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McPherson SM, Smith CL, Hall L, Miguel AQ, Bowden T, Keever A, Schmidt A, Olson K, Rodin N, McDonell MG, Roll JM, LeBrun J. Mobile Medication Adherence Platform for Buprenorphine (MAP4BUP): A Phase I feasibility, usability and efficacy pilot randomized clinical trial. Drug Alcohol Depend 2024; 256:111099. [PMID: 38306822 PMCID: PMC10923156 DOI: 10.1016/j.drugalcdep.2024.111099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Revised: 01/05/2024] [Accepted: 01/11/2024] [Indexed: 02/04/2024]
Abstract
BACKGROUND/AIM Poor medication adherence is one of the main barriers to the long-term efficacy of buprenorphine/naloxone (BUP/NAL). The aims of this pilot investigation were to examine if a Bluetooth-enabled pill cap and mobile application is a feasible, usable tool for increasing BUP/NAL adherence among people with an opioid use disorder. METHODS This pilot randomized clinical trial (RCT; total n = 41) lasted 12 weeks and was conducted in two office-based BUP/NAL provider locations in Spokane, WA and Coeur d'Alene, ID from January 2020 to September of 2021 with an 11-month gap due to COVID-19. Patients receiving BUP/NAL who consented to participate were randomized to receive the pill cap device (PLY group; n = 19) or a service as usual (SAU group; n = 22) group that included an identical but inactive cap for their bottle. The PLY group received reminders via text and voice, and the support of a "helper" (e.g., friend) to monitor pill cap openings. RESULTS Most participants in PLY group found the device both feasible (92.86 %) and usable (78.57 %). Most participants liked using the device (92.86 %) and were satisfied with the device (85.71 %). While not statistically different from one another, medication adherence per the Medication Possession Ratio was 75 % in the SAU group and 84 % in the PLY group. Pill cap openings were significantly higher in the PLY group with an average of 91.8 openings versus the SAU group's average of 56.7 (p < 0.05). CONCLUSION The devices was feasible, usable, and patients had high levels of satisfaction. The device was associated with increased pill openings.
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Affiliation(s)
- Sterling M McPherson
- Elson S. Floyd College of Medicine, Washington State University, Spokane, WA, United States; Analytics and PsychoPharmacology Laboratory (APPL), Washington State University, Spokane, WA, United States; Program of Excellence in Addiction Research (PEAR), Washington State University, Spokane, WA, United States.
| | - Crystal L Smith
- Elson S. Floyd College of Medicine, Washington State University, Spokane, WA, United States; Analytics and PsychoPharmacology Laboratory (APPL), Washington State University, Spokane, WA, United States; Program of Excellence in Addiction Research (PEAR), Washington State University, Spokane, WA, United States
| | - Luke Hall
- Elson S. Floyd College of Medicine, Washington State University, Spokane, WA, United States; Analytics and PsychoPharmacology Laboratory (APPL), Washington State University, Spokane, WA, United States; Program of Excellence in Addiction Research (PEAR), Washington State University, Spokane, WA, United States
| | - André Q Miguel
- Elson S. Floyd College of Medicine, Washington State University, Spokane, WA, United States; Analytics and PsychoPharmacology Laboratory (APPL), Washington State University, Spokane, WA, United States; Program of Excellence in Addiction Research (PEAR), Washington State University, Spokane, WA, United States
| | - Theresa Bowden
- Analytics and PsychoPharmacology Laboratory (APPL), Washington State University, Spokane, WA, United States; Program of Excellence in Addiction Research (PEAR), Washington State University, Spokane, WA, United States; College of Nursing, Washington State University, Spokane, WA, United States
| | - Abigail Keever
- Elson S. Floyd College of Medicine, Washington State University, Spokane, WA, United States; Analytics and PsychoPharmacology Laboratory (APPL), Washington State University, Spokane, WA, United States; Program of Excellence in Addiction Research (PEAR), Washington State University, Spokane, WA, United States
| | - Alex Schmidt
- Elson S. Floyd College of Medicine, Washington State University, Spokane, WA, United States; Analytics and PsychoPharmacology Laboratory (APPL), Washington State University, Spokane, WA, United States; Program of Excellence in Addiction Research (PEAR), Washington State University, Spokane, WA, United States
| | | | - Nicole Rodin
- Analytics and PsychoPharmacology Laboratory (APPL), Washington State University, Spokane, WA, United States; Program of Excellence in Addiction Research (PEAR), Washington State University, Spokane, WA, United States; College of Pharmacy and Pharmaceutical Sciences, Washington State University, Spokane, WA, United States
| | - Michael G McDonell
- Elson S. Floyd College of Medicine, Washington State University, Spokane, WA, United States; Program of Excellence in Addiction Research (PEAR), Washington State University, Spokane, WA, United States
| | - John M Roll
- Elson S. Floyd College of Medicine, Washington State University, Spokane, WA, United States; Program of Excellence in Addiction Research (PEAR), Washington State University, Spokane, WA, United States
| | - Jeff LeBrun
- Optimize Health, 5601 22nd Ave NW #200, Seattle, WA, United States
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Kane JC, Allen I, Fatch R, Scheffler A, Emenyonu N, Puryear SB, Chirayil P, So-Armah K, Kahler CW, Magidson JF, Conroy AA, Edelman EJ, Woolf-King S, Parry C, Kiene SM, Chamie G, Adong J, Go VF, Cook RL, Muyindike W, Morojele N, Blokhina E, Krupitsky E, Fiellin DA, Hahn JA. Efficacy of alcohol reduction interventions among people with HIV as evaluated by self-report and a phosphatidylethanol (PEth) outcome: protocol for a systematic review and individual participant data meta-analysis. BMJ Open 2023; 13:e070713. [PMID: 37280036 PMCID: PMC10254608 DOI: 10.1136/bmjopen-2022-070713] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Accepted: 05/07/2023] [Indexed: 06/08/2023] Open
Abstract
INTRODUCTION Unhealthy alcohol use is associated with a range of adverse outcomes among people with HIV (PWH). Testing the efficacy and promoting the availability of effective interventions to address unhealthy alcohol use among PWH is thus a priority. Alcohol use outcomes in intervention studies are often measured by self-report alone, which can lead to spurious results due to information biases (eg, social desirability). Measuring alcohol outcomes objectively through biomarkers, such as phosphatidylethanol (PEth), in addition to self-report has potential to improve the validity of intervention studies. This protocol outlines the methods for a systematic review and individual participant data meta-analysis that will estimate the efficacy of interventions to reduce alcohol use as measured by a combined categorical self-report/PEth variable among PWH and compare these estimates to those generated when alcohol is measured by self-report or PEth alone. METHODS AND ANALYSIS We will include randomised controlled trials that: (A) tested an alcohol intervention (behavioural and/or pharmacological), (B) enrolled participants 15 years or older with HIV; (C) included both PEth and self-report measurements, (D) completed data collection by 31 August 2023. We will contact principal investigators of eligible studies to inquire about their willingness to contribute data. The primary outcome variable will be a combined self-report/PEth alcohol categorical variable. Secondary outcomes will include PEth alone, self-report alone and HIV viral suppression. We will use a two-step meta-analysis and random effects modelling to estimate pooled treatment effects; I2 will be calculated to evaluate heterogeneity. Secondary and sensitivity analyses will explore treatment effects in adjusted models and within subgroups. Funnel plots will be used to explore publication bias. ETHICS AND DISSEMINATION The study will be conducted with deidentified data from completed randomised controlled trials and will be considered exempt from additional ethical approval. Results will be disseminated through peer-reviewed publications and international scientific meetings. PROSPERO REGISTRATION NUMBER CRD42022373640.
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Affiliation(s)
- Jeremy C Kane
- Epidemiology, Columbia University Mailman School of Public Health, New York, New York, USA
| | - Isabel Allen
- Epidemiology & Biostatistics, University of California, San Francisco, California, USA
| | - Robin Fatch
- Medicine, University of California, San Francisco, California, USA
| | - Aaron Scheffler
- Epidemiology & Biostatistics, University of California, San Francisco, California, USA
| | - Nneka Emenyonu
- Medicine, University of California, San Francisco, California, USA
| | - Sarah B Puryear
- Medicine, University of California, San Francisco, California, USA
| | - Priya Chirayil
- Epidemiology, Columbia University Mailman School of Public Health, New York, New York, USA
| | - Kaku So-Armah
- School of Medicine, Boston University, Boston, Massachusetts, USA
| | - Christopher W Kahler
- Center for Alcohol and Addiction Studies, Brown University School of Public Health, Providence, Rhode Island, USA
| | - Jessica F Magidson
- Psychology, University of Maryland, College Park, Maryland, USA
- Center for Substance Use, Addiction & Health Research, University of Maryland, College Park, MD, USA
| | - Amy A Conroy
- Medicine, University of California, San Francisco, California, USA
| | | | | | - Charles Parry
- Mental Health, Alcohol, Substance Use & Tobacco Research Unit, South African Medical Research Council, Cape Town, South Africa
- Department of Psychiatry, Stellenbosch University, Cape Town, South Africa
| | - Susan M Kiene
- Epidemiology and Biostatistics, San Diego State University College of Health and Human Services School of Public Health, San Diego, California, USA
| | - Gabriel Chamie
- Medicine, University of California, San Francisco, California, USA
| | - Julian Adong
- Makerere University School of Public Health, Kampala, Uganda
| | - Vivian F Go
- Department of Health Behavior, University of North Carolina Gillings School of Global Public Health, Chapel Hill, North Carolina, USA
| | - Robert L Cook
- Epidemiology, University of Florida, Gainesville, Florida, USA
| | | | - Neo Morojele
- University of Johannesburg, Auckland Park, South Africa
| | - Elena Blokhina
- Global Health Institute, St. Petersburg, Russian Federation
| | - Evgeny Krupitsky
- V.M. Bekhterev National Medical Research Center for Psychiatry and Neuroology, St. Petersburg, Russian Federation
| | | | - Judith A Hahn
- Epidemiology & Biostatistics, University of California, San Francisco, California, USA
- Medicine, University of California, San Francisco, California, USA
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Wu F, Dong P, Wu G, Deng J, Gao X, Song X, Yuan J, Sun H. The disruption of white matter integrity of systemic striatal circuits in alcohol-dependent males with physiological cue reactivity. Addict Biol 2023; 28:e13273. [PMID: 37016754 DOI: 10.1111/adb.13273] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Revised: 02/05/2023] [Accepted: 02/23/2023] [Indexed: 04/06/2023]
Abstract
Alcohol dependence (AD) is a chronic and relapsing disorder. Conditioned cues associated with the rewarding properties of drugs could trigger motivational/physiological reactions and render subjects vulnerable to relapse. Striatal circuit dysfunction has been implicated in alcohol addiction behaviours. However, little is known about the striatal tracts structural connectivity changes underlying cue induced reactivity in AD. In our present study, we recruited 51 patients with AD; 31 individuals had physiological response. We used seed-based classification by probabilistic tractography with nine target masks to explore the white matter integrity of striatal circuits in physiological responders (N = 31), non-responders (N = 20), and healthy controls (N = 27). Compared with healthy controls, physiological responders showed lower fractional anisotropy (FA) and/or higher mean diffusivity in the striatum-dorsolateral prefrontal cortex (dlPFC), striatum-ventral lateral prefrontal cortex, striatum-supplementary motor area (SMA), and striatum-insular. Considering age and smoking are potential nuisances to diffusion parameters, an analysis of covariance also was conducted and similar results were found. We also found the cue-induced physiological response was negatively associated with the FA of the striatum-SMA (r = -0.287; p = 0.045) and left striatum-dlPFC (r = -0.253; p = 0.079) in AD. In our study, we found abnormal integrity of striatal circuit structural connectivity in AD with physiological cue reactivity, especially trajectory from prefrontal cortex and insular. We also found the FA of striatal tracks was negatively associated with the degree of cue reactivity. Our findings provide further evidence for reduced white matter integrity of striatal circuits for cue reactivity in male individuals with AD.
