title: Positive affect and processes of recovery among treatment-seeking methamphetamine users.
abstract: BACKGROUND
  Revised Stress and Coping Theory proposes that positive affect serves adaptive functions, independent of negative affect. However, scant research has examined whether, how, and under what circumstances positive affect is associated with decreased substance use.
  
  
  METHODS
  Eighty-eight methamphetamine-using men who have sex with men (MSM) completed the baseline assessment for substance abuse treatment outcome study which included measures of positive and negative affect, cognitive-behavioral change processes (i.e., approach-oriented coping, self-efficacy for managing methamphetamine triggers, and abstinence-related action tendencies), abstinence-specific social support, and self-reported substance use. Participants also provided a urine sample for toxicology screening.
  
  
  RESULTS
  After controlling for demographic characteristics and negative affect, higher positive affect was independently associated with greater approach-oriented coping, abstinence-related action tendencies, and abstinence-specific social support. Positive affect was also independently associated with greater self-efficacy for managing methamphetamine triggers, but only at lower levels of negative affect. Through these cognitive-behavioral and social pathways, positive affect was indirectly associated with lower frequency of stimulant use in the past 30 days, lower odds of reporting stimulant use two or more days in a row, and lower odds of providing a urine sample that was reactive for stimulant metabolites. On the other hand, negative affect was not indirectly associated with any measure of stimulant use.
  
  
  CONCLUSIONS
  Clinical research is needed to examine the pathways whereby positive affect may predict better substance abuse treatment outcomes.
authors.affiliation: University of California, San Francisco School of Nursing, San Francisco, CA, United States; University of California, San Francisco Center for AIDS Prevention Studies, San Francisco, CA, United States. Electronic address: adam.carrico@ucsf.edu.
authors.forename: Adam W
authors.initials: AW
authors.lastname: Carrico
authors.forename: William J
authors.initials: WJ
authors.lastname: Woods
authors.forename: Michael D
authors.initials: MD
authors.lastname: Siever
authors.forename: Michael V
authors.initials: MV
authors.lastname: Discepola
authors.forename: Samantha E
authors.initials: SE
authors.lastname: Dilworth
authors.forename: Torsten B
authors.initials: TB
authors.lastname: Neilands
authors.forename: Nicole
authors.initials: N
authors.lastname: Miller
authors.forename: Judith Tedlie
authors.initials: JT
authors.lastname: Moskowitz
mesh_terms: D000328:Adult; D000368:Aged; D019969:Amphetamine-Related Disorders / Q000523:psychology* / Q000628:therapy*; D015331:Cohort Studies; D018451:Homosexuality, Male / Q000523:psychology*; D006801:Humans; D008297:Male; D008694:Methamphetamine; D008875:Middle Aged; D011446:Prospective Studies; D020377:Self Efficacy; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D008694:Methamphetamine
keywords: Coping; HIV; Methamphetamine; Negative affect; Positive affect; Social support