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González-Roz A, Belisario K, Secades-Villa R, Muñiz J, MacKillop J. Behavioral economic analysis of legal and illegal cannabis demand in Spanish young adults with hazardous and non-hazardous cannabis use. Addict Behav 2024; 149:107878. [PMID: 37924581 DOI: 10.1016/j.addbeh.2023.107878] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Revised: 09/26/2023] [Accepted: 10/03/2023] [Indexed: 11/06/2023]
Abstract
BACKGROUND In October 2021, a legal framework that regulates cannabis for recreational purposes in Spain was proposed, but research on its potential impacts on cannabis use is currently limited. This study examined the reliability and discriminant validity of two Marijuana Purchase Tasks (MPTs) for measuring hypothetical legal and illegal cannabis demand, and to examine differences in demand of both commodities in young adults at hazardous vs. non-hazardous cannabis use risk levels. METHODS A total of 171 Spanish young adults [Mage = 19.82 (SD = 1.81)] with past-month cannabis use participated in a cross-sectional study from September to November 2021. Two 27-item MPTs were used to estimate hypothetical demand for legal and illegal cannabis independently. The Cannabis Use Disorder Identification Test (CUDIT-R) was used to assess hazardous cannabis use and test for discriminant validity of the MPTs. Reliability analyses were conducted using Classical Test Theory (Cronbach's alpha) and Item Response Theory (Item Information Functions). RESULTS The MPT was reliable for measuring legal (α = 0.94) and illegal (α = 0.90) cannabis demand. Breakpoint (price at which demand ceases), and Pmax (price associated with maximum expenditure) were the most sensitive indicators to discriminate participants with different levels of the cannabis reinforcing trait. No significant differences between legal and illegal cannabis demand in the whole sample were observed, but hazardous vs. non-hazardous users showed higher legal and illegal demand, and decreased Breakpoint and Pmax if cannabis were legal vs illegal. CONCLUSION The MPT exhibits robust psychometric validity and may be useful to inform on cannabis regulatory science in Spain.
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Affiliation(s)
- Alba González-Roz
- Addictive Behaviors Research Group (GCA), Department of Psychology, University of Oviedo, Oviedo 33003, Spain.
| | - Kyla Belisario
- Peter Boris Centre for Addictions Research, St Joseph's Healthcare Hamilton and McMaster University, Hamilton, Ontario L9C 0E3, Canada
| | - Roberto Secades-Villa
- Addictive Behaviors Research Group (GCA), Department of Psychology, University of Oviedo, Oviedo 33003, Spain
| | - José Muñiz
- Faculty of Psychology, University of Nebrija, Madrid 28015, Spain
| | - James MacKillop
- Peter Boris Centre for Addictions Research, St Joseph's Healthcare Hamilton and McMaster University, Hamilton, Ontario L9C 0E3, Canada
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Pérez-Vázquez J, González-Roz A, Amigo-Vázquez I. Effectiveness of an e-Health Quasi-Randomized Controlled Universal Prevention Program for Eating Disorders in Spanish Adolescents. J Prev (2022) 2024; 45:87-105. [PMID: 37906405 PMCID: PMC10844343 DOI: 10.1007/s10935-023-00751-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 10/06/2023] [Indexed: 11/02/2023]
Abstract
Eating disorders (EDs) and sub-threshold conditions are prevalent in the adolescent population. Unfortunately, most preventive interventions have been targeted at emerging adults and the effectiveness of online prevention programs has yet to be determined in adolescents. This study sought to examine the short-term effectiveness of a universal e-Health psychoeducational prevention program for EDs compared to a control (non-intervention) group in Spanish adolescents. Using a quasi-randomized trial design, a total of 161 [% girls: 45.96; Mage(SD) = 12.43 (0.43)] adolescents from 5 participating schools were allocated to two intervention arms: (1) psychoeducational intervention (n = 79) and (2) wait-list control (n = 82). The intervention was delivered over 3 months through 3 modules that were accessible 24/7 and 3 school sessions guided by the students´ tutors focusing on nutrition, promoting a healthy lifestyle, mitigating body concerns, and social pressures. Participants completed an online assessment battery including the Eating Attitudes Test (EAT-26) and measures of self-esteem, family disruption, compliance with the Mediterranean diet, and lifestyle. Correlational analysis showed small to moderate relationships between self-esteem and family function (rho = 0.413, p = 0.001), BMI (body mass index) and the EAT-26 dieting subscale (rho = 0.417, p = 0.001), physical activity and the bulimia subscale (rho = - 0.237, p = 0.003), and self-esteem and the dieting subscale (rho = - 0.223, p = 0.004). At the post-intervention assessment, the intervention group showed a statistically significant reduction in ED risk (EAT-26) (d = - 0.323, p = 0.040) and the oral control subscale (d = 0.327, p = 0.038). The e-health intervention including tutor-led digital components was effective for reducing ED risk in children. Results must be interpreted with caution due to the low statistical power and the limited sample size. Large scale randomized controlled trials with longer follow-ups will be needed to bolster the evidence.
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Affiliation(s)
- Jorge Pérez-Vázquez
- Department of Psychology, Faculty of Psychology, Plaza Feijoo S/N, 33003, Oviedo, Asturias, Spain.
| | - Alba González-Roz
- Department of Psychology, Faculty of Psychology, Plaza Feijoo S/N, 33003, Oviedo, Asturias, Spain
| | - Isaac Amigo-Vázquez
- Department of Psychology, Faculty of Psychology, Plaza Feijoo S/N, 33003, Oviedo, Asturias, Spain
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González-Roz A, Martínez-Loredo V, Postigo Á, Yoon JH. Comparative assessment of psychometric performance on the adjusting amounts versus the 21-item Monetary Choice Delay Discounting tasks among young adult substance users. Exp Clin Psychopharmacol 2023:2024-28152-001. [PMID: 38010762 DOI: 10.1037/pha0000688] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2023]
Abstract
Delay discounting (DD) assessments offer a wide variety of procedures to suit specific clinical and research needs. This study compared the reliability and validity of two DD tasks: (a) an adjusting amounts task presented on a computer (AAC) and (b) the 21-item Monetary Choice Task, which was administered online (MCT). Participants were 1,573 Spanish young-adults reporting past-month substance use. Measures included quantity and severity of drug use (i.e., cigarette smoking, cannabis, alcohol) and two DD assessments (i.e., AAC, MCT). Reliability was assessed using both the classical test and item response theory. Correlations and linear regressions examined the validity of both DD tasks in relation to substance use. The MCT showed higher internal consistency than the AAC (α = .941 vs. α = .748). AAC precision was adequate for moderate levels of discounting (θ values between -2 and +2), but the MCT showed superior reliability at low, moderate, and high levels of discounting (θ values between -1 and +1.5). Both DD tasks showed more significant correlations for alcohol-related measures (|rs| ranged between .053 and .093) compared to cigarettes and cannabis. The incremental validity of DD tasks in relation to nicotine dependence (AUClogd: β = -.664, 95% CI [-1.256, -.071]) and alcohol problems (AUClogd: β = -3.098, 95% CI [-5.209, -.988]) was only supported for the AAC. The MCT was more reliable than the AAC for measuring impulsive choice in young adult substance users. Nevertheless, the AAC may serve as a valid marker of nicotine dependence and alcohol problems. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
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Affiliation(s)
- Alba González-Roz
- Department of Psychology, Addictive Behaviors Research Group, University of Oviedo
| | | | - Álvaro Postigo
- Department of Psychology, Addictive Behaviors Research Group, University of Oviedo
| | - Jin H Yoon
- Department of Psychiatry and Behavioral Sciences, University of Texas Health Science Center at Houston
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Martínez-Loredo V, González-Roz A, Martin-Roig A, Fernández-Artamendi S. New Validity Evidence of the Global Appraisal of Individual Needs-Short Screener for Evaluating Internalizing/Externalizing Behaviors in Spanish Adolescents. J Stud Alcohol Drugs 2023; 84:754-761. [PMID: 37306368 DOI: 10.15288/jsad.22-00394] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/13/2023] Open
Abstract
OBJECTIVE The Global Appraisal of Individual Needs (GAIN-SS) is a screening instrument evaluating internalizing/externalizing behaviors. This study examines the validity evidence of the GAIN-SS in Spanish adolescents and explores sex differences in its performance. METHOD Participants were 1,547 Spanish adolescents from the community (females = 48.2%, mean [SD] age = 15.20 [0.74]). A cross-sectional online assessment was used to evaluate past-month substance use and gambling involvement. Problems associated to these behaviors were assessed using the GAIN-SS, the South Oaks Gambling Screen-Revised for Adolescents (SOGS-RA), and the Rutgers Alcohol Problem Index (RAPI). Factor analyses were conducted to examine the internal structure of the GAIN-SS. RESULTS Results revealed four subscales accounting for 47.03% of the variance related to externalizing (EDScr), internalizing (IDScr), substance use disorders (SDScr), and crime/violence problems (CVScr). Concurrent validity was supported through significant correlations between the GAIN-SS subscales, alcohol-related problems, and gambling behavior, with the exception of the IDScr. Past-month gamblers or substance users evidenced higher scores in the CVScr. Females reported more internalizing symptoms, whereas males reported higher scores in CVScr. CONCLUSIONS The GAIN-SS is a valid screener for substance use and gambling in Spanish adolescents. Sensitivity of the GAIN-SS to sex differences suggests that it may be useful to design gender-sensitive interventions.
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Affiliation(s)
- Víctor Martínez-Loredo
- Department of Psychology and Sociology, University of Zaragoza: Universidad de Zaragoza, Teruel, Spain
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Weidberg S, González-Roz A, Castaño Y, Secades-Villa R. Emotion dysregulation in relation to cannabis use and mental health among young adults. Addict Behav 2023; 144:107757. [PMID: 37224581 DOI: 10.1016/j.addbeh.2023.107757] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Revised: 05/08/2023] [Accepted: 05/18/2023] [Indexed: 05/26/2023]
Abstract
BACKGROUND Emotion dysregulation (ED) is a transdiagnostic variable that accounts for the onset and maintenance of mental health disorders. The interplay between ED, cannabis use and mental health has not been appraised in the young adult population and whether there are sex-dependent effects has yet to be examined. This study looked at whether ED mediates the association between past-month cannabis use and mental health, while considering sex as a moderator. METHODS 2,762 (64.2% women) undergraduate Spanish students completed an online battery. Among others, they fulfilled the Depression Anxiety Stress Scale-21 (DASS-21) and the Difficulties in Emotion Regulation Scale (DERS-28). A two-way ANOVA assessed the effects of sex and past-month cannabis use on participants' DASS-21 scores. A set of moderated mediations tested whether the indirect effect of past-month cannabis use on DASS-21 through DERS differed by sex. RESULTS Past-month cannabis female users showed higher levels of depression, anxiety and stress (M = 51.10, SD = 26.72) than did men [(M = 33.76, SD = 20.31); F(1, 2758) = 5.119, p =.024, η2p =.002]. In female young adults only, the effect of past-month cannabis use on mental health was mediated by ED (total score), non-acceptance of emotional responses, lack of emotional control, difficulties in engaging in goal-directed behavior, and lack of emotional clarity (all p's < 0.005) CONCLUSIONS: Findings indicate the importance of considering ED in assessment and intervention practices. Interventions targeting ED may be particularly effective for female young adult cannabis users.
