Bibliographic record
Abstract
Alcohol and tobacco use are leading causes of preventable death. Studying novel determinants of substance use may inform prevention and cessation. Attachment insecurity (attachment avoidance and attachment anxiety) describes interactions between adults and their attachment figures, which may influence substance use. This thesis assessed how attachment may be relevant in understanding and addressing substance use. Study 1, a cross-sectional survey study of 348 adult primary care patients, tested hypothesized associations between childhood adversity, attachment insecurity and substance use; if attachment insecurity could mediate between childhood adversity and substance use; and hypothesized sex differences in these associations. In Study 2, 38 smokers participated in experiments designed to assess the influence of cigarette cues and an attachment figure photo on craving and affect. In Study 1, 61% of participants reported childhood adversity, 11% reported harmful drinking and 20% reported current smoking. Attachment anxiety was associated with harmful drinking in women and men. Attachment anxiety was a statistical mediator between childhood adversity and harmful drinking (95% CI 0.09 to 0.30). Sex did not moderate the relationship between attachment anxiety and hazardous drinking in this mediation model. In women, attachment anxiety was associated with both childhood adversity (p=.002) and current smoking (p=.04), and was a statistical mediator between childhood adversity and smoking (95% CI 0.003 to 0.236). In Study 2, 56% of participants reported decreased craving after seeing an attachment figure photo (Neutral photo = 50.9 (SD 29.8), Attachment figure photo = 38.2 (SD 31.6), t(35)= -2.661, p=0.01). Cigarette cues (d=.50) and the attachment figure photo (d=.42) had similar effect sizes. Cigarette cue reactivity and attachment figure smoking status did not influence responses to photo exposures. Attachment anxiety was associated with alcohol and tobacco use, and may mediate between childhood adversity and substance use. Viewing an attachment figure photo decreased craving in smokers, with an effect that is comparable to the increase caused by cigarette cues. These studies indicate that attachment phenomena may play a role in substance use. Childhood adversity, attachment anxiety, and the presence of an attachment figure are factors to consider in the design of prevention and cessation strategies.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".