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Kline AC, Harlé KM, Panza KE, Nichter B, Lyons R, Pitts M, Haller M, Allard CB, Capone C, Norman SB. Changes in guilt cognitions mediate the effect of trauma-informed guilt reduction therapy on PTSD and depression outcomes. J Clin Psychol 2024; 80:1147-1160. [PMID: 38340354 DOI: 10.1002/jclp.23659] [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] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Revised: 01/08/2024] [Accepted: 01/25/2024] [Indexed: 02/12/2024]
Abstract
OBJECTIVE Trauma-informed guilt reduction therapy (TrIGR), a six-session cognitive behavioral therapy targeting trauma-related guilt and distress, reduces guilt and symptoms of posttraumatic stress disorder (PTSD) and depression, yet little is known regarding how and why TrIGR may be effective. METHOD This study examined treatment-related changes in avoidant coping and trauma-related guilt cognitions as possible mediators of treatment effects on PTSD and depression outcomes at 3- and 6-month follow-up. Data were from a randomized controlled trial for treatment of trauma-related guilt comparing TrIGR and supportive care therapy among 145 post-9/11 US veterans (Mage = 39.2 [8.1], 93.8% male). RESULTS At pretreatment, most (86%) met PTSD criteria. Intent to treat analyses using parallel mediation models indicated changes in guilt cognitions, but not avoidant coping, mediated the effect of TrIGR on reducing PTSD severity at 3-month (a × b = -0.15, p < 0.01, 95% CI: [-0.24 to -0.06], p = 0.001) and 6-month (a × b = -0.17, 95% CI: [-0.26 to -0.07], p = 0.001) follow-up. Similarly, changes in guilt cognitions, but not avoidant coping, mediated the effect of TrIGR on reducing depression severity at 3-month (a × b = -0.10, 95% CI: [-0.18 to -0.02], p = 0.02) and 6-month (a × b = -0.11, 95% CI: [-0.20 to -0.03], p = 0.01) follow-up. CONCLUSIONS Compared to guilt cognitions, changes in avoidant coping were less integral to downstream PTSD and depression symptom reduction. Guilt cognition change may be a salient active ingredient of PTSD and depression treatment for those with trauma-related guilt and a key therapy element to which providers should be attuned.
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Affiliation(s)
- Alexander C Kline
- VA San Diego Healthcare System, San Diego, California, USA
- Department of Psychiatry, University of California San Diego, La Jolla, California, USA
| | - Katia M Harlé
- VA San Diego Healthcare System, San Diego, California, USA
- Department of Psychiatry, University of California San Diego, La Jolla, California, USA
| | - Kaitlyn E Panza
- VA San Diego Healthcare System, San Diego, California, USA
- Department of Psychiatry, University of California San Diego, La Jolla, California, USA
| | | | - Robert Lyons
- VA San Diego Healthcare System, San Diego, California, USA
| | - Michelle Pitts
- VA San Diego Healthcare System, San Diego, California, USA
- Department of Psychiatry, University of California San Diego, La Jolla, California, USA
| | - Moira Haller
- VA San Diego Healthcare System, San Diego, California, USA
- Department of Psychiatry, University of California San Diego, La Jolla, California, USA
| | - Carolyn B Allard
- VA San Diego Healthcare System, San Diego, California, USA
- California School of Professional Psychology, Alliant International University, San Diego, California, USA
| | - Christy Capone
- Providence VA Medical Center, Providence, Rhode Island, USA
- Warren Alpert School of Medicine, Brown University, Providence, Rhode Island, USA
| | - Sonya B Norman
- VA San Diego Healthcare System, San Diego, California, USA
- Department of Psychiatry, University of California San Diego, La Jolla, California, USA
- VA Center of Excellence for Stress and Mental Health, San Diego, California, USA
- National Center for Posttraumatic Stress Disorder, White River Junction, Vermont, USA
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2
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Olmos D, Lorente D, Alameda D, Cattrini C, Romero-Laorden N, Lozano R, Lopez-Casas PP, Jambrina A, Capone C, Vanden Broecke AM, Trevisan M, Van Sanden S, Jürgens A, Herrera-Imbroda B, Castro E. Treatment patterns and outcomes in metastatic castration-resistant prostate cancer patients with and without somatic or germline alterations in homologous recombination repair genes. Ann Oncol 2024; 35:458-472. [PMID: 38417742 DOI: 10.1016/j.annonc.2024.01.011] [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: 10/04/2023] [Revised: 01/30/2024] [Accepted: 01/31/2024] [Indexed: 03/01/2024] Open
Abstract
BACKGROUND Although germline BRCA mutations have been associated with adverse outcomes in prostate cancer (PC), understanding of the association between somatic/germline alterations in homologous recombination repair (HRR) genes and treatment outcomes in metastatic castration-resistant PC (mCRPC) is limited. The aim of this study was to investigate the prevalence and outcomes associated with somatic/germline HRR alterations, particularly BRCA1/2, in patients initiating first-line (1L) mCRPC treatment with androgen receptor signalling inhibitors (ARSi) or taxanes. PATIENTS AND METHODS Data from 729 mCRPC patients were pooled for CAPTURE from four multicentre observational studies. Eligibility required 1L treatment with ARSi or taxanes, adequate tumour samples and biomarker panel results. Patients underwent paired normal and tumour DNA analyses by next-generation sequencing using a custom gene panel including ATM, BRCA1, BRCA2, BRIP1, CDK12, CHEK2, FANCA, HDAC2, PALB2, RAD51B and RAD54L. Patients were divided into subgroups based on somatic/germline alteration(s): with BRCA1/2 mutations (BRCA); with HRR mutations except BRCA1/2 (HRR non-BRCA); and without HRR alterations (non-HRR). Patients without BRCA1/2 mutations were classified as non-BRCA. Radiographic progression-free survival (rPFS), progression-free survival 2 (PFS2) and overall survival (OS) were assessed. RESULTS Of 729 patients, 96 (13.2%), 127 (17.4%) and 506 (69.4%) were in the BRCA, HRR non-BRCA and non-HRR subgroups, respectively. BRCA patients performed significantly worse for all outcomes than non-HRR or non-BRCA patients (P < 0.05), while PFS2 and OS were significantly shorter for BRCA than HRR non-BRCA patients (P < 0.05). HRR non-BRCA patients also had significantly worse rPFS, PFS2 and OS than non-HRR patients. Exploratory analyses suggested that for BRCA patients, there were no significant differences in outcomes associated with 1L treatment choice (ARSi or taxanes) or with the somatic/germline origin of the alterations. CONCLUSIONS Worse outcomes were observed for mCRPC patients in the BRCA subgroup compared with non-BRCA subgroups, either HRR non-BRCA or non-HRR. Despite its heterogeneity, the HRR non-BRCA subgroup presented worse outcomes than the non-HRR subgroup. Screening early for HRR mutations, especially BRCA1/2, is crucial in improving mCRPC patient prognosis.
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Affiliation(s)
- D Olmos
- Hospital Universitario 12 de Octubre, Instituto de Investigación Sanitaria Hospital 12 de Octubre, Madrid.
| | - D Lorente
- Instituto Valenciano de Oncología, Valencia; Hospital Provincial de Castellón, Castellón de la Plana
| | - D Alameda
- Instituto de Investigación Biomédica de Málaga, Málaga, Spain
| | - C Cattrini
- Maggiore della Carità University Hospital, Novara, Italy
| | - N Romero-Laorden
- Cátedra UAM-Fundación Instituto Roche de Medicina Personalizada de Precisión, Hospital Universitario de La Princesa, Madrid
| | - R Lozano
- Hospital Universitario de Salamanca, Instituto de Investigación Biomédica de Salamanca (IBSAL), Salamanca, Spain
| | - P P Lopez-Casas
- Hospital Universitario 12 de Octubre, Instituto de Investigación Sanitaria Hospital 12 de Octubre, Madrid
| | - A Jambrina
- Hospital Universitario 12 de Octubre, Instituto de Investigación Sanitaria Hospital 12 de Octubre, Madrid
| | - C Capone
- Janssen Inc., Issy-les-Moulineaux, France
| | | | - M Trevisan
- Janssen Pharmaceuticals, Zug, Switzerland
| | | | | | - B Herrera-Imbroda
- Instituto de Investigación Biomédica de Málaga, Málaga, Spain; Hospital Universitario Virgen de la Victoria, Málaga, Spain
| | - E Castro
- Hospital Universitario 12 de Octubre, Instituto de Investigación Sanitaria Hospital 12 de Octubre, Madrid; Instituto de Investigación Biomédica de Málaga, Málaga, Spain.
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Soliman PS, Curley DE, Capone C, Eaton E, Haass-Koffler CL. In the new era of psychedelic assisted therapy: A systematic review of study methodology in randomized controlled trials. Psychopharmacology (Berl) 2024:10.1007/s00213-024-06598-6. [PMID: 38683460 DOI: 10.1007/s00213-024-06598-6] [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] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2024] [Accepted: 04/22/2024] [Indexed: 05/01/2024]
Abstract
Recent years have seen a resurgence in randomized, placebo controlled trials (RCTs) utilizing non-classical psychedelics (e.g. 3,4-methyl enedioxy methamphetamine [MDMA]), and classical psychedelics (e.g. psilocybin, lysergic acid diethylamide [LSD], and N,N-dimethyltryptamine [DMT/ayahuasca]) in conjunction with assisted therapy (AT) for psychiatric disorders. A notable methodological challenge in psychedelic AT, however, is the complexity of blinding procedures. The lack of efficacious blinding can introduce considerable response bias, reduce internal validity, and compromise participant retention. This systematic review examines design and blinding techniques in RCTs utilizing psychedelics and placebo for the treatment of psychiatric disorders. The aim of this work is to identify factors that may inform future RTC design for conducting psychedelics research. We conducted a systematic review of PubMed, MEDLINE, CINAHL, Cochrane Central Register of Controlled Trials (CENTRAL), Psycinfo, Embase, and Web of Science Core Collection to examine: (1) placebo selection, (2) study design, and (3) integrity of blinding measures. Sixteen publications were identified as meeting the criteria for a systematic review. Our findings suggest that traditional placebo administration is insufficient to control for expectancy confounds. Consequently, experimental methodology that limits personnel unblinding and the use of an active placebo are important considerations when designing prospective clinical studies involving psychedelics.
