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Parenti M, Melough MM, Lapehn S, MacDonald J, Bammler T, Firsick EJ, Choi HY, Derefinko KJ, Enquobahrie DA, Carroll KN, LeWinn KZ, Bush NR, Zhao Q, Sathyanarayana S, Paquette AG. Associations Between Prenatal Vitamin D and Placental Gene Expression. bioRxiv 2024:2024.05.10.593571. [PMID: 38765981 PMCID: PMC11100832 DOI: 10.1101/2024.05.10.593571] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/22/2024]
Abstract
Background Vitamin D is a hormone regulating gene transcription. Prenatal vitamin D has been linked to immune and vascular function in the placenta, a key organ of pregnancy. To date, studies of vitamin D and placental gene expression have focused on a limited number of candidate genes. Transcriptome-wide RNA sequencing can provide a more complete representation of the placental effects of vitamin D. Objective We investigated the association between prenatal vitamin D levels and placental gene expression in a large, prospective pregnancy cohort. Methods Participants were recruited in Shelby County, Tennessee in the Conditions Affecting Neurocognitive Development and Learning in Early childhood (CANDLE) study. Vitamin D level (plasma total 25-hydroxyvitatmin D, [25(OH)D]) was measured at mid-pregnancy (16-28 weeks' gestation) and delivery. Placenta samples were collected at birth. RNA was isolated and sequenced. We identified differentially expressed genes (DEGs) using adjusted linear regression models. We also conducted weighted gene co-expression network analysis (WGCNA). Results The median 25(OH)D of participants was 21.8 ng/mL at mid-pregnancy ( N =774, IQR: 15.4-26.5 ng/mL) and 23.6 ng/mL at delivery ( N =753, IQR: 16.8-29.1 ng/mL). Placental expression of 25 DEGs was associated with 25(OH)D at mid-pregnancy, but no DEG was associated with 25(OH)D at delivery. DEGs were related to energy metabolism, cytoskeletal function, and RNA transcription. Using WGCNA, we identified 2 gene modules whose expression was associated with 25(OH)D at mid-pregnancy and 1 module associated with 25(OH)D at delivery. These modules were enriched for genes related to mitochondrial and cytoskeletal function, and were regulated by transcription factors including ARNT2 , BHLHE40 , FOSL2 , JUND , and NFKB1 . Conclusions Our results indicate that 25(OH)D during mid-pregnancy, but not at delivery, is associated with placental gene expression at birth. Future research is needed to investigate a potential role of vitamin D in programming placental mitochondrial metabolism, intracellular transport, and transcriptional regulation during pregnancy.
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Pebley K, Bursac Z, Klesges RC, Ebbert JO, Womack CR, Graber J, Little MA, Derefinko KJ, Krukowski RA. A randomized controlled trial to reduce post-cessation weight gain. Int J Obes (Lond) 2023; 47:471-478. [PMID: 36841886 PMCID: PMC9958320 DOI: 10.1038/s41366-023-01286-5] [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] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Revised: 02/15/2023] [Accepted: 02/17/2023] [Indexed: 02/27/2023]
Abstract
BACKGROUND/OBJECTIVES Weight gain is a barrier to smoking cessation. Previous interventions targeting weight gain while quitting smoking have largely been unsuccessful. The current study aimed to assess the efficacy of weight stability and weight loss interventions compared to a low-intensity, self-guided bibliotherapy weight management group. SUBJECTS/METHODS A randomized controlled trial with 12-month follow-up from 2018 to 2022 was conducted with participants (N = 305) who reported smoking at least five cigarettes per day for the last year and interest in quitting initially recruited from the Memphis, TN, USA area. Recruitment was expanded nationally with the onset of the COVID-19 pandemic. Subsequently, 276 completed 12-month follow-up. INTERVENTIONS/METHODS The Bibliotherapy group was provided a weight management book. Both the Stability and Loss groups met via telephone for eight weeks to learn strategies for maintaining/losing weight, respectively. All three groups then received the same six-week smoking cessation intervention, with six months of varenicline provided. RESULTS Individuals in the Loss group lost more weight (-2.01 kg, SE = 1.58) than individuals in the Bibliotherapy group (+1.08 kg, SE = 1.49, p = 0.0004), while the Stability group (-0.30 kg, SE = 1.56) was not significantly different from the Bibliotherapy group (p = 0.17). Those in the Stability group did not gain a significant amount of weight. Participants in the Loss group did not gain back all weight lost after smoking cessation and ended the study approximately 2.01 kg lower than baseline. The Bibliotherapy group did not gain the amount of weight expected after cessation. There were no significant differences between groups related to self-reported smoking cessation at each time point except at eight-month follow-up (p = 0.005). CONCLUSIONS AND RELEVANCE Results indicated the Stability and the Loss interventions were effective for preventing post-smoking cessation weight gain, with the Loss group having the benefit of sustained weight loss. These interventions may be helpful to implement to combat weight gain and potentially facilitate smoking cessation. TRIAL REGISTRATION The trial is registered on clinicaltrials.gov (NCT03156660).
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Affiliation(s)
- Kinsey Pebley
- The University of Memphis, Department of Psychology, 400 Innovation Drive, Memphis, TN, 38152, USA
| | - Zoran Bursac
- Florida International University, Department of Biostatistics, Miami, FL, 33199, USA
| | - Robert C Klesges
- University of Virginia, School of Medicine Department of Public Health Sciences, PO Box 800765, Charlottesville, VA, 22903, USA
| | - Jon O Ebbert
- Mayo Clinic, Department of Medicine, 200 1st Street SW, Rochester, MN, 55905, USA
| | - Catherine R Womack
- University of Tennessee Health Science Center, Department of Preventive Medicine, 66 N Pauline St, Memphis, TN, 38105, USA
| | - Julia Graber
- University of Tennessee Health Science Center, Department of Preventive Medicine, 66 N Pauline St, Memphis, TN, 38105, USA
| | - Melissa A Little
- University of Virginia, School of Medicine Department of Public Health Sciences, PO Box 800765, Charlottesville, VA, 22903, USA
| | - Karen J Derefinko
- University of Tennessee Health Science Center, Department of Preventive Medicine, 66 N Pauline St, Memphis, TN, 38105, USA
| | - Rebecca A Krukowski
- University of Virginia, School of Medicine Department of Public Health Sciences, PO Box 800765, Charlottesville, VA, 22903, USA.
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Peter SC, Murphy JG, Witkiewitz K, Hand SB, Thomas F, Johnson KC, Cowan R, Harris M, Derefinko KJ. Use of a sequential multiple assignment randomized trial to test contingency management and an integrated behavioral economic and mindfulness intervention for buprenorphine-naloxone medication adherence for opioid use disorder. Trials 2023; 24:237. [PMID: 36991453 DOI: 10.1186/s13063-023-07102-9] [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] [Received: 11/18/2022] [Accepted: 01/18/2023] [Indexed: 03/31/2023] Open
Abstract
BACKGROUND Buprenorphine-naloxone is a medication shown to improve outcomes for individuals seeking treatment for opioid use disorder (OUD); however, outcomes are limited by low medication adherence rates. This is especially true during the early stages of treatment. METHODS The present study proposes to utilize a sequential multiple assignment randomized trial design to compare two psychological interventions targeting buprenorphine-naloxone adherence: (1) contingency management (CM) and (2) brief motivational interviewing plus substance-free activities session plus mindfulness (BSM). Participants will be N = 280 adults who present to a university-based addictions clinic seeking treatment for OUD. Participants will be randomized to condition to receive 4 sessions of their assigned intervention (CM or BSM). Participants who are adherent, defined as attending physician appointments and having buprenorphine present in urine toxicology, will enter maintenance intervention for an additional 6 months. Those who are not adherent will be re-randomized to receive either the other intervention or both interventions. Follow-up will occur at 8 months post-randomization. CONCLUSIONS This novel design will examine the benefit of sequential treatment decisions following non-adherence. The primary outcome of this study is buprenorphine-naloxone medication adherence, as assessed by physician visit attendance and presence of buprenorphine in urine. Results will elicit the relative efficacy of CM and BSM compared to one another and whether keeping the initial treatment approach when adding the alternative approach for initially non-adherent individuals is beneficial. TRIAL REGISTRATION ClinicalTrials.gov NCT04080180.
