My research focuses on identifying mechanisms of behavior change that underlie substance use and associated problems in adolescents and young adults. I am particularly interested in the role emotional and cognitive processes play in the development, progression, maintenance, and remission of substance use disorders. To accomplish this, my work uses advanced mobile technology (e.g., ecological momentary assessment, wearable sensors) to examine how key state and trait level variables lead to systematic changes in substance use over time. The express intent of this work is to develop personalized substance use disorder treatments targeting these mechanisms. Supervisors: Jeffery S. Simons and Robert Miranda, Jr. Address: United States
Influential psychological theories hypothesize that people consume alcohol in response to the exp... more Influential psychological theories hypothesize that people consume alcohol in response to the experience of both negative and positive emotions. Despite two decades of daily diary and ecological momentary assessment research, it remains unclear whether people consume more alcohol on days they experience higher negative and positive affect in everyday life. In this preregistered meta-analysis, we synthesized the evidence for these daily associations between affect and alcohol use. We included individual participant data from 69 studies (N = 12,394), which used daily and momentary surveys to assess affect and the number of alcoholic drinks consumed. Results indicate that people do not drink more often on days they experience high negative affect, but are more likely to drink and drink heavily on days high in positive affect. People self-reporting a motivational tendency to drink-to-cope and drink-to-enhance were estimated to consume more alcohol, but not to consume more alcohol on day...
We aim to test whether the experience of boredom is associated with cannabis craving and use amon... more We aim to test whether the experience of boredom is associated with cannabis craving and use among adolescents receiving treatment for cannabis misuse. Boredom was assessed via smartphone reports completed multiple times per day in daily life, and we plan to focus only on boredom occurring outside of cannabis use episodes; on days when participants used cannabis, we will only examine boredom prior to cannabis use.
Alcoholism: Clinical and Experimental Research, 2021
BACKGROUND Naltrexone is an efficacious medication for the treatment of alcohol use disorder in a... more BACKGROUND Naltrexone is an efficacious medication for the treatment of alcohol use disorder in adults. As an opioid receptor antagonist, naltrexone blocks activation of the endogenous opioid system, which is involved in the affectively reinforcing properties of substance use. Few studies, however, have examined the moderating effect of naltrexone on the association of affect and alcohol use. Additionally, most existing research on naltrexone studied adults in the human laboratory. METHOD We conducted a secondary analysis of ecological momentary assessment data from a randomized, double-blinded, placebo-controlled cross-over study, comparing naltrexone (50 mg/daily) and placebo in 26 adolescents (15-19 years old) exhibiting problematic drinking patterns. Multilevel models tested whether naltrexone moderated associations of alcohol use with both positive and negative affect (PA, NA). RESULTS Results indicated that, during the naltrexone arm, greater estimated blood alcohol concentration (eBAC) levels were associated with greater NA further into drinking episodes. In turn, greater NA after the first drink of an episode was associated with reduced subsequent eBAC values in the naltrexone arm. Low PA was also associated with lower subsequent eBAC levels in the naltrexone condition after the first drink. CONCLUSIONS Findings support the idea that naltrexone can disrupt the association of affect and alcohol use, and these effects emerge later in drinking episodes. Greater attention to the effects of naltrexone on affect and reinforcement may help us to better tailor psychotherapy to maximize the benefits of naltrexone. However, as most drink reports were in the first two hours of the drinking episode and participants only reported affect at the first three end-drink reports of a drinking episode (limiting the number of drinks reported), replication of the findings is needed.
This study builds upon research indicating that focusing narrowly on model fit when evaluating fa... more This study builds upon research indicating that focusing narrowly on model fit when evaluating factor analytic models can lead to problematic inferences regarding the nature of item sets, as well as how models should be applied to inform measure development and validation. To advance research in this area, we present concrete examples relevant to researchers in clinical, personality, and related subfields highlighting two specific scenarios when an overreliance on model fit may be problematic. Specifically, we present data analytic examples showing that focusing narrowly on model fit may lead to (a) incorrect conclusions that heterogeneous item sets reflect narrower homogeneous constructs and (b) the retention of potentially problematic items when developing assessment measures. We use both interview data from adult outpatients (N = 2,149) and self-report data from adults recruited online (N = 547) to demonstrate the importance of these issues across sample types and assessment meth...
