The Predictive Value of Emotion Regulation in Cocaine Use Disorder Severity: Psychotherapeutic Implications During...

Traditional treatment approaches in cocaine use disorder (CUD) still report high rates of poor outcomes. Emotion regulation (ER) is a transdiagnostic factor that may contribute to the initiation and maintenance of CUD, strengthening addiction severity. A deeper understanding of ER in this population is crucial for improving treatment outcomes. This study explores whether ER difficulties at treatment entry predict addiction severity and withdrawal symptom severity after discharge in patients with CUD. Secondarily, it examines whether withdrawal symptom severity mediates the relationship between ER difficulties and relapse.

A total of 70 CUD patients underwent a 14-day inpatient detoxification. At admission, cocaine use-related variables and ER questionnaires (DERS and ERQ) were registered. After discharge, addiction severity (SDS), craving (WCS), cocaine withdrawal symptom severity (CSSA) and relapse were recorded. Multiple linear regression and mediation analysis were conducted to address the primary and secondary aims, respectively. This study draws on data from a larger randomized clinical trial.

Impulse control difficulties and nonacceptance of emotional responses predicted SDS, and nonacceptance of emotional responses predicted CSSA. However, mediation analyses showed no indirect effect of DERS total score on relapse through the effect of the mediating variable CSSA.

ER screening at hospitalization admission may optimize treatment by identifying high-risk CUD patients. Third-generation therapies targeting ER skills may enhance outcomes by helping patients manage emotional distress, potentially reducing addiction severity and withdrawal symptoms. Because of mixed results and the exploratory nature of this study, further research on the ER role in this context is needed.

ClinicalTrials.gov; ID: NCT05207228.