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Monley CM, Liese BS, Oberleitner LM. Gamers' and non-gamers' perspectives on the development of problematic video game play. Curr Psychol 2023; 43:1-10. [PMID: 36776145 PMCID: PMC9900197 DOI: 10.1007/s12144-023-04278-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/15/2023] [Indexed: 02/09/2023]
Abstract
Gaming Disorder was recently included in the 11th Edition of the International Classification of Diseases and Internet Gaming Disorder may be introduced in the sixth edition of The Diagnostic and Statistical Manual. Much is not understood about how problems with video games develop. This qualitative study aimed to better understand the development of problematic gaming through focus groups. Eleven young adult "frequent gamers," twelve young adult "non-frequent or non-gamers," and five older adult "non-gamers" discussed vulnerabilities and risk factors of problematic gaming. Participants across all groups believed that problematic gaming developed when people used video games as a primary means of meeting basic psychological needs that were unsatisfied, thwarted, or blocked outside of video games. Frequent and non-frequent gamers, compared to older adult non-gamers, were more likely to view video games as a healthy way to meet basic psychological needs and less likely to stereotype gamers. Video games are equipped to meet basic psychological needs for autonomy, competence, and relatedness. That is, gamers often experience a sense of agency, skill, and connection to others when playing video games. However, problematic gaming may develop when people with unmet psychological needs rely exclusively on video games to meet them. Treatment and prevention approaches to problematic gaming can benefit from greater attention to helping at risk individuals meet needs for autonomy, competence, and relatedness outside of video games.
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Affiliation(s)
- Corey M. Monley
- Department of Educational and Counseling Psychology, University at Albany-State University of New York, 1400 Washington Ave, Catskill 228, Albany, NY 12222 USA
- Cofrin Logan Center for Addiction Research and Treatment, University of Kansas, Lawrence, KS USA
| | - Bruce S. Liese
- Cofrin Logan Center for Addiction Research and Treatment, University of Kansas, Lawrence, KS USA
- Department of Family Medicine and Community Health, University of Kansas Medical Center, Kansas City, KS USA
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Morie KP, Potenza MN, Beitel M, Oberleitner LM, Roos CR, Yip SW, Oberleitner DE, Gaeta M, Barry DT. Alexithymia and pain experience among patients using methadone-maintenance therapy. Drug Alcohol Depend 2021; 218:108387. [PMID: 33168339 PMCID: PMC8103623 DOI: 10.1016/j.drugalcdep.2020.108387] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Revised: 09/09/2020] [Accepted: 10/19/2020] [Indexed: 11/16/2022]
Abstract
BACKGROUND Alexithymia, difficulty identifying and describing one's emotions coupled with a tendency to externalize, is a potentially important yet understudied treatment target for patients with opioid use disorder. The aim of this study was to examine the role of alexithymia in pain experience among individuals with opioid use disorder. METHODS One-hundred-and-sixty-four patients receiving methadone maintenance treatment completed a battery of self-report measures related to alexithymia, drug use, and pain experiences. Comparisons were performed on the full sample between those with or without clinically significant levels of alexithymia. For a subsample reporting pain (n = 138), intercorrelations were performed to test whether drug use history, pain catastrophizing, pain acceptance, and alexithymia were related to pain severity and pain interference. Regression analyses were performed to test for serial mediation of pain catastrophizing and pain acceptance on the relationship between alexithymia and pain interference in this subsample. RESULTS Individuals with alexithymia showed increased pain catastrophizing and interference, and intercorrelations indicated that increased alexithymia was associated with increased pain interference, more pain catastrophizing, and reduced pain acceptance. A serial regression model among a subset of patients with pain indicated that pain catastrophizing and pain acceptance mediated the effect of alexithymia on pain interference. CONCLUSIONS These findings suggest that alexithymia, as well as both pain catastrophizing and pain acceptance, contribute to interference associated with pain and are potentially important intervention targets among methadone-treated patients with pain.
