engaging with biomedical SUD healthcare providers to address concerns about psychedelic-assisted therapy in future research for SUD treatment.

<p><strong>AIM </strong>People with marginalized sexual orientations experience mental health and substance use problems at a higher rate compared to heterosexuals. Experiences of discrimination have been identified as a significant factor in explaining such disparities, and a growing body of literature has developed seeking to explore the contexts in which discrimination occurs. However, one context that is understudied is the online environment. Based on Meyer’s (2003) Minority Stress Model (MSM), it is postulated that specific proximal group-specific processes mediate the relationship between discrimination and health outcomes, with other social factors providing protective effects. However, research is sparse empirically investigating different mechanisms, consequences, and potential modifying factors for sexual minority young adults experiencing online heterosexist discrimination (OHD). Thus, the current study aims to explore experiences of OHD among young adults. <strong>METHODS </strong>Using the MSM as a guiding framework, the study examined proximal factors of internalized heterosexism, online concealment, and rejection sensitivity as mechanisms underlying the effect of OHD on health outcomes and online social support as a moderating factor. 383 young adults (18-35) with marginalized sexual orientations were recruited from an introductory psychology subject pool, two online crowdsourcing platforms (Prolific, MTurk), and the community. They completed measures of OHD, online social support, online concealment, rejection sensitivity, internalized heterosexism, psychological distress, and substance use. <strong>RESULTS </strong>Path analyses in Mplus revealed that two proximal stressors (rejection sensitivity, sexual orientation concealment) were positively related to psychological distress as a result of OHD. Sexual orientation concealment was associated with increased risk for cannabis use due to OHD. Online social support from LGBTQ+ peers did not buffer these relationships. <strong>CONCLUSION </strong>The MSM is a viable guiding framework in exploring OHD. Rejection sensitivity and online sexual orientation concealment are important constructs to consider for future research and may be ideal treatment targets for individuals experiencing psychological distress or engaging in cannabis use due to OHD.</p>

Bakgrund: Forskning har visat att stigma gentemot personer relaterat till särskiljande egenskaper leder till försämrad hälsa för dessa individer. Sedan pionjären Erving Goffman 1963 formulerade sin teori om stigma har forskning kring stigma och personer med psykisk ohälsa grenat ut sig. Forskning har även influerat till att revolutionera förståelsen för substansbrukssyndrom, och hur det under det senaste seklet utvecklats från tron att substansbrukssyndrom orsakas av moraliska brister till att det kan ses som en sjukdom som påverkar både hjärna och beteende. Syfte: Syftet med litteraturstudien var att sammanställa och belysa hur personer med substansbrukssyndrom upplever stigma. Metod: En systematisk kvalitativ litteraturstudie med induktiv ansats inspirerad av Polit och Becks niostegsmodell. Sjutton vetenskapliga artiklar söktes fram systematiskt, sammanställdes och analyserades. Sökningar genomfördes i databaserna PubMed, Cinahl och Taylor &amp; Francis. Resultat: Analysen utmynnade i fem kategorier som beskrev hur personer med substansbrukssyndrom upplevde stigma: att mötas av misstro och att inte bli tagen på allvar, att endast ses för sitt substansbruk och inte som människa, att få en sämre vård än andra, att vårdpersonalen har negativt bemötande och att beskyllas för sin sjukdom. Slutsats: Att leva med substansbrukssyndrom innebär för individen ett dagligt möte med stigma. Litteraturstudiens resultat kan bidra med viktig kunskap om hur patienter med substansbrukssyndrom upplever möten i vården. Detta kan öka kunskap och förståelse som i sin tur kan bidra till en förbättrad vård för personer med substansbrukssyndrom där lidande för individen minimeras och kostnader för samhället minskas.

Pathological gambling and substance use disorders are highly prevalent and comorbid among veteran populations. These disorders also share genetic influences, although the underlying constructs and magnitude of their influence remain unclear. This project utilized the Hierarchical Taxonomy of Psychopathology (HiTOP) as a framework for modeling the underlying dimensions of psychopathology as latent factors and modeled genetic and environmental influences on substance use disorders and pathological gambling. Study 1 examined the structure of psychopathology for 15 common mental disorders in a sample of Vietnam-era veteran twins from the Harvard Drug Study (nMZ = 3,748 and nDZ = 2,996) to determine the appropriate location for pathological gambling within the HiTOP framework. The best fitting model included internalizing and externalizing spectra and an illicit substance use subfactor. Pathological gambling (loading = .30) loaded onto the externalizing spectrum with legal substance use, conduct disorder, antisocial personality disorder, and a subfactor that subsumed all six illicit substance use disorders. The best fitting model in Study 1 did not support the existence of a ‘p’ factor underlying all psychopathology. In Study 2, genetic and environmental components were modeled for the 15 disorders and 3 latent factors modeled in Study 1. Additive genetics explained from 10% (generalized anxiety disorder, panic disorder) to 49% (nicotine use) of the variance in specific disorders and from 24% (internalizing) to 46% (externalizing) of the variance of latent factors. Only cocaine use and conduct disorder demonstrated significant variance attributable to shared environment, the entirety of which occurred at the disorder-specific level. Only 9% of the genetic variance associated with alcohol use was shared across disorders, whereas 100% of genetic variance in cocaine and hallucinogen use was shared with latent factors. In total, 12% of the variance in risk for pathological gambling was associated with additive genetics, and 13% of that variance was shared via the externalizing spectrum. Findings highlight shared risk among illicit substance use disorders and among other disorders on the externalizing spectrum. These findings suggest externalizing and illicit substance use as transdiagnostic targets for treatments aimed at individuals with comorbid substance use disorders, pathological gambling, and other externalizing disorders.