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Affiliation(s)
- Samuel C Peter
- Department of Psychology, Durham VA Medical Center, 508 Fulton Street, Durham, NC, 27705, USA
| | - James G Murphy
- Department of Psychology, The University of Memphis, 400 Innovation Drive, Memphis, TN, 38152-6400, USA
| | - Katie Witkiewitz
- Department of Psychology, University of New Mexico, Logan Hall, Albuquerque, NM, 87131-0001, USA
| | - Sarah B Hand
- Department of Preventive Medicine, University of Tennessee Health Science Center, 66 N Pauline St, Memphis, TN, 38163, USA
| | - Fridtjof Thomas
- Department of Preventive Medicine, University of Tennessee Health Science Center, 66 N Pauline St, Memphis, TN, 38163, USA
| | - Karen Chandler Johnson
- Department of Preventive Medicine, University of Tennessee Health Science Center, 66 N Pauline St, Memphis, TN, 38163, USA
| | - Ronald Cowan
- Department of Psychiatry, University of Tennessee Health Science Center, 920 Madison Avenue, Memphis, TN, 38163, USA
| | - Matt Harris
- Boyd Center for Business and Economic Research, University of Tennessee, 1000 Volunteer Boulevard, Knoxville, TN, 37996, USA
| | - Karen J Derefinko
- Department of Preventive Medicine, University of Tennessee Health Science Center, 66 N Pauline St, Memphis, TN, 38163, USA.
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Nguyen RH, Knapp EA, Li X, Camargo CA, Conradt E, Cowell W, Derefinko KJ, Elliott AJ, Friedman AM, Khurana Hershey GK, Hofheimer JA, Lester BM, McEvoy CT, Neiderhiser JM, Oken E, Ondersma SJ, Sathyanarayana S, Stabler ME, Stroustrup A, Tung I, McGrath M. Characteristics of Individuals in the United States Who Used Opioids During Pregnancy. J Womens Health (Larchmt) 2023; 32:161-170. [PMID: 36350685 PMCID: PMC9940795 DOI: 10.1089/jwh.2022.0118] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [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] [Indexed: 11/11/2022] Open
Abstract
Background: Opioid use has disproportionally impacted pregnant people and their fetuses. Previous studies describing opioid use among pregnant people are limited by geographic location, type of medical coverage, and small sample size. We described characteristics of a large, diverse group of pregnant people who were enrolled in the Environmental Influences on Child Health Outcomes (ECHO) Program, and determined which characteristics were associated with opioid use during pregnancy. Materials and Methods: Cross-sectional data obtained from 21,905 pregnancies of individuals across the United States enrolled in the ECHO between 1990 and 2021 were analyzed. Medical records, laboratory testing, and self-report were used to determine opioid-exposed pregnancies. Multiple imputation methods using fully conditional specification with a discriminant function accounted for missing characteristics data. Results: Opioid use was present in 2.8% (n = 591) of pregnancies. The majority of people who used opioids in pregnancy were non-Hispanic White (67%) and had at least some college education (69%). Those who used opioids reported high rates of alcohol use (32%) and tobacco use (39%) during the pregnancy; although data were incomplete, only 5% reported heroin use and 86% of opioid use originated from a prescription. After adjustment, non-Hispanic White race, pregnancy during the years 2010-2012, higher parity, tobacco use, and use of illegal drugs during pregnancy were each significantly associated with opioid use during pregnancy. In addition, maternal depression was associated with increased odds of opioid use during pregnancy by more than two-fold (adjusted odds ratio 2.42, 95% confidence interval: 1.95-3.01). Conclusions: In this large study of pregnancies from across the United States, we found several factors that were associated with opioid use among pregnant people. Further studies examining screening for depression and polysubstance use may be useful for targeted interventions to prevent detrimental opioid use during pregnancy, while further elucidation of the reasons for use of prescription opioids during pregnancy should be further explored.
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Affiliation(s)
- Ruby H.N. Nguyen
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, Minnesota, USA
| | - Emily A. Knapp
- Department of Epidemiology, Johns Hopkins School of Public Health, Baltimore, Maryland, USA
| | - Xiuhong Li
- Department of Epidemiology, Johns Hopkins School of Public Health, Baltimore, Maryland, USA
| | - Carlos A. Camargo
- Department of Emergency Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Elisabeth Conradt
- Department of Psychology, Pediatrics, Obstetrics/Gynecology, University of Utah, Salt Lake City, Utah, USA
| | - Whitney Cowell
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mt. Sinai, New York, New York, USA
| | - Karen J. Derefinko
- Department of Preventative Medicine and Pharmacology, Addictive Science, and Toxicology, University of Tennessee, Memphis, Tennessee, USA
| | - Amy J. Elliott
- Department of Pediatrics, Avera Research Institute, School of Medicine, University of South Dakota, Sioux Falls, South Dakota, USA
| | - Alexander M. Friedman
- Department of Obstetrics and Gynecology, School of Medicine, Columbia University, New York, New York, USA
| | - Gurjit K. Khurana Hershey
- Division of Asthma Research, Department of Pediatrics, Cincinnati Children's Hospital, University of Cincinnati, Cincinnati, Ohio, USA
| | - Julie A. Hofheimer
- Department of Pediatrics, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Barry M. Lester
- Department of Psychiatry and Pediatrics, Center for the Study of Children at Risk, Alpert Medical School of Brown University and Women and Infants Hospital of Rhode Island, Providence, Rhode Island, USA
| | - Cindy T. McEvoy
- Department of Pediatrics, Oregon Health and Science University, Portland, Oregon, USA
| | - Jenae M. Neiderhiser
- Department of Psychology, Penn State University, University Park, Pennsylvania, USA
| | - Emily Oken
- Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, Massachusetts, USA
| | - Steven J. Ondersma
- Division of Public Health, Department of Obstetrics, Gynecology, and Reproductive Sciences, Michigan State University, Flint, Michigan, USA
| | - Sheela Sathyanarayana
- Department of Pediatrics, University of Washington, Seattle Children's Research Institute, Seattle, Washington, USA
| | - Meagan E. Stabler
- Department of Epidemiology, Dartmouth Geisel School of Medicine, Hanover, New Hampshire, USA
| | - Annemarie Stroustrup
- Department of Pediatrics and Occupational Medicine, Epidemiology and Prevention, Zucker School of Medicine at Hofstra/Northwell, Hempstead, New York, USA
| | - Irene Tung
- Department of Psychiatry, School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Monica McGrath
- Department of Epidemiology, Johns Hopkins School of Public Health, Baltimore, Maryland, USA
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Derefinko KJ, Bursac Z, Hand SB, Ebbert JO, Womack C, Klesges RC. Planning a Change Easily (PACE) for smokers who are not ready to quit: a telephone-based, randomized controlled trial. Addiction 2022; 117:1748-1757. [PMID: 34985171 DOI: 10.1111/add.15796] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Accepted: 12/09/2021] [Indexed: 11/28/2022]
Abstract
AIMS To compare brief advice (BA), motivational interviewing (MI), rate reduction (RR), and combined MI and RR (MI + RR) to promote smoking cessation in smokers not ready to quit. DESIGN Randomized controlled trial with four parallel groups of smoking cessation intervention. Participants were randomly assigned 1:2:2:2 to receive one of the following interventions: BA (n = 128), MI (n = 258), RR (n = 257), and MI + RR (n = 260). SETTING The United States. All participant contact occurred over the telephone to be consistent with the typical quit line format. PARTICIPANTS A total of 903 adult smokers. Participants had a mean age of 49 (SD = 13.3) years and were 28.9% male and 63.3% Caucasian. INTERVENTIONS The BA group received advice similar to typical smoking cessation quit lines. The MI group received advice using basic MI principles to elicit language that indicates behavioral change. The RR group received behavioral skills training and nicotine gum. The MI + RR group combined elements of MI and RR conditions. All interventions were six sessions. MEASUREMENTS The primary outcome measure was self-reported point prevalence at 12 months. The secondary outcome was self-reported prolonged abstinence at 12 months. FINDINGS Intention to treat (ITT) point prevalence at 12 months indicated that BA (10.9%) had significantly lower point prevalence rates than RR (27.2%, OR = 3.17, 1.69-5.94), and MI + RR (26.9%, OR = 3.16, 1.68-5.93). BA did not have a significantly lower point prevalence rate than MI (15.5%, OR = 1.56, 95% CI = 0.81-3.02). CONCLUSIONS This randomized controlled trial provided evidence that rate reduction, which offers structured behavioral skills and nicotine gum, either alone or combined with motivational interviewing, is the most effective form of cessation intervention for smokers not ready to quit.