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Affiliation(s)
- Kristen P Morie
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA; Child Study Center, Yale School of Medicine, New Haven, CT, USA.
| | - Marc N Potenza
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA; Child Study Center, Yale School of Medicine, New Haven, CT, USA; Connecticut Mental Health Center, New Haven, CT, USA; Connecticut Council on Problem Gambling, Wethersfield, CT, USA; Department of Neuroscience, Yale University, New Haven, CT, USA
| | - Mark Beitel
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA; Child Study Center, Yale School of Medicine, New Haven, CT, USA; Pain Treatment Services, APT Foundation, Inc, New Haven, CT, USA
| | - Lindsay M Oberleitner
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA; Department of Psychology, Western Connecticut State University, Danbury, CT, USA
| | - Corey R Roos
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
| | - Sarah W Yip
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA; Child Study Center, Yale School of Medicine, New Haven, CT, USA
| | | | - Marina Gaeta
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA; Pain Treatment Services, APT Foundation, Inc, New Haven, CT, USA
| | - Declan T Barry
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA; Child Study Center, Yale School of Medicine, New Haven, CT, USA; Pain Treatment Services, APT Foundation, Inc, New Haven, CT, USA
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Peltier MR, Flores JM, Smith PH, Roberts W, Verplaetse TL, Moore KE, Hacker R, Oberleitner LM, McKee SA. Smoking Across the Menopausal Transition in a 10-Year Longitudinal Sample: The Role of Sex Hormones and Depressive Symptoms. Nicotine Tob Res 2020; 22:872-877. [PMID: 31058288 PMCID: PMC7249927 DOI: 10.1093/ntr/ntz069] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2018] [Accepted: 04/26/2019] [Indexed: 12/18/2022]
Abstract
INTRODUCTION Current cigarette smoking rates among older women remain problematic, especially given that this population experiences increased smoking-related health consequences. Despite these increased health concerns, little research to date has explored smoking patterns across the menopausal transition (pre-, early-peri-, late-peri-, and postmenopausal) or the effect of unique factors such as sex hormones and depression during this transition. METHODS This study used 10 yearly waves of data from the Study of Women's Health Across the Nation, a longitudinal dataset. Data included 1397 women endorsing ever smoking regularly at baseline. Random-effects logistic regression models were used to examine smoking transitions. RESULTS Although there were no associations between menopausal transition stage and smoking behavior, increased estradiol was associated with an increased likelihood of quitting regular smoking (eg, transitioning from regular smoking to non-regular or no smoking; odds ratio [OR] = 1.28), whereas increased testosterone was associated with an increased likelihood of relapsing to regular smoking (eg, transitioning from former or nonregular smoking to regular smoking OR = 2.56). Depression was associated with increased likelihood of continued smoking (OR = 0.97) and relapse (OR = 1.03). CONCLUSIONS The results emphasize the need to develop interventions to target initiated or continued smoking among women across the menopausal transition and specifically highlight the importance of developing treatments that target depressive symptoms in this population. In addition, although singular hormone measures were associated with smoking behavior, there is a need for future study of dynamic changes in hormones, as well as the impact of progesterone on smoking behaviors across the menopausal transition. IMPLICATIONS To date, no studies have examined smoking behaviors across the menopausal transition. In this study, although menopausal transition status was not significantly related to transitions in smoking behavior, important relationships between sex hormones and depression were observed. Increased estradiol was associated with an increased likelihood of quitting regular smoking, whereas increased testosterone was associated with an increased likelihood of relapsing to regular smoking behavior. Higher depression scores were related to continued smoking and relapse to regular smoking behavior. These results highlight the need to develop interventions to target smoking cessation among women across the menopausal transition.