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Affiliation(s)
- Paul S Soliman
- Center for Alcohol and Addiction Studies, Brown University, Providence, RI, USA
- Department of Neuroscience, Brown University, Providence, RI, USA
| | - Dallece E Curley
- Center for Alcohol and Addiction Studies, Brown University, Providence, RI, USA
- Department of Neuroscience, Neuroscience Graduate Program, Brown University, Providence, RI, USA
| | - Christy Capone
- Center for Alcohol and Addiction Studies, Brown University, Providence, RI, USA
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School, Brown University, Providence, RI, USA
- Providence Veteran Administration Medical Center, Providence, RI, USA
| | - Erica Eaton
- Center for Alcohol and Addiction Studies, Brown University, Providence, RI, USA
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School, Brown University, Providence, RI, USA
- Providence Veteran Administration Medical Center, Providence, RI, USA
| | - Carolina L Haass-Koffler
- Center for Alcohol and Addiction Studies, Brown University, Providence, RI, USA.
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School, Brown University, Providence, RI, USA.
- Department of Behavioral and Social Sciences, School of Public Health, Brown University, Providence, RI, USA.
- Carney Institute for Brain Science, Brown University, Providence, RI, USA.
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Gully BJ, Eaton E, Capone C, Haass-Koffler CL. Treating posttraumatic stress disorder and alcohol use disorder comorbidity: Current pharmacological therapies and the future of MDMA-integrated psychotherapy. J Psychopharmacol 2023; 37:1182-1189. [PMID: 38009477 DOI: 10.1177/02698811231200880] [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] [Indexed: 11/29/2023]
Abstract
Posttraumatic stress disorder (PTSD) and alcohol use disorder (AUD) frequently co-occur in patients who have experienced trauma. This comorbidity leads to a vicious cycle where PTSD symptoms beget heavy drinking and vice versa. There are no FDA-approved medications to treat PTSD-AUD; therefore, individuals suffering from this comorbidity are treated with medication approved to treat the disorders separately or with off-label pharmacological interventions. However, these medications are limited in their efficacy for treating PTSD-AUD comorbidity. Emerging research on the nonclassical psychedelic drug 3,4-methylenedioxymethamphetamine (MDMA) suggests that it may be an effective drug used in conjunction with psychotherapy. The following reviews the current research for clinical pharmacotherapies, as well as MDMA-integrative psychotherapy as they pertain to PTSD and AUD in isolation and co-occurrence. Future directions for the role of psychedelic-integrative therapy for the treatment of this comorbidity are discussed.
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Affiliation(s)
- Brian J Gully
- Center for Alcohol and Addiction Studies, Brown University, Providence, RI, USA
- Department of Behavioral and Social Sciences, School of Public Health, Brown University, Providence, RI, USA
| | - Erica Eaton
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School, Brown University, Providence, RI, USA
- Providence Veterans Affairs Medical Center, Providence, RI, USA
| | - Christy Capone
- Center for Alcohol and Addiction Studies, Brown University, Providence, RI, USA
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School, Brown University, Providence, RI, USA
- Providence Veterans Affairs Medical Center, Providence, RI, USA
| | - Carolina L Haass-Koffler
- Center for Alcohol and Addiction Studies, Brown University, Providence, RI, USA
- Department of Behavioral and Social Sciences, School of Public Health, Brown University, Providence, RI, USA
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School, Brown University, Providence, RI, USA
- Carney Institute for Brain Science, Brown University, Providence, RI, USA
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Morse JL, Wooldridge JS, Afari N, Angkaw AC, Schnurr PP, Lang AJ, Capone C, Norman SB. Associations among meaning in life, coping, and distress in trauma-exposed U.S. military veterans. Psychol Serv 2023:2023-49912-001. [PMID: 36848054 PMCID: PMC10460455 DOI: 10.1037/ser0000755] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/01/2023]
Abstract
Experiencing meaning in life may be particularly relevant following traumatic experiences as individuals who report meaning post trauma report less psychological distress. Engaging in avoidant coping, however, may be a sign of underlying psychological distress in the aftermath of traumatic experiences. We sought to examine associations among meaning in life, avoidant coping, and psychological distress in a sample of trauma-exposed veterans. Secondary cross-sectional analyses were conducted on data from veterans exposed to a traumatic event(s) who experienced clinically meaningful guilt (N = 145). Questionnaires on meaning in life, avoidant coping, and psychological distress were administered, and structural equation modeling was used to test direct effects. Path analysis revealed that greater meaning was associated with lower depression, anxiety, and posttraumatic stress symptomatology, while higher avoidant coping was associated with greater depression, anxiety, posttraumatic stress, and somatization symptomatology. Participants who report more meaning in life and report lower avoidant coping post trauma may experience less psychological distress. If replicated longitudinally, results could suggest cultivating meaning in life and reducing avoidant coping may decrease psychological distress. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
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6
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Norman SB, Capone C, Panza KE, Haller M, Davis BC, Schnurr PP, Shea MT, Browne K, Norman GJ, Lang AJ, Kline AC, Golshan S, Allard CB, Angkaw A. A clinical trial comparing trauma-informed guilt reduction therapy (TrIGR), a brief intervention for trauma-related guilt, to supportive care therapy. Depress Anxiety 2022; 39:262-273. [PMID: 35075738 DOI: 10.1002/da.23244] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [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: 09/01/2021] [Revised: 01/06/2022] [Accepted: 01/14/2022] [Indexed: 12/15/2022] Open
Abstract
INTRODUCTION Trauma-related guilt is common, associated with posttraumatic mental health problems, and can persist after posttraumatic stress disorder (PTSD) treatment. We compared the efficacy of two six-session psychotherapies, Trauma-Informed Guilt Reduction (TrIGR) and Supportive Care Therapy (SCT), for reducing trauma-related guilt. TrIGR helps patients accurately appraise their role in the trauma and re-engage in values. In SCT, patients guide session content. METHODS A total of 184 veterans seeking VA mental health services were enrolled across two sites; 145 veterans (mean age: 39.2 [8.1]; 92.4% male; 84.8% with PTSD) who endorsed guilt related to a traumatic event that occurred during a post 9/11 Iraq or Afghanistan deployment were randomized and assessed at baseline, posttreatment, 3- and 6-month follow-up. RESULTS Linear mixed models using intent-to-treat analyses showed guilt decreased in both conditions with a greater decrease for TrIGR (treatment × time, -0.22; F 1, 455.2 = 18.49, p = .001; d = 0.92) than supportive therapy. PTSD and depressive symptoms showed the same pattern. TrIGR had significantly higher likelihood of PTSD treatment response (67% vs. 40%), loss of PTSD diagnosis (50% vs. 14%), and meaningful change in depression (54% vs. 27%) than supportive therapy. Psychological distress and trait shame improved in both conditions. Quality of life did not change. CONCLUSIONS Targeting guilt appears to be an effective means for reducing posttraumatic symptoms and distress.
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Affiliation(s)
- Sonya B Norman
- Executive Division, National Center for PTSD, Hartford, Vermont, USA.,Department of Mental Health, VA San Diego Healthcare System, San Diego, California, USA.,Clinical Research Division, VA Center of Excellence for Stress and Mental Health, San Diego, California, USA.,Department of Psychiatry, University of California, San Diego, La Jolla, California, USA
| | - Christy Capone
- Department of Mental Health, Providence VA Medical Center, Providence, Rhode Island, USA.,Department of Psychiatry and Human Behavior, Center for Alcohol and Addiction Studies, Warren Alpert School of Medicine, Brown University, Providence, Rhode Island, USA
| | - Kaitlyn E Panza
- Department of Mental Health, VA San Diego Healthcare System, San Diego, California, USA.,Department of Psychiatry, University of California, San Diego, La Jolla, California, USA
| | - Moira Haller
- Department of Mental Health, VA San Diego Healthcare System, San Diego, California, USA.,Department of Psychiatry, University of California, San Diego, La Jolla, California, USA
| | - Brittany C Davis
- Department of Mental Health, James A. Haley Veterans Hospital, Tampa, Florida, USA.,Department of Psychiatry and Behavioral Neurosciences, University of South Florida, Tampa, Florida, USA
| | - Paula P Schnurr
- Executive Division, National Center for PTSD, Hartford, Vermont, USA.,Department of Psychiatry, Geisel School of Medicine at Dartmouth, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire, USA
| | - M Tracie Shea
- Department of Mental Health, Providence VA Medical Center, Providence, Rhode Island, USA.,Department of Psychiatry and Human Behavior, Center for Alcohol and Addiction Studies, Warren Alpert School of Medicine, Brown University, Providence, Rhode Island, USA
| | - Kendall Browne
- Department of Research, Center of Excellence in Substance Addiction Treatment and Education, Corporal Michael J. Crescenz VA Medical Center, Philadelphia, Pennsylvania, USA.,Center of Excellence in Substance Addiction Treatment and Education, VA Puget Sound Health Care System, Seattle, Washington, USA.,Department of Psychiatry & Behavioral Sciences, University of Washington, Seattle, Washington, USA
| | - Gregory J Norman
- Department of Psychiatry, University of California, San Diego, La Jolla, California, USA
| | - Ariel J Lang
- Department of Mental Health, VA San Diego Healthcare System, San Diego, California, USA.,Clinical Research Division, VA Center of Excellence for Stress and Mental Health, San Diego, California, USA.,Department of Psychiatry, University of California, San Diego, La Jolla, California, USA
| | - Alexander C Kline
- Department of Mental Health, VA San Diego Healthcare System, San Diego, California, USA.,Department of Psychiatry, University of California, San Diego, La Jolla, California, USA
| | - Shahrokh Golshan
- Department of Mental Health, VA San Diego Healthcare System, San Diego, California, USA.,Department of Psychiatry, University of California, San Diego, La Jolla, California, USA
| | - Carolyn B Allard
- Department of Mental Health, VA San Diego Healthcare System, San Diego, California, USA.,Department of Clinical Psychology, California School of Professional Psychology at Alliant International University, San Diego, California, USA
| | - Abigail Angkaw
- Department of Mental Health, VA San Diego Healthcare System, San Diego, California, USA.,Department of Psychiatry, University of California, San Diego, La Jolla, California, USA
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McLean CP, Back SE, Capone C, Morland L, Norman SB, Rauch SAM, Schnurr PP, Teng E, Acierno R. The Impact of COVID-19 on Psychotherapy Participation Among Individuals With Posttraumatic Stress Disorder Enrolled in Treatment Research. J Trauma Stress 2022; 35:308-313. [PMID: 34291832 PMCID: PMC8426668 DOI: 10.1002/jts.22718] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Revised: 06/14/2021] [Accepted: 06/15/2021] [Indexed: 12/25/2022]
Abstract
The onset of the COVID-19 pandemic disrupted many aspects of daily life and required a rapid and unprecedented shift in psychotherapy delivery from in-person to telemental health. In the present study, we explored the impact of the pandemic on individuals' ability to participate in posttraumatic stress disorder (PTSD) psychotherapy and the association between the impact of COVID-19 impact on health and financial well-being and psychotherapy participation. Participants (N = 161, 63.2% male, Mage = 42.7 years) were United States military veterans (n = 108), active duty military personnel (n = 12), and civilians (n = 6), who were participating in one of nine PTSD treatment trials. The results indicate a predominately negative COVID-19 impact on therapy participation, although some participants (26.1%) found attending therapy sessions through telehealth to be easier than in-person therapy. Most participants (66.7%) reported that completing in vivo exposure homework became harder during the pandemic. Moreover, the impact of the pandemic on PTSD symptom severity and daily stress were each associated with increased difficulty with aspects of therapy participation. The findings highlight the unique challenges to engaging in PTSD treatment during the pandemic as well as a negative impact on daily stress and PTSD severity, both of which were related to treatment engagement difficulties.