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Affiliation(s)
- Karen J Derefinko
- Department of Preventive Medicine, University of Tennessee Health Science Center, Memphis, TN, USA
| | - Zoran Bursac
- Department of Biostatistics, Florida International University, Miami, FL, USA
| | - Sarah B Hand
- Department of Preventive Medicine, University of Tennessee Health Science Center, Memphis, TN, USA
| | - Jon O Ebbert
- Department of Internal Medicine, Mayo Clinic, Rochester, MN, USA
| | - Catherine Womack
- Department of Preventive Medicine, University of Tennessee Health Science Center, Memphis, TN, USA
| | - Robert C Klesges
- Department of Public Health Sciences, University of Virginia School of Medicine, Charlottesville, VA, USA
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García FIS, Indic P, Stapp J, Chintha KK, He Z, Brooks JH, Carreiro S, Derefinko KJ. Using wearable technology to detect prescription opioid self-administration. Pain 2022; 163:e357-e367. [PMID: 34270522 PMCID: PMC10348884 DOI: 10.1097/j.pain.0000000000002375] [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: 09/11/2020] [Accepted: 06/11/2021] [Indexed: 11/25/2022]
Abstract
ABSTRACT Appropriate monitoring of opioid use in patients with pain conditions is paramount, yet it remains a very challenging task. The current work examined the use of a wearable sensor to detect self-administration of opioids after dental surgery using machine learning. Participants were recruited from an oral and maxillofacial surgery clinic. Participants were 46 adult patients (26 female) receiving opioids after dental surgery. Participants wore Empatica E4 sensors during the period they self-administered opioids. The E4 collected physiological parameters including accelerometer x-, y-, and z-axes, heart rate, and electrodermal activity. Four machine learning models provided validation accuracies greater than 80%, but the bagged-tree model provided the highest combination of validation accuracy (83.7%) and area under the receiver operating characteristic curve (0.92). The trained model had a validation sensitivity of 82%, a specificity of 85%, a positive predictive value of 85%, and a negative predictive value of 83%. A subsequent test of the trained model on withheld data had a sensitivity of 81%, a specificity of 88%, a positive predictive value of 87%, and a negative predictive value of 82%. Results from training and testing model of machine learning indicated that opioid self-administration could be identified with reasonable accuracy, leading to considerable possibilities of the use of wearable technology to advance prevention and treatment.
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Affiliation(s)
| | | | | | | | - Zhaomin He
- Department of Nursing, The University of Texas at Tyler, Tyler, TX, United States
| | - Jeffrey H. Brooks
- Department of Oral and Maxillofacial Surgery, University of Tennessee Health Science Center, Memphis, TN, United States
| | - Stephanie Carreiro
- Department of Emergency Medicine, University of Massachusetts Medical School, Worcester, MA, United States
| | - Karen J. Derefinko
- Department of Preventive Medicine, University of Tennessee Health Science Center, Memphis, TN, United States
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Derefinko KJ, Gong Z, Bursac Z, Hand SB, Johnson KC, Mihalko WM. Opioid Use Patterns After Primary Total Knee Replacement. Orthop Clin North Am 2021; 52:103-110. [PMID: 33752831 DOI: 10.1016/j.ocl.2020.12.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
Orthopedic surgeries are associated with the prescription of more narcotics than any other surgical specialty, particularly for total knee replacement (TKR) surgery. The authors examined controlled substance prescriptions following TKR surgery in a sample of 560 TKR patients. Results indicated that of all the 5164 prescriptions documented on the controlled substance monitoring database, 64% were for opioid medications. More than half of the patients received controlled substances from both the surgery site provider and a nonsurgery site provider in the year following surgery. The authors recommend that providers consider the possibility of outside prescribing when prescribing opioid analgesic.
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Affiliation(s)
- Karen J Derefinko
- Department of Preventive Medicine, Department of Pharmacology, Addiction Science, and Toxicology, The University of Tennessee Health Science Center, 66 North Pauline Street, Room 649, Memphis, TN 38163-2181, USA.
| | - Zhenghua Gong
- Department of Biostatistics, Florida International University, 11200 Southwest 8th Street, Miami, FL 33199, USA
| | - Zoran Bursac
- Department of Biostatistics, Florida International University, 11200 Southwest 8th Street, Miami, FL 33199, USA
| | - Sarah B Hand
- Department of Preventive Medicine, University of Tennessee Health Science Center, 403 Doctor's Office Building, 66 North Pauline Street, Memphis, TN 38163, USA. https://twitter.com/SarahHand
| | - Karen C Johnson
- Department of Preventive Medicine, University of Tennessee Health Science Center, 659 Doctor's Office Building, 66 North Pauline Street, Memphis, TN 38163, USA
| | - William M Mihalko
- Department of Orthopaedic Surgery and Biomedical Engineering, Joint Graduate Program in Biomedical Engineering, Campbell Clinic, University of Tennessee Health Science Center, E226 Coleman Building, 956 Court Avenue, Memphis, TN 38163, USA
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Melough MM, Murphy LE, Graff JC, Derefinko KJ, LeWinn KZ, Bush NR, Enquobahrie DA, Loftus CT, Kocak M, Sathyanarayana S, Tylavsky FA. Maternal Plasma 25-Hydroxyvitamin D during Gestation Is Positively Associated with Neurocognitive Development in Offspring at Age 4-6 Years. J Nutr 2020; 151:132-139. [PMID: 33136167 PMCID: PMC7779214 DOI: 10.1093/jn/nxaa309] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Revised: 09/04/2020] [Accepted: 09/15/2020] [Indexed: 01/02/2023] Open
Abstract
BACKGROUND Vitamin D is critical to embryonic neuronal differentiation and other developmental processes that may affect future neurocognitive function. However, observational studies have found inconsistent associations between gestational vitamin D and neurocognitive outcomes. OBJECTIVES We examined the association of gestational 25-hydroxyvitamin D [25(OH)D] with children's IQ at 4-6 y, and explored whether associations differed by race. METHODS This study used data from the CANDLE (Conditions Affecting Neurocognitive Development and Learning in Early Childhood) cohort. Between 2006 and 2011, CANDLE recruited 1503 women in their second trimester of healthy singleton pregnancies. Inclusion criteria for this analysis were gestation of ≥34 wk and availability of 25(OH)D and IQ data. Associations between second-trimester 25(OH)D plasma concentration and Stanford-Binet IQ scores in offspring at 4-6 y were examined using multivariable linear regression; interaction terms were used to explore possible effect modification by race. RESULTS Mean ± SD 25(OH)D concentration among 1019 eligible dyads was 21.6 ± 8.4 ng/mL, measured at a mean ± SD gestational age of 23.0 ± 3.0 wk. Vitamin D deficiency [25(OH)D < 20 ng/mL] was observed in 45.6%. Maternal 25(OH)D differed by race with a mean ± SD of 19.8 ± 7.2 ng/mL in Blacks sand 25.9 ± 9.3 ng/mL in Whites ( P < 0.001). In adjusted models a 10-ng/mL increase in 25(OH)D was associated with a 1.17-point higher Full Scale IQ (95% CI: 0.27, 2.06 points), a 1.17-point higher Verbal IQ (95% CI: 0.19, 2.15 points), and a 1.03-point higher Nonverbal IQ (95% CI: 0.10, 1.95 points). We observed no evidence of effect modification by race. CONCLUSIONS Second-trimester maternal 25(OH)D was positively associated with IQ at 4-6 y, suggesting that gestational vitamin D status may be an important predictor of neurocognitive development. These findings may help inform prenatal nutrition recommendations and may be especially relevant for Black and other dark-skinned women at high risk of vitamin D deficiency.