Supplemental material, Miranda_Open_Practices_Disclosure for Weaker Memory Performance Exacerbate... more Supplemental material, Miranda_Open_Practices_Disclosure for Weaker Memory Performance Exacerbates Stress-Induced Cannabis Craving in Youths’ Daily Lives by Robert Miranda, Stephanie E. Wemm, Hayley Treloar Padovano, Ryan W. Carpenter, Noah N. Emery, Joshua C. Gray and Ethan H. Mereish in Clinical Psychological Science
Difficulty regulating substance use is a core feature of addiction that can manifest as unplanned... more Difficulty regulating substance use is a core feature of addiction that can manifest as unplanned use. This study sought to identify internal and situational influences on unplanned marijuana use among youth ages 15 to 24 years (N = 85; 48% female; 27% age <18 years). Additionally, we disentangled person-level associations from within-person day-to-day influences. Ecological momentary assessment methods captured affective (positive: energized, excited, sociable, happy, relaxed; negative: bored, tense, sad, stressed) and situational factors in real-world settings during a 1-week monitoring period. Participants reported no plan to use on 51% of days (269/527), and youth ultimately used marijuana on 35% of these unplanned days. At the day level, on days when youth spent more time in the presence of marijuana-related cues than they typically do, they used more grams on planned days and less on unplanned days. Regardless of use plans, youth were more likely to use on days when they spent more time with using friends and if they reported greater availability of marijuana in general across the monitoring period. At the person level, youth who generally reported higher positive affect, relative to other participants, used more on planned days and less on unplanned days. Regardless of use plans, youth who generally reported greater craving and time in the presence of marijuana-related cues used more grams, whereas youth who generally reported greater negative affect used less. Together, findings revealed several factors, with clear clinical relevance, which may explain why some youth struggle to control their marijuana use. (PsycINFO Database Record (c) 2020 APA, all rights reserved).
Theories of addiction posit that stimuli associated with drug use, including both exteroceptive (... more Theories of addiction posit that stimuli associated with drug use, including both exteroceptive (e.g., paraphernalia) and interoceptive (e.g., feeling tense or stressed), evoke craving and contribute to the pathogenesis of substance misuse. Control over drug cue response and stress is essential for moderating use. Building from laboratory data supporting associations between cue exposure, stress, and craving, this study tested whether these associations generalize to real-world settings and examined whether a well-vetted neurocognitive control capacity (i.e., working memory, or WM) moderated associations. Youths ( N = 85; 15–24 years old) completed baseline and ecological momentary assessments. Cue exposure and participants’ average stress predicted higher craving. Youths with weaker WM experienced stronger craving at higher-stress moments but not when faced with cues. Interactions were present for both previous-moment and same-moment stress. Craving among adolescents with stronger ...
The Mood Disorder Questionnaire is a screening measure for bipolar disorder, previously found to ... more The Mood Disorder Questionnaire is a screening measure for bipolar disorder, previously found to comprise separate Positive and Negative Activation subscales. We sought to replicate these factors and examine their associations with a range of psychopathology. To further explicate the nature of Negative Activation, we examined associations with the Difficulties in Emotion Regulation Scale, a measure of emotion dysregulation. The sample consisted of 1,787 participants from an outpatient treatment facility. Confirmatory factor analysis replicated the existence of Positive and Negative Activation subscales. Logistic regressions, as hypothesized, found that Positive Activation was positively associated only with bipolar disorder, while Negative Activation was associated with almost all disorders. The Impulse and Goals subscales of the Difficulties in Emotion Regulation Scale were uniquely associated with Negative Activation, suggesting it may specifically assess impulsive behavior in emo...
ABSTRACT Alcohol misuse among young adult college students remains a major public health problem ... more ABSTRACT Alcohol misuse among young adult college students remains a major public health problem in the United States. Although much effort has been made to identify factors associated with problem drinking among college students, there is a lack of research investigating the role parents may have on college student drinking. Recent evidence indicates parents matter when it comes to adolescent drinking, both before and after their children go to college. In this study, the authors examined mutual reciprocity as a moderator variable between perceived parental approval of drinking and negative consequences of alcohol use. Contrary to the hypothesized results, our findings indicate that mutual reciprocity does not moderate the relationship between perceived parental approval and negative alcohol-related consequences.