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Affiliation(s)
- Carmen P. McLean
- Dissemination and Training Division, National Center for PTSDVA Palo Alto Health Care SystemMenlo ParkCaliforniaUSA,Department of Psychiatry and Behavioral Sciences, School of MedicineStanford UniversityStanfordCaliforniaUSA
| | - Sudie E. Back
- Department of Psychiatry and Behavioral SciencesMedical University of South CarolinaCharlestonSouth CarolinaUSA,Ralph H. Johnson Veterans Affairs Medical CenterCharlestonSouth Carolina
| | - Christy Capone
- Providence VA Medical CenterProvidenceRhode IslandUSA,Department of Psychiatry and Human BehaviorCenter for Alcohol and Addiction StudiesBrown UniversityProvidenceRhode IslandUSA
| | - Leslie Morland
- VA San Diego Healthcare SystemSan DiegoCaliforniaUSA,National Center for PTSD Pacific Islands DivisionHonoluluHawaiiUSA,Department of PsychiatryUniversity of California San Diego School of MedicineSan DiegoCaliforniaUSA
| | - Sonya B. Norman
- VA San Diego Healthcare SystemSan DiegoCaliforniaUSA,Department of PsychiatryUniversity of California San Diego School of MedicineSan DiegoCaliforniaUSA,Executive DivisionNational Center for PTSDWhite River JunctionVermontUSA
| | - Sheila A. M. Rauch
- Health Service LineAtlanta VA Medical CenterAtlantaGeorgiaUSA,Department of Psychiatry and Behavioral SciencesEmory University School of MedicineAtlantaGeorgiaUSA
| | - Paula P. Schnurr
- Executive DivisionNational Center for PTSDWhite River JunctionVermontUSA,Geisel School of Medicine at DartmouthHanoverNew HampshireUSA
| | - Ellen Teng
- Department of Psychiatry and Behavioral SciencesBaylor College of MedicineHoustonTexasUSA,Michael E. DeBakey VA Medical CenterHoustonTexasUSA
| | - Ron Acierno
- Louis Faillace Department of PsychiatryMcGovern Medical School at UTHealth HoustonHoustonTexas
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Cameron AY, Eaton E, Brake CA, Capone C. Moral injury as a unique predictor of suicidal ideation in a veteran sample with a substance use disorder. Psychol Trauma 2021; 13:856-860. [PMID: 33370139 DOI: 10.1037/tra0000988] [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] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVE Suicide among military veterans accounts for 22.2% of all suicide deaths in the United States per year, and veterans with a substance use disorder (SUD) are at an even higher risk for death by suicide. This prevalence has led to increased efforts to identify and investigate both potential risks and protective factors for veterans. This study examines relationships between depression symptomology, exposure to potentially morally injurious events, posttraumatic stress disorder (PTSD) diagnosis, and suicidal ideation, with the primary aim of examining exposure to moral injurious events as a risk factor for suicide in veterans with SUD. METHOD An inpatient sample of 40 veterans with an active SUD admitted for suicidal ideation was evaluated to examine differences in suicidal ideation, depression symptomology, and exposure to morally injurious events in participants with and without a PTSD diagnosis. Further, exposure to morally injurious events and depression symptomology were examined as predictors of suicidal ideation. RESULTS Analyses revealed that exposure to morally injurious events (d = 1.72) and depression symptomology (d = 0.72) were higher in participants with a PTSD diagnosis compared to those without a diagnosis, though no significant differences emerged between the two groups on suicidality. A hierarchical regression analysis indicated that only exposure to morally injurious events significantly accounted for variance in suicidality (β = .31, p = .04, 95% confidence interval [.01, .37]). CONCLUSIONS These results suggest that although PTSD may be associated with exposure to morally injurious events and depression symptoms, exposure to morally injurious events may potentially lead to higher suicide risk among veterans above and beyond PTSD and depressive symptoms. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
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Capone C, Norman SB, Haller M, Davis B, Shea MT, Browne K, Lang AJ, Schnurr PP, Golshan S, Afari N, Pittman J, Allard CB, Westendorf L. Trauma Informed Guilt Reduction (TrIGR) therapy for guilt, shame, and moral injury resulting from trauma: Rationale, design, and methodology of a two-site randomized controlled trial. Contemp Clin Trials 2020; 101:106251. [PMID: 33326878 DOI: 10.1016/j.cct.2020.106251] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [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: 08/28/2020] [Revised: 11/19/2020] [Accepted: 12/11/2020] [Indexed: 01/05/2023]
Abstract
Guilt, shame, and moral injury (MI) are common reactions following exposure to traumatic events and are associated with greater severity of several mental health problems, including posttraumatic stress disorder (PTSD), depression, increased risk of suicidal ideation and poorer psychosocial functioning. Trauma-Informed Guilt Reduction (TrIGR) is a transdiagnostic psychotherapy to address guilt, shame, and MI stemming from traumatic events. The primary goals of TrIGR are to help patients accurately appraise their trauma and to re-engage with their values in order to lead a more meaningful life. This paper presents the rationale, design, and methodology of a two-site randomized controlled trial (RCT) examining the efficacy of TrIGR compared to Supportive Care Therapy (SCT) in a sample of U.S. veterans (N = 145) who endorse guilt related to a traumatic event that occurred during military deployment. This study is the first RCT powered to investigate TrIGR's efficacy on reducing posttraumatic guilt, as measured by the Trauma Related Guilt Inventory (TRGI), in comparison to an active control condition. In addition, the study will examine a range of secondary and exploratory outcomes including shame, quality of life, suicidal ideation, substance use, and PTSD and depression symptoms. Findings from this efficacy study will be essential in informing future efficacy and effectiveness trials.
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Affiliation(s)
- Christy Capone
- Providence VA Medical Center, 830 Chalkstone Ave, Providence, RI 02908, USA; Department of Psychiatry and Human Behavior, Center for Alcohol and Addiction Studies, Warren Alpert School of Medicine, Brown University, Providence, RI, USA.
