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The Mediating Role of Cognitive Flexibility in the Relationship between Traumatic Experiences in the Childhood Period and Substance Abuse Proclivity

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Abstract

Within the scope of this study, the mediating effect of cognitive flexibility in the relationship between traumatic experiences in the childhood period and substance abuse tendency was investigated. In the study 532 university students at undergraduate level participated. In selecting of the sample of this study, the convenience sampling methods in probability sampling methods were used. Participants completed a Demographic Information Form, Childhood Trauma Questionnaire-Short Form, Substance Abuse Proclivity Scale and Cognitive Flexibility Inventory. The results of the analysis found evidence of a positive significant correlation between all subdimensions of childhood traumatic experiences and substance abuse proclivity and negative significant correlations between all subdimensions of childhood abuse experiences and substance abuse tendency with cognitive flexibility. According to the mediation test results, cognitive flexibility was identified to play a partial mediating role in the correlation between all subdimensions of childhood abuse experiences and substance abuse tendency. The mediating role of cognitive flexibility in the relationship between childhood traumatic experiences and substance abuse tendency explained between 13 and 23% of the total effect. Mediating variable analysis showed that cognitive flexibility has a partial mediating effect between all subdimensions of childhood abuse experiences and substance abuse tendency.

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References

  • Afifi, T. O. (2012). The relationship between child maltreatment and axis I mental disorders: A summary of the published literature from 2006 to 2010. Open Journal of Psychiatry, 2, 21–32. https://doi.org/10.4236/ojpsych.2012.21004.

    Article  Google Scholar 

  • Altunkol, F. (2011). The analysis of the relation between cognitive flexibility and perceived stress levels of college students. Unpublished Master’s Thesis, Cukurova University Institute of Social Sciences, Adana.

  • Arikan, Z. (2011). Alcohol use disorder. In Y. Akvardarlar, Z. Arıkan, K. Berkman, N. Dilbaz, G. Oral, B. Uluğ, İ. T. Uzbay, S. Aknür Annette, M. Bilici, D. Tamar Gürol, L. Mete, Ş. C. Gürel, & N. Zorlu (Eds.), Substance abuse diagnosis and treatment guide handbook. TR Ministry of Health, General Directorate of Health Services (pp. 105–124). Ankara: Positive Press.

    Google Scholar 

  • Bandura, A. (1986). Social foundations of thought and action: A social cognitive theory. Upper Saddle River: Prentice-Hall.

    Google Scholar 

  • Baron, R. M., & Kenny, D. A. (1986). The moderator-mediator variable distinction in social psychological research: Conceptual, strategic, and statistical considerations. Journal of Personality and Social Psychology, 51(6), 1173–1182. https://doi.org/10.1037//0022-3514.51.6.1173.

    Article  PubMed  Google Scholar 

  • Berber Celik, Ç., & Odaci, H. (2019). Does child abuse have an impact on self-esteem, depression, anxiety and stress conditions of individuals? International Journal of Social Psychiatry, 66(2), 171–178. https://doi.org/10.1177/0020764019894618.

    Article  PubMed  Google Scholar 

  • Bernstein, D. P., Stein, J. A., Newcomb, M. D., Walker, E., Pogge, D., Ahluvalia, T., et al. (2003). Development and validation of a brief screening version of the childhood trauma questionnaire. Child Abuse and Neglect, 27, 169–190. https://doi.org/10.1016/S0145-2134(02)00541-0.

    Article  PubMed  Google Scholar 

  • Bilgin, M. (2009). Some variables predicting cognitive flexibility. Cukurova University Journal of Education Faculty, 3(36), 142–157.

    Google Scholar 

  • Briere, J. N., & Elliott, D. M. (1994). Immediate and long-term impacts of child sexual abuse. The Future of children/Center for the Future of Children, the David and Lucile Packard Foundation, 4, 54–69. https://doi.org/10.2307/1602523.

    Article  Google Scholar 

  • Brown, T. A. (2006). Confirmatory factor analysis for applied research. New York: Guilford Press.

    Google Scholar 

  • Bruce, L. C., Heimberg, R. G., Goldin, P. R., & Gross, J. J. (2013). Childhood maltreatment and response to cognitive behavioral therapy among individuals with social anxiety disorder. Depression and Anxiety, 30, 662–669. https://doi.org/10.1002/da.22112.