Studien utgår ifrån behandlingspersonal på ett SiS LVM-hem och deras beskrivningar av sitt förhållningssätt gentemot kvinnor med samsjuklighet i form av missbruk och ätstörning, samt vilka utmaningar och möjligheter som de upplever i sitt arbete i förhållande till gruppen. Studien har en kvalitativ ansats med semi-strukturerade intervjuer som utförts med fem personer som arbetar som behandlingspersonal på ett SiS LVM-hem i Sverige. Den insamlade datan har framställts i en tematisk analys med fem identifierade huvudteman och 13 subteman som tolkats utifrån tolkningsramen, vilken inkluderar nationella regelverk och de teoretiska begreppen yrkeskompetens; relationskompetens och handlingskompetens samt teori om idealtypiska handlingar. Resultatet visar att det förekommer missbruk och ätstörning på LVM-hemmet och att behandlingspersonalen arbetar med det genom att förhålla sig lika till klienten oberoende dess problematik med viljan att hjälpa och anpassa strategier till problematiken, även om syftet med LVM inte är att behandla ätstörningar och det saknas förutsättningar på organisatoriskt plan. Resultatet visar även att behandlingspersonalen har fokus vid att arbeta relationsskapande för att nå klienterna och motivera dem. Studiens slutsatser är att det saknas kompetens om ätstörningar inom LVM-hemmet men att behandlingspersonalen bemöter missbruk och ätstörning genom att använda rutiner och begränsningar samt sin yrkes- och relationskompetens / The study is based on treatment workers at a SiS LVM-home and their descriptions of their approach to women with co-morbidity in the form of substance abuse and eating disorders, as well as the challenges and opportunities they experience in their work in relation to the group. The study has a qualitative approach with semi-structured interviews conducted with five treatment workers from one SiS LVM-home. The collected data have been represented in a thematic analysis with five identified main themes and 13 sub-themes interpreted based on our interpretive framework which includes the following theoretical concepts of professional competence; relational competence and action competence as well as the theory of four ideal actions. The result shows that there is substance abuse and eating disorders at the LVM-home and that the treatment staff works with it by treating the client equally regardless of their problem with the desire to help and adapt strategies to the problem, even if the purpose of LVM is not to treat eating disorders and that there are no prerequisites on an organizational level. The results also show that the treatment workers have a focus on relationship-building in order to reach the clients and motivate them. The study's conclusions are that there is a lack of expertise on eating disorders within the LVM-home, but that the treatment staff deal with addiction and eating disorders by using routines and restrictions as well as using their professional and relational skills

This single-session feasibility trial aimed to examine the effects of Directed-Imaginal Music Psychotherapy (DIMP) on self-awareness in relation to change in adults being treated for substance use disorder. DIMP is a two-part protocol. The first part is a live music, receptive intervention in which a trained music therapist plays a specified harmony sequence on guitar accompanied by verbal guidance to promote imagery and sensory experiences in participants. The verbal guidance is based on participant-defined “Comforts” in each of their five primary senses. The music and imagery component was followed by group verbal processing to discuss physical, emotional, or cognitive changes participant’s experience and gauge an understanding of insights into treatment gained by the participants. Participants completed the Self-Awareness Outcomes Questionnaire (SAOQ; Sutton, 2016) before and after the intervention to measure possible change in self-awareness in relation to change in their recovery. The Wilcoxon signed rank test indicated statically significant improvements in self-awareness scores from 3.37 pre-test to 3.77 post-test. Fieldnotes and transcripts from audio recordings were also used in thematic analysis. Deductive themes of Insight, Mindfulness, Reflection, and Rumination were taken from Sutton’s (2016) SAOQ study. Inductive themes of Disconnection/Connection, Safety & Comfort, Independence/Isolation, and Goal Orientation emerged from the qualitative data. Feasibility for implementation was considered through the lenses of adoption, reach fidelity, and sustainability (Pearson et al., 2020). The study found that DIMP is feasible for implementation (Bowen et al., 2009). Considerations for future research and clinical practice were identified. / Music Therapy