| | - Sonya B Norman
- National Center for PTSD, Executive Division, VA Medical Center, 215 North Main Street, White River Junction, VT 05009, USA; VA Center of Excellence for Stress and Mental Health; Veterans Affairs San Diego Healthcare System, Research Service (MC116B), 3350 La Jolla Village Dr, San Diego, CA 92161, USA; University of California, San Diego, Department of Psychiatry, 9500 Gilman Drive, San Diego, CA 92093, USA
| | - Moira Haller
- Veterans Affairs San Diego Healthcare System, Research Service (MC116B), 3350 La Jolla Village Dr, San Diego, CA 92161, USA; University of California, San Diego, School of Medicine, Department of Psychiatry, 9500 Gilman Drive, San Diego, CA 92093, USA
| | - Brittany Davis
- James A. Haley Veterans Hospital, 13000 Bruce B. Downs Blvd., Tampa, FL 33612, USA; Department of Psychiatry and Behavioral Neurosciences, University of South Florida, 3515 E. Fletcher Ave, Tampa, FL 33613, USA
| | - M Tracie Shea
- Providence VA Medical Center, 830 Chalkstone Ave, Providence, RI 02908, USA; Department of Psychiatry and Human Behavior, Warren Alpert School of Medicine, Brown University, Providence, RI, USA
| | - Kendall Browne
- Center of Excellence in Substance Addiction Treatment and Education, Corporal Michael J. Crescenz VA Medical Center; 21 S. University Ave, Philadelphia, PA 19104, USA; Center of Excellence in Substance Addiction Treatment and Education, VA Puget Sound Health Care System, 1660 S. Columbian Way, MC: S-116-ATC, Seattle, WA 98136, USA; Department of Psychiatry & Behavioral Sciences, University of Washington, 1959 NE Pacific St, Seattle, WA 98195, USA
| | - Ariel J Lang
- Veterans Affairs San Diego Healthcare System, Research Service (MC116B), 3350 La Jolla Village Dr, San Diego, CA 92161, USA; University of California, San Diego, School of Medicine, Department of Psychiatry, 9500 Gilman Drive, San Diego, CA 92093, USA
| | - Paula P Schnurr
- National Center for PTSD, Executive Division, VA Medical Center, 215 North Main Street, White River Junction, VT 05009, USA; Department of Psychiatry, Geisel School of Medicine at Dartmouth, Dartmouth-Hitchcock Medical Center, One Medical Center Drive, Lebanon, NH 03756, USA
| | - Shahrokh Golshan
- Veterans Affairs San Diego Healthcare System, Research Service (MC116B), 3350 La Jolla Village Dr, San Diego, CA 92161, USA; University of California, San Diego, School of Medicine, Department of Psychiatry, 9500 Gilman Drive, San Diego, CA 92093, USA
| | - Niloofar Afari
- VA Center of Excellence for Stress and Mental Health; Veterans Affairs San Diego Healthcare System, Research Service (MC116B), 3350 La Jolla Village Dr, San Diego, CA 92161, USA; University of California, San Diego, Department of Psychiatry, 9500 Gilman Drive, San Diego, CA 92093, USA
| | - James Pittman
- VA Center of Excellence for Stress and Mental Health; Veterans Affairs San Diego Healthcare System, Research Service (MC116B), 3350 La Jolla Village Dr, San Diego, CA 92161, USA; University of California, San Diego, Department of Psychiatry, 9500 Gilman Drive, San Diego, CA 92093, USA
| | - Carolyn B Allard
- Veterans Affairs San Diego Healthcare System, Research Service (MC116B), 3350 La Jolla Village Dr, San Diego, CA 92161, USA; California School of Professional Psychology at Alliant International University, 10455 Pomerado Rd, San Diego, CA 92131, USA
| | - Laura Westendorf
- Veterans Affairs San Diego Healthcare System, Research Service (MC116B), 3350 La Jolla Village Dr, San Diego, CA 92161, USA
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Eaton E, Capone C, Shea MT, Cameron A. Evaluation of Self-Compassion Focused Group Treatment for Co-Occurring PTSD and Substance Use in Veterans with Posttraumatic Guilt: A Case Study. Int J Group Psychother 2020; 70:481-508. [PMID: 38449164 DOI: 10.1080/00207284.2020.1805617] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Co-occurring posttraumatic stress disorder (PTSD) and substance use disorders (SUD) following combat exposure affects a significant proportion of military veterans. Guilt and shame are common to PTSD-SUD, suggesting a possible role as a mechanism underlying both disorders. Cultivating self-compassion (SC) among veterans is a logical approach to treating guilt and shame. The purpose of this article is threefold: (a) present scientific theories of SC in the veteran population with emphasis on PTSD, substance use, and guilt and shame; (b) present a case study that highlights how self-compassion-focused treatment (SCFT) can be utilized in a group format with veterans with PTSD-SUD and posttraumatic guilt; and (c) discuss implications of our findings for refining SCFT within a group intervention setting among this population and for future research.
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Capone C, Tripp JC, Trim RS, Davis BC, Haller M, Norman SB. Comparing Exposure- and Coping Skills-Based Treatments on Trauma-Related Guilt in Veterans With Co-Occurring Alcohol Use and Posttraumatic Stress Disorders. J Trauma Stress 2020; 33:603-609. [PMID: 32521096 DOI: 10.1002/jts.22538] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [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] [Received: 05/31/2019] [Revised: 12/30/2019] [Accepted: 01/17/2020] [Indexed: 11/07/2022]
Abstract
Posttraumatic stress disorder (PTSD) and substance use disorders (SUD) commonly co-occur, and this comorbidity (PTSD-SUD) is associated with more severe symptoms and functional impairment than either disorder alone. Growing evidence indicates that trauma-related guilt, typically concerning negative appraisals of one's actions or inaction during a traumatic event, is associated with PTSD, depression, suicidality, and, possibly, substance use. The present study examined whether integrated treatment for PTSD-SUD was effective in reducing trauma-related guilt as measured by the Trauma-Related Guilt Inventory. Data were drawn from a randomized clinical trial comparing the effectiveness of two integrated therapies on treatment outcomes in a sample of U.S. veterans (N = 119) with comorbid PTSD and SUD. Participants were randomized to receive either Concurrent Treatment of PTSD and Substance Use Disorders Using Prolonged Exposure (COPE; n = 63) or Seeking Safety (SS; n = 56). The results indicated that global guilt decreased over time for the whole sample. However, there was a significant Treatment × Time interaction, such that participants in the COPE condition reported lower rates of global guilt, d = 0.940, over time compared to those in the SS condition, d = .498. To our knowledge, this was the first study to examine the effects of integrated PTSD-SUD treatment on trauma-related guilt. The findings highlight that exposure-based, trauma-focused treatment for comorbid PTSD-SUD can be more effective in decreasing trauma-related guilt, with potentially longer-lasting effects, than non-exposure-based treatment, adding evidence that patients with PTSD-SUD should be offered such treatment.
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Affiliation(s)
- Christy Capone
- Providence VA Medical Center, Providence, Rhode Island, USA.,Department of Psychiatry and Human Behavior, Center for Alcohol and Addiction Studies Warren Alpert School of Medicine, Brown University, Providence, Rhode Island, USA
| | - Jessica C Tripp
- VA San Diego Healthcare System, San Diego, California, USA.,School of Medicine, University of California, San Diego, La Jolla, California, USA
| | - Ryan S Trim
- VA San Diego Healthcare System, San Diego, California, USA.,School of Medicine, University of California, San Diego, La Jolla, California, USA
| | - Brittany C Davis
- James A Haley Veterans Hospital, Tampa, Florida, USA.,Department of Psychiatry and Behavioral Neurosciences, University of South Florida, Tampa, Florida, USA
| | - Moira Haller
- VA San Diego Healthcare System, San Diego, California, USA.,School of Medicine, University of California, San Diego, La Jolla, California, USA
| | - Sonya B Norman
- VA San Diego Healthcare System, San Diego, California, USA.,School of Medicine, University of California, San Diego, La Jolla, California, USA.,National Center for PTSD, White River Junction, Vermont, USA.,Center of Excellence for Stress and Mental Health, San Diego, California, USA
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Haller M, Norman SB, Davis BC, Capone C, Browne K, Allard CB. A model for treating COVID-19–related guilt, shame, and moral injury. ACTA ACUST UNITED AC 2020; 12:S174-S176. [DOI: 10.1037/tra0000742] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [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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13
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Thurin N, Rouyer M, Jové J, Gross-Goupil M, Haaser T, Rebillard X, Soulié M, De Pouvourville G, Capone C, Pierres M, Lamarque S, Bignon E, Droz-Perroteau C, Moore N, Blin P. Changes in therapeutic strategy in metastatic castration resistant prostate cancer (mCRPC) between 2012 and 2014 from the French nationwide claims database (SNDS). EUR UROL SUPPL 2020. [DOI: 10.1016/s2666-1683(20)33183-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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14
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Carlu M, Chehab O, Dalla Porta L, Depannemaecker D, Héricé C, Jedynak M, Köksal Ersöz E, Muratore P, Souihel S, Capone C, Zerlaut Y, Destexhe A, di Volo M. A mean-field approach to the dynamics of networks of complex neurons, from nonlinear Integrate-and-Fire to Hodgkin-Huxley models. J Neurophysiol 2020; 123:1042-1051. [PMID: 31851573 PMCID: PMC7099478 DOI: 10.1152/jn.00399.2019] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2019] [Revised: 12/05/2019] [Accepted: 12/09/2019] [Indexed: 11/22/2022] Open
Abstract
We present a mean-field formalism able to predict the collective dynamics of large networks of conductance-based interacting spiking neurons. We apply this formalism to several neuronal models, from the simplest Adaptive Exponential Integrate-and-Fire model to the more complex Hodgkin-Huxley and Morris-Lecar models. We show that the resulting mean-field models are capable of predicting the correct spontaneous activity of both excitatory and inhibitory neurons in asynchronous irregular regimes, typical of cortical dynamics. Moreover, it is possible to quantitatively predict the population response to external stimuli in the form of external spike trains. This mean-field formalism therefore provides a paradigm to bridge the scale between population dynamics and the microscopic complexity of the individual cells physiology.NEW & NOTEWORTHY Population models are a powerful mathematical tool to study the dynamics of neuronal networks and to simulate the brain at macroscopic scales. We present a mean-field model capable of quantitatively predicting the temporal dynamics of a network of complex spiking neuronal models, from Integrate-and-Fire to Hodgkin-Huxley, thus linking population models to neurons electrophysiology. This opens a perspective on generating biologically realistic mean-field models from electrophysiological recordings.