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Affiliation(s)
- Fei Wu
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Peking University, Beijing, China
| | - Ping Dong
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Peking University, Beijing, China
| | - Guowei Wu
- Chinese Institute for Brain Research, Beijing, China
| | - Jiahui Deng
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Peking University, Beijing, China
| | - Xuejiao Gao
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Peking University, Beijing, China
| | - Xiaopeng Song
- McLean Imaging Center, McLean Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Junliang Yuan
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Peking University, Beijing, China
- Department of Neurology, Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Peking University, Beijing, China
| | - Hongqiang Sun
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Peking University, Beijing, China
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Kusiak E, Johnson K. Shifts in Motivation to Seek Substance Use Disorder Treatment in Adolescents, Emerging Adults, and Older Adults. JOURNAL OF SUBSTANCE USE 2023; 29:295-299. [PMID: 38919831 PMCID: PMC11196021 DOI: 10.1080/14659891.2022.2157771] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2022] [Accepted: 12/02/2022] [Indexed: 01/07/2023]
Affiliation(s)
- Ethan Kusiak
- University of South Florida, College of Behavioral and Community Sciences, Department of Mental Health Law and Policy 13301 Bruce B. Downs Blvd. Tampa, FL 33612, USA
| | - Kimberly Johnson
- University of South Florida, College of Behavioral and Community Sciences, Department of Mental Health Law and Policy 13301 Bruce B. Downs Blvd. Tampa, FL 33612, USA
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Leite Ferreira V, Gonçalves de Andrade Tostes J, Knaak S, Silveira PSD, Fernandes Martins L, Mota Ronzani T. Attitudes of health professionals towards people with substance use disorders in Brazil, controlling for the effects of social desirability. HEALTH & SOCIAL CARE IN THE COMMUNITY 2022; 30:e3041-e3052. [PMID: 35142406 DOI: 10.1111/hsc.13749] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Revised: 12/27/2021] [Accepted: 01/24/2022] [Indexed: 06/14/2023]
Abstract
Health professionals are in a strategic position to help people with substance use disorders (SUDs) who seek health services for support or treatment. However, it is known that professionals' attitudes towards people who use alcohol and other drugs are marked by stigmatizing attitudes that create barriers to access quality treatment and make it difficult for the user to adhere to it. From this, the present study aimed to investigate the attitudes of 264 health professionals from specialised services and primary health care (PHC) in the Southeast region of Brazil, through Opening Minds Scale for Healthcare Providers (OMS-HC), taking into account the hypothesis of contact with the subject as a predictor of more positive attitudes. For this, a Multiple Hierarchical Regression was carried out to ascertain the contribution of the variables used in the explanatory model of attitudes. In addition, the measure of social desirability (SD), assessed by Brazilian Portuguese adaptation of Marlowe-Crowne Social Desirability Scale, was used as a control variable in the regression model to obtain a more robust and accurate model regarding the presence of biased responses, pervasive in studies on attitudes. In general, our findings showed that contact/familiarity with substance use, either through direct contact with users or through the respondent's own use, predicted more positive attitudes, with specialised service professionals expressing more positive attitudes than those working in PHC. Blaming the user for his/her condition presented itself as a predictor of more negative attitudes. Studies like this are of paramount importance for understanding the relationship established between professionals and service users and, therefore, for tailoring interventions and programs that aim to reduce stigmatizing attitudes and provide better access to health for people with SUDs. The importance of using the SD measure as a control variable in Regression is also emphasised, as an effective way to overcome to a common limitation in studies of attitudes.
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Affiliation(s)
- Vitor Leite Ferreira
- Centro de Referência em Pesquisa, Intervenção e Avaliação em Álcool & Drogas (CREPEIA), Federal University of Juiz de Fora, Juiz de Fora, Brazil
| | - Joanna Gonçalves de Andrade Tostes
- Centro de Referência em Pesquisa, Intervenção e Avaliação em Álcool & Drogas (CREPEIA), Federal University of Juiz de Fora, Juiz de Fora, Brazil
| | | | | | - Leonardo Fernandes Martins
- Post-Graduate Program in Clinical Psychology, Pontifícia Universidade Católica - PUC RJ, Rio de Janeiro, Brazil
| | - Telmo Mota Ronzani
- Centro de Referência em Pesquisa, Intervenção e Avaliação em Álcool & Drogas (CREPEIA), Federal University of Juiz de Fora, Juiz de Fora, Brazil
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Zemore SE, Ware OD, Gilbert PA, Pinedo M. Barriers to retention in substance use treatment: Validation of a new, theory-based scale. J Subst Abuse Treat 2021; 131:108422. [PMID: 34098296 PMCID: PMC8528875 DOI: 10.1016/j.jsat.2021.108422] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Revised: 04/14/2021] [Accepted: 04/15/2021] [Indexed: 11/24/2022]
Abstract
PURPOSE Few studies and no theory-based scales have addressed specific barriers to substance use disorder (SUD) treatment retention. The current study, building on the Theory of Planned Behavior (TPB), sought to (a) identify those barriers that are most strongly associated with treatment retention, and most common, and (b) develop and validate a new scale of retention barriers, focusing on TPB attitude and perceived control components. METHODS The study administered surveys to 200 participants initiating SUD treatment at a public, outpatient program in Northern California; the analytic sample (N = 156) included only those not strongly coerced into treatment. Surveys included TPB-based measures of treatment barriers; other motivational readiness measures; treatment coercion and social desirability measures; and clinical severity variables and demographics. Discharge status was collected from program records. RESULTS Item and scale analyses identified three dimensions of attitudinal barriers (i.e., Low Perceived Treatment Need/Value, Social Concerns, and Concerns about Missing Substances) and two dimensions of perceived control barriers (i.e., Personal Limitations and Basic Logistic Barriers). Results informed creation of a 19-item Barriers to Retention Scale (BRS) with 5 subscales and very good internal reliability (alpha = 0.88). While all subscale scores were correlated with treatment completion, only Concerns about Missing Substances and total BRS scores predicted treatment completion in multivariate analyses. CONCLUSIONS The present study identified core dimensions of treatment retention barriers and developed a new scale predictive of treatment completion and potentially useful as a screener and in future research. Results suggest that interventions to improve retention should focus strongly on concerns about the negative impacts of abstaining from alcohol and drugs on craving and quality of life.
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Affiliation(s)
- Sarah E Zemore
- Alcohol Research Group, Emeryville, CA, United States of America.
| | - Orrin D Ware
- School of Social Work, University of Maryland, Baltimore, MD, United States of America
| | - Paul A Gilbert
- Department of Community and Behavioral Health, University of Iowa, Iowa City, IA, United States of America
| | - Miguel Pinedo
- Department of Kinesiology and Health Education, College of Education, University of Texas at Austin, TX, United States of America
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McGeough BL, Karriker-Jaffe KJ, Zemore SE. Rates and predictors of Alcoholics Anonymous attendance across sexual orientations. J Subst Abuse Treat 2021; 129:108400. [PMID: 34080558 PMCID: PMC8380678 DOI: 10.1016/j.jsat.2021.108400] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Revised: 04/04/2021] [Accepted: 04/05/2021] [Indexed: 10/21/2022]
Abstract
Sexual minority (e.g., gay, lesbian, bisexual) individuals experience alcohol dependence at 2-6 times the rates of heterosexual individuals. Among the general population, Alcoholics Anonymous (AA) serves as the most common source of support for alcohol-related problems in the United States. Yet, relatively little is known about sexual minority involvement in AA, including rates and predictors of AA attendance among sexual minorities. This paper aims to: 1) Compare rates of AA attendance across sexual orientations; 2) Compare relationships between AA attendance and common predictors of AA attendance across sexual orientations. Using five waves of the National Alcohol Survey (N = 7862 respondents with at least one lifetime AUD symptom), this study found lesbian and bisexual women, but not gay and bisexual men, had greater odds of attending AA, even while controlling for lifetime AUD severity, gender, race/ethnicity, age, religiosity, and current income. Interaction models for women showed there was a stronger association between older age and AA attendance, a stronger association between greater religiosity and AA attendance, and a weaker association between lifetime AUD severity and AA attendance for sexual minority women relative to heterosexual women. This study did not find significant interactions between sexual orientation and these covariates for men. These results suggest AA may serve as a promising resource for sexual minority individuals experiencing alcohol-related problems, particularly for sexual minority women who are older, more religious, and have less severe AUD.
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Affiliation(s)
- Briana L McGeough
- School of Social Welfare, University of Kansas, Lawrence, KS, United States of America.
| | | | - Sarah E Zemore
- Alcohol Research Group, Emeryville, CA, United States of America
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Studer-Luethi B, Brasser M, Lusti S, Schaerli R. A cross-sectional survey of a public, evidence-based multimodal program for cognitive health in older adults. Arch Public Health 2021; 79:165. [PMID: 34530899 PMCID: PMC8443915 DOI: 10.1186/s13690-021-00670-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Accepted: 08/03/2021] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND In recent decades, the proportion of older adults in the population has continued to rise, and with it, the need for intervention programs to maintain cognitive functions into old age. Multiple lifestyle factors, including physical, cognitive, and social activities, are crucial to forestalling a decline in cognitive functions. However, Covid-19 curtailed most activities, and therefore, strategies are needed to support older adults in remaining cognitively healthy. This study describes a newly developed and publicly available multimodal program, called "brain coach", to support and stimulate cognitive activity in older adults. The autonomy supportive program integrates into daily life recommendations for evidence-based physical, cognitive, social, mindful, and creative activation exercises. METHODS The study design corresponds to a correlational, analytical, and cross-sectional study with 660 older adults, who participated in the program for at least 3 months and completed an online survey. RESULTS The survey results demonstrate that the average age of the participants was 71 years and 75 % were female. Participants experienced benefits in memory, well-being, attitudes towards the brain, and lifestyle habits. Importantly, time invested in the intervention and participant's positive attitude toward brain health and neuroplasticity, show positive relationships with the experienced benefits. CONCLUSIONS The results reveal the potential of a public program with a multimodal approach to increase cognitive health and promote an active lifestyle. Further research will explore the effects of such a multimodal intervention in a longitudinal randomized controlled trial study.
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Meredith LR, Grodin EN, Karno MP, Montoya AK, MacKillop J, Lim AC, Ray LA. Preliminary study of alcohol problem severity and response to brief intervention. Addict Sci Clin Pract 2021; 16:54. [PMID: 34429151 PMCID: PMC8386030 DOI: 10.1186/s13722-021-00262-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Accepted: 08/13/2021] [Indexed: 11/29/2022] Open
Abstract
Background Findings have been mixed as to whether brief intervention (BI) is appropriate and effective for individuals with more severe alcohol use problems. Motivation to change drinking has been supported as a mechanism of behavior change for BI. This exploratory study examined aspects of motivation as mechanisms of clinical response to BI and alcohol problem severity as a moderator of treatment effects. Methods Non-treatment-seeking heavy drinkers (average age = 35 years; 57% male) were randomized to receive BI (n = 27) or attention-matched control (n = 24). Three indices of motivation to change were assessed at baseline and post-intervention: importance, confidence, and readiness. Moderated mediation analyses were implemented with treatment condition as the focal predictor, changes in motivation as mediator, 1-month follow-up drinks per day as the outcome, and an alcohol severity factor as second-stage moderator. Results Analysis of importance displayed a significant effect of intervention condition on importance (p < 0.003) and yielded a significant index of moderated mediation (CI − 0.79, − 0.02), indicating that the conditional indirect effect of treatment condition on drinking through importance was stronger for those with higher alcohol severity. For all motivation indices, alcohol severity moderated the effect of post-intervention motivation levels on drinking (p’s < 0.05). The direct effect of treatment condition on drinking was not significant in any model. Conclusions Findings highlight the relevance of considering one’s degree of alcohol problem severity in BI and alcohol screening efforts among non-treatment seeking heavy drinkers. These nuanced effects elucidate both potential mechanisms and moderators of BI response. Trial registration Clinicaltrials.gov: NCT04710095. Registered January 14, 2021—retrospectively registered, https://clinicaltrials.gov/ct2/show/study/NCT04710095.
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Affiliation(s)
- Lindsay R Meredith
- Department of Psychology, University of California Los Angeles, 1285 Franz Hall, Box 951563, Los Angeles, CA, 90095-1563, USA
| | - Erica N Grodin
- Department of Psychology, University of California Los Angeles, 1285 Franz Hall, Box 951563, Los Angeles, CA, 90095-1563, USA
| | - Mitchell P Karno
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, CA, USA
| | - Amanda K Montoya
- Department of Psychology, University of California Los Angeles, 1285 Franz Hall, Box 951563, Los Angeles, CA, 90095-1563, USA
| | - James MacKillop
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada
| | - Aaron C Lim
- Department of Psychology, University of California Los Angeles, 1285 Franz Hall, Box 951563, Los Angeles, CA, 90095-1563, USA
| | - Lara A Ray
- Department of Psychology, University of California Los Angeles, 1285 Franz Hall, Box 951563, Los Angeles, CA, 90095-1563, USA. .,Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, CA, USA.
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Almanza-Avendaño AM, Romero Mendoza M, Gomez-San Luis AH. "I Didn't See It as a Problem, I Thought It Was Going to Be Taken Away": Narratives From Family Members of Users in Rehab. Front Psychiatry 2021; 12:649961. [PMID: 34483979 PMCID: PMC8416069 DOI: 10.3389/fpsyt.2021.649961] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2021] [Accepted: 07/21/2021] [Indexed: 11/13/2022] Open
Abstract
There are multiple discourses on addictions that influence the way in which relatives interpret the substance use of a family member. The purpose of this study is to understand the influence of these discourses on the construction of use as a problem by relatives of people in recovery. Narratives were obtained on the path of the illness to identify the phases in the construction of use as a problem and the influence of the discourses on each phase. The process has four successive phases: normalization, impasse, exasperation, and adoption of the treatment ideology. This process goes from the legitimization of use to its moral interpretation and subsequently to the transition to medical discourse. It is concluded that it is important to reduce the influence of the moral discourse in order to facilitate timely detection and early care, as well as to design interventions focused on the reconstruction of use as a problem.