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Affiliation(s)
| | - Laura E Murphy
- Department of Psychiatry, University of Tennessee Health Science Center, Memphis, TN, USA,Boling Center for Developmental Disabilities, University of Tennessee Health Science Center, Memphis, TN, USA
| | - J Carolyn Graff
- Boling Center for Developmental Disabilities, University of Tennessee Health Science Center, Memphis, TN, USA,College of Nursing, University of Tennessee Health Science Center, Memphis, TN, USA
| | - Karen J Derefinko
- Department of Preventive Medicine, University of Tennessee Health Science Center, Memphis, TN, USA
| | - Kaja Z LeWinn
- Weill Institute for Neurosciences, Department of Psychiatry and Behavioral Sciences, University of California San Francisco, San Francisco, CA, USA
| | - Nicole R Bush
- Weill Institute for Neurosciences, Department of Psychiatry and Behavioral Sciences, University of California San Francisco, San Francisco, CA, USA
| | - Daniel A Enquobahrie
- Department of Epidemiology, University of Washington School of Public Health, Seattle, WA, USA
| | - Christine T Loftus
- Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, WA, USA
| | - Mehmet Kocak
- Department of Preventive Medicine, University of Tennessee Health Science Center, Memphis, TN, USA
| | - Sheela Sathyanarayana
- Department of Child Health, Behavior, and Development, Seattle Children's Research Institute, Seattle, WA, USA,Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, WA, USA,Department of Pediatrics, University of Washington, Seattle, WA, USA
| | - Frances A Tylavsky
- Department of Preventive Medicine, University of Tennessee Health Science Center, Memphis, TN, USA
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Goh PK, Lee CA, Martel MM, Fillmore MT, Derefinko KJ, Lynam DR. Conceptualizing the UPPS‐P model of impulsive personality through network analysis: Key dimensions and general robustness across young adulthood. J Pers 2020; 88:1302-1314. [DOI: 10.1111/jopy.12572] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2019] [Revised: 04/14/2020] [Accepted: 06/24/2020] [Indexed: 12/20/2022]
Affiliation(s)
- Patrick K. Goh
- Department of Psychology University of Kentucky Lexington KY USA
| | - Christine A. Lee
- Division of Behavioral Medicine and Clinical Psychology Cincinnati Children's Hospital Medical Center Cincinnati OH USA
| | | | - Mark T. Fillmore
- Department of Psychology University of Kentucky Lexington KY USA
| | - Karen J. Derefinko
- Department of Preventative Medicine University of Tennessee Health Science Center Memphis TN USA
| | - Donald R. Lynam
- Department of Psychological Sciences Purdue University West Lafayette IN USA
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Sandoval-Sierra JV, Salgado García FI, Brooks JH, Derefinko KJ, Mozhui K. Effect of short-term prescription opioids on DNA methylation of the OPRM1 promoter. Clin Epigenetics 2020; 12:76. [PMID: 32493461 PMCID: PMC7268244 DOI: 10.1186/s13148-020-00868-8] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2020] [Accepted: 05/19/2020] [Indexed: 12/14/2022] Open
Abstract
Background A long-term opioid use has been associated with hypermethylation of the opioid receptor mu 1 (OPRM1) promoter. Very little is currently known about the early epigenetic response to therapeutic opioids. Here, we examine whether we can detect DNA methylation changes associated with a few days’ use of prescribed opioids. Genome-wide DNA methylation was assayed in a cohort of 33 opioid-naïve participants who underwent standard dental surgery followed by opioid self-administration. Saliva samples were collected before surgery (visit 1), and at two postsurgery visits at 2.7 ± 1.5 days (visit 2), and 39 ± 10 days (visit 3) after the discontinuation of opioid analgesics. Results The perioperative methylome underwent significant changes over the three visits that were primarily due to postoperative inflammatory response and cell heterogeneity. To specifically examine the effect of opioids, we started with a candidate gene approach and evaluated 10 CpGs located in the OPRM1 promoter. There was a significant cross-sectional variability in opioid use, and for participants who self-administered the prescribed drugs, the total dosage ranged from 5–210 morphine milligram equivalent (MME). Participants were categorized by cumulative dosage into three groups: < 25 MME, 25–90 MME, and ≥ 90 MME. Using mixed-effects modeling, 4 CpGs had significant positive associations with opioid dose at two-tailed p value < 0.05, and overall, 9 of the 10 OPRM1 promoter CpGs showed the predicted higher methylation in the higher dose groups relative to the lowest dose group. After adjustment for age, cellular heterogeneity, and past tobacco use, the promoter mean methylation also had positive associations with cumulative MME (regression coefficient = 0.0002, one-tailed p value = 0.02) and duration of opioid use (regression coefficient = 0.003, one-tailed p value = 0.001), but this effect was significant only for visit 3. A preliminary epigenome-wide association study identified a significant CpG in the promoter of the RAS-related signaling gene, RASL10A, that may be predictive of opioid dosage. Conclusion The present study provides evidence that the hypermethylation of the OPRM1 promoter is in response to opioid use and that epigenetic differences in OPRM1 and other sites are associated with a short-term use of therapeutic opioids.
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Affiliation(s)
- Jose Vladimir Sandoval-Sierra
- Department of Preventive Medicine, College of Medicine, University of Tennessee Health Science Center, Memphis, Tennessee, USA
| | - Francisco I Salgado García
- Department of Preventive Medicine, College of Medicine, University of Tennessee Health Science Center, Memphis, Tennessee, USA
| | - Jeffrey H Brooks
- Department of Oral and Maxillofacial Surgery, College of Dentistry, University of Tennessee Health Science Center, Memphis, Tennessee, USA
| | - Karen J Derefinko
- Department of Preventive Medicine, College of Medicine, University of Tennessee Health Science Center, Memphis, Tennessee, USA
| | - Khyobeni Mozhui
- Department of Preventive Medicine, College of Medicine, University of Tennessee Health Science Center, Memphis, Tennessee, USA.
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11
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Derefinko KJ, Ashby S, Hayes T, Kaplan C, Bursac Z, García FIS, Madjlesi A, Tonkin L, Bowden M, Popescu F, Waters T. Sexually Transmitted Infections and Contraceptive Use in Adolescents. Am J Prev Med 2020; 58:536-546. [PMID: 32081571 DOI: 10.1016/j.amepre.2019.11.012] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2019] [Revised: 11/07/2019] [Accepted: 11/08/2019] [Indexed: 11/25/2022]
Abstract
INTRODUCTION Although a number of contraception methods exist, long-acting reversible contraceptives have been recommended for female adolescents owing to their low failure rates. However, concern exists that the increasing use of long-acting reversible contraceptive among female adolescents may have unintended consequences of decreasing condom use for the prevention of sexually transmitted infections. Despite this concern, few studies have directly explored the relationship between the use of long-acting reversible contraceptive versus other forms of contraception and diagnosis of sexually transmitted infections in female adolescents. This study compares the rates of sexually transmitted infection diagnosis following various forms of contraceptive use. METHODS This study was an archival data analysis of single state Medicaid claims retrieved for female adolescents, aged 14-19 years, who received a contraceptive prescription and had 1 year of follow-up data available (n=62,550) between 2011 and 2015. Incidence of sexually transmitted infections was the outcome of interest. Data analysis was conducted in 2018. RESULTS Compared with the contraceptive pill, hormonal implant (a form of long-acting reversible contraceptives) was associated with significantly lower risk of sexually transmitted infections (hazard ratio=0.81; 95% CI=0.70, 0.93; p=0.004), and hormonal injection was associated with higher risk of sexually transmitted infections (hazard ratio=1.08; 95% CI=1.00, 1.16; p=0.040). CONCLUSIONS This analysis provides strong evidence that the risk for the acquisition of sexually transmitted infections is no higher for long-acting reversible contraceptives than for other forms of contraception. These results support the use of long-acting reversible contraceptive in female adolescents, as proposed and reaffirmed by the American College of Obstetricians and Gynecologists and American Academy of Pediatrics.
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Affiliation(s)
- Karen J Derefinko
- Department of Preventive Medicine, University of Tennessee Health Science Center, Memphis, Tennessee.
| | | | - Tristan Hayes
- Department of Preventive Medicine, University of Tennessee Health Science Center, Memphis, Tennessee
| | - Cameron Kaplan
- Keck School of Medicine of the University of Southern California, Los Angeles, California
| | - Zoran Bursac
- Robert Stempel College of Public Health, Florida International University, Miami, Florida
| | | | | | - Leah Tonkin
- Obstetrics and Gynecology, Methodist Le Bonheur Healthcare, Memphis, Tennessee
| | - Michelle Bowden
- Department of Pediatrics, University of Tennessee Health Science Center, Memphis, Tennessee
| | | | - Teresa Waters
- College of Public Health, University of Kentucky, Lexington, Kentucky
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12
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Derefinko KJ, Salgado García FI, Johnson KC, Hand S, Murphy JG, McDevitt-Murphy M, Suda KJ, Andrasik F, Bursac Z, Chiu CY, Talley K, Brooks JH. A randomized pilot program to reduce opioid use following dental surgery and increase safe medication return. Addict Behav 2020; 102:106190. [PMID: 31704436 DOI: 10.1016/j.addbeh.2019.106190] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2019] [Revised: 10/21/2019] [Accepted: 10/21/2019] [Indexed: 11/29/2022]
Abstract
Research indicates that increased cumulative exposure (duration of administration and strength of dose) is associated with long-term opioid use. Because dentists represent some of the highest opioid prescribing medical professionals in the US, dental practices offer a critical site for intervention. The current study used a randomized clinical trial design to examine the efficacy of an opioid misuse prevention program (OMPP), presented as a brief intervention immediately prior to dental extraction surgery. The OMPP provided educational counseling about risks and appropriate use of opioid medication, as well as 28 tablets of ibuprofen (200 mg) and 28 tablets of acetaminophen (500 mg) for weaning off opioid medication. This was compared with a Treatment as Usual (TAU) control condition. Participants were individuals presenting for surgery who were eligible for opioid medication (N = 76). Follow up assessment was conducted at 1 week following surgery, with 4 individuals refusing follow up or not prescribed opioid. Intent to treat analysis indicated a non-significant treatment group effect (N = 72, Beta = 0.16, p = .0835), such that the OMPP group self-reported less opioid use (in morphine milligram equivalents, MMEs) than the TAU group (37.94 vs. 47.79, effect size d = 0.42). Sensitivity analysis, excluding individuals with complications following surgery (n = 6) indicated a significant treatment group effect (N = 66, Beta = 0.24, p = .0259), such that the OMPP group self-reported significantly less MMEs than the TAU group (29.74 vs. 43.59, effect size d = 0.56). Results indicate that a 10-minute intervention and provision of non-narcotic pain medications may reduce the amount of self-administered opioid medication following dental surgery.