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Affiliation(s)
- M. Carlu
- Department of Integrative and Computational Neuroscience, Paris-Saclay Institute of Neuroscience, Centre National de la Recherche Scientifique, Gif sur Yvette, France
| | - O. Chehab
- Ecole Normale Superieure Paris-Saclay, France
| | - L. Dalla Porta
- Institut d’Investigacions Biomèdiques August Pi i Sunyer, Barcelona, Spain
| | - D. Depannemaecker
- Department of Integrative and Computational Neuroscience, Paris-Saclay Institute of Neuroscience, Centre National de la Recherche Scientifique, Gif sur Yvette, France
| | - C. Héricé
- Strathclyde Institute of Pharmacy and Biomedical Sciences, Glasgow, Scotland, United Kingdom
| | - M. Jedynak
- Université Grenoble Alpes, Grenoble Institut des Neurosciences and Institut National de la Santé et de la Recherche Médicale (INSERM), U1216, France
| | - E. Köksal Ersöz
- INSERM, U1099, Rennes, France
- MathNeuro Team, Inria Sophia Antipolis Méditerranée, Sophia Antipolis, France
| | - P. Muratore
- Physics Department, Sapienza University, Rome, Italy
| | - S. Souihel
- Université Côte d’Azur, Inria Sophia Antipolis Méditerranée, France
| | - C. Capone
- Department of Integrative and Computational Neuroscience, Paris-Saclay Institute of Neuroscience, Centre National de la Recherche Scientifique, Gif sur Yvette, France
| | - Y. Zerlaut
- Department of Integrative and Computational Neuroscience, Paris-Saclay Institute of Neuroscience, Centre National de la Recherche Scientifique, Gif sur Yvette, France
| | - A. Destexhe
- Department of Integrative and Computational Neuroscience, Paris-Saclay Institute of Neuroscience, Centre National de la Recherche Scientifique, Gif sur Yvette, France
| | - M. di Volo
- Department of Integrative and Computational Neuroscience, Paris-Saclay Institute of Neuroscience, Centre National de la Recherche Scientifique, Gif sur Yvette, France
- Laboratoire de Physique Théorique et Modelisation, Université de Cergy-Pontoise, Cergy-Pontoise, France
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15
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Thurin N, Rouyer M, Gross-Goupil M, Soulié M, Roumiguié M, Le Moulec S, Capone C, Chevalier J, Lamarque S, Bignon E, Jové J, Droz-Perroteau C, Moore N, Blin P. Validation d’un algorithme complexe dans le Système national des données de santé. Exemple avec le cancer de la prostate résistant à la castration et métastatique. Rev Epidemiol Sante Publique 2019. [DOI: 10.1016/j.respe.2019.04.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
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16
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Thurin N, Blin P, Rouyer M, Jové J, Gross–Goupil M, Haaser T, Rébillard X, Soulié M, Capone C, Droz–Perroteau C, Moore N. Identification des cas de cancer de la prostate résistants à la castration et métastatiques dans la base du Système national des données de santé (SNDS) : étude CAMERRA. Rev Epidemiol Sante Publique 2018. [DOI: 10.1016/j.respe.2018.04.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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17
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Eaton EM, Magill M, Capone C, Cramer MA, Mastroleo NR, Reavy R, Borsari B. Mechanisms of Behavior Change Within Peer-Implemented Alcohol Interventions. J Stud Alcohol Drugs 2018; 79:208-216. [PMID: 29553347 PMCID: PMC9798476] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
OBJECTIVE Colleges continue to experience a high number of referred students because of campus alcohol violations. Subsequently, there has been a trend to use peer-implemented minimal interventions (PMIs), often using motivational interviewing (MI). However, little is known about how PMIs facilitate behavior change. This study aims to examine the mechanisms of behavior change within PMIs and their influence on alcohol reduction among mandated students. METHOD Participants (N = 146; mean age = 18.7 years; 67% male; 94% White) were college students who violated campus alcohol policy at a Northeastern liberal arts college who received a 15-minute PMI addressing their alcohol use. The Motivational Interviewing Skill Code (Miller et al., 2003) was used to identify peer counselor behaviors that were MI consistent (MICO), client change talk (CT), and client self-exploration. RESULTS MICO behaviors were positively associated with CT and self-exploration. Client CT and self-exploration were negatively associated with alcohol-related outcomes. Furthermore, mediational models examining MICO behaviors revealed effects for two paths: (a) from MICO to client CT to reduced alcohol use; and (b) from MICO to client self-exploration to reduced alcohol-related consequences and use. CONCLUSIONS These data support the primary causal chain examining the influence of MICO on in-session client behaviors and related post-session behavior change in PMIs among at-risk students.
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Affiliation(s)
- Erica M. Eaton
- Fielding Graduate University, Santa Barbara, California,Center for Alcohol and Addiction Studies, Brown University, Providence, Rhode Island,Mental Health and Behavioral Sciences Service, Department of Veterans Affairs Medical Center, Providence, Rhode Island,Correspondence may be sent to Erica M. Eaton at the Mental Health and Behavioral Sciences Service, Department of Veterans Affairs Medical Center, 830 Chalkstone Avenue, Providence, RI 02908, or via email at: Erica.
| | - Molly Magill
- Center for Alcohol and Addiction Studies, Brown University, Providence, Rhode Island
| | - Christy Capone
- Center for Alcohol and Addiction Studies, Brown University, Providence, Rhode Island,Mental Health and Behavioral Sciences Service, Department of Veterans Affairs Medical Center, Providence, Rhode Island
| | | | - Nadine R. Mastroleo
- Center for Alcohol and Addiction Studies, Brown University, Providence, Rhode Island,Community and Public Affairs, Binghamton University, Binghamton, NewYork
| | - Racheal Reavy
- Edna Bennett Pierce Prevention Research Center, The Pennsylvania State University, University Park, Pennsylvania
| | - Brian Borsari
- Center for Alcohol and Addiction Studies, Brown University, Providence, Rhode Island,San Francisco Veterans Affairs Medical Center, San Francisco, California,Department of Psychiatry, University of California–San Francisco, San Francisco, California
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18
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Eaton EM, Magill M, Capone C, Cramer MA, Mastroleo NR, Reavy R, Borsari B. Mechanisms of Behavior Change Within Peer-Implemented Alcohol Interventions. J Stud Alcohol Drugs 2018; 79:208-216. [PMID: 29553347 PMCID: PMC9798476 DOI: 10.15288/jsad.2018.79.208] [Citation(s) in RCA: 6] [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] [Received: 05/20/2016] [Accepted: 05/19/2017] [Indexed: 12/01/2023] Open
Abstract
OBJECTIVE Colleges continue to experience a high number of referred students because of campus alcohol violations. Subsequently, there has been a trend to use peer-implemented minimal interventions (PMIs), often using motivational interviewing (MI). However, little is known about how PMIs facilitate behavior change. This study aims to examine the mechanisms of behavior change within PMIs and their influence on alcohol reduction among mandated students. METHOD Participants (N = 146; mean age = 18.7 years; 67% male; 94% White) were college students who violated campus alcohol policy at a Northeastern liberal arts college who received a 15-minute PMI addressing their alcohol use. The Motivational Interviewing Skill Code (Miller et al., 2003) was used to identify peer counselor behaviors that were MI consistent (MICO), client change talk (CT), and client self-exploration. RESULTS MICO behaviors were positively associated with CT and self-exploration. Client CT and self-exploration were negatively associated with alcohol-related outcomes. Furthermore, mediational models examining MICO behaviors revealed effects for two paths: (a) from MICO to client CT to reduced alcohol use; and (b) from MICO to client self-exploration to reduced alcohol-related consequences and use. CONCLUSIONS These data support the primary causal chain examining the influence of MICO on in-session client behaviors and related post-session behavior change in PMIs among at-risk students.
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Affiliation(s)
- Erica M. Eaton
- Fielding Graduate University, Santa Barbara, California
- Center for Alcohol and Addiction Studies, Brown University, Providence, Rhode Island
- Mental Health and Behavioral Sciences Service, Department of Veterans Affairs Medical Center, Providence, Rhode Island
| | - Molly Magill
- Center for Alcohol and Addiction Studies, Brown University, Providence, Rhode Island
| | - Christy Capone
- Center for Alcohol and Addiction Studies, Brown University, Providence, Rhode Island
- Mental Health and Behavioral Sciences Service, Department of Veterans Affairs Medical Center, Providence, Rhode Island
| | | | - Nadine R. Mastroleo
- Center for Alcohol and Addiction Studies, Brown University, Providence, Rhode Island
- Community and Public Affairs, Binghamton University, Binghamton, NewYork
| | - Racheal Reavy
- Edna Bennett Pierce Prevention Research Center, The Pennsylvania State University, University Park, Pennsylvania
| | - Brian Borsari
- Center for Alcohol and Addiction Studies, Brown University, Providence, Rhode Island
- San Francisco Veterans Affairs Medical Center, San Francisco, California
- Department of Psychiatry, University of California–San Francisco, San Francisco, California
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19
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Contractor AA, Presseau C, Capone C, Reddy MK, Shea MT. The moderating role of dysphoria in the relationship between intrusions and alcohol use. Addict Behav 2016; 55:5-14. [PMID: 26735913 DOI: 10.1016/j.addbeh.2015.12.010] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2015] [Revised: 09/20/2015] [Accepted: 12/14/2015] [Indexed: 11/24/2022]
Abstract
Posttraumatic Stress Disorder (PTSD) is frequently comorbid with alcohol use disorders (AUD; Calabrese et al., 2011; McFall, Mackay, & Donovan, 1992). Among several explanations for this comorbidity, the most empirically supported is the self-medication theory which postulates that substances are used to medicate PTSD-related distress (Keane & Wolfe, 1990; Khantzian, 1985; Stewart, 1996). The current study examines the effects of trauma-related distress on alcohol use (total drinking days, drinks per drinking day, heavy drinking days) in a sample of 127 trauma-exposed Veterans following deployment to Iraq or Afghanistan. The dysphoria symptoms of PTSD were used as an indicator of distress, and examined as a moderator in the relationship between intrusion symptoms of PTSD and alcohol use. The proposed moderation model was tested using cross-sectional data from the first month following return from deployment, and at 6 months and at 12 months post-deployment. Results showed that dysphoria symptoms significantly moderated relations between intrusions and total drinking days and heavy drinking days at one month post-deployment; however, a significant pattern was not demonstrated at 6 months and 12 months. Further, dysphoria did not moderate the relation between intrusion symptoms and drinks per drinking day at the three time points. Theoretical and clinical implications are subsequently discussed.
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20
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Biganzoli I, Capone C, Barni R, Riccardi C. Note: Background Oriented Schlieren as a diagnostics for airflow control by plasma actuators. Rev Sci Instrum 2015; 86:026103. [PMID: 25725896 DOI: 10.1063/1.4907543] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Background Oriented Schlieren (BOS) is an optical technique sensitive to the first spatial derivative of the refractive index inside a light-transmitting medium. Compared to other Schlieren-like techniques, BOS is more versatile and allows to capture bi-dimensional gradients rather than just one spatial component. We propose to adopt BOS for studying the capabilities of surface dielectric barrier discharges to work like plasma actuators in flow control applications. The characteristics of the BOS we implemented at this purpose are discussed, together with few results concerning the ionic wind produced by the discharge in absence of an external airflow.