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Affiliation(s)
| | - José M Flores
- Department of Psychiatry, Yale School of Medicine, New Haven, CT
| | - Philip H Smith
- Department of Psychiatry, Yale School of Medicine, New Haven, CT
| | - Walter Roberts
- Department of Psychiatry, Yale School of Medicine, New Haven, CT
| | | | - Kelly E Moore
- Department of Psychiatry, Yale School of Medicine, New Haven, CT
| | - Robyn Hacker
- Department of Psychiatry, Yale School of Medicine, New Haven, CT
| | | | - Sherry A McKee
- Department of Psychiatry, Yale School of Medicine, New Haven, CT
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Verplaetse TL, Moore KE, Pittman BP, Roberts W, Oberleitner LM, Peltier MKR, Hacker R, Cosgrove KP, McKee SA. Intersection of E-Cigarette Use and Gender on Transitions in Cigarette Smoking Status: Findings Across Waves 1 and 2 of the Population Assessment of Tobacco and Health Study. Nicotine Tob Res 2020; 21:1423-1428. [PMID: 30239953 DOI: 10.1093/ntr/nty187] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2018] [Accepted: 09/05/2018] [Indexed: 02/02/2023]
Abstract
INTRODUCTION Cigarette smokers report using electronic cigarettes (e-cigarettes) to reduce or quit smoking, but findings are mixed regarding the benefit and risk of e-cigarettes in this population, and effects of gender are unknown. METHODS The Population Assessment of Tobacco and Health (PATH; waves 1 and 2; adult interviews) was used to evaluate relationships among wave 1 e-cigarette use (daily, nondaily, never) and gender and their association with transitions (quit vs. current; relapse vs. former) in cigarette smoking status across waves 1 and 2 of the PATH study. RESULTS Daily e-cigarette users had higher odds of quitting smoking (odds ratio [OR] = 1.56, 95% confidence interval [CI] = 1.12 to 2.18) compared with never e-cigarette users. Conversely, daily and nondaily e-cigarette users were at greater risk of smoking relapse (OR = 1.84, 95% CI = 1.15 to 2.94 and OR = 1.85, 95% CI = 0.99 to 3.46, respectively) compared with never e-cigarette users. Women were less likely to quit smoking compared with men independent of e-cigarette use (OR = 0.76, 95% CI = 0.59 to 0.99). In stratified analyses, daily or nondaily e-cigarette use did not increase the likelihood of quitting or relapse in women. In men, daily and nondaily e-cigarette users were at greater risk of smoking relapse (OR = 2.96, 95% CI = 1.49 to 5.86 and OR = 3.05, 95% CI = 1.29 to 7.17, respectively) compared with men who were never e-cigarette users. CONCLUSIONS Findings identify e-cigarettes as a potential aid for smoking cessation but also as a potential risk for smoking relapse in men only. Overall, women were less likely to quit smoking, and e-cigarette use did not impact their ability to quit or to stay quit. IMPLICATIONS Cigarette smokers report using e-cigarettes to reduce or quit smoking, but findings are mixed regarding the benefit and risk of e-cigarettes in this population. Using data from the newly available PATH (waves 1 and 2; adult interviews), our findings identify e-cigarettes as a potential aid for smoking cessation but also identify e-cigarettes as a potential risk for smoking relapse in men only. These findings may have implications for the regulation of e-cigarettes by the Food and Drug Administration and the benefit-cost ratio of e-cigarette use in smokers.
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Affiliation(s)
| | - Kelly E Moore
- Department of Psychiatry, Yale School of Medicine, New Haven, CT
| | - Brian P Pittman
- Department of Psychiatry, Yale School of Medicine, New Haven, CT
| | - Walter Roberts
- Department of Psychiatry, Yale School of Medicine, New Haven, CT
| | | | | | - Robyn Hacker
- Department of Psychiatry, Yale School of Medicine, New Haven, CT
| | - Kelly P Cosgrove
- Department of Psychiatry, Yale School of Medicine, New Haven, CT
| | - Sherry A McKee
- Department of Psychiatry, Yale School of Medicine, New Haven, CT
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Smith KZ, Smith PH, Oberleitner LM, Grekin ER, McKee SA. Child Maltreatment and Physical Victimization: Does Heavy Drinking Mediate the Relationship? Child Maltreat 2018; 23:234-243. [PMID: 29347837 DOI: 10.1177/1077559517751669] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Past studies examining the child maltreatment (CM)/victimization pathway have been limited by their focus on sexual victimization, narrow windows of assessment, and failure to examine gender differences. In the current study, we sought to examine (1) the impact of CM on physical victimization (PV) trajectories from adolescence to young adulthood and (2) the extent to which heavy drinking mediated the relationship between CM and later PV. Using three waves of the National Longitudinal Study of Adolescent to Adult Health, we found that CM was associated with a 69% greater odds of later PV for both genders, after the inclusion of control variables, and that the risk continued into adulthood. Further, heavy drinking was found to mediate the CM/victimization pathway at Wave I, but not at later waves. When mediation was examined separately for men and women, support for mediation was found for men and women. The current study suggests that CM represents a liability for interpersonal violence for both genders and highlights the importance of looking at victimization across time.