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Affiliation(s)
- Sara Weidberg
- Department of Psychology. Addictive Behaviors Research Group (GCA), University of Oviedo. Plaza Feijoo s/n, 33003, Oviedo, Spain
| | - Alba González-Roz
- Department of Psychology. Addictive Behaviors Research Group (GCA), University of Oviedo. Plaza Feijoo s/n, 33003, Oviedo, Spain.
| | - Yasmina Castaño
- Department of Psychology. University of the Balearic Islands. Ctra. Valldemossa, km 7.5, 07122, Palma, Spain
| | - Roberto Secades-Villa
- Department of Psychology. Addictive Behaviors Research Group (GCA), University of Oviedo. Plaza Feijoo s/n, 33003, Oviedo, Spain
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García-Fernández G, Krotter A, González-Roz A, García-Pérez Á, Secades-Villa R. Effectiveness of including weight management in smoking cessation treatments: A meta-analysis of behavioral interventions. Addict Behav 2023; 140:107606. [PMID: 36642013 DOI: 10.1016/j.addbeh.2023.107606] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Revised: 12/29/2022] [Accepted: 01/03/2023] [Indexed: 01/09/2023]
Abstract
INTRODUCTION The potential of weight gain after smoking cessation reduces the incentive to quit. This meta-analysis examines the efficacy of behavioral interventions for smoking cessation that also address post-cessation weight gain. METHODS Medline, Web of Science, PsycINFO, and the Cochrane Central Register of Controlled Trials were searched for randomized controlled trials on behavioral treatments targeting both health outcomes. Six separate meta-analyses were undertaken to assess treatment efficacy on smoking abstinence and weight outcomes at end of treatment (EOT), short-term, and long-term follow-up. Individual and treatment moderators were examined as well as methodological quality and publication bias of studies. RESULTS A total of 28 studies were included in the meta-analysis. There was a statistically significant positive impact of treatments addressing both targets on smoking outcomes at EOT (RR = 1.279, 95% CI: 1.096, 1.492, p = .002), but not at follow-ups. Age impacted on EOT abstinence rates Q (1) = 4.960, p = .026) while increasing the number of sessions significantly improved EOT abstinence rates (p = .020). There was no statistically significant impact of these treatments on weight at EOT (Hedges' g = -0.015, 95% CI: -.164, 0.135, p = .849) or follow-ups (short term: Hedges' g = 0.055, 95% CI: -0.060, 0.170, p = .347; long term: Hedges' g = -0.320, 95% CI: -.965, 0.325, p = .331). There were minimal impacts of publication bias, mostly related to sample size, meaning studies including small sample sizes revealed larger effect sizes on abstinence at EOT. DISCUSSION Addressing post-cessation weight management in treatments for smoking cessation significantly enhances tobacco abstinence at EOT though it was not found to have a lasting impact after treatment.
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Affiliation(s)
- Gloria García-Fernández
- Department of Psychology, Addictive Behaviors Research Group, University of Oviedo, Plaza Feijoo S-N, Oviedo 33003, Spain.
| | - Andrea Krotter
- Department of Psychology, Addictive Behaviors Research Group, University of Oviedo, Plaza Feijoo S-N, Oviedo 33003, Spain
| | - Alba González-Roz
- Department of Psychology, Addictive Behaviors Research Group, University of Oviedo, Plaza Feijoo S-N, Oviedo 33003, Spain
| | - Ángel García-Pérez
- Department of Psychology, Addictive Behaviors Research Group, University of Oviedo, Plaza Feijoo S-N, Oviedo 33003, Spain
| | - Roberto Secades-Villa
- Department of Psychology, Addictive Behaviors Research Group, University of Oviedo, Plaza Feijoo S-N, Oviedo 33003, Spain
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González-Roz A, Secades-Villa R. Contingency management for smokers with mental health disorders and smoking-sensitive conditions caused or exacerbated by tobacco use: A review of existing studies, intervention parameters, and research priorities. Exp Clin Psychopharmacol 2023; 31:560-573. [PMID: 35737555 DOI: 10.1037/pha0000585] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Cigarette smoking is highly prevalent in people with smoking-sensitive conditions and mental health disorders. As early as the 1960s, evidence indicated the efficacy of contingency management (CM) for smoking cessation in various populations. This invited review is a critical appraisal of existing CM studies on smoking cessation in populations presenting smoking-sensitive conditions. It is particularly focused on examining the differences between two populations: smokers presenting health-related conditions and smokers with mental health disorders. Smoking abstinence is discussed in relation to treatment parameters (duration of interventions, schedules of reinforcement, and adjunctive therapies). A systematic review was conducted using PubMed, PsycINFO, and Scopus databases in December 2021. A total of 18 studies (N = 1,697; weighted age: 48.66 (8.57); Mdn % females: 41) were included in this review. Populations included hospitalized patients, smokers with chronic obstructive pulmonary disease (COPD), overweight, cancer, mood disorders, attentional deficits, psychosis, and posttraumatic stress disorder. CM abstinence rates were 43.04% at the earliest follow-up assessment (i.e., end of treatment-15 weeks) and 23.28% at subsequent follow-ups (10 days to 1-year posttreatment). Virtually all of the CM studies used cash as a reinforcer and were in place for an average of 5.53 weeks. Incremental versus fixed reinforcement schedules are more commonly used to promote smoking abstinence, but there are still not enough sufficiently powered and well-designed (active vs. control) studies to clarify the optimal magnitude and frequency of incentives. Dismantling studies are needed to refine the CM parameters most likely to produce enduring abstinence. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
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González-Roz A, Martínez-Loredo V, Aston ER, Metrik J, Murphy J, Balodis I, Secades-Villa R, Belisario K, MacKillop J. Concurrent validity of the marijuana purchase task: a meta-analysis of trait-level cannabis demand and cannabis involvement. Addiction 2023; 118:620-633. [PMID: 36305652 PMCID: PMC10020890 DOI: 10.1111/add.16075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Accepted: 10/03/2022] [Indexed: 11/29/2022]
Abstract
BACKGROUND AND AIMS The Marijuana Purchase Task (MPT) is increasingly used to measure cannabis reinforcing value and has potential use for cannabis etiological and regulatory research. This meta-analysis sought to evaluate for the first time the MPT's concurrent validity in relation to cannabis involvement. METHODS Electronic databases and pre-print repositories were searched for MPT studies that examined the cross-sectional relationship between frequency and quantity of cannabis use, problems, dependence, and five MPT indicators: intensity (i.e. unrestricted consumption), Omax (i.e. maximum consumption), Pmax (i.e. price at which demand becomes elastic), breakpoint (i.e. first price at which consumption ceases), and elasticity (i.e. sensitivity to rising costs). Random effects meta-analyses of cross-sectional effect sizes were conducted, with Q tests for examining differences by cannabis variables, meta-regression to test quantitative moderators, and publication bias assessment. Moderators included sex, number of MPT prices, variable transformations, and year of publication. Populations included community and clinical samples. RESULTS The searches yielded 14 studies (n = 4077, median % females: 44.8%: weighted average age = 29.08 [SD = 6.82]), published between 2015 and 2022. Intensity, Omax , and elasticity showed the most robust concurrent validity (|r's| = 0.147-325, ps < 0.014) with the largest significant effect sizes for quantity (|r| intensity = 0.325) and cannabis dependence (|r| Omax = 0.320, |r| intensity = 0.305, |r| elasticity = 0.303). Higher proportion of males was associated with increased estimates for elasticity-quantity and Pmax -problems. Higher number of MPT prices significantly altered magnitude of effects sizes for Pmax and problems, suggesting biased estimations if excessively low prices are considered. Methodological quality was generally good, and minimal evidence of publication bias was observed. CONCLUSIONS The marijuana purchase task presents adequate concurrent validity to measure cannabis demand, most robustly for intensity, Omax , and elasticity. Moderating effects by sex suggest potentially meaningful sex differences in the reinforcing value of cannabis.
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Affiliation(s)
- Alba González-Roz
- Peter Boris Centre for Addictions Research, St Joseph's Healthcare Hamilton, Hamilton, ON, Canada
- Addictive Behaviors Research Group, Department of Psychology, University of Oviedo, Oviedo, Spain
| | | | - Elizabeth R Aston
- Center for Alcohol and Addiction Studies, Brown University School of Public Health, Providence, RI, USA
| | - Jane Metrik
- Center for Alcohol and Addiction Studies, Brown University School of Public Health, Providence, RI, USA
- Providence VA Medical Center, Providence, RI, USA
| | - James Murphy
- Department of Psychology, The University of Memphis, Memphis, TN, USA
| | - Iris Balodis
- Peter Boris Centre for Addictions Research, St Joseph's Healthcare Hamilton, Hamilton, ON, Canada
| | - Roberto Secades-Villa
- Addictive Behaviors Research Group, Department of Psychology, University of Oviedo, Oviedo, Spain
| | - Kyla Belisario
- Peter Boris Centre for Addictions Research, St Joseph's Healthcare Hamilton, Hamilton, ON, Canada
| | - James MacKillop
- Peter Boris Centre for Addictions Research, St Joseph's Healthcare Hamilton, Hamilton, ON, Canada
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García-Pérez Á, García-Fernández G, Krotter A, González-Roz A, Martínez-Loredo V, Secades-Villa R. Validation of the Food Purchase Task (FPT) in a clinical sample of smokers with overweight and obesity. Appetite 2023; 185:106549. [PMID: 37004940 DOI: 10.1016/j.appet.2023.106549] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Revised: 03/22/2023] [Accepted: 03/25/2023] [Indexed: 04/03/2023]
Abstract
Obesity is a major health problem associated with disease burden and mortality. In this context, analyzing food as a powerful reinforcer from a behavioral economics framework could be relevant for the treatment and prevention of obesity. The purposes of this study were to validate a food purchase task (FPT) in a clinical sample of Spanish smokers with overweight and obesity and to assess the internal structure of the FPT. We also analyzed the clinical utility of single-item breakpoint (i.e., commodity price that suppresses demand). A total of 120 smokers [% females: 54.2; Mage = 52.54; SD = 10.34] with overweight and obesity completed the FPT and weight/eating-related variables. Principal component analysis was used to examine the FPT structure, and a set of correlations were used to examine the relationship between the FPT, eating and weight-related variables. The FPT demonstrated robust convergent validity with other measures of eating. Higher food demand was related to higher food craving (r = .33), more binge eating problems (r = 0.39), more weight gain concerns (r = 0.35), higher frequency of both controlled (r = 0.37) and uncontrolled (r = 0.30) grazing, as well as to an eating style in response to emotions (r = 0.34) and external eating (r = 0.34). Of the demand indices, Intensity and Omax showed the highest magnitudes of effects. The FPT factors, persistence and amplitude, do not improve individual FPT indices; and the single-item breakpoint was not related to any eating or weight variable. The FPT is a valid measure of food reinforcement with potential clinical utility in smokers with obesity/overweight.
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Affiliation(s)
- Ángel García-Pérez
- Department of Psychology. Addictive Behaviors Research Group. University of Oviedo, Plaza Feijoo, s/n, 33003, Oviedo, Spain; Department of Psychology, Sociology and Philosophy. University of Leon, Facultad de Educación, Campus de Vegazana, s/n, 24071, Leon, Spain.
| | - Gloria García-Fernández
- Department of Psychology. Addictive Behaviors Research Group. University of Oviedo, Plaza Feijoo, s/n, 33003, Oviedo, Spain
| | - Andrea Krotter
- Department of Psychology. Addictive Behaviors Research Group. University of Oviedo, Plaza Feijoo, s/n, 33003, Oviedo, Spain
| | - Alba González-Roz
- Department of Psychology. Addictive Behaviors Research Group. University of Oviedo, Plaza Feijoo, s/n, 33003, Oviedo, Spain
| | - Víctor Martínez-Loredo
- Department of Psychology. Addictive Behaviors Research Group. University of Oviedo, Plaza Feijoo, s/n, 33003, Oviedo, Spain; Department of Psychology and Sociology. University of Zaragoza, C/ Ciudad escolar s/n, 44003, Teruel, Spain
| | - Roberto Secades-Villa
- Department of Psychology. Addictive Behaviors Research Group. University of Oviedo, Plaza Feijoo, s/n, 33003, Oviedo, Spain
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González-Roz A, Martínez-Loredo V, Maalouf W, Fernández-Hermida JR, Al-Halabí S. Protocol for a Trial Assessing the Efficacy of a Universal School-Based Prevention Program for Addictive Behaviors. Psicothema 2023; 35:41-49. [PMID: 36695849 DOI: 10.7334/psicothema2022.251] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
BACKGROUND "Juego de Llaves" [ Set of Keys ] is a universal school-based prevention program for adolescents aged 12-15. It is aimed at reducing drug use and other addictive behaviors. This paper describes the full protocol for the evaluation design, instruments, randomization procedure, follow-ups, and primary outcomes. METHOD Non-Randomized Control Cluster Trial in a set of Spanish secondary schools, with follow-ups at 12-, 24- and 36-months. Participants will be allocated to an experimental or control group. Using a digital application designed for the study, a battery of instruments will be used to assess addictive behaviors, sociodemographic variables, school climate and other transdiagnostic psychological variables. RESULTS A pilot test will be carried out to test the implementation protocol and to calculate the sample size needed for outcome evaluation. After implementing the program, longitudinal statistical approaches will be used to report intervention efficacy and potential moderators and mediators. CONCLUSIONS There is a lack of assessments on the effectiveness of school prevention programs, and this paper is expected to improve monitoring and ongoing evaluation in prevention.