    Article  PubMed  Google Scholar 

  • Bulbul, K., & Odaci, H. (2018a). High school students’ substance abuse tendencies: A comparison based on personal, social, and academic variables. Addicta: The Turkish Journal on Addictions, 5(4), 691–719. https://doi.org/10.15805/addicta.2018.5.4.0026.

    Article  Google Scholar 

  • Bulbul, K., & Odaci, H. (2018b). Hopelessness, attachment style and family structure’s predictive power in substance abuse proclivity among high school students. Turkish Journal of Clinical Psychiatry, 21(4), 360–369. https://doi.org/10.5505/kpd.2018.06977.

    Article  Google Scholar 

  • Campbell, R., Dworkin, E., & Cabral, G. (2009). An ecological model of the impact of sexual assault on women’s mental health. Trauma, Violence, and Abuse, 10, 225–246. https://doi.org/10.1177/1524838009334456.

    Article  PubMed  Google Scholar 

  • Celikkaleli, Ö. (2014). The relation between cognitive flexibility and academic, social and emotional self-efficacy beliefs among adolescents. Education and Science, 39, 347–354. https://doi.org/10.15390/EB.2014.3467.

    Article  Google Scholar 

  • Ceyhun, B., Oguzturk, Ö., & Ceyhun, A. G. (2001). The reliability and validity of substance abuse proclivity scale. Turkish Journal of Clinical Psychiatry, 4, 87–93.

    Google Scholar 

  • Clark, D. B., Thatcher, D. L., & Martin, C. S. (2010). Child abuse and other traumatic experiences, alcohol use disorders, and health problems in adolescence and young adulthood. Journal of Pediatric Psychology, 35(5), 499–510. https://doi.org/10.1093/jpepsy/jsp117.

    Article  PubMed  Google Scholar 

  • Cook, M. N., & Peterson, J. (2011). Substance abuse. Berman’s Pediatric Decision Making. https://doi.org/10.1016/b978-0-323-05405-8.00122-4.

    Article  Google Scholar 

  • Crawford, E., & O’Dougherty Wright, M. (2007). The impact of childhood psychological maltreatment on interpersonal schemas and subsequent experiences of relationship aggression. Journal of Emotional Abuse, 7, 93–116. https://doi.org/10.1300/J135v07n02_06.

    Article  Google Scholar 

  • Cuhadaroglu, A. (2011). Predictors of cognitive flexibility. Unpublished Doctoral Thesis. Ankara University, Institute of Educational Sciences, Ankara.

  • Cuhadaroglu, A. (2013). Predictors of cognitive flexibility. Cumhuriyet International Journal of Education, 2(1), 86–101.

    Google Scholar 

  • Delano-Wood, L. M. (2002). The relationship between cognitive flexibility, depression, and anxiety in older adults. Unpublished Master’s Thesis, Michigan State University, USA.

  • Dennis, J. P., & Vander Wal, J. S. (2010). The cognitive flexibility inventory: Instrument development and estimates of reliability and validity. Cognitive Therapy and Research, 34(3), 241–253. https://doi.org/10.1007/s10608-009-9276-4.

    Article  Google Scholar 

  • Diril, A. (2011). An investigation of cognitive flexibility in terms of sociodemographic variables and anger level and anger styles in adolescent. Unpublished Master’s Thesis, Cukurova University Institute of Social Sciences, Adana.

  • English, A., Widom, M., & Brandfor, G. (2004). Another look at the effect of child abuse. NIJ Journal, 18, 251–259.

    Google Scholar 

  • Finkelhor, D. (1990). Early and long-term effects of child sexual abuse: An update. Professional Psychology: Research and Practice, 21, 325–330. https://doi.org/10.1037/0735-7028.21.5.325.

    Article  Google Scholar 

  • Fisher, H. L., Appiah-Kusi, E., & Grant, C. (2012). Anxiety and negative self-schemas mediate the association between childhood maltreatment and paranoia. Psychiatry Research, 196, 323–324. https://doi.org/10.1016/j.psychres.2011.12.004.

    Article  PubMed  Google Scholar 

  • Gay, L. E., Harding, H. G., Jackson, J. L., Burns, E. E., & Baker, B. D. (2013). Attachment style and early maladaptive schemas as mediators of the relationship between childhood emotional abuse and intimate partner violence. Journal of Aggression, Maltreatment and Trauma, 22, 408–424. https://doi.org/10.1080/10926771.2013.775982.

    Article  Google Scholar 

  • Gulum, I. V., & Dag, I. (2012). The Turkish adaptation, validity and reliability study of the repetitive thinking questionnaire and the cognitive flexibility inventory. Anatolian Journal of Psychiatry, 13(3), 216–223.