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Affiliation(s)
| | - Martha Romero Mendoza
- Dirección de Investigaciones Epidemiológicas y Psicosociales, Instituto Nacional de Psiquiatría, Ciudad de México, Mexico City, Mexico
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Differences in Substance Use Among Immigrants and the Canadian-Born Population. CANADIAN STUDIES IN POPULATION 2021. [DOI: 10.1007/s42650-021-00047-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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12
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Shi Z, Jagannathan K, Padley JH, Wang A, Fairchild VP, O'Brien CP, Childress AR, Langleben DD. The role of withdrawal in mesocorticolimbic drug cue reactivity in opioid use disorder. Addict Biol 2021; 26:e12977. [PMID: 33098179 DOI: 10.1111/adb.12977] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2020] [Revised: 09/21/2020] [Accepted: 09/26/2020] [Indexed: 01/08/2023]
Abstract
Opioid use disorder (OUD) is characterized by heightened cognitive, physiological, and neural responses to opioid-related cues that are mediated by mesocorticolimbic brain pathways. Craving and withdrawal are key symptoms of addiction that persist during physiological abstinence. The present study evaluated the relationship between the brain response to drug cues in OUD and baseline levels of craving and withdrawal. We used functional magnetic resonance imaging (fMRI) to examine brain responses to opioid-related pictures and control pictures in 29 OUD patients. Baseline measures of drug use severity, opioid craving, and withdrawal symptoms were assessed prior to cue exposure and correlated with subsequent brain responses to drug cues. Mediation analysis was conducted to test the indirect effect of drug use severity on brain cue reactivity through craving and withdrawal symptoms. We found that baseline drug use severity and opioid withdrawal symptoms, but not craving, were positively associated with the neural response to drug cues in the nucleus accumbens, orbitofrontal cortex, and amygdala. Withdrawal, but not craving, mediated the effect of drug use severity on the nucleus accumbens' response to drug cues. We did not find similar effects for the neural responses to stimuli unrelated to drugs. Our findings emphasize the central role of withdrawal symptoms as the mediator between the clinical severity of OUD and the brain correlates of sensitization to opioid-related cues. They suggest that in OUD, baseline withdrawal symptoms signal a high vulnerability to drug cues.
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Affiliation(s)
- Zhenhao Shi
- Center for Studies of Addiction, Department of Psychiatry University of Pennsylvania Perelman School of Medicine Philadelphia Pennsylvania USA
| | - Kanchana Jagannathan
- Center for Studies of Addiction, Department of Psychiatry University of Pennsylvania Perelman School of Medicine Philadelphia Pennsylvania USA
| | - James H. Padley
- Center for Studies of Addiction, Department of Psychiatry University of Pennsylvania Perelman School of Medicine Philadelphia Pennsylvania USA
| | - An‐Li Wang
- Department of Psychiatry Icahn School of Medicine at Mount Sinai New York New York USA
| | - Victoria P. Fairchild
- Department of Psychology, Queens College The City University of New York New York New York USA
| | - Charles P. O'Brien
- Center for Studies of Addiction, Department of Psychiatry University of Pennsylvania Perelman School of Medicine Philadelphia Pennsylvania USA
| | - Anna Rose Childress
- Center for Studies of Addiction, Department of Psychiatry University of Pennsylvania Perelman School of Medicine Philadelphia Pennsylvania USA
| | - Daniel D. Langleben
- Center for Studies of Addiction, Department of Psychiatry University of Pennsylvania Perelman School of Medicine Philadelphia Pennsylvania USA
- Annenberg Public Policy Center University of Pennsylvania Philadelphia Pennsylvania USA
- Behavioral Health Service Corporal Michael J. Crescenz Veterans Administration Medical Center Philadelphia Pennsylvania USA
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13
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Morgan PC, Stanfield MH, Durtschi JA. "There may be a problem, but I'm not going because…": examining classes of men and their rationales for not seeking mental health treatment. JOURNAL OF MENTAL HEALTH (ABINGDON, ENGLAND) 2021; 31:180-187. [PMID: 33989504 DOI: 10.1080/09638237.2021.1922639] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
BACKGROUND Men are less likely than women to seek out mental health treatment, despite men also having mental health struggles. AIM We examined typologies of men's reasons for not seeking treatment even though they perceived a need for treatment. METHOD We conducted a latent class analysis using a U.S. national sample of 836 men who specifically indicated a need for mental health services, but did not seek treatment from the National Study on Drug Use and Health. RESULTS We identified three distinct types of men and their unique rationales for not seeking treatment: positive attitudes class, perceived high behavioral control class, and negative attitudes class. CONCLUSIONS Unique strategies to market clinical services to each of the various needs and concerns of these types of men may prove more beneficial than a generic outreach approach. We encourage mental health professionals to proactively educate men about their services and aim to reduce barriers for men seeking treatment.
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Affiliation(s)
- Preston C Morgan
- Human Development and Family Studies, Michigan State University, East Lansing, MI, USA
| | - M Hunter Stanfield
- Department of Psychology, Counseling, and Family Science, Lipscomb University, Nashville, TN, USA
| | - Jared A Durtschi
- Department of Applied Human Sciences, Kansas State University, Manhattan, KS, USA
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14
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Barrio P, Baldaquí N, Andreu M, Kilian C, Rehm J, Gual A, Manthey J. Abstinence Among Alcohol Use Disorder Patients During the COVID-19 Pandemic: Insights From Spain. Alcohol Clin Exp Res 2021; 45:802-807. [PMID: 33667019 DOI: 10.1111/acer.14555] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2020] [Accepted: 01/14/2021] [Indexed: 12/19/2022]
Abstract
BACKGROUND Patients with alcohol use disorder (AUD) are likely to suffer disproportionate harms related to the COVID-19 pandemic and related policy measures. While many surveys have been conducted, most are focused on drinking changes in the general population and validation with biological markers is lacking. METHOD We performed a retrospective cohort study among patients with AUD attending a urine drug screening program. With mixed-effects logistic regression models, we assessed the probability of screening positive for ethyl glucuronide according to patients' main clinical characteristics and time of analysis (either prior to or after a lockdown was implemented in Spain). RESULTS A total of 362 patients provided 2,040 urine samples (1,295 prior to lockdown, 745 during lockdown). The mean age of participants was 52.0 years (SD 12.6), and 69.2% were men. Of the 43% of patients tested for other drugs 22% screened positive. After adjusting for all covariates, the odds of screening positive for ethyl glucuronide during lockdown almost doubled (OR = 1.99, 95% CI 1.20 to 3.33, p = 0.008). Other significant covariates included testing positive for other drugs (OR = 10.79, 95% CI 4.60 to 26.97) and length of treatment (OR = 0.59, 95% CI 0.47 to 0.74). CONCLUSIONS Our data support an association between the lockdown due to COVID-19 and increased alcohol use in patients with AUD. Thus, addiction healthcare systems could face significant challenges ahead. In light of these findings, it is essential to evaluate prospectively how patients with AUD are affected by the pandemic and how health systems respond to their needs.
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Affiliation(s)
- Pablo Barrio
- Grup Recerca Addiccions Clínic (GRAC-GRE), Institut d'Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS), Hospital Clínic Barcelona, Barcelona, Spain
| | - Nuria Baldaquí
- Grup Recerca Addiccions Clínic (GRAC-GRE), Institut d'Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS), Hospital Clínic Barcelona, Barcelona, Spain
| | - Magalí Andreu
- Grup Recerca Addiccions Clínic (GRAC-GRE), Institut d'Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS), Hospital Clínic Barcelona, Barcelona, Spain
| | - Carolin Kilian
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany
| | - Jürgen Rehm
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany.,Centre for Addiction and Mental Health, Institute for Mental Health Policy Research, Toronto, Ontario, Canada.,Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada.,Faculty of Medicine, Institute of Medical Science, University of Toronto, Toronto, Ontario, Canada.,Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada.,Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada.,I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russian Federation.,Center for Interdisciplinary Addiction Research (ZIS), Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - Antoni Gual
- Grup Recerca Addiccions Clínic (GRAC-GRE), Institut d'Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS), Hospital Clínic Barcelona, Barcelona, Spain
| | - Jakob Manthey
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany.,Center for Interdisciplinary Addiction Research (ZIS), Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany.,Department of Psychiatry, Medical Faculty, University of Leipzig, Leipzig, Germany
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15
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Pérez de Los Cobos J, Alcaraz S, Verdejo-García A, Muñoz L, Siñol N, Fernández-Serrano MJ, Fernández P, Martínez A, Duran-Sindreu S, Batlle F, Trujols J. Factors associated with the absence of cocaine craving in treatment-seeking individuals during inpatient cocaine detoxification. THE AMERICAN JOURNAL OF DRUG AND ALCOHOL ABUSE 2021; 47:127-138. [PMID: 33164558 DOI: 10.1080/00952990.2020.1833340] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
BACKGROUND Anecdotal evidence suggests a substantial proportion of individuals with cocaine use disorder do not report craving during inpatient detoxification. OBJECTIVE To examine prevalence and clinical correlates of consistent absence of cocaine craving among inpatients during detoxification. We hypothesized that craving absence would be associated with less severity of cocaine use, depression, and anxiety. Alternative explanations were also explored. METHODS Craving absence (i.e., non-cravers) was defined as a daily score of zero across two separate craving visual analogue scales in each of the inpatient days. Participants scoring ≥1 on ≥1 day were considered cravers. Severity of cocaine use disorder as well as in-treatment depression and anxiety were assessed. Alternative contributors included presence of cocaine and other substances in urine at admission, in-treatment prescription of psychotropic medications, treatment motivation, executive function, interoception, and social desirability. RESULTS Eighty-seven participants (78.2% males) met criteria as either non-cravers (n = 29; 33.3%) or cravers (n = 58; 66.7%). Mean length of admission in non-cravers and cravers was, respectively, 10.83 and 13.16 days. Binary logistic regression model showed that non-cravers scored significantly lower than cravers on cocaine use during last month before treatment (OR, 95% CI; 0.902, 0.839-0.970), in-treatment depression (OR, 95% CI; 0.794, 0.659-0.956), and in-treatment prescribing of antipsychotics (OR, 95% CI; 0.109, 0.014-0.823). Model prediction accuracy was 88.9%. CONCLUSIONS One in three patients undergoing inpatient detoxification experienced absence of craving, linked to less pretreatment cocaine use, better mood, and decreased administration of antipsychotics. Findings may inform pretreatment strategies and improve treatment cost-effectiveness.
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Affiliation(s)
- Jose Pérez de Los Cobos
- Addictive Behaviours Unit, Department of Psychiatry, Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute Sant Pau (IIB Sant Pau), Barcelona, Spain.,Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain.,Departament de Psiquiatria i Medicina Legal, Universitat Autonoma de Barcelona, Bellaterra, Spain
| | - Saul Alcaraz
- Addictive Behaviours Unit, Department of Psychiatry, Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute Sant Pau (IIB Sant Pau), Barcelona, Spain
| | - Antonio Verdejo-García
- Monash Institute of Cognitive and Clinical Neurosciences, Monash University, Clayton, Australia
| | - Laura Muñoz
- Addictive Behaviours Unit, Department of Psychiatry, Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute Sant Pau (IIB Sant Pau), Barcelona, Spain
| | - Núria Siñol
- Addictive Behaviours Unit, Department of Psychiatry, Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute Sant Pau (IIB Sant Pau), Barcelona, Spain
| | - Maria José Fernández-Serrano
- Departamento de Metodología de las Ciencias del Comportamiento, Facultad de Psicología, Universidad de Granada, Granada, Spain
| | - Pilar Fernández
- Addictive Behaviours Unit, Department of Psychiatry, Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute Sant Pau (IIB Sant Pau), Barcelona, Spain
| | - Ana Martínez
- Addictive Behaviours Unit, Department of Psychiatry, Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute Sant Pau (IIB Sant Pau), Barcelona, Spain
| | - Santiago Duran-Sindreu
- Addictive Behaviours Unit, Department of Psychiatry, Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute Sant Pau (IIB Sant Pau), Barcelona, Spain
| | - Francesca Batlle
- Addictive Behaviours Unit, Department of Psychiatry, Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute Sant Pau (IIB Sant Pau), Barcelona, Spain
| | - Joan Trujols
- Addictive Behaviours Unit, Department of Psychiatry, Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute Sant Pau (IIB Sant Pau), Barcelona, Spain.,Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain.,Unitat de Neurociència Quantitativa, Grup de Recerca en Psicologia Quantitativa (SGR 269), Universitat de Barcelona, Barcelona, Spain
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16
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Lambert L, Serre F, Thirioux B, Jaafari N, Roux P, Jauffret-Roustide M, Lalanne L, Daulouède JP, Auriacombe M. Link Between Perception of Treatment Need and Craving Reports in Addiction. Front Psychiatry 2021; 12:790203. [PMID: 35173637 PMCID: PMC8841420 DOI: 10.3389/fpsyt.2021.790203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Accepted: 11/29/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Perception of treatment need (PTN), a component of clinical insight, is associated to negative addiction treatment outcomes when low. Our hypothesis was that lower PTN was associated with less craving when reported retrospectively, the most common measure of craving in clinical settings. OBJECTIVE To explore the association between PTN and craving among a dataset of subjects with severe substance use disorders. METHODS Participants were recruited from outpatient addiction clinic admissions or harm reduction program services. Good and low PTN were based on consistency between severe addiction (at least six DSM-5 criteria) and self-report need for addiction treatment from the Addiction Severity Index. Craving was retrospectively characterized over the past 30 days. Multiple regression analyses were conducted. RESULTS Participants with low PTN (n = 97) retrospectively reported less frequent and intense episodes of craving, compared with participants with good PTN (n = 566) after controlling for sociodemographic factors, addiction type, and severity (p < 0.0001). CONCLUSION Low perception of treatment need among subjects with severe addictions is associated to less retrospective report of craving, which may contribute to reduced efficiency of treatment. Further studies are needed to explore the mechanisms of the association.