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Aonso-Diego G, González-Roz A, Weidberg S, García-Fernández G, Secades-Villa R. Smoking cessation treatment attendance among smokers with substance use disorders. Adicciones 2022; 34:327-330. [PMID: 35472160 DOI: 10.20882/adicciones.1718] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
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González-Roz A, Haik AK, Rahman L, Todi AA, Kane C, Walji A, Dickerman SR, Scarfe M, Levitt EE, Belisario K, Kelly JF, MacKillop J. Impacts of the COVID-19 public health restrictions on substance use, mental health, and psychosocial functioning among individuals with alcohol use disorder. Am J Drug Alcohol Abuse 2022; 48:712-723. [PMID: 36417589 DOI: 10.1080/00952990.2022.2134021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Background: The COVID-19 pandemic has been associated with major psychosocial disruptions and there is particular concern for individuals with substance use disorders.Objectives: This study characterized the psychosocial and experiential impacts of the pandemic on individuals seeking alcohol use disorder (AUD) recovery, including pandemic impacts on self-reported drinking, heavy drinking, tobacco, cannabis, and stimulant use.Methods: Participants were 125 AUD+ individuals (% males: 57.60; Mage = 49.11, SD = 12.13) reporting on substance use from January 1st-24th March, 2020 (pre-pandemic) and since the stay-at-home orders commenced, 24th March-June 28th 2020 (intra-pandemic). Within-subjects changes were examined and a latent profile analysis was performed to identify subgroups differentially impacted by the pandemic.Results: Large proportions reported psychosocial impacts of COVID-19, but drinking and other substance use did not reveal significant changes. Latent profile analyses revealed two subgroups: Profile 1 (n = 41/125), "Moderately Impacted") and Profile 2 (n = 84/125), "Severely Impacted"). Compared to the pre-pandemic period, the group that was moderately impacted by the pandemic exhibited significantly fewer heavy drinking days (p = .02) during the intra-pandemic period, but no other substance use changes. The group showing severe pandemic impacts did not exhibit changes in alcohol or other drug use but evidenced more severe anxiety and depression (ps < .001).Conclusions: We found heterogeneous subtypes of pandemic-related impacts in AUD recovery patients. There is need to provide psychosocial support to this particular population and further monitoring substance use and mental health.
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Affiliation(s)
- Alba González-Roz
- Peter Boris Centre for Addictions Research, St Joseph's Healthcare Hamilton, Hamilton, Ontario, Canada.,Addictive Behaviors Research Group, Department of Psychology, University of Oviedo, Oviedo, Spain
| | - Amanda K Haik
- Recovery Research Institute, Massachusetts General Hospital, Boston, MA, USA
| | - Liah Rahman
- Peter Boris Centre for Addictions Research, St Joseph's Healthcare Hamilton, Hamilton, Ontario, Canada
| | - Akshiti A Todi
- Recovery Research Institute, Massachusetts General Hospital, Boston, MA, USA
| | - Claire Kane
- Recovery Research Institute, Massachusetts General Hospital, Boston, MA, USA
| | - Alyna Walji
- Peter Boris Centre for Addictions Research, St Joseph's Healthcare Hamilton, Hamilton, Ontario, Canada
| | - Sarah R Dickerman
- Recovery Research Institute, Massachusetts General Hospital, Boston, MA, USA
| | - Molly Scarfe
- Peter Boris Centre for Addictions Research, St Joseph's Healthcare Hamilton, Hamilton, Ontario, Canada
| | - Emily E Levitt
- Peter Boris Centre for Addictions Research, St Joseph's Healthcare Hamilton, Hamilton, Ontario, Canada
| | - Kyla Belisario
- Peter Boris Centre for Addictions Research, St Joseph's Healthcare Hamilton, Hamilton, Ontario, Canada
| | - John F Kelly
- Recovery Research Institute, Massachusetts General Hospital, Boston, MA, USA.,Harvard Medical School, Department of Psychiatry, Boston, MA, USA
| | - James MacKillop
- Peter Boris Centre for Addictions Research, St Joseph's Healthcare Hamilton, Hamilton, Ontario, Canada
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Secades-Villa R, Aonso-Diego G, González-Roz A. A randomized controlled trial of contingency management for smoking cessation in substance use treatment patients. Int J Clin Health Psychol 2022; 22:100314. [PMID: 35662791 PMCID: PMC9157212 DOI: 10.1016/j.ijchp.2022.100314] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Accepted: 05/03/2022] [Indexed: 12/04/2022] Open
Abstract
Background/Objective Contingency management (CM) is one of the most effective interventions for smokers with substance use disorder (SUD), and no empirical assessment of its long-term efficacy has been conducted so far in a real-world context. The objectives were: (1) examine the additive effectiveness of CM on cognitive-behavioral treatment (CBT) for smoking cessation, and (2) examine the relationship between smoking cessation and substance use abstinence. Method A total of 80 participants (75.8% males; Mage = 45.31; SD = 9.64) were assigned to two smoking cessation treatments: CBT or CBT+CM. A set of generalized estimating equations were conducted to examine the effect of treatment condition on smoking outcomes, as well as the effect of smoking status on substance abstinence. Results Adding CM to CBT for smoking cessation improved tobacco abstinence rates at the end-of-treatment (p = .049). Tobacco abstinence rates declined over time (p = .012), but no significant effects of treatment condition were observed across follow-ups (p = .260). Smoking cessation was not significantly related to substance abstinence (p ≥ .488). Conclusions CM facilitates early abstinence in smokers with SUD, although effects subside after treatment termination. The lack of association between smoking abstinence and substance use suggests no jeopardizing effects as a result of quitting smoking.
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Affiliation(s)
- Roberto Secades-Villa
- Addictive Behaviors Research Group, Faculty of Psychology, University of Oviedo, Plaza Feijoo s/n, 33003 Oviedo, Spain
| | - Gema Aonso-Diego
- Addictive Behaviors Research Group, Faculty of Psychology, University of Oviedo, Plaza Feijoo s/n, 33003 Oviedo, Spain
- Corresponding author.
| | - Alba González-Roz
- Addictive Behaviors Research Group, Faculty of Psychology, University of Oviedo, Plaza Feijoo s/n, 33003 Oviedo, Spain
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14
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Martinez-Loredo V, González-Roz A, Dawkins L, Singh D, Murphy JG, MacKillop J. Is E-cigarette Use Associated With Persistence or Discontinuation of Combustible Cigarettes? A 24-Month Longitudinal Investigation in Young Adult Binge Drinkers. Nicotine Tob Res 2022; 24:962-969. [PMID: 35176769 PMCID: PMC9199943 DOI: 10.1093/ntr/ntac049] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2021] [Revised: 02/11/2022] [Accepted: 02/16/2022] [Indexed: 11/14/2022]
Abstract
INTRODUCTION It remains unclear whether electronic cigarette (e-cigarette) use promotes persistent combustible tobacco use or smoking discontinuation over time. Alcohol use is associated with a greater risk of adverse health effects of tobacco, and higher likelihood of e-cigarette use, making drinkers a high-priority subpopulation. AIMS AND METHODS This study examined longitudinal patterns of combustible tobacco and e-cigarette use over 24 months in young adult binge drinkers. A pooled dataset of 1002 (58.5% female; M age = 22.14) binge drinkers from the United States (60%) and Canada (40%) was used. The primary outcomes were past month combustible tobacco and e-cigarette use. Nicotine dependence was measured using the Fagerström Test of Cigarette Dependence. Alcohol severity was measured using the Young Adult Alcohol Consequences Questionnaire. Latent transition analysis (LTA) was used to identify patterns of cigarette smoking and e-cigarette use over 24 months. RESULTS The LTA yielded a four-class solution: (1) e-cigarettes-only users (prevalence over time: 7.75%-10.10%), (2) dual-product users (2.61%-9.89%), (3) combustible-only smokers (8.12%-20.70%), and (4) nonusers (61.66%-80.06%). Dual-product users predominantly transitioned to complete abstinence or exclusively e-cigarette use. In combustible-only smokers, the most common transition was to abstinence, followed by persistence of combustible-only status. At 24 months, 63% of e-cigarettes-only users transitioned to abstinence, with 37% continuing e-cigarettes-only use and 0% transitioning to dual or combustible cigarette use. CONCLUSIONS Dual-product use in young adult binge drinkers was associated with discontinuation of combustible tobacco over time, and e-cigarette-only use was not associated with subsequent combustible tobacco use. IMPLICATIONS These findings suggest that concurrent or exclusive e-cigarette use is not a risk factor for the persistence or development of combustible tobacco use in this subpopulation, with dual-product use reflecting a transitional pattern away from combustible use, toward discontinuation.
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Affiliation(s)
- Victor Martinez-Loredo
- Corresponding Author: Víctor Martínez Loredo, PhD, Department of Psychology and Sociology, University of Zaragoza, C/ Ciudad escolar s/n, 44003 Teruel, Aragón, Spain. Telephone: +34 978-61-81-54; E-mail:
| | - Alba González-Roz
- Department of Psychology, University of Oviedo, Oviedo, Asturias, Spain
| | - Lynne Dawkins
- Department of Psychology, London South Bank University, London, UK
| | - Desmond Singh
- Peter Boris Centre for Addictions Research, St. Joseph’s Healthcare Hamilton/McMaster University, Hamilton, ON, Canada
| | - James G Murphy
- Department of Psychology, University of Memphis, Memphis, TN, USA
| | - James MacKillop
- Peter Boris Centre for Addictions Research, St. Joseph’s Healthcare Hamilton/McMaster University, Hamilton, ON, Canada
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15
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González-Roz A, Aonso-Diego G, Martínez-Loredo V, Cuesta M, Secades-Villa R. Effects of Risk Perception and Accessibility on Cannabis Use among Young Population in Spain: Findings from the 2016 National Survey (ESTUDES). Subst Use Misuse 2022; 57:36-46. [PMID: 34678115 DOI: 10.1080/10826084.2021.1981387] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
BackgroundCannabis use in the young population has undergone a significant increase in Europe. Empirical assessments of individual and contextual mediating variables in relation to cannabis use are informative for prevention actions and have yet to be conducted in Spain. Objectives: This study used the 2016 National Survey on Drug Use in Secondary Education in Spain (ESTUDES) to inform on potentially relevant cannabis prevention targets. We examined individual variables (sex, age, and cannabis risk perception), past 30-day legal and illicit substance use, substance-free activities, and contextual factors (perceived accessibility to cannabis) associated to past 30-day cannabis use. Methods: Data were drawn from 35,369 adolescents (% females: 50.1). Structural equation modeling (SEM) was implemented to identify predictors of cannabis use, and indirect paths were tested via bootstrapping to examine the mediating effects of cannabis risk perception and accessibility. Results: Demographics (male sex, higher age), and past 30-day tobacco, alcohol, and illicit substance use were associated with past 30-day cannabis use. Frequency of past-year engagement in hobbies and reading did also predict past 30-day cannabis use. The mediators worked on most of the relationships examined, except for hobbies and illegal substance use in the case of accessibility and reading and hobbies in the case of risk perception. Conclusions/importance: Cannabis use is more likely to emerge in the event of low risk perception and high accessibility. Lower frequency of past year reading and higher engagement in some hobbies that are often carried out alone represent risk factors, which could potentially influence prevention programs.
