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Tidey JW, Rohsenow DJ, Kaplan GB, Swift RM, Ahnallen CG. Separate and combined effects of very low nicotine cigarettes and nicotine replacement in smokers with schizophrenia and controls. Nicotine Tob Res 2012; 15:121-9. [PMID: 22517190 DOI: 10.1093/ntr/nts098] [Citation(s) in RCA: 51] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
INTRODUCTION The prevalence of smoking among people with schizophrenia in the United States is about 3 times that of the general population. Novel approaches are needed to reduce rates of smoking-related morbidity and mortality among these smokers. METHODS This study used a within-subjects design to investigate the separate and combined effects of sensorimotor replacement for smoking (very low nicotine content [VLNC] cigarettes vs. no cigarettes) and transdermal nicotine replacement (42 mg nicotine [NIC] vs. placebo [PLA] patches) in smokers with schizophrenia (SS; n = 30) and control smokers without psychiatric illness (CS; n = 26). Each session contained a 5-hr controlled administration period in which participants underwent the following conditions, in counterbalanced order: VLNC + NIC, VLNC + PLA, no cigarettes + NIC, no cigarettes + PLA, usual-brand cigarettes + no patches. Next, participants completed measures of cigarette craving, nicotine withdrawal, smoking habit withdrawal, and cigarette subjective effects, followed by a 90-min period of ad libitum usual-brand smoking. RESULTS Smoking VLNC cigarettes during the controlled administration periods reduced cigarette craving, nicotine withdrawal symptoms, habit withdrawal symptoms, and usual-brand smoking in SS and CS relative to the no cigarette conditions. VLNC cigarettes were well accepted by both groups and did not affect psychiatric symptom levels in SS. Transdermal nicotine significantly reduced cigarette craving but did not affect usual-brand smoking. CONCLUSIONS These findings suggest that reducing the nicotine content of cigarettes to nonaddictive levels may be a promising approach for reducing nicotine dependence among people with schizophrenia.
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Rohsenow DJ, Howland J, Winter M, Bliss CA, Littlefield CA, Heeren TC, Calise TV. Hangover sensitivity after controlled alcohol administration as predictor of post-college drinking. JOURNAL OF ABNORMAL PSYCHOLOGY 2011; 121:270-5. [PMID: 21859168 DOI: 10.1037/a0024706] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Predicting continued problematic levels of drinking after the early 20's could help with early identification of persons at risk. This study investigated whether hangover insensitivity could predict postcollege drinking and problems beyond the variance due to drinking patterns. In a preliminary study, 134 college seniors from a laboratory study of hangover (Time 1) were contacted and assessed 1-4 years (M = 2.3) later (Time 2). Hangover severity was studied after controlled alcohol administration to a specific dose while controlling sleep and environmental influences. Hangover severity at Time 1 was used to predict Time 2 drinking volume and problems while controlling for relevant demographics and Time 1 drinking volume. Hangover insensitivity at Time 1 tended to predict a clinical level of alcohol problems with a large statistical effect size. Hangover sensitivity also correlated positively with sensitivity to alcohol intoxication. Hangover severity did not predict future drinking volume. Hangover insensitivity correlates with insensitivity to intoxication and might predict more serious alcohol problems in the future, suggesting that a future larger study is warranted. Hangover insensitivity could result from physiological factors underlying low sensitivity to alcohol or risk for alcoholism.
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Martin RA, MacKinnon SM, Johnson JE, Myers MG, Cook TAR, Rohsenow DJ. The alcohol relapse situation appraisal questionnaire: development and validation. Drug Alcohol Depend 2011; 116:45-51. [PMID: 21237586 PMCID: PMC3105175 DOI: 10.1016/j.drugalcdep.2010.11.022] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2010] [Revised: 11/11/2010] [Accepted: 11/15/2010] [Indexed: 11/26/2022]
Abstract
BACKGROUND The role of cognitive appraisal of the threat of alcohol relapse has received little attention. A previous instrument, the Relapse Situation Appraisal Questionnaire (RSAQ), was developed to assess cocaine users' primary appraisal of the threat of situations posing a high risk for cocaine relapse. The purpose of the present study was to modify the RSAQ in order to measure primary appraisal in situations involving a high risk for alcohol relapse. METHODS The development and psychometric properties of this instrument, the Alcohol Relapse Situation Appraisal Questionnaire (A-RSAQ), were examined with two samples of abstinent adults with alcohol abuse or dependence. Factor structure and validity were examined in Study 1 (N=104). Confirmation of the factor structure and predictive validity was assessed in Study 2 (N=159). RESULTS Results demonstrated construct, discriminant and predictive validity and reliability of the A-RSAQ. DISCUSSION Results support the important role of primary appraisal of degree of risk in alcohol relapse situations.