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Affiliation(s)
- Karen J Derefinko
- University of Tennessee Health Science Center, Department of Preventive Medicine, United States.
| | | | - Karen C Johnson
- University of Tennessee Health Science Center, Department of Preventive Medicine, United States
| | - Sarah Hand
- University of Tennessee Health Science Center, Department of Preventive Medicine, United States
| | - James G Murphy
- University of Memphis, Department of Psychology, United States
| | | | - Katie J Suda
- VA Center of Innovation for Complex Chronic Healthcare, Edward Hines, Jr. VA Hospital and University of Illinois at Chicago, Department of Pharmacy, Systems, Outcomes, and Policy, United States
| | - Frank Andrasik
- University of Memphis, Department of Psychology, United States
| | - Zoran Bursac
- Florida International University, Department of Biostatistics, United States
| | - Chi-Yang Chiu
- University of Tennessee Health Science Center, Department of Preventive Medicine, United States
| | - Kevin Talley
- University of Tennessee Health Science Center, Department of Preventive Medicine, United States
| | - Jeffrey H Brooks
- University of Tennessee Health Science Center, Department of Oral and Maxillofacial Surgery, United States
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13
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Salgado García F, Bursac Z, Derefinko KJ. Cumulative Risk of Substance Use in Community College Students. Am J Addict 2020; 29:97-104. [PMID: 31898858 DOI: 10.1111/ajad.12983] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2019] [Revised: 11/09/2019] [Accepted: 12/15/2019] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Substance use in community college students has been explored in only a handful of studies. Differences in population characteristics and substance use between 2- and 4-year students suggest that different factors may promote and thwart this behavior. Cumulative risk is a parsimonious methodology that provides better model stability and more statistical power, yet it has only been recently used in substance use research. The aim of this study is to investigate multiple aspects of substance use risk in a population in need of substance use prevention and intervention services. METHODS We conducted a cross-sectional study of community college students (N = 288; 75% female) examining the relative contributions of different domains of cumulative risk (eg, life stressors, academic stressors, and mental health diagnoses) to develop different profiles of risk across substance use classes (ie, alcohol, cigarette, marijuana, and hard drug use). RESULTS Cumulative risk analyses indicated that alcohol and tobacco use were associated with the domains of life stressors and peer/family substance use, marijuana use with peer/family substance use and stressful childhood experiences, and hard drug use with peer/family substance use, lack of social support, low access to care, and stressful childhood experiences. DISCUSSION AND CONCLUSIONS Different strategies for prevention and intervention may be necessary to effectively address different forms of substance use in this population. SCIENTIFIC SIGNIFICANCE The risk domain profiles related to specific drugs may lead to targeted interventions to reduce substance use in community college students. (Am J Addict 2020;29:97-104).
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Affiliation(s)
| | - Zoran Bursac
- Biostatistics Consulting Service Center, Florida International University, Miami, Florida
| | - Karen J Derefinko
- Department of Preventive Medicine, University of Tennessee Health Science Center, Memphis, Tennessee
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14
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Derefinko KJ, Salgado García FI, Talley KM, Bursac Z, Johnson KC, Murphy JG, McDevitt-Murphy ME, Andrasik F, Sumrok DD. Adverse childhood experiences predict opioid relapse during treatment among rural adults. Addict Behav 2019; 96:171-174. [PMID: 31102882 DOI: 10.1016/j.addbeh.2019.05.008] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [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: 10/17/2018] [Revised: 05/06/2019] [Accepted: 05/06/2019] [Indexed: 11/19/2022]
Abstract
Adverse childhood experiences (ACE) are a public health concern and strong predictor of substance abuse, but no studies to date have explored the association between ACE and opioid relapse during medication-assisted treatment. Using an observational design, we examined this relationship using archived medical records of 87 patients who attended opioid use disorder treatment (buprenorphine-naloxone and group counseling) at a rural medical clinic. All variables were collected from medical files. ACE scores were derived from a 10-item screening questionnaire administered at intake, a regular procedure for this clinic. The primary outcome was opioid relapse observed at each visit, as indicated by self-reported opioid use, positive urine drug screen for opioids, or prescription drug database results for opioid acquisition. The sample was 100% Caucasian and 75% male. A total of 2052 visit observations from the 87 patients were extracted from the medical records. Patients had an average of 23.6 (SD = 22) treatment visits. Opioid relapse occurred in 54% of patients. Results indicated that for every unit increase in ACE score, there was an increase of 17% in the odds of relapse (95% CI: 1.05-1.30, p = .005). Additionally, each treatment visit was associated with a 2% reduction in the odds of opioid relapse (95% CI: 0.97-0.99, p = .008). We conclude that ACE may increase the risk for poor response to buprenorphine-naloxone treatment due to high rates of opioid relapse during the first treatment visits. However, consistent adherence to treatment is likely to reduce the odds of opioid relapse.
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Affiliation(s)
- Karen J Derefinko
- University of Tennessee Health Science Center, 66 North Pauline St., Room 649, Memphis, TN 38163-2181, USA.
| | - Francisco I Salgado García
- University of Tennessee Health Science Center, 66 North Pauline St., Room 649, Memphis, TN 38163-2181, USA
| | - Kevin M Talley
- University of Tennessee Health Science Center, 66 North Pauline St., Room 649, Memphis, TN 38163-2181, USA
| | - Zoran Bursac
- University of Tennessee Health Science Center, 66 North Pauline St., Room 649, Memphis, TN 38163-2181, USA
| | - Karen C Johnson
- University of Tennessee Health Science Center, 66 North Pauline St., Room 649, Memphis, TN 38163-2181, USA
| | - James G Murphy
- University of Memphis, Psychology Building, 400 Innovation Dr., Memphis, TN 38111, USA
| | | | - Frank Andrasik
- University of Memphis, Psychology Building, 400 Innovation Dr., Memphis, TN 38111, USA
| | - Daniel D Sumrok
- University of Tennessee Health Science Center, 66 North Pauline St., Room 649, Memphis, TN 38163-2181, USA
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15
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Derefinko KJ, Hallsell TA, Isaacs MB, Salgado Garcia FI, Colvin LW, Bursac Z, McDevitt-Murphy ME, Murphy JG, Little MA, Talcott GW, Klesges RC. Substance Use and Psychological Distress Before and After the Military to Civilian Transition. Mil Med 2019; 183:e258-e265. [PMID: 29420791 DOI: 10.1093/milmed/usx082] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2017] [Accepted: 10/30/2017] [Indexed: 11/13/2022] Open
Abstract
Background Those currently serving in the military constitute a vulnerable population given their high-risk status for substance use, and population data suggest that veterans continue to engage in significant substance use long after their military service ends. Recent research suggests that the separation transition from active duty to civilian life may be critical in terms of the future functioning of the veteran. Methods We sought to explore substance use prevalence, as well as potential emotional distress among veterans by retrospectively assessing substance use during active duty and following separation to examine possible changes in use over this period. This study assessed substance use and emotional distress in veterans (N = 80; 90% male) across the military to civilian transition. Findings Repeated measures tests indicated that endorsement of alcohol use, cigarette use, and prescription drug misuse was similar during active duty and post-separation, and marijuana and hard drug use endorsement increased significantly in the 6-mo period post-separation. Further, comorbid use of different substances was common. Active duty levels of anxiety/depression and aggressive feelings were maintained from active duty to post-separation, and feeling alone and military-based trauma symptoms increased significantly. Finally, participants indicated that only a minority of the veterans they knew were doing emotionally well or did not have alcohol/substance use issues. Discussion These findings indicate a clear need for substance use and psychological intervention availability before and after transition to enable veterans to transition to civilian life effectively. Based on the many issues at work during the transition process, programs may do well to focus more specifically on identification of problems and raising awareness, rather than awaiting more severe issues in the future. Validation of the difficulties of the separation transition, veterans' feelings of isolation, and the importance of veteran community support may help newly transitioning veterans find advocates who may help them navigate existing assistance programs.