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Affiliation(s)
- Alba González-Roz
- Department of Psychology, University of Oviedo, Oviedo, Spain.,Department of Psychology, Research Institute of Health Sciences (IUNICS) - University of the Balearic Islands, Palma de Mallorca, Spain
| | | | - Víctor Martínez-Loredo
- Department of Psychology, University of Oviedo, Oviedo, Spain.,Department of Psychology and Sociology, University of Zaragoza, Zaragoza, Spain
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16
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Martínez-Loredo V, González-Roz A, Secades-Villa R, Fernández-Hermida JR, MacKillop J. Concurrent validity of the Alcohol Purchase Task for measuring the reinforcing efficacy of alcohol: an updated systematic review and meta-analysis. Addiction 2021; 116:2635-2650. [PMID: 33338263 PMCID: PMC9186155 DOI: 10.1111/add.15379] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Revised: 09/09/2020] [Accepted: 12/09/2020] [Indexed: 12/28/2022]
Abstract
BACKGROUND AND AIMS An early meta-analysis testing the concurrent validity of the Alcohol Purchase Task (APT), a measure of alcohol's relative reinforcing value, reported mixed associations, but predated a large number of studies. This systematic review and meta-analysis sought to: (1) estimate the relationships between trait-based alcohol demand indices from the APT and multiple alcohol indicators, (2) test several moderators and (3) analyze small study effects. METHODS A meta-analysis of 50 cross-sectional studies in four databases (n = 18 466, females = 43.32%). Sex, year of publication, number of APT prices and index transformations (logarithmic, square root or none) were considered as moderators. Small study effects were examined by using the Begg-Mazumdar, Egger's and Duval & Tweedie's trim-and-fill tests. Alcohol indicators were quantity of alcohol use, number of heavy drinking episodes, alcohol-related problems and hazardous drinking. APT indices were intensity (i.e. consumption at zero cost), elasticity (i.e. sensitivity to increases in costs), Omax (i.e. maximum expenditure), Pmax (i.e. price associated to Omax ) and breakpoint (i.e. price at which consumption ceases). RESULTS All alcohol demand indices were significantly associated with all alcohol-related outcomes (r = 0.132-0.494), except Pmax , which was significantly associated with alcohol-related problems only (r = 0.064). The greatest associations were evinced between intensity in relation to alcohol use, hazardous drinking and heavy drinking and between Omax and alcohol use. All the tested moderators emerged as significant moderators. Evidence of small-study effects was limited. CONCLUSIONS The Alcohol Purchase Task appears to have concurrent validity in alcohol research. Intensity and Omax are the most relevant indices to account for alcohol involvement.
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Affiliation(s)
- Victor Martínez-Loredo
- Department of Psychology and Sociology, University of Zaragoza, Zaragoza, Spain,Department of Psychology, University of Oviedo, Oviedo, Spain
| | - Alba González-Roz
- Department of Psychology, University of the Balearic Islands, Research Institute on Health Sciences, Palma de Mallorca, Spain,Department of Psychology, University of Oviedo, Oviedo, Spain
| | | | | | - James MacKillop
- Peter Boris Centre for Addictions Research, St Joseph’s Healthcare Hamilton/McMaster University, Hamilton, ON, Canada
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17
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González-Roz A, Secades-Villa R, Aonso-Diego G, Weidberg S, Fernández-Hermida JR. No evidence of the clinical utility of single-item breakpoint to inform on tobacco demand in persons with substance use disorders. Psychopharmacology (Berl) 2021; 238:2525-2533. [PMID: 34031700 DOI: 10.1007/s00213-021-05875-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Accepted: 05/10/2021] [Indexed: 11/30/2022]
Abstract
RATIONALE Behavioral economics has shown that single-item demand indicators are promising for capturing crucial aspects of nicotine reinforcement. It is suggested that brief breakpoint measures perform comparably to full-length demand indices in characterizing nicotine dependence; however, there have been no thorough assessments of their validity in clinical settings. OBJECTIVES This study aimed to assess the validity and accuracy of a single-item breakpoint in informing on tobacco demand. METHODS The sample consisted of 88 treatment-seeking smokers (% males = 70.5%) enrolled in substance use treatment. Participants provided data on smoking characteristics and completed the Fagerström Test for Nicotine Dependence, a single-item breakpoint measure and a 14-item cigarette purchase task (CPT). Hierarchical regressions were performed to compare the predictive capability of a single-item breakpoint and full-length tobacco demand indicators in determining nicotine addiction severity. RESULTS The single-item breakpoint was significantly correlated with all indices stemmed from the CPT and both latent factors (all r values = .250-.368). Neither the brief breakpoint nor the full-length breakpoint significantly predicted nicotine dependence. After controlling for sex and smoking variables, factor 2 [β = .565, p < .001] and its observed variables Omax [β = .279, p = .006], 1/elasticity [β = .340, p = .001], and intensity [β = .551, p < .001], robustly predicted nicotine dependence severity. CONCLUSIONS Our findings do not support the validity of single-item breakpoint measures for characterizing nicotine dependence in substance users. In a bid to foster translational research, brief demand measures capturing Omax, intensity, and elasticity should be developed.
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Affiliation(s)
- Alba González-Roz
- Department of Psychology, University of Oviedo, Plaza Feijóo s/n, 33003, Oviedo, Spain.
- Department of Psychology/Research Institute of Health Sciences (IUNICS), University of the Balearic Islands, Valldemossa Km. 7.5, E-07122, Palma de Mallorca, Spain.
| | - Roberto Secades-Villa
- Department of Psychology, University of Oviedo, Plaza Feijóo s/n, 33003, Oviedo, Spain
| | - Gema Aonso-Diego
- Department of Psychology, University of Oviedo, Plaza Feijóo s/n, 33003, Oviedo, Spain
| | - Sara Weidberg
- Department of Psychology, University of Oviedo, Plaza Feijóo s/n, 33003, Oviedo, Spain
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18
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Syan SK, González-Roz A, Amlung M, Sweet LH, MacKillop J. Delayed Reward Discounting as a Prognostic Factor for Smoking Cessation Treatment Outcome: A Systematic Review. Nicotine Tob Res 2021; 23:1636-1645. [PMID: 33772298 DOI: 10.1093/ntr/ntab052] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2020] [Accepted: 03/25/2021] [Indexed: 12/19/2022]
Abstract
INTRODUCTION While large proportions of smokers attempt to quit, rates of relapse remain high and identification of valid prognostic markers is of high priority. Delayed reward discounting (DRD) is a behavioral economic index of impulsivity that has been associated with smoking cessation, albeit inconsistently. This systematic review sought to synthesize the empirical findings on DRD as a predictor of smoking cessation treatment outcome, to critically appraise the quality of the literature, and to propose directions for future research. AIMS AND METHODS A total of 734 articles were identified, yielding k = 14 studies that met the eligibility criteria. The Quality in Prognosis Studies (QUIPS) tool was used to assess methodological quality of the included studies. RESULTS Individual study methods were highly heterogeneous, including substantial variation in research design, DRD task, clinical subpopulation, and treatment format. The predominant finding was that steeper DRD (higher impulsivity) was associated with significantly worse smoking cessation outcomes (10/14 studies). Negative results tended to be in pregnant and adolescent subpopulations. The QUIPS results suggested low risk of bias across studies; 11/14 studies were rated as low risk of bias for 5/6 QUIPS domains. CONCLUSIONS This review revealed consistent low-bias evidence for impulsive DRD as a negative prognostic predictor of smoking cessation treatment outcome in adults. However, methodological heterogeneity was high, precluding meta-analysis and formal tests of small study bias. The prospects of targeting impulsive DRD as a potentially modifiable risk factor or providing targeted treatment for smokers exhibiting high levels of discounting are discussed. IMPLICATIONS These findings indicate consistent evidence for DRD as a negative prognostic factor for smoking cessation outcome in adults. As such, DRD may be a useful as a novel treatment target or for identifying high-risk populations requiring more intensive treatment.
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Affiliation(s)
- Sabrina K Syan
- Peter Boris Centre for Addictions Research, McMaster University & St. Joseph's Healthcare Hamilton, Hamilton, ON, Canada
| | - Alba González-Roz
- Department of Psychology, University of the Balearic Islands, Majorca, Spain
| | - Michael Amlung
- Peter Boris Centre for Addictions Research, McMaster University & St. Joseph's Healthcare Hamilton, Hamilton, ON, Canada.,Cofrin Logan Center for Addiction Research and Treatment, University of Kansas, Lawrence, KS, USA
| | - Lawrence H Sweet
- Department of Psychology, University of Georgia, Athens, GA, USA
| | - James MacKillop
- Peter Boris Centre for Addictions Research, McMaster University & St. Joseph's Healthcare Hamilton, Hamilton, ON, Canada
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González-Roz A, Secades-Villa R, García-Fernández G, Martínez-Loredo V, Alonso-Pérez F. Depression symptom profiles and long-term response to cognitive behavioral therapy plus contingency management for smoking cessation. Drug Alcohol Depend 2021; 225:108808. [PMID: 34198211 DOI: 10.1016/j.drugalcdep.2021.108808] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2021] [Revised: 04/22/2021] [Accepted: 04/25/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND Depression is heterogeneous in nature and using diagnostic categories limits insight into understanding psychopathology and its impact on treatment efficacy. This secondary analysis sought to: 1) identify distinct subpopulations of cigarette users with depression, and 2) examine their response to cognitive-behavioral treatment (CBT) + contingency management (CM) for smoking cessation at one year. METHOD The sample comprised 238 (74 % females) adults who smoke receiving CBT only or CBT + CM. A latent class analysis was conducted on baseline depressive symptoms measured using the Beck Depression Inventory-II. Generalized estimating equations assessed the main and interactive effects of class, time, treatment, and sex on smoking abstinence. RESULTS Three distinct classes were identified: C1 (n= 76/238), characterized by mild depression, loss of energy, pessimism, and criticism, C2 (n= 100/238) presenting moderate severity and decreased appetite, and C3 (n= 62/238) showing severe depression, increased appetite, and feelings of punishment. There was a significant cluster × treatment interaction, which indicated additive effects of CM over CBT alone for Class 1 and 2. Persons in Class 1 and 2 were 3.60 [95 % CI: 1.62, 7.97] and 2.65 [95 % CI: 1.19, 5.91] times more likely to be abstinent if CBT + CM was delivered rather than CBT only. No differential sex effects were observed on treatment response according to cluster. CONCLUSIONS Profiling depression symptom subtypes of cigarette users may be more informative to improve CM treatment response than merely focusing on total scores.
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Affiliation(s)
- Alba González-Roz
- Department of Psychology/Research Institute of Health Sciences (IUNICS), University of the Balearic Islands, Spain; Department of Psychology, University of Oviedo, Spain.
| | | | | | - Víctor Martínez-Loredo
- Department of Psychology, University of Oviedo, Spain; Department of Psychology and Sociology, University of Zaragoza, Spain
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20
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Aonso-Diego G, González-Roz A, Krotter A, García-Pérez A, Secades-Villa R. Contingency management for smoking cessation among individuals with substance use disorders: In-treatment and post-treatment effects. Addict Behav 2021; 119:106920. [PMID: 33798921 DOI: 10.1016/j.addbeh.2021.106920] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Revised: 03/18/2021] [Accepted: 03/18/2021] [Indexed: 12/18/2022]
Abstract
INTRODUCTION Smokers with substance use disorders (SUDs) show elevated tobacco prevalence, and smoking abstinence rates are considerably low. This randomized controlled trial sought to compare the effect of a cognitive behavioral treatment (CBT) that includes an episodic future thinking (EFT) component with the same treatment protocol plus contingency management (CM). This study aims to examine the effect of CM on smoking outcomes and in-treatment behaviors (i.e., retention, session attendance and adherence to nicotine use reduction guidelines), and to analyze whether these in-treatment variables predicted days of continuous abstinence at end-of-treatment. METHOD A total of 54 treatment-seeking participants (75.9% males, M = 46.19 years old) were allocated to CBT + EFT (n = 30) or CBT + EFT + CM (n = 24). Intervention consisted of eight weeks of group-based sessions. Tobacco abstinence was verified biochemically by testing levels of carbon monoxide (≤4ppm) and urine cotinine (≤80 ng/ml). RESULTS CM intervention increased 24-hour tobacco abstinence (50% vs. 20%, χ2(1) = 5.4; p = .021) and days of continuous abstinence (M = 5.92 ± 7.67 vs. 5.53 ± 12.42; t(52) = -0.132; p = 0.89) at end-of-treatment in comparison with CBT + EFT intervention. Although not statistically significant, CBT + EFT + CM enhanced in-treatment behaviors, in terms of retention (83.3% vs. 70%; χ2(1) = 0.255; p = .208), sessions attended (12.29 ± 3.22 vs. 10.93 ± 3.26; t(52) = -1.527; p = .133) and adherence to weekly nicotine use reduction targets (41.07% ± 31.96 vs. 35% ±2 6.28; t(52) = -0.766; p = .447). A higher percentage of samples meeting reduction guidelines (β = 0.609; p<.001) predicted days of continuous abstinence at end-of-treatment. CONCLUSION Combining CM with CBT + EFT improves short-term quitting rates. Findings suggest the need to incorporate strategies for improving adherence to nicotine reduction guidelines.