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Spirito A, Sindelar-Manning H, Colby SM, Barnett NP, Lewander W, Rohsenow DJ, Monti PM. Individual and family motivational interventions for alcohol-positive adolescents treated in an emergency department: results of a randomized clinical trial. ACTA ACUST UNITED AC 2011; 165:269-74. [PMID: 21383276 DOI: 10.1001/archpediatrics.2010.296] [Citation(s) in RCA: 79] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
OBJECTIVE To determine whether a brief individual motivational interview (IMI) plus a family motivational interview (Family Check-Up [FCU]) would reduce alcohol use in adolescents treated in an emergency department after an alcohol-related event more effectively than would an IMI only. DESIGN Two-group randomized design with 3 follow-up time points. SETTING An urban regional level I trauma center. PARTICIPANTS Adolescents aged 13 to 17 years (N = 125) with a positive blood alcohol concentration as tested using blood, breath, or saliva. INTERVENTIONS Either IMI or IMI plus FCU. MAIN OUTCOME MEASURES Drinking frequency (days per month), quantity (drinks per occasion), and frequency of high-volume drinking (≥5 drinks per occasion). RESULTS Both conditions resulted in a reduction in all drinking outcomes at all follow-up points (P < .001 for all), with the strongest effects at 3 and 6 months. Adding the FCU to the IMI resulted in a somewhat better outcome than did the IMI only on high-volume drinking days at 3-month follow-up (14.6% vs 32.1%, P = .048; odds ratio, 2.76; 95% confidence interval, 0.99-7.75). CONCLUSIONS Motivational interventions have a positive effect on drinking outcomes in the short term after an alcohol-related emergency department visit. Adding the FCU to an IMI resulted in somewhat better effects on high-volume drinking at short-term follow-up than did an IMI only. The cost of extra sessions necessary to complete the FCU should be weighed against the potential benefit of reducing high-volume drinking when considering adding the FCU to an IMI for this population.
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Arnedt JT, Rohsenow DJ, Almeida AB, Hunt SK, Gokhale M, Gottlieb DJ, Howland J. Sleep following alcohol intoxication in healthy, young adults: effects of sex and family history of alcoholism. Alcohol Clin Exp Res 2011; 35:870-8. [PMID: 21323679 PMCID: PMC3083467 DOI: 10.1111/j.1530-0277.2010.01417.x] [Citation(s) in RCA: 72] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND This study evaluated sex and family history of alcoholism as moderators of subjective ratings of sleepiness/sleep quality and polysomnography (PSG) following alcohol intoxication in healthy, young adults. METHODS Ninety-three healthy adults [mean age 24.4 ± 2.7 years, 59 women, 29 subjects with a positive family history of alcoholism (FH+)] were recruited. After screening PSG, participants consumed alcohol (sex/weight adjusted dosing) to intoxication [peak breath alcohol concentration (BrAC) of 0.11 ± 0.01 g% for men and women] or matching placebo between 20:30 and 22:00 hours. Sleep was monitored using PSG between 23:00 and 07:00 hours. Participants completed the Stanford Sleepiness Scale and Karolinska Sleepiness Scale at bedtime and on awakening and a validated post-sleep questionnaire. RESULTS Following alcohol, total sleep time, sleep efficiency, nighttime awakenings, and wake after sleep onset were more disrupted in women than men, with no differences by family history status. Alcohol reduced sleep onset latency, sleep efficiency, and rapid eye movement sleep while increasing wakefulness and slow wave sleep across the entire night compared with placebo. Alcohol also generally increased sleep consolidation in the first half of the night, but decreased it during the second half. Sleepiness ratings were higher following alcohol, particularly in women at bedtime. Morning sleep quality ratings were lower following alcohol than placebo. CONCLUSIONS Alcohol intoxication increases subjective sleepiness and disrupts sleep objectively more in healthy women than in men, with no differences evident by family history of alcoholism status. Evaluating moderators of alcohol effects on sleep may provide insight into the role of sleep in problem drinking.