Influential psychological theories hypothesize that people consume alcohol in response to the exp... more Influential psychological theories hypothesize that people consume alcohol in response to the experience of both negative and positive emotions. Despite two decades of daily diary and ecological momentary assessment research, it remains unclear whether people consume more alcohol on days they experience higher negative and positive affect in everyday life. In this preregistered meta-analysis, we synthesized the evidence for these daily associations between affect and alcohol use. We included individual participant data from 69 studies (N = 12,394), which used daily and momentary surveys to assess affect and the number of alcoholic drinks consumed. Results indicate that people do not drink more often on days they experience high negative affect, but are more likely to drink and drink heavily on days high in positive affect. People self-reporting a motivational tendency to drink-to-cope and drink-to-enhance were estimated to consume more alcohol, but not to consume more alcohol on day...
We aim to test whether the experience of boredom is associated with cannabis craving and use amon... more We aim to test whether the experience of boredom is associated with cannabis craving and use among adolescents receiving treatment for cannabis misuse. Boredom was assessed via smartphone reports completed multiple times per day in daily life, and we plan to focus only on boredom occurring outside of cannabis use episodes; on days when participants used cannabis, we will only examine boredom prior to cannabis use.
Alcoholism: Clinical and Experimental Research, 2021
BACKGROUND Naltrexone is an efficacious medication for the treatment of alcohol use disorder in a... more BACKGROUND Naltrexone is an efficacious medication for the treatment of alcohol use disorder in adults. As an opioid receptor antagonist, naltrexone blocks activation of the endogenous opioid system, which is involved in the affectively reinforcing properties of substance use. Few studies, however, have examined the moderating effect of naltrexone on the association of affect and alcohol use. Additionally, most existing research on naltrexone studied adults in the human laboratory. METHOD We conducted a secondary analysis of ecological momentary assessment data from a randomized, double-blinded, placebo-controlled cross-over study, comparing naltrexone (50 mg/daily) and placebo in 26 adolescents (15-19 years old) exhibiting problematic drinking patterns. Multilevel models tested whether naltrexone moderated associations of alcohol use with both positive and negative affect (PA, NA). RESULTS Results indicated that, during the naltrexone arm, greater estimated blood alcohol concentration (eBAC) levels were associated with greater NA further into drinking episodes. In turn, greater NA after the first drink of an episode was associated with reduced subsequent eBAC values in the naltrexone arm. Low PA was also associated with lower subsequent eBAC levels in the naltrexone condition after the first drink. CONCLUSIONS Findings support the idea that naltrexone can disrupt the association of affect and alcohol use, and these effects emerge later in drinking episodes. Greater attention to the effects of naltrexone on affect and reinforcement may help us to better tailor psychotherapy to maximize the benefits of naltrexone. However, as most drink reports were in the first two hours of the drinking episode and participants only reported affect at the first three end-drink reports of a drinking episode (limiting the number of drinks reported), replication of the findings is needed.
This study builds upon research indicating that focusing narrowly on model fit when evaluating fa... more This study builds upon research indicating that focusing narrowly on model fit when evaluating factor analytic models can lead to problematic inferences regarding the nature of item sets, as well as how models should be applied to inform measure development and validation. To advance research in this area, we present concrete examples relevant to researchers in clinical, personality, and related subfields highlighting two specific scenarios when an overreliance on model fit may be problematic. Specifically, we present data analytic examples showing that focusing narrowly on model fit may lead to (a) incorrect conclusions that heterogeneous item sets reflect narrower homogeneous constructs and (b) the retention of potentially problematic items when developing assessment measures. We use both interview data from adult outpatients (N = 2,149) and self-report data from adults recruited online (N = 547) to demonstrate the importance of these issues across sample types and assessment meth...