Introduction: Over the last decades, our understanding of the cognitive, motivational, and neural processes involved in addictive behavior has increased enormously. A plethora of laboratory-based and cross-sectional studies has linked cognitive-behavioral measures to between-subject differences in drinking behavior. However, such laboratory-based studies inevitably suffer from small sample sizes and the inability to link temporal fluctuations in task measures to fluctuations in real-life substance use. To overcome these problems, several existing behavioral tasks have been transferred to smartphones to allow studying cognition in the field. Method: In this narrative review, we first summarize studies that used existing behavioral tasks in the laboratory and self-reports of substance use with ecological momentary assessment (EMA) in the field. Next, we review studies on psychometric properties of smartphone-based behavioral tasks. Finally, we review studies that used both smartphone-based tasks and self-reports with EMA in the field. Results: Overall, studies were scarce and heterogenous both in tasks and in study outcomes. Nevertheless, existing findings are promising and point toward several methodological recommendations: concerning psychometrics, studies show that – although more systematic studies are necessary – task validity and reliability can be improved, for example, by analyzing several measurement sessions at once rather than analyzing sessions separately. Studies that use tasks in the field, moreover, show that power can be improved by choosing sampling schemes that combine time-based with event-based sampling, rather than relying on time-based sampling alone. Increasing sampling frequency can further increase power. However, as this also increases the burden to participants, more research is necessary to determine the ideal sampling frequency for each task. Conclusion: Although more research is necessary to systematically study both the psychometrics of smartphone-based tasks and the frequency at which task measures fluctuate, existing studies are promising and reveal important methodological recommendations useful for researchers interested in implementing behavioral tasks in EMA studies.

It is quite noteworthy that relapse in substance use has been discussed more on an international level, than on a national level. In Sweden, research has focused on the recovery process, relapse avoiding strategies, and on relapse prevention treatment. Therefore, this study aims to describe and analyze individual and social risk factors for relapse in substance use from the perspective of both therapists and substance users. This is to analyze whether there are common denominators and/or major differences between these perspectives. Through qualitative interviews, where four therapists and four previously treated substance users were interviewed, we got access to different people’s substance use stories and opinions on relapse. To summarize our results, both users and therapists named triggers as negative emotions, and multi-problems such as mental health issues, but even damaged brain as an individual risk factor. They mentioned, furthermore, social relations, poor working alliance between users and professionals, and alcohol availability as Swedish tradition as social risk factors. Users alsomentioned exclusion and stigma in Sweden as social risk factors, meanwhile, therapists named loneliness as a social risk factor. These perspectives overlapped to a considerable extent, but therapists in some cases had a more scientific understanding of relapse.

Although previous research identified exposure to significant adverse childhood experiences (ACEs) as harmful to individuals in several psychological and physiological health domains, research examining the mechanisms of action driving this relationship has been lacking. As a result, the current study examined the role that psychological symptoms serve in the relationship between ACEs and substance misuse behaviors. The current study included a sample of 183 participants (i.e., 82 men and 101 women) who completed five questionnaires assessing exposure to ACEs; psychological symptoms of depression, anxiety, and post-traumatic stress disorder (PTSD); and substance misuse behaviors. Correlational analyses indicated significant associations among the variables of interest. Exposure to ACEs was a significant predictor of substance misuse behaviors in both men and women. Additionally, depressive symptoms, anxiety symptoms, and PTSD symptoms were significant predictors of men's substance misuse behaviors, whereas only PTSD symptoms were a significant predictor of women's substance misuse behaviors. Symptoms of depression, anxiety, and PTSD each contributed unique and significant variance to the relationship between ACEs and substance misuse behaviors in men, consistent with partial mediations. A different pattern of prediction was evident for women. Such findings suggested that psychological symptoms of depression, anxiety, and PTSD may serve as a risk factor for substance misuse behaviors in men later in life, especially when they have had a history of ACEs. These results demonstrated the importance of promoting trauma-informed mental health care to remediate negative substance outcomes, particularly in those who have had significant ACEs. The importance of studying the relationships among these variables is discussed further.

Past research has shown a positive relationship between alcohol consumption and alcohol related consequences. Protective behavioral strategies (PBS) are able to lower the negative effects of drinking alcohol, however, the protective effects of PBS at times is moderated by situational circumstances or individual differences. This study looks at the cognitive metaphor of being a Head or Heart person and the moderating effects it has on PBS and alcohol consumption and alcohol related consequences. Participants completed the AUDIT-C to measure drinking habits, the PBSS to asses strategy usage, the YAAQC to measure drinking problems and a self-report single item measure for Head versus Heart identification. It was found that those who identify themselves as Head people have a stronger relationship between PBS use and alcohol consumption which in turn showed a stronger negative relationship between PBS use and alcohol related consequences via alcohol use. These findings suggest that PBS have stronger protective effects within those who identify themselves as Head people.