    Google Scholar 

  • Harms, M. B., Shannon Bowen, K. E., Hanson, J. L., & Pollak, S. D. (2017). Instrumental learning and cognitive flexibility processes are impaired in children exposed to early life stress. Developmental Science, 21(4), 1–13.

    Google Scholar 

  • Hart, H., & Rubia, K. (2012). Neuroimaging of child abuse: A critical review. Frontiers in Human Neuroscience, 6, 52.

    Article  PubMed  PubMed Central  Google Scholar 

  • Hayes, S. C., Luoma, J. B., Bond, F. W., Masuda, A., & Lillis, J. (2006). Acceptance and commitment therapy: Model, processes, and outcomes. Behavior Research and Therapy, 44(1), 1–25.

    Article  Google Scholar 

  • Hughes, T. L., Johnson, T. P., Wilsnack, S. C., & Szalacha, L. A. (2007). Childhood risk factors for alcohol abuse and psychological distress among adult lesbians. Child Abuse and Neglect, 31(7), 769–789. https://doi.org/10.1016/j.chiabu.2006.12.014.

    Article  PubMed  Google Scholar 

  • Johnco, C., Wuthrich, V. M., & Rapee, R. M. (2014). The influence of cognitive flexibility on treatment outcome and cognitive restructuring skill acquisition during cognitive behavioural treatment for anxiety and depression in older adults: Results of a pilot study. Behaviour Research and Therapy, 57c(1), 55–64.

    Article  Google Scholar 

  • Kaya, S. (2014). The adaptation of the brief screening version of childhood trauma questionnaire into Turkish. Unpublished Master’s Thesis, Sıtkı Koçman University Educational Sciences Institute, Muğla.

  • Kazantzis, N., Flett, R. A., Long, N. R., MacDonald, C., Millar, M., & Clark, B. (2010). Traumatic events and mental health in the community: A New Zealand study. International Journal of Social Psychiatry, 56(1), 35–49. https://doi.org/10.1177/0020764008095929.

    Article  PubMed  Google Scholar 

  • Kim-Spoon, J. A., Cicchetti, D., & Rogosch, F. A. (2012). A longitudinal study of emotion regulation, emotion lability-negativity, and internalizing symptomatology in maltreated and nonmaltreated children. Child Development, 84, 512–527.

    Article  PubMed  PubMed Central  Google Scholar 

  • Kline, R. B. (2016). Principles and practice of structural equation modeling. London: The Guilford Press.

    Google Scholar 

  • Koob, G. F., Everitt, B. J., & Robbins, T. W. (2013). Reward, motivation, and addiction. Fundamental Neuroscience. https://doi.org/10.1016/b978-0-12-385870-2.00041-x.

    Article  Google Scholar 

  • Kural, S., Evren, C., & Cakmak, D. (2005). Personality disorder comorbidity among substance dependents and its relationship with other axis I disorders and childhood abuse and neglect history. Journal of Dependence, 6(1), 9–18.

    Google Scholar 

  • Kushner, M. G., Abrams, K., & Borchardt, C. (2000). The relationship between anxiety disorders and alcohol use disorders: A review of major perspectives and findings. Clinical Psychology Review, 20(2), 149–171. https://doi.org/10.1016/S0272-7358(99)00027-6.

    Article  PubMed  Google Scholar 

  • Lau, J. T. F., Kim, J. H., Tsui, H. Y., Cheung, A., Lau, M., & Yu, A. (2005). The relationship between physical maltreatment and substance use among adolescents: A survey of 95,788 adolescents in Hong Kong. Journal of Adolescent Health, 37(2), 110–119. https://doi.org/10.1016/j.jadohealth.2004.08.005.

    Article  Google Scholar 

  • Lin, W. L., Tsai, P. H., Lin, H. Y., & Chen, H. C. (2014). How does emotion influence different creative performances? The mediating role of cognitive flexibility. Cognition and Emotion, 28, 834–844. https://doi.org/10.1080/02699931.2013.854195.

    Article  PubMed  Google Scholar 

  • Lubin, H., Johnson, D. R., & Southwick, S. M. (1996). Impact of child abuse on adult psychopathology: A case report. Dissociation, 9(2), 134–139.