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21
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García-Pérez Á, Aonso-Diego G, Weidberg S, González-Roz A, Secades-Villa R. Reinforcer pathology predicts relapse in smokers. Psychol Addict Behav 2021; 36:565-571. [PMID: 34323527 DOI: 10.1037/adb0000773] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVE The purpose of this secondary analysis is to analyze whether both of the processes of the reinforcer pathology model (delay discounting and demand) are predictors of relapse up to 12-month follow-up in a sample of abstinent smokers who received a smoking cessation treatment. METHOD Participants were 202 abstinent smokers who completed the delay discounting task and the cigarette purchase task. In order to analyze the smoking relapse predictors and the impact of time to relapse, Kaplan-Meier curves, log-rank test, and Cox regression analysis were carried out. RESULTS Fewer years of regular smoking (HR = .79, p = .014), as well as higher delay discounting (HR AUClogd = .80, p = .019) and intensity of demand (HR = 1.26, p = .019) were associated with a higher likelihood of smoking relapse. These variables were associated with a faster relapse. CONCLUSIONS High delay discounting and intensity of demand were associated with a higher risk of relapse after quitting smoking. These findings highlight the importance of adapting treatment strategies for these two variables (delay discounting and cigarette demand), which might confer protective risk against smoking relapse. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
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22
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Minhas M, Belisario K, González-Roz A, Halladay J, Murphy JG, MacKillop J. COVID-19 impacts on drinking and mental health in emerging adults: Longitudinal changes and moderation by economic disruption and sex. Alcohol Clin Exp Res 2021; 45:1448-1457. [PMID: 34081349 PMCID: PMC8212111 DOI: 10.1111/acer.14624] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2021] [Revised: 04/20/2021] [Accepted: 04/21/2021] [Indexed: 12/31/2022]
Abstract
BACKGROUND There are significant concerns that the COVID-19 pandemic may have negative effects on substance use and mental health, but most studies to date are cross-sectional. In a sample of emerging adults, over a two-week period during the pandemic, the current study examined: (1) changes in drinking-related outcomes, depression, anxiety, and posttraumatic stress disorder and (2) differences in changes by sex and income loss. The intra-pandemic measures were compared to pre-pandemic measures. METHODS Participants were 473 emerging adults (Mage = 23.84; 41.7% male) in an existing longitudinal study on alcohol misuse who were assessed from June 17 to July 1, 2020, during acute public health restrictions in Ontario, Canada. These intra-pandemic data were matched to participant pre-pandemic reports, collected an average of 5 months earlier. Assessments included validated measures of drinking, alcohol-related consequences, and mental health indicators. RESULTS Longitudinal analyses revealed significant decreases in heavy drinking and adverse alcohol consequences, with no moderation by sex or income loss, but with substantial heterogeneity in changes. Significant increases in continuous measures of depression and anxiety were present, both of which were moderated by sex. Females reported significantly larger increases in depression and anxiety. Income loss >50% was significantly associated with increases in depression. CONCLUSIONS During the initial phase of the pandemic, reductions in heavy drinking and alcohol consequences were present in this sample of emerging adults, perhaps due to restrictions on socializing. In contrast, there was an increase in internalizing symptoms , especially in females, highlighting disparities in the mental health impacts of the pandemic.
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Affiliation(s)
- Meenu Minhas
- Peter Boris Centre for Addictions Research, St Joseph's Healthcare Hamilton, McMaster University, Hamilton, ON, Canada
| | - Kyla Belisario
- Peter Boris Centre for Addictions Research, St Joseph's Healthcare Hamilton, McMaster University, Hamilton, ON, Canada
| | - Alba González-Roz
- Department of Psychology/IUNICS, University of the Balearic Islands, Majorca, Spain
| | - Jillian Halladay
- Peter Boris Centre for Addictions Research, St Joseph's Healthcare Hamilton, McMaster University, Hamilton, ON, Canada.,Department of Health Evidence and Impact, McMaster University, Hamilton, ON, Canada
| | - James G Murphy
- Department of Psychology, University of Memphis, Memphis, TN, USA
| | - James MacKillop
- Peter Boris Centre for Addictions Research, St Joseph's Healthcare Hamilton, McMaster University, Hamilton, ON, Canada.,Homewood Research Institute, Guelph, ON, Canada
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González-Roz A, Suárez-Martínez I, Alonso-Diego GAD, Martínez-Loredo V, Secades-Villa R. Insights from behavioral economics to characterize substance use involvement in adolescents: a cluster analysis. rpcna 2021. [DOI: 10.21134/rpcna.2021.08.2.5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Reinforcement pathology (RP), a framework rooted in behavioral economics, has contributed to advances in the etiology and treatment of substance use. Drug demand and delay discounting (DD) have gained considerable interest, as they inform on the risk for escalation to substance use as well as treatment-specific targets. No prior study conducted in Spain has explored the interplay of demand and DD in adolescents. This study was aimed to: 1) identify whether DD and alcohol demand can yield empirically driven subgroups, and 2) examine differences in substance use involvement. The sample comprised 107 (% females = 54.2) adolescents (M=15.46, SD=1.25) from a high school in Asturias (Spain). Participants filled out an ad-hoc survey on substance use over the prior 30 days and one year. A 20-item alcohol purchase task (APT) was used to assess the reinforcing value of alcohol. The 21-item Monetary Choice Questionnaire evaluated impulsive choice. Two subgroups emerged: Cluster 1 (n = 72) and Cluster 2 (n = 35). Participants in C2 consistently showed higher impulsivity and demand for alcohol, signifying lower responsiveness to alcohol pricing. As compared to C1, those in C2 had a higher prevalence of past-month substance use [C1: 26/72 (36.1%) vs. C2: 33/35 (94.3%), p <.001], and a greater frequency of drunkenness [p <.001] and binge drinking episodes [p <.001]. RP differentiate between subgroups of adolescent substance users with patterns of more versus less substance use involvement. The existence of specific drug use subpopulations should be considered when designing environmental preventive policies
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Martínez-Loredo V, González-Roz A, García-Cueto E, Grande-Gosende A. Does e-assessment always fit digital natives? A within-subject comparison between paper- and tablet-based gambling assessments in adolescents. rpcna 2021. [DOI: 10.21134/rpcna.2021.08.2.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Technological development has enabled the use of sophisticated methods for assessing multiple human behaviors. Despite the advantages of these new technologies, concerns exist regarding their equivalence with paper-based measures in epidemiological and health-related surveys. To date, literature on this topic in relation to adolescents is virtually nonexistent. This study compares respondents’ performance on the same survey using both paper- and electronic tablet-based assessment methods. A final sample of 135 adolescents (mean age 17.30 years, SD = 0.59; 56.3% males) consecutively completed two versions of the same survey on gambling behaviors and two questionnaires: The Gambling Motives Questionnaire (GMQ) and the South Oaks Gambling Screening-Revised for Adolescents (SOGS-RA). An ad-hoc questionnaire assessing participants’ satisfaction levels with each method was also used. The digital survey yielded a lifetime, past year, and past month gambling prevalence of 54.1%, 45.2%, and 27.4%, respectively. Paper-based prevalence rates were 3.7-5.2% lower (all p < .092) and there were discrepancies in gambling activities. Although the reliability of the questionnaires was high in both formats, total scores were consistently higher in the paper-based format. GMQ and SOGS-RA intraclass correlations between versions ranged from .856-.884. Unexpectedly, students preferred the paper-based survey to the e-assessment (51.5% vs. 48.5%) and also enjoyed it more (31.3% vs 26.1%). Paper- and tablet-based surveys yield different, albeit non-statistically significant, estimations of gambling behaviors even when the same participants were surveyed at one time. We recommend that consistency be routinely checked across assessment formats when adapting paper-and-pencil measures to digital formats
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González-Roz A, Weidberg S, García-Pérez Á, Martínez-Loredo V, Secades-Villa R. One-Year Efficacy and Incremental Cost-effectiveness of Contingency Management for Cigarette Smokers With Depression. Nicotine Tob Res 2021; 23:320-326. [PMID: 32772097 DOI: 10.1093/ntr/ntaa146] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2020] [Accepted: 07/31/2020] [Indexed: 11/13/2022]
Abstract
INTRODUCTION Contingency management (CM) is efficacious for smoking cessation. To date, the number of cost-effectiveness evaluations of behavioral and pharmacological smoking cessation treatments far outnumbers the ones on CM. This study estimated 1-year efficacy and incremental cost-effectiveness of adding CM in relation to abstinence outcomes for a cognitive-behavioral therapy (CBT)+behavioral activation (BA) treatment. METHODS The study sample comprised 120 smokers with depression (% females: 70.8%; mean age: 51.67 [SD = 9.59]) enrolled in an 8-week randomized controlled clinical trial. Clinical effectiveness variables were point-prevalence abstinence, continuous abstinence, longest duration of abstinence (LDA), and Beck-Depression Inventory-II (BDI-II) scores at 1-year follow-up. Cost-effectiveness analyses were based on resource utilization, unit costs per patient, and incremental cost per additional LDA week at 1 year. RESULTS There was a significant effect of time by treatment group interaction, which indicated superior effects of CBT+BA+CM across time. Point-prevalence abstinence (53.3% [32/60]) was superior in participants receiving CBT+BA+CM compared with those in CBT+BA (23.3% [14/60]), but both groups were equally likely to present sustained reductions in depression. The average cost per patient was €208.85 (US$236.57) for CBT+BA and €410.64 (US$465.14) for CBT+BA+CM, p < .001. The incremental cost of using CM to enhance 1-year abstinence by one extra LDA week was €18 (US$20.39) (95% confidence interval: 17.75-18.25). CONCLUSIONS Behavioral treatments addressing both smoking and depression are efficacious for sustaining high quit rates at 1 year. Adding CM to CBT+BA for smoking cessation is highly cost-effective, with an estimated net benefit of €4704 (US$5344.80). IMPLICATIONS Informing on the cost-effectiveness of CM might expedite the translation of research findings into clinical practice. Findings suggested that CM is feasible and highly cost-effective, confirming that its implementation is worthwhile. At a CM cost per patient of €410.64 (US$465.14), the net benefit equals €4704 (US$5344.80), although even starting from a minimum investment of €20 (US$22.72) was cost-effective. CLINICALTRIALS-GOV IDENTIFIER NCT03163056.
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Affiliation(s)
- Alba González-Roz
- Department of Psychology, University of Oviedo, Plaza Feijóo s/n, Oviedo, Spain
| | - Sara Weidberg
- Department of Psychology, University of Oviedo, Plaza Feijóo s/n, Oviedo, Spain
| | - Ángel García-Pérez
- Department of Psychology, University of Oviedo, Plaza Feijóo s/n, Oviedo, Spain
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López-Núñez C, González-Roz A, Weidberg S, Fernández-Artamendi S. Anxiety sensitivity as a transdiagnostic vulnerability factor for cigarette smoking: Clinical and treatment implications. Adicciones 2021; 33:85-94. [PMID: 33768255 DOI: 10.20882/adicciones.1549] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Weidberg S, González-Roz A, García-Fernández G, Secades-Villa R. Activation level as a mediator between behavioral activation, sex, and depression among treatment-seeking smokers. Addict Behav 2021; 114:106715. [PMID: 33131968 DOI: 10.1016/j.addbeh.2020.106715] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Revised: 10/08/2020] [Accepted: 10/13/2020] [Indexed: 12/29/2022]
Abstract
INTRODUCTION Behavioral activation (BA) has gained interest when combined with tobacco interventions as it relates to improved depression and cessation rates. However, no prior efforts have examined mediators of BA effectiveness and sex-dependent effects. This secondary analysis assesses the main and interactive effects of sex and type of smoking cessation intervention [a cognitive behavioral treatment (CBT) only, or CBT + BA] on depressive symptoms among treatment-seeking patients with depression. It also examines the activation level as a mediator between BA, BA by sex, and depression. METHOD 120 smokers were assigned to an 8-week CBT or to CBT + BA. They completed the Beck Depression Inventory-II (BDI-II) and the Behavioral Activation for Depression scale-short-form (BADS-SF). A two-way ANOVA assessed the effects of sex and treatment condition on participants' BDI-II scores. A moderated mediational analysis tested whether the indirect effect of treatment condition on BDI-II through BADS-SF differed by sex. RESULTS After controlling for end-of-treatment smoking status and baseline BDI-II, there were no significant effects of treatment condition, sex, and their interaction on end-of-treatment BDI-II. Being a male was indirectly associated with higher BDI-II scores through lower BADS-SF score (point estimate = -3.440; SE = 1.637; BC 95% CI [-7.105, -0.749]). This effect was not found for women. CONCLUSIONS There is a need to tailor interventions by sex when treating smokers with depression. It is recommended to assess symptoms such as mental rumination or self-consciousness, which tend to be more pronounced in women.
