Sherry H. Stewart, PhD, is Professor of Psychiatry and Psychology & Neuroscience at Dalhousie University in Canada. She holds a Tier 1 Canada Research Chair in Addictions and Mental Health. Her research program focuses on the overlap of emotional disorders (anxiety, mood, and stress disorders) with addictive behaviors and disorders.
Daily diary methodology is becoming popular in human menstrual cycle (MC) research. However, variations in MC length makes it difficult to examine fluctuations in dependent variables (e.g., substance use levels), across the MC. Existing analytic approaches collapse data across MC phases, examining phase-related changes; however, a loss of potentially vital information can result when data is collapsed across phase. Additionally, current phase designation methods (phase designation and days within each phase) vary substantially across studies, making it difficult to interpret/compare results across studies. To address these problems, two methods were developed to standardize intensive longitudinal data collected via daily diary methodologies—phasic and continuous standardization. Phasic standardization accounts for individual variability in MC length by allowing luteal phase length differences while remaining phases are fixed, enabling the analysis of phasic variations. Alternatively, continuous standardization accounts for individual variability in MC length by standardizing the luteal phase to a seven-day phase, while remaining phases are fixed, allowing for the exploration of continuously reported variables across MC day. This chapter will discuss how to standardize daily diary data collected across the MC using phasic and continuous standardization methods and demonstrate the two standardization methods using two clinically-relevant hypothetical examples.
Part of the book: Menstrual Cycle
Among trauma-exposed individuals, substances may be used as a means of obtaining symptom relief following exposure to trauma reminders. Repeated pairing of trauma cues with substance use may lead to the development of classically conditioned craving to trauma cues. Conditioned craving following cue exposure can be studied in-lab using the cue-reactivity paradigm. To map cue-reactivity research conducted with trauma-exposed substance users, we aimed to synthesize research which studied our population of interest, used a cue-reactivity paradigm, and measured craving as an outcome. Three databases were searched using relevant keywords. Twenty-eight studies met our criteria. Four key 19 themes are discussed in our review of these scoped studies—(1) craving as an outcome; (2) methodological subtypes across paradigms; (3) affect as an additional outcome or as a mediator of cue-induced craving; and (4) cue-reactivity paradigms as an intervention outcome assessment tool. Overall, there is strong evidence for cue-reactivity paradigms as a useful means of eliciting craving in response to trauma cues. Our scoping review suggests the need for a meta-analysis to determine the magnitude of the trauma cue-induced craving effect in substance users with trauma histories, and to determine significant moderators (e.g., PTSD symptom severity) and mediators of this effect (e.g., negative affect).
Part of the book: Stress-Related Disorders