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Affiliation(s)
- Karen J Derefinko
- Department of Preventive Medicine, University of Tennessee Health Sciences Center, 66 N. Pauline St., Memphis, TN 38163-2181
| | - Troy A Hallsell
- Department of History, The University of Memphis, Memphis, TN 38152-3450
| | - Matthew B Isaacs
- Department of History, The University of Memphis, Memphis, TN 38152-3450
| | - Francisco I Salgado Garcia
- Department of Preventive Medicine, University of Tennessee Health Sciences Center, 66 N. Pauline St., Memphis, TN 38163-2181
| | - Lauren W Colvin
- Research Informatics for the Cancer Center, St. Jude Children's Research Hospital, 262 Danny Thomas Place, Memphis, TN 38105
| | - Zoran Bursac
- Department of Preventive Medicine, University of Tennessee Health Sciences Center, 66 N. Pauline St., Memphis, TN 38163-2181
| | | | - James G Murphy
- Department of Psychology, University of Memphis, 400 Innovation Drive, Memphis, TN 38152
| | - Melissa A Little
- Department of Public Health Sciences, University of Virginia School of Medicine, 560 Ray Hunt Drive, Room 2120, Charlottesville, VA 22911
| | - Gerald W Talcott
- Department of Public Health Sciences, University of Virginia School of Medicine, 560 Ray Hunt Drive, Room 2120, Charlottesville, VA 22911
| | - Robert C Klesges
- Department of Public Health Sciences, University of Virginia School of Medicine, 560 Ray Hunt Drive, Room 2120, Charlottesville, VA 22911
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16
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Salgado García FI, Derefinko KJ, Bursac Z, Klesges RC, Ebbert JO, Womack CR, Krukowski RA. Fit & quit: An efficacy trial of two behavioral post-cessation weight gain interventions. Contemp Clin Trials 2019; 76:31-40. [PMID: 30445176 PMCID: PMC6519455 DOI: 10.1016/j.cct.2018.11.009] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2018] [Revised: 11/07/2018] [Accepted: 11/12/2018] [Indexed: 12/24/2022]
Abstract
While smoking cessation leads to significant improvements in both mortality and morbidity, post-cessation weight gain partially attenuates this benefit. Even though post-cessation weight gain is small (4.7 kg on average), it is a stated reason to delay cessation attempts and is associated with smoking relapse. Fit & Quit is a randomized, controlled efficacy trial that aims to examine the ability of a weight stability intervention and a weight loss intervention to reduce post-cessation weight gain. For this purpose, Fit & Quit will randomize participants to three conditions: (a) Small Changes, a weight gain prevention intervention; (b) Look AHEAD Intensive Lifestyle Intervention; and (c) a lower-intensity bibliotherapy intervention. All conditions will receive a highly efficacious behavioral (i.e., rate reduction skills, motivational interviewing) and pharmacological (i.e., varenicline) smoking cessation program. A total of 400 participants will be recruited and randomized to the three interventions. Participants will be recruited in waves, with 10 waves of approximately 40 participants per wave. The primary outcomes of this study include post-cessation weight gain and cessation status at 12-month follow-up. Fit & Quit will integrate and adapt the strongest evidence-based interventions available for weight management and smoking cessation. Fit & Quit is highly innovative in the areas of the target population, study design, and use of technology. For these reasons, we expect that Fit & Quit will make a significant public health contribution to curtailing the important cessation barrier of post-cessation weight gain.
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Affiliation(s)
- Francisco I Salgado García
- Department of Preventive Medicine, University of Tennessee Health Science Center, 66 N. Pauline St., Memphis, TN 38163, USA.
| | - Karen J Derefinko
- Department of Preventive Medicine, University of Tennessee Health Science Center, 66 N. Pauline St., Memphis, TN 38163, USA
| | - Zoran Bursac
- Department of Preventive Medicine, University of Tennessee Health Science Center, 66 N. Pauline St., Memphis, TN 38163, USA
| | - Robert C Klesges
- Department of Public Health Sciences, University of Virginia School of Medicine, 560 Ray Hunt Drive, Charlottesville, VA 22911, USA
| | - Jon O Ebbert
- Department of Medicine, Mayo Clinic, 200 1st Street SW, Rochester, MN 55905, USA
| | - Catherine R Womack
- Department of Preventive Medicine, University of Tennessee Health Science Center, 66 N. Pauline St., Memphis, TN 38163, USA; Department of Medicine, University of Tennessee Health Science Center, 956 Court Ave., Memphis, TN 38163, USA
| | - Rebecca A Krukowski
- Department of Preventive Medicine, University of Tennessee Health Science Center, 66 N. Pauline St., Memphis, TN 38163, USA
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17
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Derefinko KJ, Hallsell TA, Isaacs MB, Colvin LW, Salgado Garcia FI, Bursac Z. Perceived Needs of Veterans Transitioning from the Military to Civilian Life. J Behav Health Serv Res 2018; 46:384-398. [DOI: 10.1007/s11414-018-9633-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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18
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Peters JR, Eisenlohr-Moul TA, Walsh EC, Derefinko KJ. Exploring the pathophysiology of emotion-based impulsivity: The roles of the sympathetic nervous system and hostile reactivity. Psychiatry Res 2018; 267:368-375. [PMID: 29957555 PMCID: PMC6309543 DOI: 10.1016/j.psychres.2018.06.013] [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] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2017] [Revised: 06/07/2018] [Accepted: 06/07/2018] [Indexed: 11/22/2022]
Abstract
The tendency to engage in impulsive behavior in the context of negative affect, known as negative urgency, has emerged as a powerful transdiagnostic predictor of behavioral dysregulation. Although general vulnerability to negative affect (neuroticism) correlates with negative urgency, not all neurotic individuals engage in urgent behavior. Given prior experimental evidence that sympathetic nervous system (SNS) activation may promote emotion-related impulsivity, the present study examines tonic SNS activity as a moderator of the link between neuroticism and negative urgency. Participants (N = 194) completed measures of neuroticism and negative urgency, as well as a stress task. They also underwent assessment of tonic SNS activity (cardiac pre-ejection period). The link between neuroticism and negative urgency was strengthened for individuals with higher tonic SNS activity; however, this was not the case for behavioral performance on the task. A similar pattern was demonstrated for hostile reactivity to the stress task; increased hostile response partially explained the interaction between SNS activation and neuroticism on negative urgency. These findings suggest a potential facilitative role of the SNS in hostile reactivity and emotion-driven impulsivity among more neurotic individuals.
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Affiliation(s)
- Jessica R Peters
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, RI, USA.
| | | | - Erin C Walsh
- Department of Physical Medicine and Rehabilitation, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Karen J Derefinko
- Department of Preventive Medicine, University of Tennessee Health Science Center, Memphis, TN, USA
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Abstract
This article summarizes the literature regarding the similar biopsychosocial mechanisms of tobacco use and alcohol and substance use disorders, and the evidence for and against the provision of tobacco cessation for those in treatment for alcohol and substance use disorders. The practicality of treatment, focusing on methods, timing, and breadth of intervention strategies, are also presented. Common methodologies that may be used across tobacco use and alcohol and substance use disorder to prevent lapse and relapse are discussed. Physicians can and should adhere to the policy that tobacco use is a common and dangerous comorbid condition that demands concomitant treatment.
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Affiliation(s)
- Karen J Derefinko
- University of Tennessee Health Science Center, 66 North Pauline Street, Suite 305, Memphis, TN 38163-2181, USA.
| | - Francisco I Salgado García
- University of Tennessee Health Science Center, 66 North Pauline Street, Suite 305, Memphis, TN 38163-2181, USA
| | - Daniel D Sumrok
- University of Tennessee Health Science Center, Department of Addiction Medicine, 6401 Popular Avenue, Suite 500, Memphis, TN 38119, USA
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20
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Salgado García FI, Derefinko KJ, Bursac Z, Hand S, Klesges RC. Planning a Change Easily (PACE): A randomized controlled trial for smokers who are not ready to quit. Contemp Clin Trials 2018; 68:14-22. [PMID: 29549007 PMCID: PMC5899672 DOI: 10.1016/j.cct.2018.03.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2017] [Revised: 02/28/2018] [Accepted: 03/12/2018] [Indexed: 11/20/2022]
Abstract
Smoking cessation programs are efficacious and have been validated to assist the 10% to 30% of smokers who are ready to quit in the next 30 days. While the majority of smokers want to quit smoking in the future, only 69% are planning to quit within the next year. Planning a Change Easily (PACE) is a nation-wide, telephone-based comparative effectiveness, randomized controlled trial for smokers not ready to quit (SNRTQ). This project, as well as its intervention components, outcomes, and hypotheses are discussed. This study will compare the effectiveness of four intervention conditions that could potentially help SNRTQ to quit smoking: Brief Advice, Motivational Interviewing, Rate Reduction, and Motivational Interviewing plus Rate Reduction combined. Rate Reduction conditions will include the provision of nicotine replacement therapy in the form of gum. Approximately 840 participants will be recruited and randomized to the four intervention conditions. The main outcomes for this study include self-report prolonged and point prevalence abstinence with biochemical verification of cessation. Secondary outcomes include quit attempts, cost-per-quit, and cost-effectiveness analyses. Informed by evidenced-based interventions, strong clinical guidelines, and economic analysis, PACE has the potential for significant public health impact. Results could readily be disseminated and translated to tobacco quitlines, which are present in all 50 states and are offered free to the public.