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Affiliation(s)
- Sara Weidberg
- Department of Psychology, University of Oviedo, Plaza Feijóo s/n, 33003 Oviedo, Spain.
| | - Alba González-Roz
- Department of Psychology, University of Oviedo, Plaza Feijóo s/n, 33003 Oviedo, Spain
| | | | - Roberto Secades-Villa
- Department of Psychology, University of Oviedo, Plaza Feijóo s/n, 33003 Oviedo, Spain
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Aonso-Diego G, González-Roz A, Martínez-Loredo V, Krotter A, Secades-Villa R. Episodic future thinking for smoking cessation in individuals with substance use disorder: Treatment feasibility and acceptability. J Subst Abuse Treat 2021; 123:108259. [PMID: 33612193 DOI: 10.1016/j.jsat.2020.108259] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Revised: 11/09/2020] [Accepted: 12/10/2020] [Indexed: 12/21/2022]
Abstract
BACKGROUND Smokers with substance use disorders (SUD) smoke approximately four times more than the general population. Current efforts are focused on improving smoking cessation treatments for this population. Episodic future thinking (EFT), a novel intervention aimed at decreasing impulsive choice, has shown promising results for reducing cigarette demand in experimental settings. This feasibility study sought to examine the feasibility and preliminary EFT effects on delay discounting (DD) and nicotine intake reductions throughout treatment. METHOD Smokers in substance use treatment (N = 29; 75.9% males) received an 8-week cognitive-behavioral treatment (CBT) + EFT for smoking cessation. The study assessed feasibility through successful recruitment rates, retention, and adherence to treatment. Participants' satisfaction acted as our acceptability measure. We computed nonparametric range tests to analyze changes in continuous variables. RESULTS Among interested individuals, 42 (43.75%) met the inclusion criteria, and 29 entered the treatment program. Rate of treatment completion was 65.5% (19/29). Mean (SD) sessions attended were 7(1.11), and mean patient satisfaction rating with treatment was 8.83/10. The study observed low compliance with EFT, with 15.8% (3/19) of patients practicing at least 50% of the requested times. CONCLUSIONS CBT + EFT is acceptable for the SUD population. However, future studies should implement some adjustments to improve the adherence and feasibility of EFT, such as reducing the number of practices and temporal intervals in EFT events. Given the small sample size, and the absence of a control group, future larger scale trials are needed to elucidate EFT effects on DD and smoking cessation.
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Affiliation(s)
- Gema Aonso-Diego
- Department of Psychology, University of Oviedo, Plaza Feijoo, s/n, 33003 Oviedo, Spain.
| | - Alba González-Roz
- Department of Psychology, University of Oviedo, Plaza Feijoo, s/n, 33003 Oviedo, Spain
| | | | - Andrea Krotter
- Department of Psychology, University of Oviedo, Plaza Feijoo, s/n, 33003 Oviedo, Spain
| | - Roberto Secades-Villa
- Department of Psychology, University of Oviedo, Plaza Feijoo, s/n, 33003 Oviedo, Spain
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Secades-Villa R, Aonso-Diego G, García-Pérez Á, González-Roz A. Effectiveness of contingency management for smoking cessation in substance users: A systematic review and meta-analysis. J Consult Clin Psychol 2020; 88:951-964. [DOI: 10.1037/ccp0000611] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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González-Roz A, Secades-Villa R, Weidberg S, García-Pérez Á, Reed DD. Latent Structure of the Cigarette Purchase Task Among Treatment-Seeking Smokers With Depression and Its Predictive Validity on Smoking Abstinence. Nicotine Tob Res 2020; 22:74-80. [PMID: 30371826 DOI: 10.1093/ntr/nty236] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2018] [Accepted: 10/24/2018] [Indexed: 12/12/2022]
Abstract
INTRODUCTION Research has recently shown that nicotine reinforcement is better characterized by a bifactorial latent structure: persistence (insensitivity to cigarette pricing) and amplitude (consumption at inexpensive prices). No study to date has examined its value as a predictor of abstinence. This study aimed to provide new evidence on the latent structure of the cigarette purchase task (CPT) in smokers with depressive symptoms and to examine whether the latent structure performs better as a predictor of continuous abstinence than do the individual indices. METHODS Participants (n = 205 smokers; 72% female: Beck Depression Inventory, Second Edition, M = 24.68, SD = 10.45) were randomized to two smoking cessation treatments for quitting smoking: cognitive behavioral treatment (CBT) or CBT + contingency management (CM). A principal-components analysis was conducted to examine the latent structure of the CPT and a set of regression models were performed to assess its predictive validity. RESULTS The principal-components analysis revealed a bifactorial solution, which was interpreted as persistence (breakpoint, Omax, Pmax, and elasticity) and psychological inertia (intensity and elasticity of demand). Evidence on the convergent validity was obtained through significant associations between the two latent factors and smoking variables (all r values ≥.17). Psychological inertia was negatively related to the number of days of continuous abstinence at the end of treatment regardless of the treatment condition [R2 = .038; F(2, 202) = 4.989, p = .008]. CONCLUSIONS Psychological inertia informs on which patients benefit less from smoking cessation treatments incorporating CM and CBT. Treatment components that affect individuals' excessive valuation of cigarettes might improve cessation outcomes. IMPLICATIONS This is the first attempt to examine the latent structure of the CPT in depressed smokers and to yield evidence on its predictive validity. A specific bifactorial solution exists for this population: persistence (breakpoint, Omax, Pmax, and elasticity) and psychological inertia (intensity and elasticity). Isolating demand indices and factors provides a high-resolution characterization of nicotine reinforcement for depressed smokers in that it informs on treatment response. Compared to the individual CPT indices, psychological inertia more effectively predicts which patients benefit most from either CM or CBT. Treatment components that affect individuals' excessive valuation of cigarettes (eg, episodic future thinking) should be integrated into smoking cessation treatments.
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Affiliation(s)
| | | | - Sara Weidberg
- Department of Psychology, University of Oviedo, Oviedo, Spain
| | | | - Derek D Reed
- Department of Applied Behavioral Science, University of Kansas, Lawrence, KS
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García-Pérez Á, Vallejo-Seco G, Weidberg S, González-Roz A, Secades-Villa R. Long-term changes in delay discounting following a smoking cessation treatment for patients with depression. Drug Alcohol Depend 2020; 212:108007. [PMID: 32370930 DOI: 10.1016/j.drugalcdep.2020.108007] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2020] [Revised: 03/27/2020] [Accepted: 04/01/2020] [Indexed: 12/31/2022]
Abstract
BACKGROUND Delay discounting (DD) has been identified as a trans-disorder process underlying addictive behaviors, including smoking. Previous studies have evaluated how different treatments for drug dependence have affected DD, showing mixed results. Furthermore, no study has examined the effects of changes in depression on DD rates. The aim of this study was to evaluate the impact of treatment type: cognitive behavioral treatment (CBT), CBT + behavioral activation (BA), or CBT + BA + contingency management (CM), and changes in smoking status and depression on DD rates in long-term follow-up among a sample of treatment-seeking smokers with depression. METHODS Participants were 180 treatment-seeking smokers with depression who were randomly assigned to one of the following treatment conditions: CBT (n = 60), CBT + BA (n = 60), and CBT + BA + CM (n = 60). Depressive symptomatology and major depression diagnosis were evaluated through the BDI-II and the SCID-I of the DSM-IV-TR. DD rates were assessed using the DD task with hypothetical monetary rewards. Smoking status, DD, and depressive symptomatology were collected at baseline, at end-of-treatment and at one-, two-, three-, and six-month follow-ups. RESULTS CM for smoking cessation reduces DD rates (p = .0094). Smoking abstinence (p = .0024) and reduction in depressive symptoms (p = .0437) were associated with decreases in DD rates in long-term follow-up. CONCLUSIONS CM interventions for smoking cessation, smoking abstinence, and the improvement of depression contribute to reductions in DD over time.
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Affiliation(s)
- Ángel García-Pérez
- Department of Psychology. University of Oviedo, Plaza Feijoo, s/n, 33003 Oviedo, Spain.
| | | | - Sara Weidberg
- Department of Psychology. University of Oviedo, Plaza Feijoo, s/n, 33003 Oviedo, Spain
| | - Alba González-Roz
- Department of Psychology. University of Oviedo, Plaza Feijoo, s/n, 33003 Oviedo, Spain
| | - Roberto Secades-Villa
- Department of Psychology. University of Oviedo, Plaza Feijoo, s/n, 33003 Oviedo, Spain
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González-Roz A, Martínez-Loredo V, Secades-Villa R, Amlung M, MacKillop J. Concurrent validity of the alcohol purchase task in relation to alcohol involvement: protocol for a systematic review and meta-analysis. BMJ Open 2020; 10:e035400. [PMID: 32595153 PMCID: PMC7322270 DOI: 10.1136/bmjopen-2019-035400] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
Abstract
INTRODUCTION Alcohol demand, as measured by an alcohol purchase task (APT), provides a multidimensional assessment of the relative reinforcing efficacy of alcohol. The objective of this meta-analysis is to critically appraise the existing literature on the concurrent validity of the APT by meta-analysing the cross-sectional relationships between indices of the APT (ie, breakpoint, Omax, Pmax, elasticity and intensity) and alcohol-related measures. It also aims to examine methodological procedures used to obtain APT indices and individual variables as potential moderators on the assessed estimations. METHODS AND ANALYSIS A comprehensive literature search conducted from inception to April 2020 will be conducted in the PubMed, PsycINFO, Web of Science and Scopus databases. Two authors will independently screen and extract data from articles using a predefined protocol search and extraction forms. Disagreements will be resolved through discussion with two additional reviewers. All results will be tabulated, and a random-effect meta-analysis will be conducted. Participants' sex, number of prices and APT methodological procedures will be examined as potential moderators on the observed effect sizes. ETHICS AND DISSEMINATION Results of this meta-analysis will characterise the concurrent validity of the APT in the existing literature. Further, the results are anticipated to provide evidence on which index (or indices) is most robustly associated with alcohol use and severity. Ethics approval was not required for this study and the results will be published in a peer-reviewed journal. PROSPERO REGISTRATION NUMBER CRD42019137512.
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Affiliation(s)
- Alba González-Roz
- Department of Psychology, University of Oviedo, Oviedo, Asturias, Spain
| | | | | | - Michael Amlung
- Peter Boris Centre for Addictions Research, McMaster University, Hamilton, Ontario, Canada
| | - James MacKillop
- Peter Boris Centre for Addictions Research, McMaster University, Hamilton, Ontario, Canada
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González-Roz A, Secades-Villa R, Weidberg S, Muñiz J, MacKillop J. Characterizing the reinforcing value of tobacco using a cigarette purchase task: An item response theory approach. Exp Clin Psychopharmacol 2020; 28:291-298. [PMID: 31556676 DOI: 10.1037/pha0000323] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
The Cigarette Purchase Task (CPT) affords a high-resolution index of the reinforcing efficacy of nicotine. Although a high number and steep progression of prices have traditionally been used, attention is now placed on developing brief measures of this task. This study sought to assess the psychometric properties of a brief CPT for assessing cigarette demand in treatment-seeking smokers with and without depressive symptoms. The study sample comprised 360 participants (210 with and 150 without depressive symptomatology). We tested the effect of different CPT price densities (14-19) on the variation of CPT indices and provided a thorough assessment of its reliability using 2 different approaches: the classical test theory and item response theory models. Reliability analyses indicated that the 14-item CPT performed the best in terms of reliability across study samples. The CPT's information functions for this shortened version yielded the highest precision at medium levels of the measured construct (for theta values between -0.4 and 0.4). Omax (nondepressed: discrimination parameter a = 14.66; depressed smokers: a = 6.73) and elasticity (nondepressed: a = -3.89; depressed smokers; a = -2.97) best discriminated between patients with different levels of cigarette demand. Results support the utility of item response theory to evaluate the precision of the CPT for different levels of the reinforcing efficacy of nicotine. A 14-item CPT stands as a reliable and efficient method for research and clinical purposes. This task performs particularly well with depressed and nondepressed smokers endorsing moderate levels of the CPT construct. (PsycInfo Database Record (c) 2020 APA, all rights reserved).