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Affiliation(s)
- I Biganzoli
- Dipartimento di Fisica G.Occhialini, Università degli Studi di Milano-Bicocca, Piazza della Scienza 3, Milano I-20126, Italy
| | - C Capone
- Dipartimento di Fisica G.Occhialini, Università degli Studi di Milano-Bicocca, Piazza della Scienza 3, Milano I-20126, Italy
| | - R Barni
- Dipartimento di Fisica G.Occhialini, Università degli Studi di Milano-Bicocca, Piazza della Scienza 3, Milano I-20126, Italy
| | - C Riccardi
- Dipartimento di Fisica G.Occhialini, Università degli Studi di Milano-Bicocca, Piazza della Scienza 3, Milano I-20126, Italy
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21
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Capone C, Eaton E, McGrath AC, McGovern MP. Integrated Cognitive Behavioral Therapy (ICBT) For PTSD and Substance Use in Iraq and Afghanistan Veterans: A Feasibility Study. J Trauma Stress Disord Treat 2015; 3. [PMID: 25580442 DOI: 10.4172/2324-8947.1000134] [Citation(s) in RCA: 3] [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] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Co-occurring posttraumatic stress disorder (PTSD) and substance use disorder (SUD) is prevalent in military Veterans and is associated with poorer outcomes than either disorder alone. The current pilot study examines the feasibility of delivering integrated cognitive behavioral therapy (ICBT) for co-occurring PTSD-SUD to Veterans who served in Iraq and Afghanistan. Our primary aims were testing the feasibility of engaging and retaining Veterans with a complex clinical presentation in a 12-week structured therapy. We focused on two feasibility outcomes: 1) acceptability; and 2) tolerability. We also examined clinically meaningful change in PTSD and depressive symptoms as a secondary aim. Over the course of the study, we recruited 12 eligible Veterans, 6 of whom completed ICBT. We encountered challenges related to engaging and retaining Veterans in treatment and discuss adaptations and refinements of ICBT or other integrated treatments for returning Veterans with co-occurring PTSD-SUD to increase feasibility with military Veterans.
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Affiliation(s)
- Christy Capone
- Mental Health and Behavioral Sciences Service, Department of Veterans Affairs Medical Center, 830 Chalkstone Avenue Providence, RI 02908, USA ; Brown University, Center for Alcohol and Addiction Studies, Box G-S121-5 Providence, RI 02903, USA
| | - Erica Eaton
- Brown University, Center for Alcohol and Addiction Studies, Box G-S121-5 Providence, RI 02903, USA
| | - Ashlee C McGrath
- Mental Health and Behavioral Sciences Service, Department of Veterans Affairs Medical Center, 830 Chalkstone Avenue Providence, RI 02908, USA ; Brown University, Center for Alcohol and Addiction Studies, Box G-S121-5 Providence, RI 02903, USA
| | - Mark P McGovern
- Department of Psychiatry, Geisel School of Medicine at Dartmouth, 85 Mechanic Street, Suite B4-1, Lebanon, New Hampshire 03766, USA
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22
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Donzelli R, Mariniello G, Vitelli M, Capone C, Sgulò F, Dones F, Maiuri F. Reconstruction of artery wall in experimental giant aneurysms. J Neurosurg Sci 2014; 58:103-111. [PMID: 24819487] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
AIM This study describes five experimental techniques for the surgical treatment of giant aneurysms based on the resection of the aneurysm sac and reconstruction of the arterial wall. METHODS The aneurysm was realized with a venous graft implanted with end-to-side anastomosis on the common carotid artery on 50 rabbits (with each technique realized in 10 rabbits). The first two experimental techniques (A and B) involve the reconstruction of the artery wall by a synthetic dural patch and by direct suture reinforced by a venous patch, respectively. In the model C a collateral branch arising from the aneurysm is resected and reimplanted on the parent artery after aneurysm resection. In the experimental model D the arterial defect is closed by a venous patch surrounding the whole arterial wall and sutured with the aid of fibrin glue. In the model E clamping of the parent artery proximal to the aneurysm site and termino-lateral anastomosis with the contralateral artery lead to the thrombosis of the aneurysm fulled only by refluent flow. RESULTS AND CONCLUSION The venous pouch experimental models are useful to realize giant aneurysms. The above described techniques allow to realize the reconstruction of the arterial wall without stenosis and shortening the clamping time.
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Affiliation(s)
- R Donzelli
- Department of Neurosurgical Sciences "Federico II" University of Naples, Naples, Italy -
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Abstract
The co-occurrence of posttraumatic stress disorder (PTSD) and alcohol use disorders (AUDs) is well documented. Little is known about the factors that contribute to alcohol use and the development of AUDs among military personnel following deployment. The primary aim of this study was to examine trauma-related correlates of alcohol use in recently deployed Operation Enduring Freedom/Operation Iraqi Freedom veterans. Members of the Rhode Island National Guard and Army Reserves (N = 238) completed an in-person, initial assessment an average of 6 months postdeployment. Multiple regression analyses examined predictors of drinking outcomes (combat exposure, total PTSD symptoms, and PTSD symptom clusters) after accounting for gender, age, and history of AUD. Results indicated that total PTSD symptoms, but not combat exposure, significantly predicted alcohol use at the initial assessment. When PTSD symptom clusters were considered separately, reexperiencing symptoms (Cluster B) were the strongest predictor of total alcohol use (B = 3.58, p = .002) and heavy drinking episodes (B = 0.31, p = .005). Implications for these findings include early identification of risk factors that could lead to the development of AUDs, and the importance of integrated treatment approaches for co-occurring PTSD and AUD among veterans postdeployment.
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Affiliation(s)
- Christy Capone
- Providence Veterans Affairs Medical Center, Providence, RI 02908, USA.
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24
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Borsari B, Capone C, Mastroleo NR, Monti PM. Clinical Considerations in the Treatment of Substance Use Disorders with Veterans. J Contemp Psychother 2011; 41:10.1007/s10879-011-9172-6. [PMID: 24415798 PMCID: PMC3885181 DOI: 10.1007/s10879-011-9172-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
This article addresses issues associated with the treatment of substance use disorders (SUD) in the U.S. veteran population. First, we examine special considerations regarding the assessment of alcohol and drug use in veterans. Second, we discuss current treatment approaches that have demonstrated efficacy in this population, with special consideration the issue of co-morbidity (especially SUD and Posttraumatic Stress Disorder). Third, we discuss two strategies to coordinate treatment of SUD: stepped care as a way to implement these treatments for SUD alone, and integrated treatment for SUD and co-morbid disorders. Finally, we discuss promising future directions for the treatment of SUD in the veteran population, including examination of mechanisms of behavior change, formal involvement of the veteran's family in treatment, and use of existing datasets.
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Affiliation(s)
- Brian Borsari
- Mental Health and Behavioral Sciences Service, Department of Veterans Affairs Medical Center, Providence, RI, USA
- Center for Alcohol and Addiction Studies, Brown University, Box G-S121-5, Providence, RI 02903, USA
| | - Christy Capone
- Mental Health and Behavioral Sciences Service, Department of Veterans Affairs Medical Center, Providence, RI, USA
- Center for Alcohol and Addiction Studies, Brown University, Box G-S121-5, Providence, RI 02903, USA
| | - Nadine R. Mastroleo
- Center for Alcohol and Addiction Studies, Brown University, Box G-S121-5, Providence, RI 02903, USA
- Brown University, Providence, RI, USA
| | - Peter M. Monti
- Center for Alcohol and Addiction Studies, Brown University, Box G-S121-5, Providence, RI 02903, USA
- Brown University, Providence, RI, USA
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Abstract
Co-occurring posttraumatic stress disorder (PTSD) and alcohol use disorders have become increasingly prevalent in military populations. Over the past decade, PTSD has emerged as one of the most common forms of psychopathology among the 1.7 million American military personnel deployed to Iraq and Afghanistan in Operation Enduring Freedom (OEF), Operation Iraqi Freedom (OIF), and Operation New Dawn (OND). Among veterans from all eras, symptoms of PTSD have been highly correlated with hazardous drinking, leading to greater decreases in overall health and greater difficulties readjusting to civilian life. In fact, a diagnosis of co-occurring PTSD and alcohol use disorder has proven more detrimental than a diagnosis of PTSD or alcohol use disorder alone. In order to effectively address co-occurring PTSD and alcohol use disorder, both the clinical and research communities have focused on better understanding this comorbidity, as well as increasing treatment outcomes among the veteran population. The purpose of the present article is threefold: (1) present a case study that highlights the manner in which PTSD and alcohol use disorder co-develop after trauma exposure; (2) present scientific theories on co - occurrence of PTSD and alcohol use disorder; and (3) present current treatment options for addressing this common comorbidity.
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Affiliation(s)
- Ashlee C Carter
- Brown University Center for Alcohol and Addiction Studies Providence Veterans Affairs Medical Center
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Abstract
OBJECTIVE Primary outcomes from the COMBINE Study indicated support for naltrexone (Revia) on measures of abstinence and time to heavy drinking; however, effect sizes were modest. The delineation of individual difference variables that qualify these results could aid efforts to target treatment approaches appropriately. Laboratory and clinical studies have found greater effectiveness of naltrexone among men and those with familial alcoholism. The present study used multilevel modeling to investigate family history of alcoholism (FHA) based on first-degree relatives and gender as moderators of naltrexone's effects on three drinking outcomes: percentage of days abstinent, drinks per drinking day, and percentage of heavy drinking days. METHOD Data were drawn from the COMBINE public data set and included the subsample of participants (n = 603) randomized to receive active medication or placebo plus medical management. RESULTS We observed a main effect of FHA on drinks per drinking day (B = 2.01, SE = .91, p = .03) such that greater FHA was associated with greater alcohol use per drinking occasion. No other main effects of FHA were observed on drinking outcomes. A significant Naltrexone × Time interaction was observed for percentage of heavy drinking days (B = -1.61, SE = .69, p = .02), consistent with the previously published COMBINE results. No significant Naltrexone × FHA interactions were observed for any of the three outcomes. Gender did not modify these results. CONCLUSIONS Taken together, these results indicate an effect of FHA on drinking behavior but do not support FHA among first-degree relatives as a moderator of naltrexone's efficacy in this sample.