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Affiliation(s)
- Francisco I Salgado García
- Department of Preventive Medicine, University of Tennessee Health Science Center, 66 N Pauline St., Memphis, TN 38163, USA.
| | - Karen J Derefinko
- Department of Preventive Medicine, University of Tennessee Health Science Center, 66 N Pauline St., Memphis, TN 38163, USA
| | - Zoran Bursac
- Department of Preventive Medicine, University of Tennessee Health Science Center, 66 N Pauline St., Memphis, TN 38163, USA
| | - Sarah Hand
- Department of Preventive Medicine, University of Tennessee Health Science Center, 66 N Pauline St., Memphis, TN 38163, USA
| | - Robert C Klesges
- Department of Public Health Sciences, University of Virginia School of Medicine, 560 Ray Hunt Drive, Charlottesville, VA 22911, USA
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21
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Derefinko KJ, Linde BD, Klesges RC, Boothe T, Colvin L, Leroy K, Little MA, Pasker C, Murphy JG, McDevitt-Murphy ME, Bursac Z, Ebbert JO, Waters TM, Brooks I, Talcott GW. Dissemination of the Brief Alcohol Intervention in the United States Air Force: Study Rationale, Design, and Methods. ACTA ACUST UNITED AC 2017. [DOI: 10.1080/21635781.2017.1397569] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Karen J. Derefinko
- Department of Preventive Medicine, University of Tennessee Health Sciences Center, Memphis, Tennessee
| | - Brittany D. Linde
- Organizational Wellness & Learning Systems (OWLS), Fort Worth, Texas
| | - Robert C. Klesges
- Department of Preventive Medicine, University of Tennessee Health Sciences Center, Memphis, Tennessee
| | - Tina Boothe
- Department of Preventive Medicine, University of Tennessee Health Sciences Center, San Antonio, Texas
| | - Lauren Colvin
- Department of Preventive Medicine, University of Tennessee Health Sciences Center, Memphis, Tennessee
| | - Karen Leroy
- Department of Preventive Medicine, University of Tennessee Health Sciences Center, San Antonio, Texas
| | - Melissa A. Little
- Department of Preventive Medicine, University of Tennessee Health Sciences Center, San Antonio, Texas
| | - Christin Pasker
- Department of Preventive Medicine, University of Tennessee Health Sciences Center, San Antonio, Texas
| | - James G. Murphy
- Department of Psychology, The University of Memphis, Memphis, Tennessee
| | - Meghan E. McDevitt-Murphy
- Department of Preventive Medicine, University of Tennessee Health Sciences Center, Memphis, Tennessee
| | - Zoran Bursac
- Department of Preventive Medicine, University of Tennessee Health Sciences Center, Memphis, Tennessee
| | - Jon O. Ebbert
- Nicotine Dependence Center, Mayo Clinic, Rochester, Minnesota
| | - Teresa M. Waters
- Department of Preventive Medicine, University of Tennessee Health Sciences Center, Memphis, Tennessee
| | - Ian Brooks
- Department of Preventive Medicine, University of Tennessee Health Sciences Center, Memphis, Tennessee
| | - G. Wayne Talcott
- Department of Preventive Medicine, University of Tennessee Health Sciences Center, San Antonio, Texas
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Haas SM, Derefinko KJ, Waschbusch DA. The use of multimethod impulsivity assessment in the prediction of ADHD, conduct problems, and callous-unemotional symptoms. Personality and Individual Differences 2017. [DOI: 10.1016/j.paid.2017.04.028] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Lee CA, Derefinko KJ, Davis HA, Milich R, Lynam DR. Cross-lagged relations between motives and substance use: Can use strengthen your motivation over time? Drug Alcohol Depend 2017; 178:544-550. [PMID: 28732317 PMCID: PMC5562286 DOI: 10.1016/j.drugalcdep.2017.05.027] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2017] [Revised: 05/11/2017] [Accepted: 05/17/2017] [Indexed: 11/16/2022]
Abstract
Motives for substance use have garnered considerable attention due to the strong predictive utility of this construct, both in terms of use and problems associated with use. The current study examined the cross-lagged relations between alcohol use and motives, and marijuana use and motives over three yearly assessment periods in a large sample (N=526, 48% male) of college students. The relations between substance use and motives were assessed at each time point, allowing for the examination of these inter-relations over time. Results indicated different trends based on the type of substance. For alcohol use, cross-lagged trends were found between freshman and sophomore year for coping, social, and conformity motives with cross-lagged relations between enhancement motives and alcohol use across all years. However, outside of enhancement motives, cross-lagged relations were not found between sophomore and junior year. In contrast, cross-lagged effects were found for marijuana use and coping, enhancement, and expansion motives between sophomore and junior year, but not freshman year. These results suggest that people's expectations that drinking or smoking marijuana makes activities more reinforcing and helps them cope with distress may perpetuate use. In turn, use itself may enhance these expectations over time. Results have direct implications for treatment, with recommended focus on motives, behavior activation, and healthy coping skills in order to interrupt the cycle of substance use.
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Derefinko KJ, Charnigo RJ, Peters JR, Adams ZW, Milich R, Lynam DR. Substance Use Trajectories From Early Adolescence Through the Transition to College. J Stud Alcohol Drugs 2017; 77:924-935. [PMID: 27797694 DOI: 10.15288/jsad.2016.77.924] [Citation(s) in RCA: 68] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE The transition to college is an important developmental period for the development of alcohol, marijuana, and hard drug (cocaine, opiates, inhalants, stimulants, hallucinogens, Ecstasy, club drugs) use. The current study explored specific changes in substance use patterns during and after the transition to college through the use of trajectory analyses. METHOD Participants were 526 students who reported retrospectively and prospectively on their substance use from age 13 through the junior year of college. Group-based trajectory modeling was used to estimate developmental trajectory groups for alcohol, marijuana, and hard drug use during this period. RESULTS Results supported a five-group model of alcohol use, a four-group model of marijuana use, and a four-group model of hard drug use. Although three of the five alcohol trajectories indicated high escalation throughout adolescence, one of these groups decreased in alcohol use dramatically during the freshman and sophomore years, a trend also found for hard drug use. Trajectories demonstrated significant differences in terms of gender, race, and impulsive personality characteristics. CONCLUSIONS These results indicate that the start of college is an important developmental transition in terms of polysubstance use, and that despite the homogeneity of this undergraduate sample, there is considerable divergence in trajectories during college.
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Affiliation(s)
- Karen J Derefinko
- Department of Preventive Medicine, University of Tennessee Health Sciences Center, Memphis, Tennessee.,Department of Psychology, University of Kentucky, Lexington, Kentucky
| | - Richard J Charnigo
- Department of Biostatistics and Statistics, University of Kentucky, Lexington, Kentucky
| | - Jessica R Peters
- Department of Psychology, University of Kentucky, Lexington, Kentucky.,Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, Rhode Island
| | - Zachary W Adams
- Department of Psychiatry, Medical University of South Carolina, Charleston, South Carolina
| | - Richard Milich
- Department of Psychology, University of Kentucky, Lexington, Kentucky
| | - Donald R Lynam
- Department of Psychological Sciences, Purdue University, West Lafayette, Indiana
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Derefinko KJ, Bursac Z, Mejia MG, Milich R, Lynam DR. Rural and urban substance use differences: Effects of the transition to college. Am J Drug Alcohol Abuse 2017; 44:224-234. [PMID: 28726520 DOI: 10.1080/00952990.2017.1341903] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
BACKGROUND With approximately 20% of Americans residing in rural communities, substance use differences is an important topic for appropriate use of resources, policy decisions, and the development of prevention and intervention programs. OBJECTIVES The current study examined differences in alcohol, tobacco, and marijuana use among students from rural and urban backgrounds across the transition to college. METHODS Participants were 431 (48% male) undergraduate students from a large, public southeastern university who provided yearly alcohol, tobacco, and marijuana use data during freshman, sophomore, and junior years. RESULTS Prevalence of alcohol, tobacco, and marijuana use was lower during early college years, and females were less likely to use tobacco and marijuana. Results indicated that rural individuals were less likely to use alcohol and marijuana than their urban counterparts as freshmen, but rose to meet the rates of urban students by junior year. In contrast, no rural/urban differences in tobacco were noted, although rural minorities were more likely to endorse tobacco use across all years. Finally, perceived peer use of each substance was a significant predictor of future use of that substance for all years. CONCLUSION This is the first study to explore rural/urban, gender, and racial differences in substance use across the college transition. Results suggest that there are subgroups of individuals at specific risk who may benefit not only from feedback regarding the influence of perceived peer use in college, but also from a deeper understanding of how cultural norms maintain their substance use behaviors over time.