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Howland J, Rohsenow DJ, Calise TV, Mackillop J, Metrik J. Caffeinated alcoholic beverages: an emerging public health problem. Am J Prev Med 2011; 40:268-71. [PMID: 21238877 DOI: 10.1016/j.amepre.2010.10.026] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2010] [Revised: 08/17/2010] [Accepted: 10/12/2010] [Indexed: 11/24/2022]
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Howland J, Rohsenow DJ, Arnedt JT, Bliss CA, Hunt SK, Calise TV, Heeren T, Winter M, Littlefield C, Gottlieb DJ. The acute effects of caffeinated versus non-caffeinated alcoholic beverage on driving performance and attention/reaction time. Addiction 2011; 106:335-41. [PMID: 21134017 DOI: 10.1111/j.1360-0443.2010.03219.x] [Citation(s) in RCA: 65] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
AIMS Marketing that promotes mixing caffeinated 'energy' drinks with alcoholic beverages (e.g. Red Bull with vodka) targets young drinkers and conveys the expectation that caffeine will offset the sedating effects of alcohol and enhance alertness. Such beliefs could result in unwarranted risk taking (e.g. driving while intoxicated). The aim of this study was to assess the acute effects of caffeinated versus non-caffeinated alcoholic beverages on a simulated driving task and attention/reaction time. DESIGN We conducted a 2 × 2 between-groups randomized trial in which participants were randomized to one of four conditions: beer and non-alcoholic beer, with and without caffeine added. Caffeine was added in the same proportion as found in a commercially available caffeinated beer (69 mg/12 oz of beer at 4.8% alc. by vol). PARTICIPANTS Participants were 127 non-dependent, heavy episodic, young adult drinkers (age 21-30) who were college students or recent graduates. The target breath alcohol level was 0.12 g%. MEASURES Driving performance was assessed with a driving simulator; sustained attention/reaction with the Psychomotor Vigilance Task (PVT). FINDINGS Across the driving and attention/reaction time we found main effects for alcohol, with alcohol significantly impairing driving and sustained attention/reaction time, with mainly large statistical effects; however, the addition of caffeine had no main or interaction effects on performance. CONCLUSION The addition of caffeine to alcohol does not appear to enhance driving or sustained attention/reaction time performance relative to alcohol alone.
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Metrik J, Kahler CW, McGeary JE, Monti PM, Rohsenow DJ. Acute Effects of Marijuana Smoking on Negative and Positive Affect. J Cogn Psychother 2011; 25. [PMID: 24319318 DOI: 10.1891/0889-8391.25.1.31] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Human studies and animal experiments present a complex and often contradictory picture of the acute impact of marijuana on emotions. The few human studies specifically examining changes in negative affect find either increases or reductions following delta-9-tetrahydrocannabinol (THC) administration. In a 2 × 2, instructional set (told THC vs. told no THC) by drug administration (smoked marijuana with 2.8% THC vs. placebo) between-subjects design, we examined the pharmacologic effect of marijuana on physiological and subjective stimulation, subjective intoxication, and self-reported negative and positive affect with 114 weekly marijuana smokers. Individuals were first tested under a baseline/no smoking condition and again under experimental condition. Relative to placebo, THC significantly increased arousal and confusion/bewilderment. However, the direction of effect on anxiety varied depending on instructional set: Anxiety increased after THC for those told placebo but decreased among other participants. Furthermore, marijuana users who expected more impairment from marijuana displayed more anxiety after smoking active marijuana, whereas those who did not expect the impairment became less anxious after marijuana. Both pharmacologic and stimulus expectancy main effects significantly increased positive affect. Frequent marijuana users were less anxious after smoking as compared to less frequent smokers. These findings show that expectancy instructions and pharmacology play independent roles in effects of marijuana on negative affect. Further studies examining how other individual difference factors impact marijuana's effects on mood are needed.
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Rohsenow DJ, Howland J. The role of beverage congeners in hangover and other residual effects of alcohol intoxication: a review. ACTA ACUST UNITED AC 2010; 3:76-9. [PMID: 20712591 DOI: 10.2174/1874473711003020076] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2010] [Accepted: 07/28/2010] [Indexed: 11/22/2022]
Abstract
Congeners are minor compounds other than ethanol that occur naturally in alcohol beverages as a result of distilling and fermenting processes. While ethanol itself is the main source of hangover (subjective distress) and other residual effects of alcohol (cognitive and behavioral), the role of the congeners is of interest due to the potential toxicity of many of them despite their minute quantities. Survey studies, while comparing beer to liquor to wine, have generally not addressed beverage effects that clearly differ in congener content. The few experimental studies indicate that the highest congener beverage (bourbon) results in more severe hangover ratings than does the beverage with essentially no congeners (vodka), although ethanol effects per se had a considerably stronger effect on hangover than did congener content. Safety-sensitive performance that was affected by alcohol intoxication the previous night (vigilance with reaction time; ataxia) was not differentially affected by bourbon versus vodka. The paucity of studies indicates more work is needed in order to have confidence in these results.