    Google Scholar 

  • Luoma, J., Drake, C. E., Kohlenberg, B. S., & Hayes, S. C. (2011). Substance abuse and psychological flexibility: The development of a new measure. Addiction Research & Theory, 19(1), 3–13. https://doi.org/10.3109/16066359.2010.524956.

    Article  Google Scholar 

  • MacAndrew, C. (1986). Toward the psychometric detection of substance misuse in young men: The SAP scale. Journal of Studies on Alcohol, 47(2), 161–166. https://doi.org/10.15288/jsa.1986.47.161.

    Article  PubMed  Google Scholar 

  • Martin, M. M. (1994). Development of a measure of interpersonal communication competence. Communication Research Reports, 59, 171–178. https://doi.org/10.1080/08824099409359938.

    Article  Google Scholar 

  • Martin, M. M., & Anderson, C. M. (1998). The cognitive flexibility scale: Three validity studies. International Journal of Phytoremediation, 11, 1–9. https://doi.org/10.1080/08934219809367680.

    Article  Google Scholar 

  • Martin, M. M., & Rubin, R. B. (1995). A new measure of cognitive flexibility. Psychological Reports, 76(2), 623–626.

    Article  Google Scholar 

  • Martin, M. M., Staggers, S. M., & Anderson, C. M. (2011). The relationships between cognitive flexibility with dogmatism, intellectual flexibility, preference for consistency, and self-compassion. Communication Research Reports, 28, 275–280. https://doi.org/10.1080/08824096.2011.587555.

    Article  Google Scholar 

  • Möhler, E., Matheis, V., Poustka, L., Marysko, M., Finke, P., Kaufmann, C., et al. (2009). Mothers with a history of abuse tend to show more impulsiveness. Child Abuse and Neglect, 33, 123–126. https://doi.org/10.1016/j.chiabu.2008.06.002.

    Article  PubMed  Google Scholar 

  • Molnar, B. E., Buka, S. L., & Kessler, R. C. (2001). Child sexual abuse and subsequent psychopathology: Results from the national comorbidity survey. American Journal of Public Health, 91, 753–760. https://doi.org/10.2105/AJPH.91.5.753.

    Article  PubMed  PubMed Central  Google Scholar 

  • Norman, R. E., Byambaa, M., De, R., Butchart, A., Scott, J., & Vos, T. (2012). The long-term health consequences of child physical abuse, emotional abuse, and neglect: A systematic review and meta-analysis. PLoS Medicine, 9(11), 1–31. https://doi.org/10.1371/journal.pmed.1001349.

    Article  Google Scholar 

  • Oz, S. (2012). Analysis of the relationship between the cognitive flexibility, adaptation and anxiety levels in adolescents based on sex, socio-economic status and education level. Unpublished Master’s Thesis, Cukurova University Institute of Social Sciences, Adana.

  • Palm, K. M., & Follette, V. M. (2011). The roles of cognitive flexibility and experiential avoidance in explaining psychological distress in survivors of interpersonal victimization. Journal of Psychopathology and Behavioral Assessment, 33, 79–86. https://doi.org/10.1007/s10862-010-9201-x.

    Article  Google Scholar 

  • Payne, J. W., Bettman, J. R., & Johnson, E. J. (1993). The adaptive decision maker. Cambridge: Cambridge University Press. https://doi.org/10.1017/cbo9781139173933.

    Book  Google Scholar 

  • Polat, O. (2007). All sizes of child abuse 1: Definitions. Ankara: Seckin Publishing.

    Google Scholar 

  • Preacher, K. J., & Hayes, A. F. (2008). Asymptotic and resampling strategies for assessing and comparing indirect effects in multiple mediator models. Behavior Research Methods, 40, 879–891. https://doi.org/10.3758/BRM.40.3.879.

    Article  PubMed  Google Scholar 

  • Ryan, J. E., Smeltzer, S. C., & Sharts-Hopko, N. C. (2019). Challenges to studying illicit drug users. Journal of Nursing Scholarship, 51(4), 480–488. https://doi.org/10.1111/jnu.12486.

    Article  PubMed  PubMed Central  Google Scholar 

  • Seedat, S., Stein, M. B., & Forde, D. R. (2005). Association between physical partner violence, posttraumatic stress, childhood trauma, and suicide attempts in a community sample of women. Violence and Victims, 20, 87–98. https://doi.org/10.1891/0886-6708.2005.20.1.87.

    Article  PubMed  Google Scholar 

  • Sesar, K., Simic, N., & Barisic, M. (2010). Multi-type childhood abuse, strategies of coping, and psychological adaptations in young adults. Croatian Medical Journal, 51, 406–416. https://doi.org/10.3325/cmj.2010.51.406.