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García-Pérez Á, Weidberg S, González-Roz A, Alonso-Pérez F, Secades-Villa R. Relationship between delay discounting and depression in cigarette smokers and non-smokers. Addict Behav 2020; 103:106251. [PMID: 31874376 DOI: 10.1016/j.addbeh.2019.106251] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2019] [Revised: 12/03/2019] [Accepted: 12/03/2019] [Indexed: 02/06/2023]
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García-Pérez Á, Weidberg S, González-Roz A, Krotter A, Secades-Villa R. Effects of combined coffee and alcohol use over cigarette demand among treatment-seeking smokers. Behav Processes 2020; 174:104108. [PMID: 32198089 DOI: 10.1016/j.beproc.2020.104108] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2019] [Revised: 02/18/2020] [Accepted: 03/16/2020] [Indexed: 01/10/2023]
Abstract
OBJECTIVE This study is aimed at comparing the relative reinforcing efficacy (RRE) of nicotine though CPT performance in function of alcohol and coffee consumption of treatment-seeking smokers. MATERIAL AND METHODS A total of 88 treatment-seeking smokers (60.2 % female) completed the CPT. A multivariate analysis of variance (MANOVA) was used to compare alcohol (consumers and abstainers of alcohol) and coffee intake (high coffee consumers and low coffee consumers) on CPT indices. RESULTS Univariate effects of coffee × alcohol use interaction were significant for elasticity [F (1, 83) = 4.9435, p = .038, η2 = .051] and intensity [F (1, 83) = 6.972, p = .01, η2 = .077]. CONCLUSIONS Alcohol and coffee use is associated with an elevated cigarette demand among treatment-seeking smokers. This finding suggests the need for specific interventions to reduce alcohol and coffee use in order to increase the effectiveness of treatments for smoking cessation.
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Affiliation(s)
- Ángel García-Pérez
- Department of Psychology, University of Oviedo, Plaza Feijoo s/n, 33003, Oviedo, Spain.
| | - Sara Weidberg
- Department of Psychology, University of Oviedo, Plaza Feijoo s/n, 33003, Oviedo, Spain
| | - Alba González-Roz
- Department of Psychology, University of Oviedo, Plaza Feijoo s/n, 33003, Oviedo, Spain
| | - Andrea Krotter
- Department of Psychology, University of Oviedo, Plaza Feijoo s/n, 33003, Oviedo, Spain
| | - Roberto Secades-Villa
- Department of Psychology, University of Oviedo, Plaza Feijoo s/n, 33003, Oviedo, Spain
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González-Roz A, García-Pérez Á, Weidberg S, Aonso-Diego G, Secades-Villa R. Reinforcer pathology and response to contingency management for smoking cessation. Psychol Addict Behav 2020; 34:156-163. [PMID: 31380658 DOI: 10.1037/adb0000500] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
The recognition of the interplay between cigarette demand and impulsivity as a proxy of reinforcer pathology (RP) has prompted studies that assess these 2 constructs. Scarce research has examined their interrelation within clinical contexts. This secondary analysis sought to identify different types of treatment-seeking smokers based on cigarette demand and delay discounting and examine their differential response to contingency management (CM). The dataset included 305 participants (68% female) receiving either a cognitive-behavioral treatment (CBT) or CBT + CM. A cluster analysis based on the bifactorial structure of a cigarette purchase task (i.e., psychological inertia and persistence) and delay discounting (base-10 logarithmic transformation of the area under the curve) was conducted. Clusters were compared in abstinence rates at posttreatment and 6-month follow-up. Two RP subgroups emerged, Cluster 1 (n = 128) and Cluster 2 (n = 177), which were interpreted as "individuals with excessive tobacco valuation" and "steep discounters," respectively. At 8 weeks, the percentage of abstinent individuals was higher in those in Cluster 2 compared to those in Cluster 1 (76.3% vs. 61%; χ2 = 8.291, p = .004, ϕ = .16). The nonsignificant effect of treatment condition on cessation outcomes indicated that both clusters equally benefited from CBT or CBT + CM. Support was reached for the generalizability of CBT and CM irrespective of patients' RP subtype. The fact that CM did not enhance abstinence outcomes beyond those obtained with CBT alone, underscores the need to evaluate the effect of innovative treatment procedures tailored to these RP phenotypes. (PsycINFO Database Record (c) 2020 APA, all rights reserved).
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Secades-Villa R, López-Núñez C, Weidberg S, González-Roz A, Alonso-Pérez F. A randomized controlled trial of contingency management for smoking abstinence versus contingency management for shaping cessation: One-year outcome. Exp Clin Psychopharmacol 2019; 27:561-568. [PMID: 30869980 DOI: 10.1037/pha0000269] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
This study analyzed whether a contingency management (CM) for shaping cessation period implemented prior to an abstinence-only period (CMS) improves outcomes relative to CM that reinforces only a fixed abstinence criteria (CMA) among treatment-seeking patients in a community setting. A total of 110 patients were randomly assigned to 1 of 2 treatment conditions: CMA (N = 55) or CMS (N = 55). All participants received cognitive-behavioral treatment (CBT) implemented in 6 group-based sessions. CMA participants earned voucher-based incentives contingent on providing biochemical evidence of smoking abstinence. CMS reinforced closer approximations to smoking abstinence. At posttreatment, patients assigned to the CMA group achieved the same rates of smoking abstinence (point-prevalence) as those in the CMS group (94.5%; p > .05). At the 6-month follow-up, 43.6% of the patients who received CMA maintained smoking abstinence in comparison to 32.7% in the CMS group (p > .05). At the 12-month follow-up, 40% of the participants assigned to the CMA group were abstinent, in comparison to 29.1% who received CMS (p > .05). There were no statistically significant differences in continuous smoking abstinence between the treatment conditions in any of the follow-ups (p > .05). These results offer a novel contribution by suggesting that CM was associated with enduring effects up to 12 months after the end of treatment and that CM for shaping cessation period implemented prior to an abstinence-only period (CMS) improves outcomes relative to CM that reinforces only a fixed abstinence criteria (CMA) among treatment-seeking patients in a community setting. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
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González-Roz A, Jackson J, Murphy C, Rohsenow DJ, MacKillop J. Behavioral economic tobacco demand in relation to cigarette consumption and nicotine dependence: a meta-analysis of cross-sectional relationships. Addiction 2019; 114:1926-1940. [PMID: 31313403 PMCID: PMC7837316 DOI: 10.1111/add.14736] [Citation(s) in RCA: 42] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2018] [Revised: 02/13/2019] [Accepted: 06/28/2019] [Indexed: 12/29/2022]
Abstract
BACKGROUND AND AIMS A cigarette purchase task (CPT) aims to characterize individual variation in the reinforcing value of tobacco. This meta-analysis estimated the associations between cigarette demand, tobacco consumption and nicotine dependence using this task. DESIGN A meta-analysis of cross-sectional studies identified by PubMed and PsycINFO databases was conducted. Fixed- and random-effects models were used. The study also examined the model used to derive elasticity of demand (exponential or exponentiated) as a potential moderator. Publication bias was assessed using 'fail-safe N', Begg-Mazumdar test, Egger's test, Tweedie's trim-and-fill approach and meta-regression of publication year with effect size. SETTING Studies from any setting that reported coefficient correlations on the tested associations. PARTICIPANTS Daily cigarette users (i.e. 5 to 38 cigarettes per day; n = 7649). MEASUREMENTS Cigarette consumption, nicotine dependence and five tobacco demand indicators: intensity (i.e. consumption at no cost), elasticity (i.e. sensitivity to rises in costs), Omax (maximum expenditure), Pmax (i.e. price at which consumption becomes elastic) and breakpoint (i.e. price at which consumption ceases). FINDINGS Twenty-three studies met inclusion criteria. All the CPT indices were significantly correlated with smoking behavior (rs = 0.044-0.572, Ps = 0.012-10-8 ). Medium-to-large effect size associations were present for intensity, Omax, and elasticity, whereas small effects were obtained for breakpoint and Pmax . Evidence of a moderating effect of the different elasticity modeling approaches was not present. There was limited evidence of publication bias. CONCLUSIONS All five demand indices derived from the cigarette purchase task by (CPT) were robustly associated with cigarette consumption and tobacco dependence. Of the demand indices, maximum expenditure, intensity and elasticity exhibited the largest magnitude associations.
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Affiliation(s)
- Alba González-Roz
- Faculty of Psychology, University of Oviedo
- Peter Boris Centre for Addictions Research, McMaster University & St. Joseph’s Healthcare Hamilton
| | - Jacob Jackson
- Peter Boris Centre for Addictions Research, McMaster University & St. Joseph’s Healthcare Hamilton
| | - Cara Murphy
- Center for Alcohol and Addiction Studies, Brown University
| | | | - James MacKillop
- Peter Boris Centre for Addictions Research, McMaster University & St. Joseph’s Healthcare Hamilton
- Center for Alcohol and Addiction Studies, Brown University
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Secades-Villa R, González-Roz A, Vallejo-Seco G, Weidberg S, García-Pérez Á, Alonso-Pérez F. Additive effectiveness of contingency management on cognitive behavioural treatment for smokers with depression: Six-month abstinence and depression outcomes. Drug Alcohol Depend 2019; 204:107495. [PMID: 31491583 DOI: 10.1016/j.drugalcdep.2019.06.003] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2019] [Revised: 06/02/2019] [Accepted: 06/03/2019] [Indexed: 10/26/2022]
Abstract
BACKGROUND Depression and smoking co-occur at high rates and there is a lack of evidence on the efficacy of treatments specifically tailored to this population. This randomized controlled trial sought to compare the effectiveness of cognitive behavioural treatment (CBT) combined with behavioural activation (BA) and the same treatment protocol plus contingency management (CM). METHODS A sample of 120 adult smokers (70.8%: females) with severe depressive symptoms were randomly allocated to: CBT + BA (n = 60) or CBT + BA + CM (n = 60). Smoking and depression outcomes were reported at end of treatment, 1-, 2-, 3-, and 6-month follow-ups. Self-reported smoking status was biochemically verified, and depression was assessed using the Beck Depression Inventory-II. RESULTS At end of treatment, the overall quit rate was 69.2% (83/120). CM showed an additive effect on CBT + BA in enhancing abstinence rates. The significant effect of group [F(1,155) = 9.55, p = .0024], time [F(4,96) = 7.93, p < .0001], and group by time interaction [F(4,96) = 6.12, p = .0002], indicated that CM is more effective for generating longer durations of abstinence beyond those of CBT+BA. All treatment conditions equally promoted sustained reductions in depression across time [F(1,111) = 0.53, p = .4665]. A greater number of days of continuous abstinence and lower depressive symptoms mutually influenced each other. CONCLUSIONS Depressed smokers achieve high cessation rates without suffering negative mood changes. Quitting smoking is not detrimental and adding CM to CBT + BA enhances long-lasting abstinence rates while promoting large depression improvements.
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Affiliation(s)
- Roberto Secades-Villa
- Department of Psychology. University of Oviedo, Plaza Feijoo, s/n, 33003 Oviedo, Spain
| | - Alba González-Roz
- Department of Psychology. University of Oviedo, Plaza Feijoo, s/n, 33003 Oviedo, Spain.
| | | | - Sara Weidberg
- Department of Psychology. University of Oviedo, Plaza Feijoo, s/n, 33003 Oviedo, Spain
| | - Ángel García-Pérez
- Department of Psychology. University of Oviedo, Plaza Feijoo, s/n, 33003 Oviedo, Spain
| | - Fernando Alonso-Pérez
- Department of Psychology. University of Oviedo, Plaza Feijoo, s/n, 33003 Oviedo, Spain
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González-Roz A, Postigo Á, Aonso-Diego G, García-Pérez Á, Secades-Villa R. Reinforcer pathology among cigarette smokers with and without history of alcohol use disorder. Psicothema 2019; 31:393-399. [PMID: 31634083 DOI: 10.7334/psicothema2019.10] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND Delay discounting (DD) and cigarette demand contribute to an understanding of nicotine reward and dependence. However, no prior attempt has been made to examine the effect of a history of Alcohol Use Disorder (AUD) on DD and tobacco demand in current smokers. This study sought to compare DD and cigarette demand in smokers with and without a history of AUD. METHODS The sample comprised 43 smokers with a history of AUD and 49 with no history of drug use. Participants completed the DD task and the 19-item version of the Cigarette Purchase Task. Mazur's equation and the Koffarnus et al. model were used to derive the discounting rates and elasticity of demand, respectively. RESULTS Smokers with a history of AUD discounted delayed rewards more steeply (Mlogk= -1.77, SD=1.46) than those without such a history (Mlogk= -2.32, SD=1.04). No statistically significant differences in cigarette demand emerged between groups. CONCLUSIONS The excessive preference for immediate rewards in smokers with a history of AUD suggests that impulsive choice persists even after alcohol abstinence. As DD constitutes an important marker of poor treatment outcomes, targeting this specific facet of impulsivity in broader clinical interventions might be helpful.