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Affiliation(s)
- Laura Lambert
- University of Bordeaux, SANPSY, USR 3413, Bordeaux, France.,CNRS, SANPSY, USR 3413, Bordeaux, France.,Pôle Interétablissement d'Addictologie, CH Ch. Perrens and CHU de Bordeaux, Bordeaux, France
| | - Fuschia Serre
- University of Bordeaux, SANPSY, USR 3413, Bordeaux, France.,CNRS, SANPSY, USR 3413, Bordeaux, France.,Pôle Interétablissement d'Addictologie, CH Ch. Perrens and CHU de Bordeaux, Bordeaux, France
| | - Berangere Thirioux
- Unité de Recherche Clinique Intersectorielle en Psychiatrie à vocation régionale Pierre Deniker, Centre Hospitalier Henri Laborit, Poitiers, France
| | - Nematollah Jaafari
- Unité de Recherche Clinique Intersectorielle en Psychiatrie à vocation régionale Pierre Deniker, Centre Hospitalier Henri Laborit, Poitiers, France.,Université de Poitiers, Poitiers, France
| | - Perrine Roux
- Aix Marseille University, INSERM, IRD, SESSTIM, Sciences Economiques and Sociales de la Santé and Traitement de l'Information Médicale, Marseille, France
| | - Marie Jauffret-Roustide
- Cermes 3, Inserm U988, CNRS UMR 8236, Université de Paris, EHESS, Paris, France.,British Columbia Centre on Substance Use, Vancouver, BC, Canada.,Baldy Center for Law and Social Policy, Buffalo University of Social Sciences, New York, NY, United States
| | - Laurence Lalanne
- INSERM 1114, Department of Psychiatry and Addictology, University Hospital of Strasbourg, Fédération de Médecine Translationnelle de Strasbourg (FMTS), Strasbourg, France
| | - Jean-Pierre Daulouède
- CNRS, SANPSY, USR 3413, Bordeaux, France.,Centre de Soins et d'Accompagnement et de Prévention en Addictologie (CSAPA), BIZIA, Médecins du Monde, Centre Hospitalier de la côte Basque, Bayonne, France
| | - Marc Auriacombe
- University of Bordeaux, SANPSY, USR 3413, Bordeaux, France.,CNRS, SANPSY, USR 3413, Bordeaux, France.,Pôle Interétablissement d'Addictologie, CH Ch. Perrens and CHU de Bordeaux, Bordeaux, France.,Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States
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17
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Akiyama MJ, Ross J, Rimawi F, Fox A, Jordan AO, Wiersema J, Litwin AH, Kaba F, MacDonald R. Knowledge, attitudes, and acceptability of direct-acting antiviral hepatitis C treatment among people incarcerated in jail: A qualitative study. PLoS One 2020; 15:e0242623. [PMID: 33264311 PMCID: PMC7710033 DOI: 10.1371/journal.pone.0242623] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2020] [Accepted: 11/03/2020] [Indexed: 01/27/2023] Open
Abstract
Introduction While U.S. jails are critical sites for engagement in HCV care, short lengths-of-stay often do not permit treatment in jail. Therefore, linkage to HCV care after incarceration is crucial. However, little is known about HCV treatment acceptability among justice-involved individuals in U.S. jails. The goal of this study was to understand knowledge, attitudes, and acceptability of HCV treatment among people living with HCV in the New York City (NYC) jail system. Methods We recruited 36 HCV-antibody-positive individuals in the NYC jails using clinical data reports and performed semi-structured interviews to explore participants’ attitudes toward HCV treatment in jail and following return to the community. We continued interviews until reaching thematic saturation and analyzed interviews using an inductive, thematic approach. Results Participants were mostly male, Latina/o, with a mean age of 40 years. Nearly all were aware they were HCV antibody-positive. Two thirds of participants had some awareness of the availability of new HCV therapies. Key themes included: 1) variable knowledge of new HCV therapies affecting attitudes toward HCV treatment, 2) the importance of other incarcerated individuals in communicating HCV-related knowledge, 3) vulnerability during incarceration and fear of treatment interruption, 4) concern for relapse to active drug use and HCV reinfection, 5) competing priorities (such as other medical comorbidities, ongoing substance use, and housing), 6) social support and the importance of family. Conclusions Patient-centered approaches to increase treatment uptake in jail settings should focus on promoting HCV-related knowledge including leveraging peers for knowledge dissemination. In addition, transitional care programs should ensure people living with HCV in jail have tailored discharge plans focused on competing priorities such as housing instability, social support, and treatment of substance use disorders.
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Affiliation(s)
- Matthew J. Akiyama
- Department of Medicine, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, NY, United States of America
- * E-mail:
| | - Jonathan Ross
- Department of Medicine, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, NY, United States of America
| | - Fatimah Rimawi
- Department of Medicine, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, NY, United States of America
| | - Aaron Fox
- Department of Medicine, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, NY, United States of America
| | - Alison O. Jordan
- Correctional Health Services, New York City Health + Hospitals, New York, NY, United States of America
| | - Janet Wiersema
- Correctional Health Services, New York City Health + Hospitals, New York, NY, United States of America
| | - Alain H. Litwin
- Department of Medicine, University of South Carolina School of Medicine–Greenville, Greenville, South Carolina, United States of America
- Department of Medicine, Prisma Health, Greenville, South Carolina, United States of America
- Clemson University School of Health Research, Clemson, South Carolina, United States of America
| | - Fatos Kaba
- Correctional Health Services, New York City Health + Hospitals, New York, NY, United States of America
| | - Ross MacDonald
- Correctional Health Services, New York City Health + Hospitals, New York, NY, United States of America
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18
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Martins RC, Machado AKF, Shenderovich Y, Soares TB, da Cruz SH, Altafim ERP, Linhares MBM, Barros F, Santos IS, Murray J. Parental attendance in two early-childhood training programmes to improve nurturing care: A randomized controlled trial. CHILDREN AND YOUTH SERVICES REVIEW 2020; 118:105418. [PMID: 33162629 PMCID: PMC7607382 DOI: 10.1016/j.childyouth.2020.105418] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Revised: 08/24/2020] [Accepted: 08/25/2020] [Indexed: 06/11/2023]
Abstract
Parent training programmes have significant potential to improve the quality of children's early environments and thereby their development and life-course outcomes. The aim of this study was to identify and explain the extent to which parents engaged in two group-based training programmes, offered to high-risk families enrolled in a randomized controlled trial study called PIÁ in Southern Brazil. The programmes were: (1) ACT: Raising Safe Kids, a 9-week programme aiming to reduce harsh parenting and maltreatment and improve positive parenting practices; (2) Dialogic book-sharing (DBS), an 8-week programme aiming to promote parental sensitivity and improve child cognitive development and social understanding. Of the 123 mothers randomly allocated to the ACT programme, 64.2% (n = 79) completed the course, and of 124 mothers allocated to DBS, 76.6% (n = 95) completed the course. After the interventions, mothers were very positive about the experience of both programmes but highlighted practical difficulties in attending. In adjusted regression analyses, only two variables significantly predicted ACT course completion (maternal age and distance between the intervention site and household); no significant predictor was found for DBS attendance. We conclude that although high completion rates are possible, there are important challenges to engaging parents of young children in training programmes, and practical difficulties occurring during training courses may be more important for attendance than baseline participant characteristics.
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Affiliation(s)
- Rafaela Costa Martins
- Post-graduate Programme in Epidemiology, Federal University of Pelotas, Brazil
- Human Development and Violence Research Centre (DOVE), Federal University of Pelotas, Brazil
| | | | - Yulia Shenderovich
- Centre for Evidence-Based Social Intervention, Department of Social Policy and Intervention, Barnett House, 32 Wellington Square, Oxford OX1 2ER, United Kingdom
| | | | - Suélen Henriques da Cruz
- Post-graduate Programme in Epidemiology, Federal University of Pelotas, Brazil
- Human Development and Violence Research Centre (DOVE), Federal University of Pelotas, Brazil
| | | | | | - Fernando Barros
- Post-graduate Programme in Epidemiology, Federal University of Pelotas, Brazil
| | - Iná S. Santos
- Post-graduate Programme in Epidemiology, Federal University of Pelotas, Brazil
| | - Joseph Murray
- Post-graduate Programme in Epidemiology, Federal University of Pelotas, Brazil
- Human Development and Violence Research Centre (DOVE), Federal University of Pelotas, Brazil
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19
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Phosphatidylethanol for Monitoring Alcohol Use in Liver Transplant Candidates: An Observational Study. J Clin Med 2020; 9:jcm9093060. [PMID: 32971960 PMCID: PMC7564451 DOI: 10.3390/jcm9093060] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2020] [Revised: 09/06/2020] [Accepted: 09/18/2020] [Indexed: 01/28/2023] Open
Abstract
Liver transplantation remains an essential procedure for many patients suffering from alcoholic liver disease. Alcohol use monitoring remains paramount all through the stages of this complex process. Direct alcohol biomarkers, with improved specificity and sensibility, should replace traditional indirect markers. Phosphatidylethanol (PEth) has been recently tested in alcoholic liver disease patients, but more evidence is needed, especially in comparison with other direct biomarkers. We conducted an observational study among patients awaiting liver transplantation. We analyzed Peth in blood, ethylglucuronide (EtG) in hair and urine and ethylsulphate (EtS) in urine, using mass spectrometry methods. In addition, transaminases, and self-reports were analyzed. A total of 50 patients were included (84% men, mean age 59 years (SD = 6)). 18 patients (36%) screened positive for any marker. Self-reports were positive in 3 patients. EtS was the biomarker with more positive screens. It also was the most frequently exclusive biomarker, screening positive in 7 patients who were negative for all other biomarkers. PEth was positive in 5 patients, being the only positive biomarker in 2 patients. It showed a false negative in a patient admitting alcohol use the previous week and screening positive for EtG and EtS. Hair EtG was positive in 3 patients who had negative Peth, EtG. EtG did not provide any exclusive positive result.A combination of biomarkers seems to be the best option to fully ascertain abstinence in this population. Our study suggest EtS might also play a significant role.
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20
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Vesely S, Klöckner CA. Social Desirability in Environmental Psychology Research: Three Meta-Analyses. Front Psychol 2020; 11:1395. [PMID: 32793022 PMCID: PMC7393925 DOI: 10.3389/fpsyg.2020.01395] [Citation(s) in RCA: 50] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2020] [Accepted: 05/25/2020] [Indexed: 11/13/2022] Open
Abstract
That social desirability might be a confounder of people's survey responses regarding environmental actions has been discussed for a long time. To produce evidence for or against this assumption, we conducted meta-analyses of correlations between social desirability scales and self-reports of environmentally relevant behaviors, intentions, and (broadly defined) attitudes, based on data from 29 previously published papers. The pooled correlations with social desirability are generally small, ranging from 0.06 to 0.11 (0.08-0.13 when correcting for measurement error attenuation). However, our results do not lead to the conclusion that social desirability can be completely disregarded by environmental psychologists as a potential confounder. For example, we found evidence of substantial heterogeneity across studies, so the effect of social desirability may be more pronounced in specific cases. Continued attention to social desirability bias is needed to fully understand its possible subtle effects.
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Affiliation(s)
- Stepan Vesely
- Department of Psychology, Norwegian University of Science and Technology, Trondheim, Norway
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21
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Tsavou E, Petkari E. Associations of Personality Traits and Emotional Intelligence: Comparing Individuals in Rehabilitation from Drug Misuse, Occasional Users and Non-Users. Subst Use Misuse 2020; 55:252-260. [PMID: 31519134 DOI: 10.1080/10826084.2019.1663359] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Background: Personality traits and Emotional Intelligence abilities have gained a central place in the etiology of drug use, although understudied until recently. Objective: To examine the associations between personality traits and Emotional Intelligence in people that are in process of rehabilitation from drug misuse, to compare them with occasional users and non-users and to estimate the factors associated with the likelihood of drug misuse. Methods: 244 individuals (52.5% male) participated in the study. Sixty of them were suffering from drug misuse disorders, thirty-two were individuals that used drugs occasionally and 142 were non-users. Personality was assessed with the EPQ and Emotional Intelligence with the WEILS. Results: Results suggested that in drug misuse, emotional use and regulation are positively correlated with extraversion, and negatively correlated with neuroticism, whilst people that misuse drugs differ from occasional and non-users in emotional use and regulation, and in all personality traits except extraversion. Regression analyses proposed that a combination of sex, age, emotional regulation, and neuroticism contributes to the likelihood of a person abusing drugs, as opposed to occasional or no use. Conclusion: Our findings showcase that Emotional Intelligence and personality traits indeed play an important role in drug use, specifically when considering factors that protect from or drive towards misuse. Such results call for the implementation of preventive programs for occasional drug users and therapeutic interventions for people that misuse drugs, targeting the levels of neuroticism and enhancing the ability of regulating the negative emotions, to protect from drug misuse.