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Martin RA, MacKinnon S, Johnson J, Rohsenow DJ. Purpose in life predicts treatment outcome among adult cocaine abusers in treatment. J Subst Abuse Treat 2010; 40:183-8. [PMID: 21129893 DOI: 10.1016/j.jsat.2010.10.002] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2010] [Revised: 09/14/2010] [Accepted: 10/06/2010] [Indexed: 11/15/2022]
Abstract
A sense of purpose in life has been positively associated with mental health and well-being and has been negatively associated with alcohol use in correlational and longitudinal studies but has not been studied as a predictor of cocaine treatment outcome. This study examined pretreatment purpose in life as a predictor of response to a 30-day residential substance use treatment program among 154 participants with cocaine dependence. Purpose in life was unrelated to cocaine or alcohol use during the 6 months pretreatment. After controlling for age, baseline use, and depressive symptoms, purpose in life significantly (p < .01) predicted relapse to any use of cocaine and to alcohol and the number of days cocaine or alcohol was used in the 6 months after treatment. Findings suggest that increasing purpose in life may be an important aspect of treatment among cocaine-dependent patients.
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Barnett NP, Apodaca TR, Magill M, Colby SM, Gwaltney C, Rohsenow DJ, Monti PM. Moderators and mediators of two brief interventions for alcohol in the emergency department. ADDICTION (ABINGDON, ENGLAND) 2010. [PMID: 20402989 DOI: 10.1038/nature09421.oxidative] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
OBJECTIVE To evaluate moderators and mediators of brief alcohol interventions conducted in the emergency department. METHODS Patients (18-24 years; n = 172) in an emergency department received a motivational interview with personalized feedback (MI) or feedback only (FO), with 1- and 3-month booster sessions and 6- and 12-month follow-ups. Gender, alcohol status/severity group [ALC+ only, Alcohol Use Disorders Identification Test (AUDIT+) only, ALC+/AUDIT+], attribution of alcohol in the medical event, aversiveness of the event, perceived seriousness of the event and baseline readiness to change alcohol use were evaluated as moderators of intervention efficacy. Readiness to change also was evaluated as a mediator of intervention efficacy, as were perceived risks/benefits of alcohol use, self-efficacy and alcohol treatment seeking. RESULTS Alcohol status, attribution and readiness moderated intervention effects such that patients who had not been drinking prior to their medical event, those who had low or medium attribution for alcohol in the event and those who had low or medium readiness to change showed lower alcohol use 12 months after receiving MI compared to FO. In the AUDIT+ only group those who received MI showed lower rates of alcohol-related injury at follow-up than those who received FO. Patients who had been drinking prior to their precipitating event did not show different outcomes in the two interventions, regardless of AUDIT status. Gender did not moderate intervention efficacy and no significant mediation was found. CONCLUSIONS Findings may help practitioners target patients for whom brief interventions will be most effective. More research is needed to understand how brief interventions transmit their effects.
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Sirota AD, Rohsenow DJ, Mackinnon SV, Martin RA, Eaton CA, Kaplan GB, Monti PM, Tidey JW, Swift RM. Intolerance for Smoking Abstinence Questionnaire: psychometric properties and relationship to tobacco dependence and abstinence. Addict Behav 2010; 35:686-93. [PMID: 20381260 DOI: 10.1016/j.addbeh.2010.02.014] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2009] [Accepted: 02/25/2010] [Indexed: 11/29/2022]
Abstract
UNLABELLED While smokers' ability to tolerate emotional or physical distress has been associated with length of smoking cessation, there is no measure of ability to tolerate smoking abstinence discomfort specifically, which may be more heuristic than a measure of tolerance of general emotional stress or physical discomfort. METHODS Questionnaires completed by 300 smokers assessed inability to tolerate smoking abstinence discomfort (IDQ-S), general physical discomfort (IDQ-P), and general emotional discomfort (IDQ-E), so that shared variance among these measures could be assessed. RESULTS The IDQ-S has three reliable components: withdrawal Intolerance, Lack of Cognitive Coping, and Pain Intolerance. The 14-item IDQ-P and 9-item IDQ-E each consist of one reliable component. Intercorrelations suggest only modest shared variance. Support for construct and discriminant validity was seen. Two scales of the IDQ-S showed excellent convergent validity, correlating with smoking use, dependence, motivation, and length of past smoking cessation, while IDQ-P and IDQ-E correlated with few indices of use or dependence and not with smoking cessation. CONCLUSIONS The final 17-item IDQ-S with two scales is reliable and valid, and more heuristic than measures of general physical or emotional discomfort intolerance as a correlate of motivation and past success with smoking cessation.