Supplemental material, Miranda_Open_Practices_Disclosure for Weaker Memory Performance Exacerbate... more Supplemental material, Miranda_Open_Practices_Disclosure for Weaker Memory Performance Exacerbates Stress-Induced Cannabis Craving in Youths’ Daily Lives by Robert Miranda, Stephanie E. Wemm, Hayley Treloar Padovano, Ryan W. Carpenter, Noah N. Emery, Joshua C. Gray and Ethan H. Mereish in Clinical Psychological Science
Difficulty regulating substance use is a core feature of addiction that can manifest as unplanned... more Difficulty regulating substance use is a core feature of addiction that can manifest as unplanned use. This study sought to identify internal and situational influences on unplanned marijuana use among youth ages 15 to 24 years (N = 85; 48% female; 27% age <18 years). Additionally, we disentangled person-level associations from within-person day-to-day influences. Ecological momentary assessment methods captured affective (positive: energized, excited, sociable, happy, relaxed; negative: bored, tense, sad, stressed) and situational factors in real-world settings during a 1-week monitoring period. Participants reported no plan to use on 51% of days (269/527), and youth ultimately used marijuana on 35% of these unplanned days. At the day level, on days when youth spent more time in the presence of marijuana-related cues than they typically do, they used more grams on planned days and less on unplanned days. Regardless of use plans, youth were more likely to use on days when they spent more time with using friends and if they reported greater availability of marijuana in general across the monitoring period. At the person level, youth who generally reported higher positive affect, relative to other participants, used more on planned days and less on unplanned days. Regardless of use plans, youth who generally reported greater craving and time in the presence of marijuana-related cues used more grams, whereas youth who generally reported greater negative affect used less. Together, findings revealed several factors, with clear clinical relevance, which may explain why some youth struggle to control their marijuana use. (PsycINFO Database Record (c) 2020 APA, all rights reserved).
Theories of addiction posit that stimuli associated with drug use, including both exteroceptive (... more Theories of addiction posit that stimuli associated with drug use, including both exteroceptive (e.g., paraphernalia) and interoceptive (e.g., feeling tense or stressed), evoke craving and contribute to the pathogenesis of substance misuse. Control over drug cue response and stress is essential for moderating use. Building from laboratory data supporting associations between cue exposure, stress, and craving, this study tested whether these associations generalize to real-world settings and examined whether a well-vetted neurocognitive control capacity (i.e., working memory, or WM) moderated associations. Youths ( N = 85; 15–24 years old) completed baseline and ecological momentary assessments. Cue exposure and participants’ average stress predicted higher craving. Youths with weaker WM experienced stronger craving at higher-stress moments but not when faced with cues. Interactions were present for both previous-moment and same-moment stress. Craving among adolescents with stronger ...
The Mood Disorder Questionnaire is a screening measure for bipolar disorder, previously found to ... more The Mood Disorder Questionnaire is a screening measure for bipolar disorder, previously found to comprise separate Positive and Negative Activation subscales. We sought to replicate these factors and examine their associations with a range of psychopathology. To further explicate the nature of Negative Activation, we examined associations with the Difficulties in Emotion Regulation Scale, a measure of emotion dysregulation. The sample consisted of 1,787 participants from an outpatient treatment facility. Confirmatory factor analysis replicated the existence of Positive and Negative Activation subscales. Logistic regressions, as hypothesized, found that Positive Activation was positively associated only with bipolar disorder, while Negative Activation was associated with almost all disorders. The Impulse and Goals subscales of the Difficulties in Emotion Regulation Scale were uniquely associated with Negative Activation, suggesting it may specifically assess impulsive behavior in emo...
ABSTRACT Alcohol misuse among young adult college students remains a major public health problem ... more ABSTRACT Alcohol misuse among young adult college students remains a major public health problem in the United States. Although much effort has been made to identify factors associated with problem drinking among college students, there is a lack of research investigating the role parents may have on college student drinking. Recent evidence indicates parents matter when it comes to adolescent drinking, both before and after their children go to college. In this study, the authors examined mutual reciprocity as a moderator variable between perceived parental approval of drinking and negative consequences of alcohol use. Contrary to the hypothesized results, our findings indicate that mutual reciprocity does not moderate the relationship between perceived parental approval and negative alcohol-related consequences.
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