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Affiliation(s)
- Eleftheria Tsavou
- Department of Social and Behavioral Sciences, European University Cyprus, Nicosia, Cyprus
| | - Eleni Petkari
- Department of Social and Behavioral Sciences, European University Cyprus, Nicosia, Cyprus.,Unit of Social and Community Psychiatry, Queen Mary University of London, London, United Kingdom
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Vesely S, Klöckner CA. Social Desirability in Environmental Psychology Research: Three Meta-Analyses. Front Psychol 2020. [PMID: 32793022 DOI: 10.3389/fpsyg.2020.01395/bibtex] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/21/2023] Open
Abstract
That social desirability might be a confounder of people's survey responses regarding environmental actions has been discussed for a long time. To produce evidence for or against this assumption, we conducted meta-analyses of correlations between social desirability scales and self-reports of environmentally relevant behaviors, intentions, and (broadly defined) attitudes, based on data from 29 previously published papers. The pooled correlations with social desirability are generally small, ranging from 0.06 to 0.11 (0.08-0.13 when correcting for measurement error attenuation). However, our results do not lead to the conclusion that social desirability can be completely disregarded by environmental psychologists as a potential confounder. For example, we found evidence of substantial heterogeneity across studies, so the effect of social desirability may be more pronounced in specific cases. Continued attention to social desirability bias is needed to fully understand its possible subtle effects.
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Affiliation(s)
- Stepan Vesely
- Department of Psychology, Norwegian University of Science and Technology, Trondheim, Norway
| | - Christian A Klöckner
- Department of Psychology, Norwegian University of Science and Technology, Trondheim, Norway
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Caputo A. Deceptive Dynamics in Drug Addiction and Their Role in Control Beliefs and Health Status Reporting: A Study on People With Substance Use Disorder in Treatment. JOURNAL OF DRUG ISSUES 2019. [DOI: 10.1177/0022042619853299] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
This study aims at exploring deceptive dynamics (i.e., impression management [IM], self-deception, and emotional manipulation [EM]) and their role in control beliefs and health status reporting in a sample of people treated for substance use disorder. Seventy-eight participants following drug rehabilitation treatment were recruited, who provided background information and completed measures of social desirability responding, EM, locus of control, and health-related status. Moderated-regression analyses and t tests were performed. The results highlight that self-deception is associated with not reporting the use of secondary substances and being in treatment for a shorter time period. IM appears as the main deceptive tendency able to account for internal control beliefs and better mental health. Some interaction effects emerge among the examined deceptive tendencies, which suggest to deepen the role of EM as a risk factor for drug relapse and treatment success.
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What Do Real Alcohol Outpatients Expect about Alcohol Transdermal Sensors? J Clin Med 2019; 8:jcm8060795. [PMID: 31195625 PMCID: PMC6616615 DOI: 10.3390/jcm8060795] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2019] [Revised: 05/29/2019] [Accepted: 06/03/2019] [Indexed: 01/14/2023] Open
Abstract
Objective: Little is known about the potential acceptability of alcohol transdermal sensors among alcohol-dependent outpatients in routine clinical settings. The aim of the present study was to investigate patients’ attitudes towards alcohol transdermal sensors, as well as features associated with enhanced acceptability and usability. Methods: A cross-sectional survey among routine alcohol outpatients was conducted. The Drug Attitude Inventory (DAI-10) was adapted to the field of alcohol transdermal sensors for attitudes assessment. Likert-type and multiple-choice questions were used for acceptability and usability evaluation. Results: 68 patients completed the questionnaire, and the DAI-10 mean score was 3 (standard deviation (SD) = 6.5). Internal consistency revealed a Cronbach alpha of 0.613. The score of a single The score of a single Likert-type question about overall perceived value was 7.4 (SD = 2.6). Its correlation with mean DAI-10 scores was r = 0.633, with p < 0.001. Relapse prevention and a stricter treatment control from therapists were the main reported advantages. Perceived stigma was the main disadvantage. Features increasing device discretion would enhance its acceptability. Conclusions: The data suggest that transdermal sensors could play a role in the clinical treatment of alcohol outpatients and concerns regarding stigma should be taken into account. Future designs should try to minimize size and visibility and stigma concerns should be discussed with patients.
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Truong C, Krawczyk N, Dejman M, Marshall-Shah S, Tormohlen K, Agus D, Bass J. Challenges on the road to recovery: Exploring attitudes and experiences of clients in a community-based buprenorphine program in Baltimore City. Addict Behav 2019; 93:14-19. [PMID: 30682677 PMCID: PMC6528177 DOI: 10.1016/j.addbeh.2019.01.020] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2018] [Revised: 10/23/2018] [Accepted: 01/14/2019] [Indexed: 10/27/2022]
Abstract
OBJECTIVE This qualitative study identifies and describes experiences and challenges to retention of individuals with opioid use disorder (OUD) who participated in a low-threshold combined buprenorphine-peer support treatment program in Baltimore. METHODS In-depth semi-structured interviews with staff and former clients of the Project Connections Buprenorphine Program (PCBP) (9 people) and focus group discussions with current and previous clients of PCBP (7 people) were conducted. Content analysis was used to extract themes regarding barriers to enrolling and remaining in, and transitioning from the program. RESULTS Primary challenges identified by the participants included struggles with cravings and symptoms of withdrawal, comorbid mental health issues, criminal justice system involvement, medication stigma, and conflicts over level of flexibility regarding program requirements and the role of employment. CONCLUSIONS This study identified several obstacles clients face when seeking care through a combined buprenorphine-peer support model. Findings highlight potential programmatic factors that can be improved and additional resources that may support treatment retention rates and better outcomes. Despite challenges, low-threshold and community-based programs can increase access to effective maintenance treatment for OUD, especially among vulnerable populations who may not have access to formal health services.
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Affiliation(s)
- C Truong
- Mental Health Department, Johns Hopkins Bloomberg School of Public Health, Hampton House 624 N. Broadway, Floor 8, Baltimore, MD 21205, United States.
| | - N Krawczyk
- Mental Health Department, Johns Hopkins Bloomberg School of Public Health, Hampton House 624 N. Broadway, Floor 8, Baltimore, MD 21205, United States; Behavioral Health Leadership Institute, 2200 Arden Road, Baltimore, MD 21209, United States.
| | - M Dejman
- Mental Health Department, Johns Hopkins Bloomberg School of Public Health, Hampton House 624 N. Broadway, Floor 8, Baltimore, MD 21205, United States.
| | - S Marshall-Shah
- Mental Health Department, Johns Hopkins Bloomberg School of Public Health, Hampton House 624 N. Broadway, Floor 8, Baltimore, MD 21205, United States.
| | - K Tormohlen
- Mental Health Department, Johns Hopkins Bloomberg School of Public Health, Hampton House 624 N. Broadway, Floor 8, Baltimore, MD 21205, United States.
| | - D Agus
- Mental Health Department, Johns Hopkins Bloomberg School of Public Health, Hampton House 624 N. Broadway, Floor 8, Baltimore, MD 21205, United States; Behavioral Health Leadership Institute, 2200 Arden Road, Baltimore, MD 21209, United States.
| | - J Bass
- Mental Health Department, Johns Hopkins Bloomberg School of Public Health, Hampton House 624 N. Broadway, Floor 8, Baltimore, MD 21205, United States.
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Kvamme TL, Pedersen MU, Overgaard M, Rømer Thomsen K, Voon V. Pupillary reactivity to alcohol cues as a predictive biomarker of alcohol relapse following treatment in a pilot study. Psychopharmacology (Berl) 2019; 236:1233-1243. [PMID: 30607476 PMCID: PMC6591462 DOI: 10.1007/s00213-018-5131-1] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2018] [Accepted: 11/21/2018] [Indexed: 01/14/2023]
Abstract
RATIONALE Identifying the predictors of relapse in detoxified alcohol-dependent patients is crucial for effective surveillance procedures and the optimization of treatment. Physiological measures such as functional MRI activity and heart rate variability have been shown as potential markers of relapse prediction. OBJECTIVES Our aim was to assess differential pupillary reactions to alcohol-related cues as an objective physiological candidate predictor of relapse. METHODS We examined the relationship between cue-elicited pupillary reactions to alcohol stimuli and luminance-controlled neutral stimuli in 21 detoxified alcohol-dependent patients and subsequent relapse outcome at a 4-month follow-up. RESULTS Differential pupillary dilation to alcohol stimuli as compared to neutral stimuli at 150 to 250 ms after stimulus onset substantially improved the model prediction of relapse outcome (additional 27% of variance) beyond that achieved from five standardized questionnaires on alcohol craving, alcohol use, problematic use severity, depressive tendencies, and duration of abstinence (47% of variance). In contrast, alcohol craving did not improve relapse model prediction. CONCLUSIONS This pilot study shows that alcohol-dependent patients with greater pupillary dilation to alcohol stimuli are more vulnerable to relapse, and that pupillometry presents as an important tool for addiction science.
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Affiliation(s)
- Timo L. Kvamme
- Centre for Alcohol and Drug Research, School of Business and Social Sciences, Aarhus University, Aarhus, Denmark
- Department of Psychiatry, University of Cambridge, Addenbrookes Hospital, Level E4, Hills Road, Box 189, Cambridge, CB2 0QQ UK
- Cognitive Neuroscience Research Unit, CFIN/MindLab, Aarhus University, Aarhus, Denmark
| | - Mads Uffe Pedersen
- Centre for Alcohol and Drug Research, School of Business and Social Sciences, Aarhus University, Aarhus, Denmark
| | - Morten Overgaard
- Cognitive Neuroscience Research Unit, CFIN/MindLab, Aarhus University, Aarhus, Denmark
| | - Kristine Rømer Thomsen
- Centre for Alcohol and Drug Research, School of Business and Social Sciences, Aarhus University, Aarhus, Denmark
| | - Valerie Voon
- Department of Psychiatry, University of Cambridge, Addenbrookes Hospital, Level E4, Hills Road, Box 189, Cambridge, CB2 0QQ UK
- Behavioral and Clinical Neurosciences Institute, University of Cambridge, Cambridge, UK
- NIHR Biomedical Research Council University of Cambridge, Cambridge, UK
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Yeung WF, Lai AYK, Ho FYY, Suen LKP, Chung KF, Ho JYS, Ho LM, Yu BYM, Chan LYT, Lam TH. Effects of Zero-time Exercise on inactive adults with insomnia disorder: a pilot randomized controlled trial. Sleep Med 2018; 52:118-127. [DOI: 10.1016/j.sleep.2018.07.025] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2018] [Revised: 07/03/2018] [Accepted: 07/05/2018] [Indexed: 10/28/2022]
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Graham S, Irving J, Cano I, Edwards M. Participation with online recovery specific groups - findings from the UK Life in Recovery survey 2015. ALCOHOLISM TREATMENT QUARTERLY 2018. [DOI: 10.1080/07347324.2018.1500873] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- Simon Graham
- Helena Kennedy Centre for International Justice, Department of Law and Criminology, Development and Society, Sheffield Hallam University, Collegiate Crescent, Sheffield, United Kingdom
| | - Jamie Irving
- Helena Kennedy Centre for International Justice, Department of Law and Criminology, Development and Society, Sheffield Hallam University, Collegiate Crescent, Sheffield, United Kingdom
| | - Ivan Cano
- Helena Kennedy Centre for International Justice, Department of Law and Criminology, Development and Society, Sheffield Hallam University, Collegiate Crescent, Sheffield, United Kingdom
| | - Michael Edwards
- Helena Kennedy Centre for International Justice, Department of Law and Criminology, Development and Society, Sheffield Hallam University, Collegiate Crescent, Sheffield, United Kingdom
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Nyamathi AM, Salem BE, Ekstrand M, Yadav K, Le Y, Oleskowicz T, Shin SS. Correlates of Treatment Readiness among Formerly Incarcerated Homeless Women. CRIMINAL JUSTICE AND BEHAVIOR 2018; 45:969-983. [PMID: 30555191 PMCID: PMC6289200 DOI: 10.1177/0093854818771111] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Treatment readiness is a key predictor of drug treatment completion, rearrest, and recidivism during community reentry; however, limited data exists among homeless, female ex-offenders (HFOs). The purpose of this study was to present baseline data from a randomized controlled trial of 130 HFOs who had been released from jail or prison. Over half (60.8%) of HFOs had a treatment readiness score of ≥ 40 (n = 79, μ = 40.2, SD = 8.72). Bivariate analyses revealed that methamphetamine use, psychological well-being, and high emotional support were positively associated with treatment readiness. On the other hand, depressive symptomology and depression/anxiety scores were negatively associated with the treatment readiness score. Multiple linear regression revealed that depressive symptomology was negatively associated with treatment readiness (β = -0.377; p = .001). Further analyses revealed that the effect of emotional support on treatment readiness was mediated by depressive symptomatology.
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Barrio P, Teixidor L, Ortega L, Lligoña A, Rico N, Bedini JL, Vieta E, Gual A. Filling the gap between lab and clinical impact: An open randomized diagnostic trial comparing urinary ethylglucuronide and ethanol in alcohol dependent outpatients. Drug Alcohol Depend 2018; 183:225-230. [PMID: 29291550 DOI: 10.1016/j.drugalcdep.2017.11.015] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2017] [Revised: 11/02/2017] [Accepted: 11/03/2017] [Indexed: 11/28/2022]
Abstract
BACKGROUND Efforts aimed at reducing alcohol-related harm include early detection of risky drinkers as well as detection of early relapse in patients with alcohol dependence. Ethyl glucuronide (EtG) has been proven to be a reliable biomarker for the detection of recent drinking; however, no randomized, diagnostic trial to date has tested its impact on drinking outcomes. The aim of this study was to assess, in a randomized design, the implications of EtG screening on alcohol outcomes, compared to screening with a low sensitivity biomarker such as ethanol. METHODS Alcohol dependent outpatients were randomized to either 24 weeks of continuous screening with EtG or ethanol. Patients were aware of screening methods and results. After 24 weeks, all participants were screened with EtG. Self-reports were also gathered. A logistic regression compared the rate of EtG positive results at study end between groups. Generalized estimating equations evaluated the descending monthly rate of EtG positive patients in the EtG group. RESULTS A total of 162 patients were randomized. During the study period, the ethanol group showed less patients with positive screens (19/64 (29.7%) vs 58/98 (59%)). After 24 weeks, the EtG group showed a greater number of patients having a negative screening test compared to ethanol subjects when they were all screened with EtG (5/62 (8.1%) vs 13/39 (33.3%)). A significant decrease in the rate of EtG positive patients was found for the first three months of the study. CONCLUSIONS Routine screening with EtG seems to reduce drinking and improve abstinence rates in alcohol dependent outpatients.