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MacKillop J, Miranda R, Monti PM, Ray LA, Murphy JG, Rohsenow DJ, McGeary JE, Swift RM, Tidey JW, Gwaltney CJ. Alcohol demand, delayed reward discounting, and craving in relation to drinking and alcohol use disorders. JOURNAL OF ABNORMAL PSYCHOLOGY 2010; 119:106-14. [PMID: 20141247 DOI: 10.1037/a0017513] [Citation(s) in RCA: 203] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
A behavioral economic approach to alcohol use disorders (AUDs) emphasizes both individual and environmental determinants of alcohol use. The current study examined individual differences in alcohol demand (i.e., motivation for alcohol under escalating conditions of price) and delayed reward discounting (i.e., preference for immediate small rewards compared to delayed larger rewards) in 61 heavy drinkers (62% with an AUD). In addition, based on theoretical accounts that emphasize the role of craving in reward valuation and preferences for immediate rewards, craving for alcohol was also examined in relation to these behavioral economic variables and the alcohol-related variables. Intensity of alcohol demand and delayed reward discounting were significantly associated with AUD symptoms, but not with quantitative measures of alcohol use, and were also moderately correlated with each other. Likewise, craving was significantly associated with AUD symptoms, but not with alcohol use, and was also significantly correlated with both intensity of demand and delayed reward discounting. These findings further emphasize the relevance of behavioral economic indices of motivation to AUDs and the potential importance of craving for alcohol in this relationship.
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Neighbors CJ, Barnett NP, Rohsenow DJ, Colby SM, Monti PM. Cost-effectiveness of a motivational intervention for alcohol-involved youth in a hospital emergency department. J Stud Alcohol Drugs 2010; 71:384-94. [PMID: 20409432 PMCID: PMC2859787 DOI: 10.15288/jsad.2010.71.384] [Citation(s) in RCA: 56] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2009] [Revised: 08/20/2009] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE Brief interventions in the emergency department targeting risk-taking youth show promise to reduce alcohol-related injury. This study models the cost-effectiveness of a motivational interviewing-based intervention relative to brief advice to stop alcohol-related risk behaviors (standard care). Average cost-effectiveness ratios were compared between conditions. In addition, a cost-utility analysis examined the incremental cost of motivational interviewing per quality-adjusted life year gained. METHOD Microcosting methods were used to estimate marginal costs of motivational interviewing and standard care as well as two methods of patient screening: standard emergency-department staff questioning and proactive outreach by counseling staff. Average cost-effectiveness ratios were computed for drinking and driving, injuries, vehicular citations, and negative social consequences. Using estimates of the marginal effect of motivational interviewing in reducing drinking and driving, estimates of traffic fatality risk from drinking-and-driving youth, and national life tables, the societal costs per quality-adjusted life year saved by motivational interviewing relative to standard care were also estimated. Alcohol-attributable traffic fatality risks were estimated using national databases. RESULTS Intervention costs per participant were $81 for standard care, $170 for motivational interviewing with standard screening, and $173 for motivational interviewing with proactive screening. The cost-effectiveness ratios for motivational interviewing were more favorable than standard care across all study outcomes and better for men than women. The societal cost per quality-adjusted life year of motivational interviewing was $8,795. Sensitivity analyses indicated that results were robust in terms of variability in parameter estimates. CONCLUSIONS This brief intervention represents a good societal investment compared with other commonly adopted medical interventions.
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Howland J, Rohsenow DJ, Greece JA, Littlefield CA, Almeida A, Heeren T, Winter M, Bliss CA, Hunt S, Hermos J. The effects of binge drinking on college students' next-day academic test-taking performance and mood state. Addiction 2010; 105:655-65. [PMID: 20403018 PMCID: PMC2859622 DOI: 10.1111/j.1360-0443.2009.02880.x] [Citation(s) in RCA: 60] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
AIM To assess the effects of binge drinking on students' next-day academic test-taking performance. DESIGN A placebo-controlled cross-over design with randomly assigned order of conditions. Participants were randomized to either alcoholic beverage [mean = 0.12 g% breath alcohol concentration (BrAC)] or placebo on the first night and then received the other beverage a week later. The next day, participants were assessed on test-taking, neurocognitive performance and mood state. PARTICIPANTS A total of 196 college students (>or=21 years) recruited from greater Boston. SETTING The trial was conducted at the General Clinical Research Center at the Boston Medical Center. MEASUREMENTS The Graduate Record Examinations(c) (GREs) and a quiz on a lecture presented the previous day measured test-taking performance; the Neurobehavioral Evaluation System (NES3) and the Psychomotor Vigilance Test (PVT) measured neurocognitive performance; and the Profile of Mood States (POMS) measured mood. FINDINGS Test-taking performance was not affected on the morning after alcohol administration, but mood state and attention/reaction-time were affected. CONCLUSION Drinking to a level of 0.12 g% BrAC does not affect next-day test-taking performance, but does affect some neurocognitive measures and mood state.