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Affiliation(s)
- Kathryn Z Smith
- 1 Department of Psychology, Wayne State University, Detroit, MI, USA
- 2 Department of Psychiatry, Yale University, School of Medicine, New Haven, CT, USA
- 3 Division on Substance Use Disorders, Department of Psychiatry, New York State Psychiatric Institute, Columbia University Medical Center New York, NY, USA
| | - Philip H Smith
- 4 Community Health and Social Medicine, CUNY School of Medicine, New York, NY, USA
| | | | - Emily R Grekin
- 1 Department of Psychology, Wayne State University, Detroit, MI, USA
| | - Sherry A McKee
- 2 Department of Psychiatry, Yale University, School of Medicine, New Haven, CT, USA
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Roberts W, Verplaetse TL, Moore K, Oberleitner LM, McKee SA. A preliminary investigation into the effects of doxazosin on cognitive functioning in tobacco-deprived and -satiated smokers. Hum Psychopharmacol 2018; 33:e2660. [PMID: 29878501 PMCID: PMC5995328 DOI: 10.1002/hup.2660] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2017] [Revised: 03/02/2018] [Accepted: 04/17/2018] [Indexed: 11/12/2022]
Abstract
OBJECTIVE To test the effects of doxazosin, an α1 antagonist, on cognitive functioning during tobacco withdrawal in smokers. METHODS Participants (n = 35) were randomly assigned to receive placebo, 4-mg/day, or 8-mg/day doxazosin. They completed a continuous performance task and self-reported their withdrawal symptoms at baseline and twice following a medication titration period: once in a tobacco-deprived state and again in a nondeprived state. Ability to resist smoking was assessed using a laboratory smoking-lapse paradigm. RESULTS Participants showed poorer cognitive performance on most measures taken from the continuous performance task when tobacco deprived. Eight-mg/day doxazosin improved inhibitory control during the nondeprivation session but did not affect sustained attention or reaction time. Participants receiving doxazosin reported fewer withdrawal symptoms during deprivation than those on placebo. Those showing the greatest improvement of inhibitory control under doxazosin were better able to resist smoking (i.e., latency to smoke) during a smoking lapse task. Self-reported withdrawal symptoms also were negatively associated with time to smoking. CONCLUSIONS Doxazosin reduced symptoms of tobacco withdrawal according to self-report and cognitive assessment and improved inhibitory control above predrug levels. This research identifies potential mechanisms by which doxazosin might improve smoking outcomes.