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Affiliation(s)
- Pablo Barrio
- Addictive Behaviors Unit, Clinical Neuroscience Institute, Clinic Hospital, Villarroel 170 08036, Barcelona, Spain; Department of Psychiatry and Clinical Psychobiology, University of Barcelona, Casanova 143 08036 Barcelona, Spain; Grup de Recerca en Addiccions Clínic, Hospital Clínic de Barcelona, IDIBAPS, Universitat de Barcelona, Red de Trastornos adictivos (RETICS), Villarroel 170 08036 Barcelona, Spain.
| | - Lídia Teixidor
- Addictive Behaviors Unit, Clinical Neuroscience Institute, Clinic Hospital, Villarroel 170 08036, Barcelona, Spain; Grup de Recerca en Addiccions Clínic, Hospital Clínic de Barcelona, IDIBAPS, Universitat de Barcelona, Red de Trastornos adictivos (RETICS), Villarroel 170 08036 Barcelona, Spain
| | - Lluisa Ortega
- Addictive Behaviors Unit, Clinical Neuroscience Institute, Clinic Hospital, Villarroel 170 08036, Barcelona, Spain; Grup de Recerca en Addiccions Clínic, Hospital Clínic de Barcelona, IDIBAPS, Universitat de Barcelona, Red de Trastornos adictivos (RETICS), Villarroel 170 08036 Barcelona, Spain
| | - Anna Lligoña
- Addictive Behaviors Unit, Clinical Neuroscience Institute, Clinic Hospital, Villarroel 170 08036, Barcelona, Spain; Grup de Recerca en Addiccions Clínic, Hospital Clínic de Barcelona, IDIBAPS, Universitat de Barcelona, Red de Trastornos adictivos (RETICS), Villarroel 170 08036 Barcelona, Spain
| | - Nayra Rico
- Department of Biochemistry, Hospital Clinic Barcelona, Spain
| | | | - Eduard Vieta
- Department of Psychiatry and Clinical Psychobiology, University of Barcelona, Casanova 143 08036 Barcelona, Spain; Centro de Investigación en Red de Salud mental (CIBERSAM), Pabellón 11, 28029, Madrid, Spain; Bipolar Disorder Program, Institute of Neuroscience, Hospital Clínic, University of Barcelona, IDIBAPS, Villarroel 170 08036 Barcelona, Spain
| | - Antoni Gual
- Addictive Behaviors Unit, Clinical Neuroscience Institute, Clinic Hospital, Villarroel 170 08036, Barcelona, Spain; Department of Psychiatry and Clinical Psychobiology, University of Barcelona, Casanova 143 08036 Barcelona, Spain; Grup de Recerca en Addiccions Clínic, Hospital Clínic de Barcelona, IDIBAPS, Universitat de Barcelona, Red de Trastornos adictivos (RETICS), Villarroel 170 08036 Barcelona, Spain
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Latkin CA, Edwards C, Davey-Rothwell MA, Tobin KE. The relationship between social desirability bias and self-reports of health, substance use, and social network factors among urban substance users in Baltimore, Maryland. Addict Behav 2017; 73:133-136. [PMID: 28511097 DOI: 10.1016/j.addbeh.2017.05.005] [Citation(s) in RCA: 264] [Impact Index Per Article: 37.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2016] [Revised: 04/07/2017] [Accepted: 05/08/2017] [Indexed: 10/19/2022]
Abstract
BACKGROUND Social desirability response bias may lead to inaccurate self-reports and erroneous study conclusions. The present study examined the relationship between social desirability response bias and self-reports of mental health, substance use, and social network factors among a community sample of inner-city substance users. METHODS The study was conducted in a sample of 591 opiate and cocaine users in Baltimore, Maryland from 2009 to 2013. Modified items from the Marlowe-Crowne Social Desirability Scale were included in the survey, which was conducted face-to-face and using Audio Computer Self Administering Interview (ACASI) methods. RESULTS There were highly statistically significant differences in levels of social desirability response bias by levels of depressive symptoms, drug use stigma, physical health status, recent opiate and cocaine use, Alcohol Use Disorders Identification Test (AUDIT) scores, and size of social networks. There were no associations between health service utilization measures and social desirability bias. In multiple logistic regression models, even after including the Center for Epidemiologic Studies Depression Scale (CES-D) as a measure of depressive symptomology, social desirability bias was associated with recent drug use and drug user stigma. Social desirability bias was not associated with enrollment in prior research studies. CONCLUSIONS These findings suggest that social desirability bias is associated with key health measures and that the associations are not primarily due to depressive symptoms. Methods are needed to reduce social desirability bias. Such methods may include the wording and prefacing of questions, clearly defining the role of "study participant," and assessing and addressing motivations for socially desirable responses.
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Patients' Knowledge and Attitudes Towards Regular Alcohol Urine Screening: A Survey Study. J Addict Med 2017; 11:300-307. [PMID: 28358755 DOI: 10.1097/adm.0000000000000315] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND Despite its wide implementation, there is a paucity of data supporting the effectiveness of regular alcohol urine screening (RAUS) in maintaining abstinence. This study aims at investigating if RAUS serves other purposes, what attitudes patients display towards it, and patients' technical knowledge about basic screening notions. METHOD We conducted a cross-sectional survey among adults with alcohol dependence, attending outpatient alcohol-dependence treatment. It aimed at investigating patients' attitudes and beliefs towards RAUS, and technical notions of alcohol urine screening. For attitude assessment, we adapted the Drug Attitude Inventory (DAI-10) to the field of alcohol urine screening. Internal consistency, test-retest reliability, and concurrent validity were evaluated for the adapted questionnaire. RESULTS In all, 128 patients completed the questionnaire. Patients rated RAUS as high. The DAI-10 mean score was 7.2 (SD = 3.6). Internal consistency analysis revealed a Cronbach alpha of 0.718. Test-retest reliability evaluation yielded an intraclass correlation coefficient of 0.932. The score of a single Likert-type question about overall perceived value was 8.5 (SD = 2). Their correlation with mean DAI-10 score was of r = 0.254, with P = 0.009. Apart from relapse prevention, patients frequently reported other functions such as showing professionals and family members that they do not drink, or having a closer contact with professionals. A majority of patients believed alcohol use goes undetected after 48 hours from last ingestion. CONCLUSION Regular alcohol screening is highly valued by alcohol outpatients. It seems that apart from relapse prevention, other functions related to therapeutic alliance building, social desirability, and impression management also play a key role.
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No association of alcohol use and the risk of ulcerative colitis or Crohn's disease: data from a European Prospective cohort study (EPIC). Eur J Clin Nutr 2017; 71:512-518. [PMID: 28120853 DOI: 10.1038/ejcn.2016.271] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2016] [Revised: 11/18/2016] [Accepted: 12/03/2016] [Indexed: 02/07/2023]
Abstract
BACKGROUND/OBJECTIVES The role of long-term alcohol consumption for the risk of developing ulcerative colitis (UC) and Crohn's disease (CD) is unclear. For the first time, to prospectively assess the role of pre-disease alcohol consumption on the risk of developing UC or CD. SUBJECTS/METHODS Nested within the European Prospective Investigation into Cancer and Nutrition (EPIC-IBD), incident UC and CD cases and matched controls where included. At recruitment, participants completed validated food frequency and lifestyle questionnaires. Alcohol consumption was classified as either: non-use, former, light (⩽0.5 and 1 drink per week), below the recommended limits (BRL) (⩽1 and 2 drinks per day), moderate (⩽2.5 and 5 drinks per day), or heavy use (>2.5 and >5 drinks per day) for women and men, respectively; and was expressed as consumption at enrolment and during lifetime. Conditional logistic regression was applied adjusting for smoking and education, taking light users as the reference. RESULTS Out of 262 451 participants in six countries, 198 UC incident cases/792 controls and 84 CD cases/336 controls were included. At enrolment, 8%/27%/32%/23%/11% UC cases and 7%/29%/40%/19%/5% CD cases were: non-users, light, BRL, moderate and heavy users, respectively. The corresponding figures for lifetime non-use, former, light, BRL, moderate and heavy use were: 3%/5%/23%/44%/19%/6% and 5%/2%/25%/44%/23%/1% for UC and CD cases, respectively. There were no associations between any categories of alcohol consumption and risk of UC or CD in the unadjusted and adjusted odds ratios. CONCLUSION There was no evidence of associations between alcohol use and the odds of developing either UC or CD.
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Tedla YG, Bautista LE. Factors associated with false-positive self-reported adherence to antihypertensive drugs. J Hum Hypertens 2016; 31:320-326. [PMID: 27853149 DOI: 10.1038/jhh.2016.80] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2016] [Revised: 09/30/2016] [Accepted: 10/10/2016] [Indexed: 11/09/2022]
Abstract
Self-reported medication adherence is known to overestimate true adherence. However, little is known about patient factors that may contribute to the upward bias in self-reported medication adherence. The objective of this study is to examine whether demographic, behavioral, medication and mood factors are associated with being a false-positive self-reported adherer (FPA) to antihypertensive drug treatment. We studied 175 patients (mean age: 50 years; 57% men) from primary-care clinics starting antihypertensive drug treatment. Self-reported adherence (SRA) was measured with the Medication Adherence Report Scale (MARS) and by the number of drug doses missed in the previous week/month, and compared with pill count adherence ratio (PCAR) as gold standard. Data on adherence, demographic, behavioral, medication and mood factors were collected at baseline and every 3 months up to 1 year. FPA was defined as being a non-adherer by PCAR and an adherer by self-report. Mixed effect logistic regression was used for the analysis. Twenty percent of participants were FPA. Anxiety increased (odds ratio (OR): 3.00; P=0.01), whereas smoking (OR: 0.40; P=0.03) and drug side effects (OR: 0.46, P=0.03) decreased the probability for FPA by MARS. Education below high-school completion increased the probability of being an FPA as measured by missing doses in the last month (OR: 1.66; P=0.04) and last week (OR: 1.88; P=0.02). The validity of SRA varies significantly according to drug side effects, behavioral factors and patient's mood. Careful consideration should be given to the use of self-reported measures of adherence among patients likely to be false-positive adherers.
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Affiliation(s)
- Y G Tedla
- Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - L E Bautista
- Department of Population Health Sciences, University of Wisconsin at Madison, Madison, WI, USA
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Sherman BJ, Baker NL, McRae-Clark AL. Gender differences in cannabis use disorder treatment: Change readiness and taking steps predict worse cannabis outcomes for women. Addict Behav 2016; 60:197-202. [PMID: 27156221 PMCID: PMC4884498 DOI: 10.1016/j.addbeh.2016.04.014] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2015] [Revised: 04/05/2016] [Accepted: 04/20/2016] [Indexed: 01/21/2023]
Abstract
INTRODUCTION Gender differences in cannabis use and cannabis use disorder have been established. Regarding treatment, some evidence suggests that women are less responsive, though the mechanisms are not well understood. Motivation to change and self-efficacy are associated with better outcomes overall, and may help explain gender differences in cannabis use outcomes. METHODS A secondary data analysis of a double-blind placebo controlled trial of buspirone treatment for cannabis dependence (N=175) was conducted. Self-report assessments of motivation to change, self-efficacy, and other clinical correlates were completed at baseline, and cannabis use was measured throughout the study. RESULTS There was a significant interaction between gender and taking steps on abstinence. Counter to hypothesis, higher taking steps reduced likelihood of achieving abstinence among women; there was no association among men. Subsequently, taking steps was associated with self-efficacy and quantity of use among men, and cannabis related problems among women. There was a significant interaction between gender and readiness to change on creatinine adjusted cannabinoid levels. Change readiness was positively associated with cannabinoid levels among women, but not men. CONCLUSIONS Motivation to change and initiation of change behavior predict worse cannabis outcomes in women. Men and women differ in what motivates change behavior. Social desirability, neurobiology, and treatment type may impact these effects. Gender differences in cannabis use and treatment responsiveness must be considered in future studies.