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Barnett NP, Apodaca TR, Magill M, Colby SM, Gwaltney C, Rohsenow DJ, Monti PM. Moderators and mediators of two brief interventions for alcohol in the emergency department. Addiction 2010; 105:452-65. [PMID: 20402989 PMCID: PMC2858352 DOI: 10.1111/j.1360-0443.2009.02814.x] [Citation(s) in RCA: 77] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To evaluate moderators and mediators of brief alcohol interventions conducted in the emergency department. METHODS Patients (18-24 years; n = 172) in an emergency department received a motivational interview with personalized feedback (MI) or feedback only (FO), with 1- and 3-month booster sessions and 6- and 12-month follow-ups. Gender, alcohol status/severity group [ALC+ only, Alcohol Use Disorders Identification Test (AUDIT+) only, ALC+/AUDIT+], attribution of alcohol in the medical event, aversiveness of the event, perceived seriousness of the event and baseline readiness to change alcohol use were evaluated as moderators of intervention efficacy. Readiness to change also was evaluated as a mediator of intervention efficacy, as were perceived risks/benefits of alcohol use, self-efficacy and alcohol treatment seeking. RESULTS Alcohol status, attribution and readiness moderated intervention effects such that patients who had not been drinking prior to their medical event, those who had low or medium attribution for alcohol in the event and those who had low or medium readiness to change showed lower alcohol use 12 months after receiving MI compared to FO. In the AUDIT+ only group those who received MI showed lower rates of alcohol-related injury at follow-up than those who received FO. Patients who had been drinking prior to their precipitating event did not show different outcomes in the two interventions, regardless of AUDIT status. Gender did not moderate intervention efficacy and no significant mediation was found. CONCLUSIONS Findings may help practitioners target patients for whom brief interventions will be most effective. More research is needed to understand how brief interventions transmit their effects.
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Rohsenow DJ, Howland J, Arnedt JT, Almeida AB, Greece J, Minsky S, Kempler CS, Sales S. Intoxication with bourbon versus vodka: effects on hangover, sleep, and next-day neurocognitive performance in young adults. Alcohol Clin Exp Res 2010; 34:509-18. [PMID: 20028364 PMCID: PMC3674844 DOI: 10.1111/j.1530-0277.2009.01116.x] [Citation(s) in RCA: 63] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND This study assessed the effects of heavy drinking with high or low congener beverages on next-day neurocognitive performance, and the extent to which these effects were mediated by alcohol-related sleep disturbance or alcoholic beverage congeners, and correlated with the intensity of hangover. METHODS Healthy heavy drinkers age 21 to 33 (n = 95) participated in 2 drinking nights after an acclimatization night. They drank to a mean of 0.11 g% breath alcohol concentration on vodka or bourbon one night with matched placebo the other night, randomized for type and order. Polysomnography recordings were made overnight; self-report and neurocognitive measures were assessed the next morning. RESULTS After alcohol, people had more hangover and more decrements in tests requiring both sustained attention and speed. Hangover correlated with poorer performance on these measures. Alcohol decreased sleep efficiency and rapid eye movement sleep, and increased wake time and next-day sleepiness. Alcohol effects on sleep correlated with hangover but did not mediate the effects on performance. No effect of beverage congeners was found except on hangover severity, with people feeling worse after bourbon. Virtually no sex differences appeared. CONCLUSIONS As drinking to this level affects complex cognitive abilities, safety could be affected, with implications for driving and for safety-sensitive occupations. Congener content affects only how people feel the next day so does not increase risk. The sleep disrupting effects of alcohol did not account for the impaired performance so other mechanisms of effect need to be sought. As hangover symptoms correlate with impaired performance, these might be contributing to the impairment.
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Ray LA, Miranda R, Tidey JW, McGeary JE, MacKillop J, Gwaltney CJ, Rohsenow DJ, Swift RM, Monti PM. Polymorphisms of the mu-opioid receptor and dopamine D4 receptor genes and subjective responses to alcohol in the natural environment. JOURNAL OF ABNORMAL PSYCHOLOGY 2010; 119:115-25. [PMID: 20141248 PMCID: PMC3703617 DOI: 10.1037/a0017550] [Citation(s) in RCA: 101] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Polymorphisms of the mu-opioid receptor (OPRM1) and dopamine D4 receptor (DRD4) genes are associated with subjective responses to alcohol and urge to drink under laboratory conditions. This study examined these associations in the natural environment using ecological momentary assessment. Participants were non-treatment-seeking heavy drinkers (n = 112, 52% female, 61% alcohol dependent) who enrolled in a study of naltrexone effects on craving and drinking in the natural environment. Data were culled from 5 consecutive days of drinking reports prior to medication randomization. Analyses revealed that, after drinking, carriers of the Asp40 allele of the OPRM1 gene reported higher overall levels of vigor and lower levels negative mood, as compared to homozygotes for the Asn40 variant. Carriers of the long allele (i.e., >or=7 tandem repeats) of the DRD4 endorsed greater urge to drink than homozygotes for the short allele. Effects of OPRM1 and DRD4 variable-number-of-tandem-repeats genotypes appear to be alcohol dose-dependent. Specifically, carriers of the DRD4-L allele reported slight decreases in urge to drink at higher levels of estimated blood alcohol concentration (eBAC), and Asp40 carriers reported decreases in vigor and increases in negative mood as eBAC rose, as compared to carriers of the major allele for each gene. Self-reported vigor and urge to drink were positively associated with alcohol consumption within the same drinking episode. This study extends findings on subjective intoxication, urge to drink, and their genetic bases from controlled laboratory to naturalistic settings.