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Affiliation(s)
- Walter Roberts
- Yale School of Medicine, Department of Psychiatry, 2 Church Street South, Suite 109, New Haven CT, 06519,Corresponding author: Telephone: (203) 737-3529 Fax: (203) 737-4243,
| | - Terril L. Verplaetse
- Yale School of Medicine, Department of Psychiatry, 2 Church Street South, Suite 109, New Haven CT, 06519
| | - Kelly Moore
- Yale School of Medicine, Department of Psychiatry, 2 Church Street South, Suite 109, New Haven CT, 06519
| | - Lindsay M. Oberleitner
- Yale School of Medicine, Department of Psychiatry, 2 Church Street South, Suite 109, New Haven CT, 06519
| | - Sherry A. McKee
- Yale School of Medicine, Department of Psychiatry, 2 Church Street South, Suite 109, New Haven CT, 06519
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Verplaetse TL, Moore KE, Pittman BP, Roberts W, Oberleitner LM, Smith PH, Cosgrove KP, McKee SA. Intersection of stress and gender in association with transitions in past year DSM-5 substance use disorder diagnoses in the United States. Chronic Stress (Thousand Oaks) 2018. [PMID: 29527591 PMCID: PMC5841251 DOI: 10.1177/2470547017752637] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background Stress contributes to the development and maintenance of substance use disorders (SUD), with some research suggesting that the impact of stress on SUD is greater in women. However, this has yet to be evaluated in a national dataset, across major substances of abuse. Methods Using data from the newly available U.S. National Epidemiologic Survey on Alcohol and Related Conditions (NESARC; Wave 3; n=36,309) we evaluated relationships among past year stressful life events (0 or 1 vs. 2+ events, range 0-16) and gender, and their association with transitions (new vs. absent cases; ongoing vs. remitted cases) in Diagnostic and Statistical Manual of Mental Disorders Fifth Edition (DSM-5) alcohol use disorder (AUD), tobacco use disorder (TUD), cannabis use disorder (CUD), and nonmedical prescription opioid use disorder (OUD) diagnoses. Results Having 2 or more stressful life events in the past year increased the odds of having a new AUD, TUD, CUD, and OUD (OR=3.14, 2.15, 5.52, and 3.06, respectively) or ongoing AUD, TUD, and CUD (OR=2.39, 2.62, and 2.95, respectively) compared to 0 or 1 stressful life event. A stress by gender interaction for new vs. absent AUD demonstrated that having 2 or more stressful life events was associated with increased odds of new AUD in men (OR=2.51) and even greater odds of new AUD in women (OR=3.94). Conclusions Results highlight that stress is a robust factor in both men and women with new or ongoing substance use disorders, and that effective treatments for substance use should consider the role of stress in addiction etiology and maintenance. There was little evidence for gender differences in the role of stress on transitions in substance use disorders, except for the onset of alcohol use disorders. Given that rates of alcohol use disorders are increasing in women; the impact of stress needs to be considered.
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Affiliation(s)
| | - Kelly E Moore
- Department of Psychiatry, Yale School of Medicine, New Haven, CT 06519
| | - Brian P Pittman
- Department of Psychiatry, Yale School of Medicine, New Haven, CT 06519
| | - Walter Roberts
- Department of Psychiatry, Yale School of Medicine, New Haven, CT 06519
| | | | - Philip H Smith
- Department of Community Health and Social Medicine, CUNY School of Medicine, New York, NY 10031
| | - Kelly P Cosgrove
- Department of Psychiatry, Yale School of Medicine, New Haven, CT 06519
| | - Sherry A McKee
- Department of Psychiatry, Yale School of Medicine, New Haven, CT 06519
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Verplaetse TL, Weinberger AH, Oberleitner LM, Smith KM, Pittman BP, Shi JM, Tetrault JM, Lavery ME, Picciotto MR, McKee SA. Effect of doxazosin on stress reactivity and the ability to resist smoking. J Psychopharmacol 2017; 31:830-840. [PMID: 28440105 PMCID: PMC5823502 DOI: 10.1177/0269881117699603] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [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: 11/15/2022]
Abstract
Preclinical findings support a role for α1-adrenergic antagonists in reducing nicotine-motivated behaviors, but these findings have yet to be translated to humans. The current study evaluated whether doxazosin would attenuate stress-precipitated smoking in the human laboratory. Using a well-validated laboratory analogue of smoking-lapse behavior, this pilot study evaluated whether doxazosin (4 and 8 mg/day) versus placebo attenuated the effect of stress (vs neutral imagery) on tobacco craving, the ability to resist smoking and subsequent ad-libitum smoking in nicotine-deprived smokers ( n=35). Cortisol, adrenocorticotropin, norepinephrine, epinephrine, and physiologic reactivity were assessed. Doxazosin (4 and 8 mg/day vs placebo) decreased cigarettes per day during the 21-day titration period. Following titration, doxazosin (4 and 8 mg/day vs placebo) decreased tobacco craving. During the laboratory session, doxazosin (8 mg/day vs placebo) further decreased tobacco craving following stress versus neutral imagery. Doxazosin increased the latency to start smoking following stress, and reduced the number of cigarettes smoked. Dosage of 8 mg/day doxazosin increased or normalized cortisol levels following stress imagery and decreased cortisol levels following neutral imagery. These preliminary findings support a role for the noradrenergic system in stress-precipitated smoking behavior, and support further development of doxazosin as a novel pharmacotherapeutic treatment strategy for smoking cessation.