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Affiliation(s)
- Brian J Sherman
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC 29425, United States.
| | - Nathaniel L Baker
- Department of Public Health Sciences, Medical University of South Carolina, Charleston, SC 29425, United States
| | - Aimee L McRae-Clark
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC 29425, United States
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Fink BC, Steele VR, Maurer MJ, Fede SJ, Calhoun VD, Kiehl KA. Brain potentials predict substance abuse treatment completion in a prison sample. Brain Behav 2016; 6:e00501. [PMID: 27547503 PMCID: PMC4893048 DOI: 10.1002/brb3.501] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2015] [Revised: 04/15/2016] [Accepted: 04/22/2016] [Indexed: 12/14/2022] Open
Abstract
INTRODUCTION National estimates suggest that up to 80% of prison inmates meet diagnostic criteria for a substance use disorder. Because more substance abuse treatment while incarcerated is associated with better post-release outcomes, including a reduced risk of accidental overdose death, the stakes are high in developing novel predictors of substance abuse treatment completion in inmate populations. METHODS Using electroencephalography (EEG), this study investigated stimulus-locked ERP components elicited by distractor stimuli in three tasks (VO-Distinct, VO-Repeated, Go/NoGo) as a predictor of treatment discontinuation in a sample of male and female prison inmates. We predicted that those who discontinued treatment early would exhibit a less positive P3a amplitude elicited by distractor stimuli. RESULTS Our predictions regarding ERP components were partially supported. Those who discontinued treatment early exhibited a less positive P3a amplitude and a less positive PC4 in the VO-D task. In the VO-R task, however, those who discontinued treatment early exhibited a more negative N200 amplitude rather than the hypothesized less positive P3a amplitude. The discontinuation group also displayed less positive PC4 amplitude. Surprisingly, there were no time-domain or principle component differences among the groups in the Go/NoGo task. Support Vector Machine (SVM) models of the three tasks accurately classified individuals who discontinued treatment with the best model accurately classifying 75% of inmates. PCA techniques were more sensitive in differentiating groups than the classic time-domain windowed approach. CONCLUSIONS Our pattern of findings are consistent with the context-updating theory of P300 and may help identify subtypes of ultrahigh-risk substance abusers who need specialized treatment programs.
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Affiliation(s)
- Brandi C. Fink
- Department of Psychiatry and Behavioral SciencesClinical and Translational Science CenterThe University of New MexicoAlbuquerqueNew Mexico
| | - Vaughn R. Steele
- Intramural Research ProgramNeuroimaging Research BranchNational Institute of Drug AbuseNational Institutes of HealthBaltimoreMaryland
- The Mind Research Network and Lovelace Biomedical and Environmental Research InstituteAlbuquerqueNew Mexico
- Department of PsychologyThe University of New MexicoAlbuquerqueNew Mexico
| | - Michael J. Maurer
- The Mind Research Network and Lovelace Biomedical and Environmental Research InstituteAlbuquerqueNew Mexico
- Department of PsychologyThe University of New MexicoAlbuquerqueNew Mexico
| | - Samantha J. Fede
- The Mind Research Network and Lovelace Biomedical and Environmental Research InstituteAlbuquerqueNew Mexico
- Department of PsychologyThe University of New MexicoAlbuquerqueNew Mexico
| | - Vince D. Calhoun
- The Mind Research Network and Lovelace Biomedical and Environmental Research InstituteAlbuquerqueNew Mexico
- Department of Electrical and Computer EngineeringThe University of New MexicoAlbuquerqueNew Mexico
| | - Kent A. Kiehl
- The Mind Research Network and Lovelace Biomedical and Environmental Research InstituteAlbuquerqueNew Mexico
- Department of PsychologyThe University of New MexicoAlbuquerqueNew Mexico
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Neurofeedback Training as a New Method in Treatment of Crystal Methamphetamine Dependent Patients: A Preliminary Study. Appl Psychophysiol Biofeedback 2016; 40:151-61. [PMID: 25894106 DOI: 10.1007/s10484-015-9281-1] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
This study aimed to compare the effectiveness of neurofeedback (NFB) plus pharmacotherapy with pharmacotherapy alone, on addiction severity, mental health, and quality of life in crystal methamphetamine-dependent (CMD) patients. The study included 100 CMD patients undergoing a medical treatment who volunteered for this randomized controlled trial. After being evaluated by a battery of questionnaires that included addiction severity index questionnaire, Symptoms Check List 90 version, and World Health Organization Quality of Life, the participants were randomly assigned to an experimental or a control group. The experimental group received thirty 50-min sessions of NFB in addition to their usual medication over a 2-month period; meanwhile, the control group received only their usual medication. In accordance with this study's pre-test-post-test design, both study groups were evaluated again after completing their respective treatment regimens. Multivariate analysis of covariance showed the experimental group to have lower severity of addiction, better psychological health, and better quality of life in than the control group. The differences between the two groups were statistically significant. These finding suggest that NFB can be used to improve the effectiveness of treatment results in CMD patients.
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Curtis JR, Bharat A, Chen L, Greenberg JD, Harrold L, Kremer JM, Sommers T, Pappas D. Agreement between Rheumatologist and Patient-reported Adherence to Methotrexate in a US Rheumatoid Arthritis Registry. J Rheumatol 2016; 43:1027-9. [PMID: 27134256 DOI: 10.3899/jrheum.151136] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/17/2016] [Indexed: 11/22/2022]
Abstract
OBJECTIVE Rheumatologists have limited tools to assess medication adherence. The extent to which methotrexate (MTX) adherence is overestimated by rheumatologists is unknown. METHODS We deployed an Internet survey to patients with rheumatoid arthritis (RA) participating in a US registry. Patient self-report was the gold standard compared to MTX recorded in the registry. RESULTS Response rate to the survey was 44%. Of 228 patients whose rheumatologist reported current MTX at the time of the most recent registry visit, 45 (19.7%) had discontinued (n = 19, 8.3%) or missed ≥ 1 dose in the last month (n = 26, 11.4%). For the subgroup whose rheumatologist also confirmed at the next visit that they were still taking MTX (n = 149), only 2.6% reported not taking it, and 10.7% had missed at least 1 dose. CONCLUSION MTX use was misclassified for 13%-20% of patients, mainly because of 1 or more missed doses rather than overt discontinuation. Clinicians should be aware of suboptimal adherence when assessing MTX response.
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Affiliation(s)
- Jeffrey R Curtis
- From the University of Alabama at Birmingham, Birmingham, Alabama; Consortium of Rheumatology Researchers of North America (CORRONA) LLC, Southborough; University of Massachusetts, Worcester, Massachusetts, USA.J.R. Curtis, MD, MS, MPH, University of Alabama at Birmingham; A. Bharat, MD, MPH, University of Alabama at Birmingham; L. Chen, PhD, University of Alabama at Birmingham; J.D. Greenberg, MD, MPH, CORRONA LLC; L. Harrold, MD, MPH, University of Massachusetts; J.M. Kremer, MD, CORRONA LLC; T. Sommers, MS, CORRONA LLC; D. Pappas, MD, MPH, CORRONA LLC.
| | - Aseem Bharat
- From the University of Alabama at Birmingham, Birmingham, Alabama; Consortium of Rheumatology Researchers of North America (CORRONA) LLC, Southborough; University of Massachusetts, Worcester, Massachusetts, USA.J.R. Curtis, MD, MS, MPH, University of Alabama at Birmingham; A. Bharat, MD, MPH, University of Alabama at Birmingham; L. Chen, PhD, University of Alabama at Birmingham; J.D. Greenberg, MD, MPH, CORRONA LLC; L. Harrold, MD, MPH, University of Massachusetts; J.M. Kremer, MD, CORRONA LLC; T. Sommers, MS, CORRONA LLC; D. Pappas, MD, MPH, CORRONA LLC
| | - Lang Chen
- From the University of Alabama at Birmingham, Birmingham, Alabama; Consortium of Rheumatology Researchers of North America (CORRONA) LLC, Southborough; University of Massachusetts, Worcester, Massachusetts, USA.J.R. Curtis, MD, MS, MPH, University of Alabama at Birmingham; A. Bharat, MD, MPH, University of Alabama at Birmingham; L. Chen, PhD, University of Alabama at Birmingham; J.D. Greenberg, MD, MPH, CORRONA LLC; L. Harrold, MD, MPH, University of Massachusetts; J.M. Kremer, MD, CORRONA LLC; T. Sommers, MS, CORRONA LLC; D. Pappas, MD, MPH, CORRONA LLC
| | - Jeffrey D Greenberg
- From the University of Alabama at Birmingham, Birmingham, Alabama; Consortium of Rheumatology Researchers of North America (CORRONA) LLC, Southborough; University of Massachusetts, Worcester, Massachusetts, USA.J.R. Curtis, MD, MS, MPH, University of Alabama at Birmingham; A. Bharat, MD, MPH, University of Alabama at Birmingham; L. Chen, PhD, University of Alabama at Birmingham; J.D. Greenberg, MD, MPH, CORRONA LLC; L. Harrold, MD, MPH, University of Massachusetts; J.M. Kremer, MD, CORRONA LLC; T. Sommers, MS, CORRONA LLC; D. Pappas, MD, MPH, CORRONA LLC
| | - Leslie Harrold
- From the University of Alabama at Birmingham, Birmingham, Alabama; Consortium of Rheumatology Researchers of North America (CORRONA) LLC, Southborough; University of Massachusetts, Worcester, Massachusetts, USA.J.R. Curtis, MD, MS, MPH, University of Alabama at Birmingham; A. Bharat, MD, MPH, University of Alabama at Birmingham; L. Chen, PhD, University of Alabama at Birmingham; J.D. Greenberg, MD, MPH, CORRONA LLC; L. Harrold, MD, MPH, University of Massachusetts; J.M. Kremer, MD, CORRONA LLC; T. Sommers, MS, CORRONA LLC; D. Pappas, MD, MPH, CORRONA LLC
| | - Joel M Kremer
- From the University of Alabama at Birmingham, Birmingham, Alabama; Consortium of Rheumatology Researchers of North America (CORRONA) LLC, Southborough; University of Massachusetts, Worcester, Massachusetts, USA.J.R. Curtis, MD, MS, MPH, University of Alabama at Birmingham; A. Bharat, MD, MPH, University of Alabama at Birmingham; L. Chen, PhD, University of Alabama at Birmingham; J.D. Greenberg, MD, MPH, CORRONA LLC; L. Harrold, MD, MPH, University of Massachusetts; J.M. Kremer, MD, CORRONA LLC; T. Sommers, MS, CORRONA LLC; D. Pappas, MD, MPH, CORRONA LLC
| | - Tanya Sommers
- From the University of Alabama at Birmingham, Birmingham, Alabama; Consortium of Rheumatology Researchers of North America (CORRONA) LLC, Southborough; University of Massachusetts, Worcester, Massachusetts, USA.J.R. Curtis, MD, MS, MPH, University of Alabama at Birmingham; A. Bharat, MD, MPH, University of Alabama at Birmingham; L. Chen, PhD, University of Alabama at Birmingham; J.D. Greenberg, MD, MPH, CORRONA LLC; L. Harrold, MD, MPH, University of Massachusetts; J.M. Kremer, MD, CORRONA LLC; T. Sommers, MS, CORRONA LLC; D. Pappas, MD, MPH, CORRONA LLC
| | - Dimitrios Pappas
- From the University of Alabama at Birmingham, Birmingham, Alabama; Consortium of Rheumatology Researchers of North America (CORRONA) LLC, Southborough; University of Massachusetts, Worcester, Massachusetts, USA.J.R. Curtis, MD, MS, MPH, University of Alabama at Birmingham; A. Bharat, MD, MPH, University of Alabama at Birmingham; L. Chen, PhD, University of Alabama at Birmingham; J.D. Greenberg, MD, MPH, CORRONA LLC; L. Harrold, MD, MPH, University of Massachusetts; J.M. Kremer, MD, CORRONA LLC; T. Sommers, MS, CORRONA LLC; D. Pappas, MD, MPH, CORRONA LLC
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Perinelli E, Gremigni P. Use of Social Desirability Scales in Clinical Psychology: A Systematic Review. J Clin Psychol 2016; 72:534-51. [PMID: 26970350 DOI: 10.1002/jclp.22284] [Citation(s) in RCA: 74] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
OBJECTIVE There is still an open debate about the utility of social desirability indicators. This report systematically reviewed the use of social desirability scales in studies addressing social desirability in clinical psychology. METHOD A systematic review (January 2010-March 2015) was conducted, including 35 studies meeting the inclusion criteria of being published in peer-reviewed journals and describing quantitative findings about an association of social desirability with clinical psychology variables using a cross-sectional or longitudinal design. RESULTS Social desirability was associated with self-reports of various clinical-psychological dimensions. Most of the included studies treated social desirability as a 1-dimensional variable and only 10 of 35 disentangled the impression management and self-deception components. Although theoretical literature does not consider social desirability a mere response bias, only 4 of the reviewed articles controlled for the possible suppressor effect of personality variables on social desirability, while the majority focused upon the stylistic (response bias) rather than the substantive (personality) nature of this construct. CONCLUSION The present review highlighted some limitations in the use of social desirability scales in recent clinical psychology research and tried to offer a few suggestions for handling this issue.
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Tse S, Zhu S, Yu CH, Wong P, Tsang S. An ecological analysis of secondary school students' drug use in Hong Kong: A case-control study. Int J Soc Psychiatry 2016; 62:31-40. [PMID: 26060281 DOI: 10.1177/0020764015589132] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Youth drug use is a significant at-risk youth behaviour and remains as one of the top priorities for mental health services, researchers and policy planners. The ecological characteristics of secondary school students' behaviour in Hong Kong are understudied. AIM To examine individual, familial, social and environmental correlates of drug use among secondary students in Hong Kong. METHOD Data were extracted from a school survey with 3078 students. Among the 3078 students, 86 students reported to have used drugs in the past 6 months. A total of 86 age- and gender-matched controls with no drug-use behaviour in the past 6 months were randomly selected from the remaining students. Multiple logistic analysis was used to examine differential correlates between those who used and did not use substance in the past 6 months. RESULT Positive school experience and perspective to school and parental support are protective factors of drug use. Lower self-esteem, lower self-efficacy against using drugs and higher level of permissive attitude towards drugs were associated with drug use. Students who were low in self-esteem and rather impulsive tend to use drugs. CONCLUSION To prevent students from drug use, efforts in individual, family, school and community-levels should be addressed.