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Affiliation(s)
- Christy Capone
- Department of Veterans Affairs Medical Center and Center for Alcohol and Addiction Studies, Brown University, Providence, Rhode Island, USA.
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Wood MD, Fairlie AM, Fernandez AC, Borsari B, Capone C, Laforge R, Carmona-Barros R. Brief motivational and parent interventions for college students: a randomized factorial study. J Consult Clin Psychol 2010; 78:349-61. [PMID: 20515210 DOI: 10.1037/a0019166] [Citation(s) in RCA: 85] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
OBJECTIVE Using a randomized factorial design, we examined the efficacy of a brief motivational intervention (BMI) and a parent-based intervention (PBI) as universal preventive interventions to reduce alcohol use among incoming college students. METHOD Participants (N = 1,014) were assessed prior to matriculation and at 10 months and 22 months postbaseline. Two-part latent growth modeling was used to simultaneously examine initiation and growth in heavy episodic drinking and alcohol-related consequences. RESULTS This study retained 90.8% (n = 921) of randomized students at the 10-month follow-up and 84.0% (n = 852) of randomized students at the 22-month follow-up. BMI participants were significantly less likely than non-BMI participants to initiate heavy episodic drinking and to begin experiencing alcohol-related consequences. Effect sizes were minimal at 10 months (Cohen's h ranged from 0.02 to 0.07) and were small at 22 months (hs ranged from 0.15 to 0.22). A significant BMI x PBI interaction revealed that students receiving both the BMI and the PBI were significantly less likely to report the onset of consequences beyond the sum of the individual intervention effects (h = 0.08 at 10 months, and h = 0.21 at 22 months). Hypothesized direct BMI effects for reductions in heavy episodic drinking and consequences were not observed. Significant mediated effects via changes in descriptive norms were present for both growth and initiation of heavy episodic drinking and consequences. CONCLUSIONS To our knowledge, the current study is the first to provide support for BMI as a universal preventive intervention for incoming college students. Although hypothesized PBI main effects were not found, mediation analyses suggest future refinements could enhance PBI effectiveness.
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Affiliation(s)
- Mark D Wood
- Department of Psychology, University of Rhode Island, Kingston, RI 02881-0808, USA.
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Capone C, Wood MD. Thinking about drinking: need for cognition and readiness to change moderate the effects of brief alcohol interventions. Psychol Addict Behav 2010; 23:684-8. [PMID: 20025374 DOI: 10.1037/a0016235] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.4] [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
Research has demonstrated the efficacy of brief motivational interventions (BMI) and alcohol expectancy challenge (AEC) in reducing alcohol use and/or problems among college students. However, little is known about variables that may qualify the effectiveness of these approaches. The present analyses tested the hypothesis that need for cognition (NFC), impulsivity/sensation seeking (IMPSS) and readiness to change (RTC) would moderate the effects of BMI and AEC. Participants (N = 335) were heavy drinking college students enrolled in a randomized 2 x 2 factorial study of BMI and AEC. Latent growth curve analyses indicated significant interactions for BMI x NFC and AEC x RTC on alcohol use but not problems. Simple slopes analyses were used to probe these relationships and revealed that higher levels of NFC at baseline were associated with a stronger BMI effect on drinking outcomes over time. Similarly, higher levels of baseline RTC were associated with stronger AEC effects on alcohol use. Future preventive interventions with this population may profit by considering individual differences and targeting approaches accordingly.
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Affiliation(s)
- Christy Capone
- Center for Alcohol and Addiction Studies, Brown University, Providence, RI 02912, USA.
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Ray LA, Capone C, Sheets E, Young D, Chelminski I, Zimmerman M. Posttraumatic stress disorder with and without alcohol use disorders: diagnostic and clinical correlates in a psychiatric sample. Psychiatry Res 2009; 170:278-81. [PMID: 19900714 PMCID: PMC3418967 DOI: 10.1016/j.psychres.2008.10.015] [Citation(s) in RCA: 11] [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: 03/11/2008] [Revised: 10/07/2008] [Accepted: 10/23/2008] [Indexed: 11/25/2022]
Abstract
This study compared outpatients (n=196) with PTSD versus PTSD+alcohol use disorders (AUD) on clinical measures. PTSD+AUD patients were more likely to meet criteria for Borderline and Antisocial Personality Disorders. Emotion dysregulation may help account for the relationship between PTSD and AUD.
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Affiliation(s)
- Lara A. Ray
- University of California Los Angeles, Department of Psychology, Los Angeles, CA,Corresponding author: Lara A. Ray, Ph.D., Department of Psychology, University of California, Los Angeles, Box 951563, Los Angeles, CA 90095-1563, U.S., telephone: 310-794-5383, fax: 310-310-207-5895,
| | - Christy Capone
- Center for Alcohol and Addiction Studies, Brown University, Providence, RI
| | - Erin Sheets
- Department of Psychiatry and Human Behavior, Brown Medical School, Providence, RI
| | - Diane Young
- Department of Psychiatry and Human Behavior, Brown Medical School, Providence, RI
| | - Iwona Chelminski
- Department of Psychiatry and Human Behavior, Brown Medical School, Providence, RI
| | - Mark Zimmerman
- Department of Psychiatry and Human Behavior, Brown Medical School, Providence, RI
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Abstract
BACKGROUND Previous studies of family history of alcoholism (FHA) in college students have typically relied on dichotomous indices of paternal drinking. This study examined the prevalence of FHA and its effects on alcohol use and problems using a density measure in a sample (n = 408) of college students. METHODS Undergraduate students completed an anonymous survey in exchange for course credit. Data was collected between 2005 and 2006. RESULTS Using a density measure of FHA, we observed an overall prevalence rate of 65.9% and a rate of 29.1% for FHA in both first and second-degree relatives. Structural equation modeling (SEM) was used to investigate relations among FHA, alcohol use/problems and previously identified etiological risk factors for alcohol use disorders (AUD). Results indicated a significant positive association between FHA and alcohol-related problems and this relationship was mediated by age of onset of drinking, behavioral undercontrol and current cigarette use. Behavioral undercontrol also mediated the relationship between gender and alcohol problems. Additionally, FHA was associated with an earlier age of onset of drinking and this was related to greater alcohol use. CONCLUSIONS Assessing density of FHA in future trajectory research may capture a greater number of students at risk for acute alcohol-related problems and/or future development of AUDs. Future preventive interventions with this population, which should begin well before the college years, may benefit from considering personality factors and incorporating smoking cessation to help identify at-risk students and assist those who wish to cut down on their alcohol use but find that smoking acts as a trigger for increased drinking.
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Affiliation(s)
- Christy Capone
- Department of Psychology, University of Rhode Island, Kingston, Rhode Island, USA.
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Capone C, Wood MD, Borsari B, Laird RD. Fraternity and sorority involvement, social influences, and alcohol use among college students: a prospective examination. Psychol Addict Behav 2007; 21:316-27. [PMID: 17874882 PMCID: PMC2726649 DOI: 10.1037/0893-164x.21.3.316] [Citation(s) in RCA: 82] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
This study used latent growth curve modeling to investigate whether the effects of gender and Greek involvement on alcohol use and problems over the first 2 years of college are best characterized by selection, socialization, or reciprocal influence processes. Three social influences (alcohol offers, social modeling, and perceived norms) were examined as potential mediators of these effects. Undergraduate participants (N = 388) completed self-report measures prior to enrollment and in the spring of their freshmen and sophomore years. Male gender and involvement in the Greek system were associated with greater alcohol use and problems prior to college. Both gender and Greek involvement significantly predicted increases in alcohol use and problems over the first 2 years of college. Cross-domain analyses provided strong support for a mediational role of each of the social influence constructs on alcohol use and problems prior to matriculation, and prematriculation social modeling and alcohol offers mediated relations between Greek involvement and changes in alcohol use over time. Findings suggest that students, particularly men, who affiliate with Greek organizations constitute an at-risk group prior to entering college, suggesting the need for selected interventions with this population, which should take place before or during the pledging process.
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Affiliation(s)
- Christy Capone
- Department of Psychology, University of Rhode Island, Kingston, RI 02881, USA
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Girouard H, Lessard A, Capone C, Milner TA, Iadecola C. The neurovascular dysfunction induced by angiotensin II in the mouse neocortex is sexually dimorphic. Am J Physiol Heart Circ Physiol 2007; 294:H156-63. [PMID: 17982007 DOI: 10.1152/ajpheart.01137.2007] [Citation(s) in RCA: 42] [Impact Index Per Article: 2.5] [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: 11/22/2022]
Abstract
Women are less susceptible to the cerebrovascular complications of hypertension, such as a stroke and vascular dementia. The mechanism of such protection may be related to a reduced vulnerability of women to the cerebrovascular actions of hypertension. To test this hypothesis, we used a model of hypertension based on infusion of angiotensin II (ANG II), an octapeptide that plays a key role in hypertension and produces cerebrovascular dysregulation. Cerebral blood flow (CBF) was monitored by laser-Doppler flowmetry in anesthetized (urethane-chloralose) C57BL/6J male and female mice equipped with a cranial window. ANG II administration (0.25 mug.kg(-1).min(-1) iv x 30-45 min) elevated arterial pressure equally in both sexes but attenuated the CBF increase induced by whisker stimulation or by the endothelium-dependent vasodilator acetylcholine (ACh) in male but not in female mice. The administration of ANG II for 7 days (2.74 mg.kg(-1).day(-1)), using osmotic minipumps, also attenuated these cerebrovascular responses in male, but not female, mice. The reduced susceptibility to the effect of ANG II in female mice was abolished by ovariectomy and reinstated by estrogen administration to ovariectomized mice. Administration of estrogen to male mice abolished the ANG II-induced attenuation of CBF responses. We conclude that female mice are less susceptible to the cerebrovascular dysregulation induced by ANG II, an effect related to estrogen. Such protection from the deleterious cerebrovascular effects of hypertension may play a role in the reduced vulnerability to the cerebrovascular complications of hypertension observed in women.