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González-Roz A, Ruano L, Aonso-Diego G, García-Pérez Á, Weidberg S, Secades-Villa R. Smoking cessation interventions in substance use treatment facilities: clinical implications and recommendations for implementation. Adicciones 2019; 31:327-329. [PMID: 31342079 DOI: 10.20882/adicciones.1270] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Letter to Editor.
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Weidberg S, Secades-Villa R, García-Pérez Á, González-Roz A, Fernández-Hermida JR. The synergistic effect of cigarette demand and delay discounting on nicotine dependence among treatment-seeking smokers. Exp Clin Psychopharmacol 2019; 27:146-152. [PMID: 30570273 DOI: 10.1037/pha0000248] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
From a behavioral economics standpoint, tobacco addiction can be conceptualized as a reinforcer pathology deriving from high cigarette demand and elevated delay discounting (DD) rates. The primary aim of this study was to assess the interactive effects of cigarette demand and DD on nicotine dependence (ND) and cigarette consumption among a sample of treatment-seeking smokers. Participants were 277 smokers (68.9% women) who completed the 19-item version of the Cigarette Purchase Task, a computerized version of the DD task and the Fagerström Test for Nicotine Dependence. To assess cigarette consumption, participants were also asked about their mean number of cigarettes smoked per day. Hierarchical multiple regressions were conducted to assess the interactive effects of demand indices and DD on ND and cigarettes smoked per day. The area under the curve for both demand and DD was used to explore the interactive effect of the 2 variables. Results showed that the interaction between cigarette demand and DD was significantly related to ND severity (p < .05) but not to cigarette consumption. This is the first study showing that the synergistic effect of cigarette demand and DD better accounts for ND in treatment-seeking smokers than the 2 isolated constructs. It also supports the utility of area under the curve as a proxy for cigarette demand, providing methodological convergence with other behavioral economic domains, such as DD. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
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Weidberg S, Vallejo-Seco G, González-Roz A, García-Pérez Á, Secades-Villa R. In-treatment cigarette demand among treatment-seeking smokers with depressive symptoms. Addict Behav 2018; 82:35-43. [PMID: 29482033 DOI: 10.1016/j.addbeh.2018.02.022] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2017] [Revised: 02/15/2018] [Accepted: 02/15/2018] [Indexed: 10/18/2022]
Abstract
INTRODUCTION Despite previous evidence supporting the use of the Cigarette Purchase Task (CPT) as a valid tool for assessing smoking reinforcement, research assessing how environmental changes affect CPT performance is scarce. AIMS This study addressed for the first time the differential effect of treatment condition [Cognitive Behavioral Treatment (CBT) + Behavioral Activation (BA) versus CBT + BA + Contingency Management (CM)] on cigarette demand among treatment seeking smokers with depressive symptoms. It also sought to assess whether reductions in smoking consumption arranged over the course of an intervention for smoking cessation impact on in-treatment cigarette demand. METHOD Participants were 92 smokers with depressive symptoms from a randomized clinical trial that received eight weeks of either CBT + BA or CBT + BA + CM. Individuals completed the CPT 8 times; the first during the intake visit and the remaining 7 scheduled once a week in midweek sessions. Cotinine samples were collected in each session. RESULTS Participants receiving CBT + BA + CM showed higher reduction in cigarette demand across sessions than participants receiving CBT + BA, although this comparison was only significant for the intensity index (p = .004). Cotinine was positively related to cigarette demand (all p values < .001), although this association became less prominent across sessions. In-treatment cotinine decreases were associated with demand reductions (all p values < .001), but this association was not significant for elasticity. CONCLUSIONS Reductions in nicotine intake arranged over the course of an intervention for smoking cessation impact in-treatment cigarette demand.
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González-Roz A, Secades-Villa R, Muñiz J. Validity evidence of the Behavioral Activation for Depression Scale-Short Form among depressed smokers. Int J Clin Health Psychol 2018; 18:162-169. [PMID: 30487921 PMCID: PMC6225060 DOI: 10.1016/j.ijchp.2018.03.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2017] [Accepted: 03/12/2018] [Indexed: 10/25/2022] Open
Abstract
A measure of Behavioral Activation (BA) is highly recommended when evaluating BA treatment effects for smokers with depression. Recently, a short version of the Behavioral Activation for Depression scale (BADS-SF) has been developed as a means of assessing changes in activation and avoidance patterns. To date there is no validated version of this questionnaire in Spanish. This study sought to adapt the BADS-SF to a Spanish population of depressed smokers. Method A sample of 169 smokers (72.2% female) with elevated depressive symptomatology completed the BADS-SF. Results A bi-factorial structure was obtained: Activation and Avoidance. Results indicated an acceptable internal consistency for both the Activation (ω = .85) and the Avoidance subscales (ω =.70). Overall, convergent validity was obtained with Activation and Avoidance subscales being related to other depression-related measures such as depressive symptomatology (Activation r = -.29; Avoidance r = .35), environmental reward (Activation r = .40; Avoidance r = -.41) and, nicotine dependence (Avoidance r = .23). This latter variable was the only one not showing a statistically significant association with the Activation factor (r = -.12). Conclusions The Spanish BADS-SF can be considered as a reliable and valid instrument when assessing behavioral activation among clinically depressed smokers.
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Secades-Villa R, Weidberg S, González-Roz A, Reed DD, Fernández-Hermida JR. Cigarette demand among smokers with elevated depressive symptoms: an experimental comparison with low depressive symptoms. Psychopharmacology (Berl) 2018; 235:719-728. [PMID: 29143193 DOI: 10.1007/s00213-017-4788-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2017] [Accepted: 11/08/2017] [Indexed: 11/25/2022]
Abstract
RATIONALE Individuals with depression smoke more than smokers without depression. Research has shown that cigarette demand is a useful tool for quantifying tobacco reinforcement and supposes a clinical predictor of treatment outcomes. Despite previous studies examining the relative reinforcing efficacy of nicotine among different populations of smokers, to date, no study has assessed cigarette demand among individuals with elevated depressive symptoms. OBJECTIVE The aim of this study was to compare cigarette demand among samples of smokers with low and elevated depressive symptoms. Further, it also sought to examine the relationship between depressive symptomatology and the individual CPT demand indices. METHODS Participants (80 non-depressed smokers and 85 depressed smokers) completed the 19-item version of the Cigarette Purchase Task (CPT). Depression symptomatology was assessed using the Beck Depression Inventory-Second Edition (BDI-II). Depressed smokers needed to present at least moderate depressive symptoms as indicated by scoring ≥ 20 on the BDI-II. RESULTS Depressive symptomatology and nicotine dependence were significantly associated with elasticity of demand (R 2 = 0.112; F(2, 155) = 9.756, p = ≤ 0.001). Depressive symptoms, cigarettes per day, and years of regular smoking also predicted breakpoint scores (R 2 = 0.088; F(4, 153) = 3.697, p = 0.007). CONCLUSION As smokers with elevated depressive symptoms are less sensitive to increases in cigarette prices than those with low depressive symptomatology, future studies should consider these cigarette demand indices when designing depression-focused smoking cessation treatments. Providing this difficult-to-treat population with interventions that promote both pleasurable and alternative reinforcing activities is highly encouraged.
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Affiliation(s)
- Roberto Secades-Villa
- Department of Psychology, University of Oviedo, Plaza Feijóo s/n, 33003, Oviedo, Spain.
| | - Sara Weidberg
- Department of Psychology, University of Oviedo, Plaza Feijóo s/n, 33003, Oviedo, Spain
| | - Alba González-Roz
- Department of Psychology, University of Oviedo, Plaza Feijóo s/n, 33003, Oviedo, Spain
| | - Derek D Reed
- Department of Applied Behavioral Science, University of Kansas, 1000 Sunnyside Avenue, Lawrence, KS, 66045, USA
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Weidberg S, Landes RD, López-Núñez C, Pericot-Valverde I, González-Roz A, Yoon JH, Secades-Villa R. Contingency management effects on delay discounting among patients receiving smoking cessation treatment. Psicothema 2017; 27:309-16. [PMID: 26493567 DOI: 10.7334/psicothema2015.184] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND Increasing evidence suggests that delay discounting may change following effective interventions. Nonetheless, previous studies that assessed the effect of contingency management (CM) on delay discounting are scarce, and their results are mixed. The current study assessed whether CM in conjunction with a cognitive-behavioral treatment (CBT) for smoking cessation was associated with changes in delay discounting at end-of-treatment and at 6-month follow-up compared to CBT alone. METHOD One hundred and sixteen treatment-seeking smokers were randomly assigned either to CM + CBT (n = 69) or to CBT alone (n = 47). Participants completed delay discounting assessments at the intake, at end-of-treatment, and at 6-month follow-up. We evaluated CM’s effect on discounting with parametric and nonparametric methods. RESULTS Between-group analyses showed that none of the interventions changed delay discounting from intake to end-of-treatment or to 6-month follow-up. Nonetheless, some within-group analyses showed that the CM + CBT condition evidenced some degree of reduction. CONCLUSIONS The current results suggest that CM intervention is not robustly associated with delay discounting changes. Future studies should address treatments that may potentially change delay discounting.
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Weidberg S, González-Roz A, Secades-Villa R. Delay discounting in e-cigarette users, current and former smokers. Int J Clin Health Psychol 2017; 17:20-27. [PMID: 30487877 PMCID: PMC6236325 DOI: 10.1016/j.ijchp.2016.07.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2016] [Accepted: 07/11/2016] [Indexed: 12/26/2022] Open
Abstract
Background/Objective: Despite the fact that electronic cigarettes, or e-cigarettes, are being increasingly used as an alternative to smoking tobacco cigarettes, few studies have explored psychological factors associated with e-cigarette use. Prior studies aimed at exploring correlates of e-cigarette use have focused on sociodemographic and smoking-related characteristics. However, no previous work has examined psychological features such as impulsivity among e-cigarettes users. The main objective of this study was to compare impulsivity rates across four groups of participants: current e-cigarette users who were former smokers; current smokers; former smokers; and controls. Method: A sample of 136 participants completed a computerized delay discounting task for hypothetical monetary values. Results: Delay discounting was greater among e-cigarette users than former smokers. E-cigarette users also showed an intermediate discounting that did not differ from smokers and controls. Moreover, delay discounting was significantly greater among current smokers compared to former smokers and controls. Conclusions: Taken together, our results extend previous research on delay discounting by providing evidence on impulsivity levels among current e-cigarette users for the first time.
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Secades-Villa R, Vallejo-Seco G, García-Rodríguez O, López-Núñez C, Weidberg S, González-Roz A. Contingency management for cigarette smokers with depressive symptoms. Exp Clin Psychopharmacol 2015; 23:351-60. [PMID: 26280589 DOI: 10.1037/pha0000044] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Despite depressive symptoms being very common among smokers from the general population, few studies have examined the effects of depressive symptoms on smoking treatment outcomes, and even less research has been carried out in the context of contingency management (CM). The authors conducted a secondary analysis to assess the interrelation between treatment condition, depressive symptoms and treatment outcomes among treatment-seeking smokers. The sample was made up of 147 treatment-seeking smokers who were randomly allocated 2 treatment conditions: cognitive behavioral treatment (CBT; n = 74), or CBT + CM (n = 73). CBT was applied in 1-hr group-based sessions over 6 weeks. The CM protocol was voucher-based with maximum earnings of €300 (US$339). Depressive symptoms were assessed using the Beck Depression Inventory-II. Smoking abstinence was verified though cotinine and carbon monoxide. Several analyses were conducted to explore the effect of treatment condition and baseline depressive symptoms on treatment outcomes, as well as the effect of treatment condition and smoking status on depressive symptoms. The CBT + CM condition was more effective than CBT, independent of depressive symptoms. The presence of depressive symptoms decreased the number of days of continuous smoking abstinence. Participants with a greater number of days of continuous smoking abstinence had fewer depressive symptoms than those with fewer days of continuous smoking abstinence. Findings suggest that health care providers should consider encouraging their patients with depressive symptoms to seek smoking cessation services that include both smoking cessation protocols and behavioral activation for mood management, thus maximizing both smoking and depressive outcomes.
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