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Affiliation(s)
- Samson Tse
- Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong
| | - Shimin Zhu
- Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong
| | - Chong Ho Yu
- Department of Psychology, Azusa Pacific University, Azusa, CA, USA
| | - Paul Wong
- Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong
| | - Sandra Tsang
- Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong
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Collins SE, Grazioli VS, Torres NI, Taylor EM, Jones CB, Hoffman GE, Haelsig L, Zhu MD, Hatsukami AS, Koker MJ, Herndon P, Greenleaf SM, Dean PE. Qualitatively and quantitatively evaluating harm-reduction goal setting among chronically homeless individuals with alcohol dependence. Addict Behav 2015; 45:184-90. [PMID: 25697724 PMCID: PMC4452113 DOI: 10.1016/j.addbeh.2015.02.001] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2014] [Revised: 01/26/2015] [Accepted: 02/02/2015] [Indexed: 10/24/2022]
Abstract
INTRODUCTION Most treatment programs for alcohol dependence have prioritized alcohol abstinence as the primary treatment goal. However, abstinence-based goals are not always considered desirable or attainable by more severely affected populations, such as chronically homeless people with alcohol dependence. Because these individuals comprise a multimorbid and high-utilizing population, they are in need of more focused research attention that elucidates their preferred treatment goals. The aim of this secondary study was therefore to qualitatively and quantitatively document participant-generated treatment goals METHODS Participants were currently or formerly chronically homeless individuals (N=31) with alcohol dependence who participated in a pilot of extended-release naltrexone and harm-reduction counseling. Throughout the treatment period, study interventionists elicited participants' goals and recorded them on an open-ended grid. In subsequent weeks, progress towards and achievement of goals was obtained via self-report and recorded by study interventionists. Conventional content analysis was performed to classify participant-generated treatment goals RESULTS Representation of the three top categories remained stable over the course of treatment. In the order of their frequency, they included drinking-related goals, quality-of-life goals and health-related goals. Within the category of drinking-related goals, participants consistently endorsed reducing drinking and alcohol-related consequences ahead of abstinence-based goals. Quantitative analyses indicated participants generated an increasing number of goals over the course of treatment. Proportions of goals achieved and progressed towards kept pace with this increase CONCLUSIONS Findings confirmed hypotheses that chronically homeless people with alcohol dependence can independently generate and achieve treatment goals towards alcohol harm reduction and quality-of-life improvement.
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Affiliation(s)
- Susan E Collins
- Department of Psychiatry and Behavioral Sciences, University of Washington, Harborview Medical Center, 325 Ninth Ave, Box 359911, Seattle, WA 98195, USA.
| | - Véronique S Grazioli
- Department of Psychiatry and Behavioral Sciences, University of Washington, Harborview Medical Center, 325 Ninth Ave, Box 359911, Seattle, WA 98195, USA
| | - Nicole I Torres
- Department of Psychiatry and Behavioral Sciences, University of Washington, Harborview Medical Center, 325 Ninth Ave, Box 359911, Seattle, WA 98195, USA
| | - Emily M Taylor
- Department of Psychiatry and Behavioral Sciences, University of Washington, Harborview Medical Center, 325 Ninth Ave, Box 359911, Seattle, WA 98195, USA
| | - Connor B Jones
- Department of Psychiatry and Behavioral Sciences, University of Washington, Harborview Medical Center, 325 Ninth Ave, Box 359911, Seattle, WA 98195, USA
| | - Gail E Hoffman
- Department of Psychiatry and Behavioral Sciences, University of Washington, Harborview Medical Center, 325 Ninth Ave, Box 359911, Seattle, WA 98195, USA
| | - Laura Haelsig
- Department of Psychiatry and Behavioral Sciences, University of Washington, Harborview Medical Center, 325 Ninth Ave, Box 359911, Seattle, WA 98195, USA
| | - Mengdan D Zhu
- Department of Psychiatry and Behavioral Sciences, University of Washington, Harborview Medical Center, 325 Ninth Ave, Box 359911, Seattle, WA 98195, USA
| | - Alyssa S Hatsukami
- Department of Psychiatry and Behavioral Sciences, University of Washington, Harborview Medical Center, 325 Ninth Ave, Box 359911, Seattle, WA 98195, USA
| | - Molly J Koker
- Department of Psychiatry and Behavioral Sciences, University of Washington, Harborview Medical Center, 325 Ninth Ave, Box 359911, Seattle, WA 98195, USA
| | - Patrick Herndon
- Department of Psychiatry and Behavioral Sciences, University of Washington, Harborview Medical Center, 325 Ninth Ave, Box 359911, Seattle, WA 98195, USA
| | - Shawna M Greenleaf
- Department of Psychiatry and Behavioral Sciences, University of Washington, Harborview Medical Center, 325 Ninth Ave, Box 359911, Seattle, WA 98195, USA
| | - Parker E Dean
- Department of Psychiatry and Behavioral Sciences, University of Washington, Harborview Medical Center, 325 Ninth Ave, Box 359911, Seattle, WA 98195, USA
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Ceballos N, Mayfield A, Graham R. ERPs to Alcohol Images among Hispanic and Non-Hispanic Female College Freshmen. AIMS Neurosci 2015. [DOI: 10.3934/neuroscience.2016.1.1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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Steele VR, Fink BC, Maurer JM, Arbabshirani MR, Wilber CH, Jaffe AJ, Sidz A, Pearlson GD, Calhoun VD, Clark VP, Kiehl KA. Brain potentials measured during a Go/NoGo task predict completion of substance abuse treatment. Biol Psychiatry 2014; 76:75-83. [PMID: 24238783 PMCID: PMC3984370 DOI: 10.1016/j.biopsych.2013.09.030] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2013] [Revised: 09/24/2013] [Accepted: 09/25/2013] [Indexed: 01/15/2023]
Abstract
BACKGROUND U.S. nationwide estimates indicate that 50% to 80% of prisoners have a history of substance abuse or dependence. Tailoring substance abuse treatment to specific needs of incarcerated individuals could improve effectiveness of treating substance dependence and preventing drug abuse relapse. We tested whether pretreatment neural measures of a response inhibition (Go/NoGo) task would predict which individuals would or would not complete a 12-week cognitive behavioral substance abuse treatment program. METHODS Adult incarcerated participants (n = 89; women n = 55) who volunteered for substance abuse treatment performed a Go/NoGo task while event-related potentials (ERPs) were recorded. Stimulus- and response-locked ERPs were compared between participants who completed (n = 68; women = 45) and discontinued (n = 21; women = 10) treatment. RESULTS As predicted, stimulus-locked P2, response-locked error-related negativity (ERN/Ne), and response-locked error positivity (Pe), measured with windowed time-domain and principal component analysis, differed between groups. Using logistic regression and support-vector machine (i.e., pattern classifiers) models, P2 and Pe predicted treatment completion above and beyond other measures (i.e., N2, P300, ERN/Ne, age, sex, IQ, impulsivity, depression, anxiety, motivation for change, and years of drug abuse). CONCLUSIONS Participants who discontinued treatment exhibited deficiencies in sensory gating, as indexed by smaller P2; error-monitoring, as indexed by smaller ERN/Ne; and adjusting response strategy posterror, as indexed by larger Pe. The combination of P2 and Pe reliably predicted 83.33% of individuals who discontinued treatment. These results may help in the development of individualized therapies, which could lead to more favorable, long-term outcomes.
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Affiliation(s)
- Vaughn R Steele
- Mind Research Network and Lovelace Biomedical and Environmental Research Institute, University of New Mexico, Albuquerque, New Mexico; Department of Psychology, University of New Mexico, Albuquerque, New Mexico.
| | - Brandi C Fink
- Department of Psychology, University of New Mexico, Albuquerque, New Mexico
| | - J Michael Maurer
- Mind Research Network and Lovelace Biomedical and Environmental Research Institute, University of New Mexico, Albuquerque, New Mexico
| | - Mohammad R Arbabshirani
- Mind Research Network and Lovelace Biomedical and Environmental Research Institute, University of New Mexico, Albuquerque, New Mexico; Department of Psychology, University of New Mexico, Albuquerque, New Mexico
| | | | | | - Anna Sidz
- Mind Research Network and Lovelace Biomedical and Environmental Research Institute, University of New Mexico, Albuquerque, New Mexico
| | - Godfrey D Pearlson
- Yale University School of Medicine, New Haven; Olin Neuropsychiatry Research Center, Institute of Living; Hartford, Connecticut
| | - Vince D Calhoun
- Mind Research Network and Lovelace Biomedical and Environmental Research Institute, University of New Mexico, Albuquerque, New Mexico; Department of Psychology, University of New Mexico, Albuquerque, New Mexico
| | - Vincent P Clark
- Mind Research Network and Lovelace Biomedical and Environmental Research Institute, University of New Mexico, Albuquerque, New Mexico; Department of Psychology, University of New Mexico, Albuquerque, New Mexico
| | - Kent A Kiehl
- Mind Research Network and Lovelace Biomedical and Environmental Research Institute, University of New Mexico, Albuquerque, New Mexico; Department of Psychology, University of New Mexico, Albuquerque, New Mexico
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Holdsworth E, Bowen E, Brown S, Howat D. Client engagement in psychotherapeutic treatment and associations with client characteristics, therapist characteristics, and treatment factors. Clin Psychol Rev 2014; 34:428-50. [DOI: 10.1016/j.cpr.2014.06.004] [Citation(s) in RCA: 79] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2013] [Revised: 05/01/2014] [Accepted: 06/12/2014] [Indexed: 11/16/2022]
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Zemore SE, Ajzen I. Predicting substance abuse treatment completion using a new scale based on the theory of planned behavior. J Subst Abuse Treat 2014; 46:174-82. [PMID: 23953167 PMCID: PMC3840042 DOI: 10.1016/j.jsat.2013.06.011] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2013] [Revised: 06/15/2013] [Accepted: 06/27/2013] [Indexed: 11/17/2022]
Abstract
We examined whether a 9-item scale based on the theory of planned behavior (TPB) predicted substance abuse treatment completion. Data were collected at a public, outpatient program among clients initiating treatment (N=200). Baseline surveys included measures of treatment-related attitudes, norms, perceived control, and intention; discharge status was collected from program records. As expected, TPB attitude and control components independently predicted intention (model R-squared=.56), and intention was positively associated with treatment completion even including clinical and demographic covariates (model R-squared=.24). TPB components were generally associated with the alternative readiness scales as expected, and the TPB remained predictive at higher levels of coercion. Meanwhile, none of the standard measures of readiness (e.g., the URICA and TREAT) or treatment coercion were positively associated with treatment participation. Results suggest promise for application of the TPB to treatment completion and support use of the intention component as a screener, though some refinements are suggested.
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Affiliation(s)
- Sarah E. Zemore
- Scientist Alcohol Research Group, 6475 Christie Ave., Suite 400, Emeryville, CA 94608-1010, Tel: (510) 597-3440
| | - Icek Ajzen
- Professor Emeritus, University of Massachusetts, Amherst, Department of Psychology, 441 Tobin Hall, Amherst, MA 01003, Tel: (413) 545-0509
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Foster DW. Readiness to change and gender: Moderators of the relationship between social desirability and college drinking. JOURNAL OF ALCOHOLISM AND DRUG DEPENDENCE 2013; 2:1000141. [PMID: 25568893 PMCID: PMC4283103 DOI: 10.4172/2329-6488.1000141] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
This study evaluates the influence of readiness to change (RTC) and gender in the relationship between social desirability (SD) and drinking among college students. Need to avoid social disapproval may lead to underreporting of stigmatized behavior and as such, we expected that SD (Crowne & Marlowe, 1960) would negatively associate with drinking. Further, we sought to facilitate understanding of mixed findings in the RTC literature by parsing out effects separately for the precontemplation, contemplation, and action stage, as measured via three validated subscales of the RTC questionnaire (Rollnick et al., 1992). Motivational enhancement efforts tend to focus on increasing RTC among drinkers in the precontemplation and contemplation stage (e.g., Miller & Rollnick, 1992) as these individuals have not yet begun to engage in behavior change, and as such, we will focus on these two subscales. Based on the mixed literature, we hypothesized that RTC would be differentially associated with drinking for precontemplators and contemplators. Moreover, we considered gender and RTC as moderators of the effect of SD on drinking and expected that moderating effects would be different for precontemplators relative to contemplators. Participants included 676 undergraduate students (M age = 22.92, SD = 5.43, 82.44% female). Findings supported predictions. RTC was differentially associated with drinking; for precontemplators, RTC negatively predicted drinking, whereas for contemplators RTC positively predicted drinking, and effects were different for each gender. Hierarchical regressions revealed multiple two- and three-way interactions between RTC, SD, and gender in predicting drinking. Implications of results are discussed.
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