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Affiliation(s)
- H Girouard
- Division of Neurobiology, Weill Cornell Medical College, 411 E. 69th Street, New York, NY 10021, USA
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Wood MD, Capone C, Laforge R, Erickson DJ, Brand NH. Brief motivational intervention and alcohol expectancy challenge with heavy drinking college students: a randomized factorial study. Addict Behav 2007; 32:2509-28. [PMID: 17658696 DOI: 10.1016/j.addbeh.2007.06.018] [Citation(s) in RCA: 77] [Impact Index Per Article: 4.5] [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] [Received: 03/29/2007] [Revised: 05/28/2007] [Accepted: 06/22/2007] [Indexed: 11/28/2022]
Abstract
This study is the first reported test of the unique and combined effects of Brief Motivational Intervention (BMI) and Alcohol Expectancy Challenge (AEC) with heavy drinking college students. Three hundred and thirty-five participants were randomly assigned in a 2x2 factorial design to either: BMI, AEC, BMI and AEC, and assessment only conditions. Follow-ups occurred at 1, 3, and 6 months. Unconditional latent curve analyses suggested that alcohol use (Q-F), heavy episodic drinking, and alcohol problems were best modeled as quadratic effects. BMI produced significant decreases in Q-F, heavy drinking, and problems, while AEC produced significant decreases in Q-F and heavy drinking. There was no evidence of an additive effect of combining the interventions. Intervention effects decayed somewhat for BMI and completely for AEC over 6 months. Multi-group analyses suggested similar intervention effects for men and women. BMI effects on alcohol problems were mediated by perceived norms. These findings extend previous research with BMI and AEC but do not support their utility as a combined preventive intervention to reduce collegiate alcohol abuse.
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Affiliation(s)
- Mark D Wood
- University of Rhode Island, Department of Psychology, Kingston, RI 02881, USA.
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Kachnowski S, Blum R, Capone C, Edwards A, Woolery C. OPTIMIZING CARE VIA INTERNET-BASED HEMOPHILIA THERAPY MANAGEMENT PLATFORM. J Thromb Haemost 2007. [DOI: 10.1111/j.1538-7836.2007.tb00792.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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O'Malley SS, Sinha R, Grilo CM, Capone C, Farren CK, McKee SA, Rounsaville BJ, Wu R. Naltrexone and cognitive behavioral coping skills therapy for the treatment of alcohol drinking and eating disorder features in alcohol-dependent women: a randomized controlled trial. Alcohol Clin Exp Res 2007; 31:625-34. [PMID: 17374042 DOI: 10.1111/j.1530-0277.2007.00347.x] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.1] [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: 11/27/2022]
Abstract
BACKGROUND Despite important gender differences in drinking patterns, physiological effects of alcohol, and co-occurring psychiatric conditions, relatively little is known about the efficacy of naltrexone for the treatment of alcohol dependence in women. This study investigated the safety and efficacy of naltrexone in combination with Cognitive Behavioral Coping Skills Therapy (CBCST) in a sample of alcohol-dependent women, some with comorbid eating pathology. METHODS One hundred three women meeting DSM-IV criteria for alcohol dependence (29 with comorbid eating disturbances) were randomized to receive either naltrexone 50 mg or placebo for 12 weeks in addition to weekly group CBCST. Subjects were enrolled between October 1995 and December 2000 at an outpatient research clinic. RESULTS No significant differences were observed on the primary outcomes of time to first drinking day, time to first day of heavy drinking, or the percentage of participants who continued to meet the criteria for alcohol dependence. Secondary analyses revealed that naltrexone significantly delayed the time to the second (chi2=5.37, p=0.02) and third (chi2=4.35, p=0.04) drinking days among subjects who did not maintain abstinence from alcohol. Among those with eating disturbances, symptoms of eating pathology improved during treatment, but the effects did not differ according to medication condition. CONCLUSION When used in conjunction with CBCST, naltrexone did not significantly improve drinking outcomes in the overall sample of alcohol-dependent women. However, naltrexone may be of benefit to women who are unable to maintain total abstinence from alcohol. For women with concurrent eating pathology, participation in treatment for alcoholism may be associated with improvements in eating pathology.
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Affiliation(s)
- Stephanie S O'Malley
- Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut, USA.
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Capone C, Di Landro L, Inzoli F, Penco M, Sartore L. Thermal and mechanical degradation during polymer extrusion processing. POLYM ENG SCI 2007. [DOI: 10.1002/pen.20882] [Citation(s) in RCA: 74] [Impact Index Per Article: 4.4] [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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Read JP, Wood MD, Capone C. A prospective investigation of relations between social influences and alcohol involvement during the transition into college. ACTA ACUST UNITED AC 2005; 66:23-34. [PMID: 15830900 DOI: 10.15288/jsa.2005.66.23] [Citation(s) in RCA: 70] [Impact Index Per Article: 3.7] [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: 11/24/2022]
Abstract
OBJECTIVE The present study used structural equation modeling to test whether prospective relations between prematriculation social influences and alcohol involvement in college were most consistent with peer selection, peer socialization or reciprocal determinism explanations and to determine if observed relations varied according to measurement interval. We tested the hypotheses that "active" (alcohol offers) and "passive" (social modeling, perceived norms) social influences would be uniquely and reciprocally associated with alcohol use and alcohol-related consequences across two and three waves of assessment. METHOD Prospective undergraduates (N = 388) completed self-report assessments in the summer before matriculation (Wave 1), in the spring of their freshman year (Wave 2) and in the spring of their sophomore year (Wave 3). RESULTS Reciprocal effects were observed between social influences and alcohol use in both two- and three-wave models. Some evidence was observed for reciprocal associations for social modeling with alcohol use and alcohol problems. Overall, however, only modest support was found for a reciprocal influence conceptualization of social influences in alcohol problems. For alcohol problems, the results were more consistent with selection effects. No significant reciprocal associations were observed for perceived norms. CONCLUSIONS Findings generally support the Social Learning Theory concept of reciprocal determinism but suggest the relationship between individual drinking behaviors and the social environment varies when distinguishing between alcohol use and alcohol problems. These findings also point to the importance of distinguishing among different types of social influences when delineating processes that result from and lead to heavy drinking in college.
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Affiliation(s)
- Jennifer P Read
- Department of Psychology, 224 Park Hall, State University of New York at Buffalo, Buffalo, New York 14260-4110, USA.
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Galeotti T, Pani G, Capone C, Bedogni B, Borrello S, Mancuso C, Eboli ML. Protective role of MnSOD and redox regulation of neuronal cell survival. Biomed Pharmacother 2005; 59:197-203. [PMID: 15862715 DOI: 10.1016/j.biopha.2005.03.002] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.6] [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: 11/03/2004] [Indexed: 11/25/2022] Open
Abstract
Reactive oxygen species (ROS) play a central role in neuronal pathophysiology and in neurodegenerative disorders. However, recent evidence indicates that these molecules also operate as signaling intermediates in a variety of physiological settings, including cell protection from apoptosis. Data presented here strongly support such a dual role for oxidants in neuronal cell homeostasis. In rat pheocromocytoma cells, cell rescue by the nerve growth factor (NGF) is accompanied by a transient burst of ROS generated in the cytosol by a GTPase-dependent mechanism. Within the NGF signaling cascade, ROS lie upstream and are necessary for activation/phosphorylation of AKT/PKB and of the antiapoptotic transcription factor cAMP-responsive element-binding protein (CREB). Conversely, an increase in mitochondrial oxygen species heralds apoptosis of serum-deprived cells, and these events can be prevented by cell exposure to NGF or by treatment with the mitochondrially targeted antioxidant MitoQ. Importantly, NGF-mediated decrease of mitochondrial ROS is dependent on the transcriptional up-regulation of the manganese superoxide dismutase (MnSOD) by active CREB. These observations therefore outline a circuitry whereby cytosolic redox signaling promotes neuronal cell survival by increasing the mitochondrial antioxidant defenses.
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Affiliation(s)
- T Galeotti
- Institute of General Pathology and Institute of Pharmacology, Catholic University Medical School, Rome, Italy.
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Aouad-Massière O, Capone C, Perron S, Tarret C, Belmin J. [Explanation: experience of a memory consultation in a geriatric hospital]. Soins Gerontol 1999:28-31. [PMID: 10745918] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/16/2023]
Affiliation(s)
- O Aouad-Massière
- Service de médecine interne gériatrique, Hôpital René Muret-Bigottini, Sevran
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Affiliation(s)
- C Faienza
- Institute of Pediatrics, Neuropsychiatric Unit, Univ. of Parma, Italy
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Faienza C, Capone C, Galgano MC, Sani E. The emergence of the sleep-wake cycle in infancy. Ital J Neurol Sci 1986; Suppl 5:37-42. [PMID: 3759407] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
In order to investigate the appearance of a rest-activity periodicity, spontaneous motor behavior of five low-risk preterm infants (gestational age range 27-31 weeks) was monitored for 24 hours at weekly intervals until term. Using a time lapse videorecorder (6.5 fields/sec.) both slow and rapid movements were counted every three minutes; this interval was adopted as basic chronological paradigm in order to evaluate the daily distribution of motor activity. The results of quantitative analysis showed a developmental trend of motor behavior which increased from earliest conceptional ages (C.A.) until 32-33 weeks, and decreased around 36-37 weeks C.A. Prolonged complete rest intervals are rare at low C.A., while in older infants (approx. 40 weeks C.A.) an initial tendency to organize motor activity in ultradian cycle-like periods seems to be more evident, contemporary with consolidated behavioral states.
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Capone C, Jacob F, O'Laughlin A. Catholic relief services: nutrition intervention program for the drought areas of kenya (1975-76). Disasters 1978; 2:255-258. [PMID: 20958393 DOI: 10.1111/j.1467-7717.1978.tb00105.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
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Granati A, Capone C, Cocuzza C. [Chronic penumopathies caused by nitrous gas and fumes. (Clinical contributions)]. Folia Med (Napoli) 1966; 49:816-33. [PMID: 5999289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
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