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Affiliation(s)
| | - Andrea H. Weinberger
- Ferkauf Graduate School of Psychology, Yeshiva University, Bronx, NY
- Department of Epidemiology & Population Health, Albert Einstein College of Medicine, Bronx, NY
| | | | - Kathryn M.Z. Smith
- Division on Substance Abuse, Department of Psychiatry, Columbia University Medical Center/New York State Psychiatric Institute, New York, NY
| | - Brian P. Pittman
- Departments of Psychiatry, Yale University School of Medicine, New Haven, CT
| | - Julia M. Shi
- Internal Medicine, Yale University School of Medicine, New Haven, CT
| | | | - Meaghan E. Lavery
- Departments of Psychiatry, Yale University School of Medicine, New Haven, CT
| | - Marina R. Picciotto
- Departments of Psychiatry, Yale University School of Medicine, New Haven, CT
| | - Sherry A. McKee
- Departments of Psychiatry, Yale University School of Medicine, New Haven, CT
- Correspondence to: Sherry A. McKee, PhD, 2 Church St South, Suite 109, Yale University School of Medicine, New Haven, CT 06519; Tele: 203.737-3529 Fax: 203.737-4243
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Verplaetse TL, Smith PH, Smith KM, Oberleitner LM, McKee SA. Guanfacine alters the effect of stress and smoking on heart rate variability in regular daily smokers. Psychopharmacology (Berl) 2017; 234:805-813. [PMID: 28028603 PMCID: PMC5309140 DOI: 10.1007/s00213-016-4517-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [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: 08/16/2016] [Accepted: 12/16/2016] [Indexed: 02/06/2023]
Abstract
BACKGROUND We had previously demonstrated that guanfacine, an α2a-adrenergic agonist, attenuated the effect of stress on smoking-lapse behavior in regular daily smokers. Heart rate variability (HRV), a measure of vagal activity, may be a potential mechanism underlying the relationship between stress, smoking, and relapse. METHODS We examined whether guanfacine (0 mg/day vs. 3 mg/day; n = 26) altered changes in high-frequency heart rate variability (HF-HRV) following stress and ad-lib smoking using a validated laboratory analogue of smoking-lapse behavior. All participants completed a parent study evaluating the effects of guanfacine on stress-precipitated smoking. Each subject completed two laboratory sessions assessing the effects of guanfacine on HF-HRV following stress imagery (vs. neutral imagery; order counterbalanced) and smoking. RESULTS Results demonstrated that guanfacine did not increase tonic levels of HF-HRV relative to placebo. Following the stress versus neutral imagery manipulation (prior to ad-lib smoking), there were no significant changes in HF-HRV in the placebo group. In contrast, guanfacine increased phasic HF-HRV following stress imagery and decreased HF-HRV following neutral imagery. Ad libitum smoking following both the stress and neutral conditions decreased HF-HRV in the placebo group across both imagery conditions. In contrast, guanfacine attenuated stress- and smoking-related decreases in phasic HF-HRV relative to the neutral imagery condition. CONCLUSIONS This is the first demonstration that a noradrenergic target altered dynamic changes in HF-HRV in response to stress and smoking, suggesting that guanfacine alters HF-HRV response to stress. Findings support current theories which suggest that phasic changes in HRV are an important marker of the stress response.