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Howland J, Rohsenow DJ, Bliss CA, Almeida AB, Calise TV, Heeren T, Winter M. Hangover Predicts Residual Alcohol Effects on Psychomotor Vigilance the Morning After Intoxication. ACTA ACUST UNITED AC 2010; 1. [PMID: 21643431 DOI: 10.4172/2155-6105.1000101] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
OBJECTIVES: Both hangover and performance deficits have been documented the day after drinking to intoxication after breath alcohol concentration (BrAC) has returned to near zero. But few studies have examined the relationship between hangover and post-intoxication performance. METHOD: We performed secondary analyses of data from a previously reported controlled cross-over laboratory study to assess the relationship of hangover incidence and severity to sustained attention/reaction time the morning after drinking to about 0.11 g% BrAC. Relationships were investigated while controlling for gender, type of alcoholic beverage (bourbon or vodka), and neurocognitive performance after placebo. RESULTS: Hangover severity and neurocognitive performance were significantly correlated. Participants reporting stronger hangover were more impaired than those reporting little or no hangover. Comparing any to no hangover showed a trend in the same direction of effect. CONCLUSIONS: More intense hangover may indicate less fitness for duty in workers in certain safety-sensitive occupations, with implications for occupational alcohol policies.
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Tidey JW, Rohsenow DJ. Smoking expectancies and intention to quit in smokers with schizophrenia, schizoaffective disorder and non-psychiatric controls. Schizophr Res 2009; 115:310-6. [PMID: 19836210 PMCID: PMC2795352 DOI: 10.1016/j.schres.2009.09.032] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2009] [Revised: 09/21/2009] [Accepted: 09/22/2009] [Indexed: 11/16/2022]
Abstract
Cigarette smoking expectancies are systematically related to intention to quit smoking in adult smokers without psychiatric illness, but little is known about these relationships in smokers with serious mental illness. In this study, we compared positive and negative smoking expectancies, and examined relationships between expectancies and intention to quit smoking, in smokers with schizophrenia (n=46), smokers with schizoaffective disorder (n=35), and smokers without psychiatric illness (n=71). In all three groups, reduction of negative affect was rated as the most important smoking expectancy and intention to quit smoking was systematically related to concerns about the health effects and social consequences of smoking. Compared to the other groups of smokers, those with schizoaffective disorder were more concerned with social expectancies and with the immediate negative physical effects of smoking. Results of this study suggest that challenging positive smoking expectancies and providing more tailored information about the negative consequences of smoking might increase motivation to quit smoking in smokers with schizophrenia and schizoaffective disorder, as has been found with non-psychiatric smokers.
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Colby SM, Leventhal AM, Brazil L, Lewis-Esquerre J, Stein LAR, Rohsenow DJ, Monti PM, Niaura RS. Smoking abstinence and reinstatement effects in adolescent cigarette smokers. Nicotine Tob Res 2009; 12:19-28. [PMID: 19933776 DOI: 10.1093/ntr/ntp167] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
INTRODUCTION The study objectives were to examine smoking abstinence and reinstatement effects on subjective experience and cognitive performance among adolescent smokers. METHODS Adolescents (aged 14-17 years, 60 daily smokers and 32 nonsmokers) participated. Participants completed baseline assessments (Session 1) and returned to the laboratory 1-3 days later to repeat assessments (Session 2); half of the smokers were randomly assigned to 15-17 hr tobacco abstinence preceding Session 2. RESULTS During Session 2, abstaining smokers reported significantly greater increases in withdrawal symptoms, smoking urges, and negative affect compared with smokers who did not abstain and compared with nonsmokers. Smoking reinstatement reversed abstinence effects, returning to baseline levels for smoking urges and negative affect. Abstaining smokers showed significantly enhanced cognitive performance on two of six tasks (two-letter search compared with nonabstaining smokers; serial reaction time compared with nonsmokers); smoking reinstatement resulted in significant decrements on these two tasks relative to nonabstaining smokers. DISCUSSION Effects of smoking abstinence and reinstatement on self-report measures are consistent with earlier research with adolescent as well as adult smokers and may help to elucidate the motivational underpinnings of smoking maintenance among adolescent smokers. Effects found on cognitive performance were contrary to hypotheses; further research is needed to understand better the role of cognitive performance effects in smoking maintenance among adolescents.