    Article  PubMed  PubMed Central  Google Scholar 

  • Shahab, M., & Taklavi, S. (2019). The relationship between the effects of adverse childhood experiences with emotion regulation and cognitive flexibility in teenage students. International Journal of School. Health, 6(4), 41–47.

    Google Scholar 

  • Shimogori, Y. (2013). Impact of biculturalism on self-efficacy and cognitive flexibilty of Japanese adults. Doctoral dissertation, Claremont Graduate University, USA.

  • Silver, J. A., Hughes, J. D., Bornstein, R. A., & Beversdorf, D. Q. (2004). Effect of anxiolytics on cognitive flexibility in problem solving. Cognitive and Behavioral Neurology, 17, 93–97. https://doi.org/10.1097/01.wnn.0000119240.65522.d9.

    Article  PubMed  Google Scholar 

  • Smith, C. A., Ireland, T. O., & Thornberry, T. P. (2005). Adolescent maltreatment and its impact on young adult antisocial behavior. Child Abuse and Neglect, 29, 1099–1119. https://doi.org/10.1016/j.chiabu.2005.02.011.

    Article  PubMed  Google Scholar 

  • Spann, M. N., Mayes, L. C., Kalmar, J. H., et al. (2012). Childhood abuse and neglect and cognitive flexibility in adolescents. Child Neuropsychology, 18(2), 182–189. https://doi.org/10.1080/09297049.2011.595400.

    Article  PubMed  Google Scholar 

  • The European Monitoring Centre For Drugs And Drug Addiction [EMCDDA]. (2018). European drug report 2018: Trends and developments. Luxembourg: Office For Official Publications Of The European Communities.

    Google Scholar 

  • Third Child Welfare İnformation Cateway [3. CWIC]. (2016). Definitions of child abuse and neglect children’s bureau 2016. Retrieved June 22, 2018, from https://www.childwelfare.gov/topics/can/.

  • Thornton, K., Veikly, W., Hollifield, M., Ruiz, J., Skipper, B., & Hawkins, T. (2005). Surving childhood abuse: Health risk behaviors in an HIV-infected clinic population 2005. Retrieved February 25, 2018, from http://www.retroconference.org/2005/CD/Abstracts/25194.ht.

  • Toker, T., Tiryaki, A., Ozcurumez, G., & Iskender, B. (2011). The relationship between traumatic childhood experiences and proclivities towards substance abuse, self-esteem and coping strategies. Turkish Journal of Psychiatry, 22(2), 83–92.

    PubMed  Google Scholar 

  • Turkish Statistical Institute [TSI]. (2018). Turkey health research. Retrieved July 18, 2018, fromhttp://www.tuik.gov.tr/PreTablo.do?alt_id=1095.

  • Windle, M. (1986). Sex role orientation, cognitive flexibility, and life satisfaction among older adults. Psychology of Women Quarterly, 10, 263–273. https://doi.org/10.1111/j.1471-6402.1986.tb00752.x.

    Article  Google Scholar 

  • World Health Organization [WHO]. (2018). Child maltreatment 2016. Retrieved June 22, 2018, from http://www.who.int/mediacentre/factsheets/fs150/en/..

  • Zahal, O. (2014). Relation between learning styles and cognitive flexibility with examination achievement who enter the special ability exam. Unpublished doctoral dissertation. Inönü University, Institute of Educational Sciences, Malatya.

  • Zhang, C.-Q., Leeming, E., Smith, P., Chung, P.-K., Hagger, M. S., & Hayes, S. C. (2018). Acceptance and commitment therapy for health behavior change: A contextually-driven approach. Frontiers in Psychology, 8, 2350–2356.

    Article  PubMed  PubMed Central  Google Scholar 

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  1. Psychological Counseling and Guidance, Department of Educational Sciences, Fatih Faculty of Education, Trabzon University, Trabzon, Turkey

    Hatice Odacı, Kenan Bülbül & Tuğba Türkkan

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  1. Hatice Odacı
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Odacı, H., Bülbül, K. & Türkkan, T. The Mediating Role of Cognitive Flexibility in the Relationship between Traumatic Experiences in the Childhood Period and Substance Abuse Proclivity. J Rat-Emo Cognitive-Behav Ther 39, 538–554 (2021). https://doi.org/10.1007/s10942-020-00385-w

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