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Affiliation(s)
- Terril L. Verplaetse
- Department of Psychiatry, Yale School of Medicine, New Haven, CT,Corresponding Author: Terril L. Verplaetse, Ph.D., Department of Psychiatry, Yale University School of Medicine, 2 Church Street South, Suite 201, New Haven, CT, 06519 USA, phone: 203.737.6496, fax: 203.737.4243,
| | - Philip H. Smith
- Department of Community Health and Social Medicine, CUNY School of Medicine, New York, NY
| | - Kathryn M.Z. Smith
- Division on Substance Abuse, Department of Psychiatry, Columbia University Medical Center/New York State Psychiatric Institute, New York, NY
| | | | - Sherry A. McKee
- Department of Psychiatry, Yale School of Medicine, New Haven, CT
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Easton CJ, Oberleitner LM, Scott MC, Crowley MJ, Babuscio TA, Carroll KM. Differences in treatment outcome among marijuana-dependent young adults with and without antisocial personality disorder. Am J Drug Alcohol Abuse 2012; 38:305-13. [PMID: 22242558 DOI: 10.3109/00952990.2011.643989] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Few studies have addressed comorbid antisocial personality disorder (ASPD) and marijuana dependence in young adults, and results from previous studies are inconsistent. OBJECTIVES This study evaluated differences in pretreatment characteristics and treatment outcomes between marijuana-dependent young adults with and without ASPD. METHODS Data for this study were derived from a randomized trial, in which marijuana-dependent young adults (n = 136) between 18 and 25 years of age were randomized to four behavioral conditions: (1) MET/CBT with CM, (2) MET/CBT without CM, (3) DC with CM, and (4) DC without CM. RESULTS Forty-four percent of the participants met DSM-IV-TR criteria for ASPD. ASPD clients had significantly more lifetime alcohol dependence disorders, marijuana use in the 28 days pretreatment, arrests, and assault and weapon charges compared to those without ASPD. ASPD clients did not differ in retention or substance use outcomes at 8 weeks posttreatment or the 6-month follow-up. In general, both groups had more attendance in the voucher condition, but there were no significant ASPD by treatment interactions. CONCLUSIONS These data suggest that marijuana-dependent young adults with comorbid ASPD do not necessarily have poorer retention or substance use outcomes compared with marijuana-dependent young adults who do not have ASPD when treated in a well-defined behavioral therapy protocol. SCIENTIFIC SIGNIFICANCE Previous research has shown increased risks for clients with comorbid ASPD and marijuana dependence; however, our findings suggest that specialized programs for clients with ASPD may not be necessary if they are provided with empirically supported, structured treatments.
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Affiliation(s)
- Caroline J Easton
- Division of Substance Abuse, Yale University School of Medicine, New Haven, CT 06511, USA.
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11
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Slavin-Spenny OM, Cohen JL, Oberleitner LM, Lumley MA. The effects of different methods of emotional disclosure: differentiating post-traumatic growth from stress symptoms. J Clin Psychol 2010; 67:993-1007. [PMID: 21905025 DOI: 10.1002/jclp.20750] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Research on emotional disclosure should test the effects of different disclosure methods and whether symptoms are affected differently than post-traumatic growth. We randomized 214 participants with unresolved stressful experiences to four disclosure conditions (written, private spoken, talking to a passive listener, talking to an active facilitator) or two control conditions. All groups had one 30-minute session. After 6 weeks, disclosure groups reported more post-traumatic growth than controls, and disclosure conditions were similar in this effect. All groups decreased in stress symptoms (intrusions, avoidance, psychological and physical symptoms), but disclosure did not differ from control. We conclude that 30 minutes of disclosure leads to post-traumatic growth but not necessarily symptom reduction, and various disclosure methods have similar effects. Research on the effects of disclosure should focus on the benefits of growth as well as symptom reduction.
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