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Howland J, Rohsenow DJ, Edwards EM. Are some drinkers resistant to hangover? A literature review. ACTA ACUST UNITED AC 2009; 1:42-6. [PMID: 19630704 DOI: 10.2174/1874473710801010042] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
To assess the incidence of hangover we: (1) reviewed the experimental and survey literature; (2) performed secondary analyses on two large population surveys; and (3) calculated the incidence of hangover among young adults participating in several randomized trials we conducted on the aftereffects of heavy drinking. Survey data included adults admitted for alcohol detoxification, community adults who ever got "tipsy" or "high", adolescents in high school who ever drank heavily, adults who drank heavily in the past 12 months, and university students. Most of the experimental trials brought participants to intoxication. The consistency of findings across study designs, populations, and referenced time period suggests that around 23% of the population may be resistant to hangover. Since propensity for hangover may affect drinking patterns, further research on the consequences and predictors of hangover insensitivity is warranted.
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Metrik J, Rohsenow DJ, Monti PM, McGeary J, Cook TAR, de Wit H, Haney M, Kahler CW. Effectiveness of a marijuana expectancy manipulation: Piloting the balanced-placebo design for marijuana. Exp Clin Psychopharmacol 2009; 17:217-25. [PMID: 19653787 PMCID: PMC2810847 DOI: 10.1037/a0016502] [Citation(s) in RCA: 63] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Although alcohol and nicotine administration studies have demonstrated that manipulating subjects' expectancies regarding drug content affects drug response, research with marijuana has not adequately studied drug expectancy effects. The present pilot study was the first to evaluate the credibility and effect of expectancy manipulation on subjective measures and smoking patterns using a marijuana administration balanced-placebo design (BPD). In a 2 x 2 instructional set (told delta-9-tetrahydrocannabinol [THC] vs. told no THC) by drug (smoked marijuana with 2.8% THC vs. placebo) between-subjects design, the authors examined the effect of marijuana expectancy manipulation and the pharmacologic effect on affective and physiologic measures, cigarette ratings, and smoking behavior with 20 marijuana smokers (mean age = 20 years; 25% female). Large main effects of expectancy were found on ratings of cigarette potency, strength, taste, smell, and satisfaction, and observed smoking behavior. Pharmacologic effects were particularly evident for self-reported physical reactions to marijuana and cigarette potency and satisfaction ratings. This study demonstrated the feasibility of the BPD research with marijuana and yielded promising results for future studies examining the independent and combined effects of marijuana pharmacology and expectancies.
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Rohsenow DJ, O'leary MR. Locus of Control Research on Alcoholic Populations: A Review. II. Relationship to Other Measures. ACTA ACUST UNITED AC 2009. [DOI: 10.3109/10826087809039275] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Magill M, Barnett NP, Apodaca TR, Rohsenow DJ, Monti PM. The role of marijuana use in brief motivational intervention with young adult drinkers treated in an emergency department. J Stud Alcohol Drugs 2009; 70:409-13. [PMID: 19371492 DOI: 10.15288/jsad.2009.70.409] [Citation(s) in RCA: 44] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE The aim of this research was to study marijuana use, associated risks, and response to brief motivational intervention among young adult drinkers treated in an emergency department. METHOD Study participants (N = 215; ages 18-24) were in a randomized controlled trial for alcohol use that compared motivational interviewing with personalized feedback (MI) with personalized feedback only. Past-month marijuana users were compared with nonusers on demographics, readiness, self-efficacy, and behavioral risk variables. Marijuana use was examined as a potential moderator of alcohol outcomes. Whether marijuana use alone or combined marijuana and alcohol use would be reduced as a result of brief intervention for alcohol was examined at 6 and 12 months. RESULTS Current marijuana users were younger, were more likely to be white, and reported more alcohol use, other illicit drug use, and more alcohol-related consequences than nonmarijuana users. Marijuana use at baseline did not moderate response to brief alcohol treatment. Marijuana use declined from baseline to 6 months for both treatment groups, but only MI participants continued to reduce their use of marijuana from 6- to 12-month follow-up. Reductions in number of days of use of marijuana with alcohol appeared to be primarily a function of decreased alcohol use. CONCLUSIONS Young adult drinkers reporting current marijuana use are at generally higher risk but responded to brief alcohol treatment by reducing alcohol and marijuana use.
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