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Affiliation(s)
- Karen J Derefinko
- a Department of Preventive Medicine , University of Tennessee Health Sciences Center , Memphis , TN , USA
| | - Zoran Bursac
- a Department of Preventive Medicine , University of Tennessee Health Sciences Center , Memphis , TN , USA
| | - Michael G Mejia
- b Department of Education , University of Kentucky, Lexington , KY , USA
| | - Richard Milich
- c Department of Psychology , University of Kentucky , Lexington , KY , USA
| | - Donald R Lynam
- d Department of Psychological Sciences , Purdue University , West Lafayette , IN , USA
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Abstract
Theorists argue that self-control failure is the underlying cause of criminal behavior, with previous research linking poor self-control to delinquency and drug use. The path from self-control to crime is well-established, but less is known about whether criminal behavior contributes to self-control deficits over time. We investigated bi-directional relations between self-control assessed via a delay discounting task and self-reported crime over a three-year period. During their first, second (73.38% retention rate), and third (63.12% retention rate) years of college, 526 undergraduates completed a delay discounting task and reported on their criminal behavior. In order to maximize variability, participants with conduct problems were overrecruited, comprising 23.1% of the final sample. As expected, more discounting of hypothetical monetary rewards significantly predicted future property crime across a one and two-year period, even when controlling for initial levels of both. This study also demonstrated evidence of a bi-directional relationship; violent crime predicted higher rates of delay discounting one year later. These results suggest that bi-directional relations exist between self-control and types of crime.
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Abstract
Many studies have demonstrated that borderline personality disorder (BPD) is associated with aggression and, in particular, intimate partner violence; however, the mechanisms underlying this association have been less clearly identified. The present study examines the hypothesis that negative urgency (impulsive behavior in response to intense, negative emotions) may explain the specific association between BPD and intimate partner violence. Cross-sectional self-report measures of BPD, violent behavior, and multiple dimensions of impulsivity were administered to 193 undergraduate men. BPD profile scores were associated with both general violence behaviors and intimate partner violence; however, an indirect path via negative urgency existed only with intimate partner violence. No indirect paths from BPD scores were demonstrated via any other factors of impulsivity, although sensation seeking was an independent predictor of general violence. Clinical implications and directions for future research are discussed.
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Affiliation(s)
- Jessica R. Peters
- University of Kentucky, Department of Psychology
- Alpert Medical School of Brown University, Department of Psychiatry and Human Behavior
| | - Karen J. Derefinko
- University of Kentucky, Department of Psychology
- University of Tennessee Health Science Center, Department of Preventative Medicine
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Li T, Waters TM, Kaplan EK, Kaplan CM, Nyarko KA, Derefinko KJ, Talcott GW, Klesges RC. Economic Analyses of an Alcohol Misconduct Prevention Program in a Military Setting. Mil Med 2017; 182:e1562-e1567. [PMID: 28051974 DOI: 10.7205/milmed-d-16-00098] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
OBJECTIVE The economic burden associated with alcohol misuse, in particular early attrition or discharge associated with alcohol-related incidents (ARIs), is significant in military settings. We assessed the potential economic benefit of a brief alcohol intervention program, the Alcohol Misconduct Prevention Program (AMPP), initially implemented at Joint Base San Antonio-Lackland Technical Training site for the U.S. Air Force (USAF) from October 1, 2010, to December 31, 2012. METHODS We conducted cost-effectiveness and cost-benefit analyses of the AMPP from the perspective of the USAF. Program effectiveness was measured as the number of ARIs avoided after the AMPP implementation, and program benefit was measured as the potential cost savings related to reductions in ARIs. One-way sensitivity analyses were conducted to examine the robustness of base case results. RESULTS The AMPP resulted in the avoidance of 59 ARIs which cost $9,869 for every ARI avoided. For every dollar invested in the AMPP, the USAF saved $4.09 in a conservative model without health effects, and saved $6.17 taking into account the potential health benefits. Our findings of favorable cost benefit were robust across sensitivity analyses. CONCLUSIONS Investing in the AMPP at other military bases is likely to produce substantial economic benefit.
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Affiliation(s)
- Tao Li
- Department of Preventive Medicine, University of Tennessee Health Science Center, 66 North Pauline Street, Memphis, TN 38163
| | - Teresa M Waters
- Department of Preventive Medicine, University of Tennessee Health Science Center, 66 North Pauline Street, Memphis, TN 38163
| | - Erin K Kaplan
- Department of Preventive Medicine, University of Tennessee Health Science Center, 66 North Pauline Street, Memphis, TN 38163
| | - Cameron M Kaplan
- Department of Preventive Medicine, University of Tennessee Health Science Center, 66 North Pauline Street, Memphis, TN 38163
| | - Kwame A Nyarko
- Department of Preventive Medicine, University of Tennessee Health Science Center, 66 North Pauline Street, Memphis, TN 38163
| | - Karen J Derefinko
- Department of Preventive Medicine, University of Tennessee Health Science Center, 66 North Pauline Street, Memphis, TN 38163
| | - Gerald W Talcott
- Department of Preventive Medicine, University of Tennessee Health Science Center, 66 North Pauline Street, Memphis, TN 38163
| | - Robert C Klesges
- Department of Preventive Medicine, University of Tennessee Health Science Center, 66 North Pauline Street, Memphis, TN 38163
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Rhodes JD, Pelham WE, Gnagy EM, Shiffman S, Derefinko KJ, Molina BSG. Cigarette smoking and ADHD: An examination of prognostically relevant smoking behaviors among adolescents and young adults. Psychol Addict Behav 2016; 30:588-600. [PMID: 27824233 PMCID: PMC5117481 DOI: 10.1037/adb0000188] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [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] [Indexed: 12/30/2022]
Abstract
Attention-deficit/hyperactivity disorder (ADHD) is associated with health risks in adolescence which includes the potential for smoking cigarettes, early smoking initiation, and rapid progression to daily smoking. Much less is known, however, about prognostically relevant smoking behaviors among individuals with childhood ADHD. Further research in this area is important for identifying individuals at pronounced risk for nicotine addiction, and for developing effective interventions for this population. This study examined initiation of cigarette smoking, progression to regular smoking, quantity of use, indicators of tobacco dependence, and quit rates among adolescents and young adults with (n = 364) and without (n = 240) childhood ADHD. Individuals with, versus without, ADHD histories were significantly more likely to become daily smokers independent of conduct disorder (CD). They were also more likely to initiate smoking at younger ages and to progress to regular smoking more quickly. There were no significant group differences in cigarettes smoked per day, Fagerström Test of Nicotine Dependence (FTND), or Nicotine Dependence Syndrome Scale (NDSS) scores or in smoking within 30 min of waking. However, smokers with ADHD reported more intense withdrawal and craving during periods of abstinence than non-ADHD smokers. There were no significant group differences in number of quit attempts. Lastly, there were no significant differences among symptom persisters and desisters in daily smoking and amount. Individuals with ADHD histories are at high risk for persistent smoking given their early onset, rapid course, and abstinence characteristics. Smoking cessation programs may need to be adapted or otherwise intensified for those with ADHD. (PsycINFO Database Record
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Affiliation(s)
| | - William E Pelham
- Center for Children and Families, Florida International University
| | | | | | - Karen J Derefinko
- Department of Preventive Medicine, University of Tennessee Health Science Center
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Little MA, Bursac Z, Derefinko KJ, Ebbert JO, Talcott GW, Hryshko-Mullen A, Klesges RC. Types of Dual and Poly-Tobacco Users in the US Military. Am J Epidemiol 2016; 184:211-8. [PMID: 27421292 DOI: 10.1093/aje/kwv321] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2015] [Accepted: 11/10/2015] [Indexed: 11/14/2022] Open
Abstract
The present investigation was designed to determine the prevalence and types of dual and poly-use of tobacco products in the US Air Force, as well as characteristics and factors associated with these types. We conducted a cross-sectional assessment of tobacco-product use among 13,873 Air Force trainees from 2013 to 2014. The assessment included prevalence of the use of 10 different tobacco products and demographic and environmental factors, such as risk perceptions of tobacco use, peer use, and tobacco-company influences. Latent class analysis was carried out to determine types of poly-tobacco users. Tobacco-product use was reported by 27.1% of participants, and of those, over half reported using more than 1 tobacco product. Latent class analysis indicated 5 classes of poly-tobacco use. Factors associated with poly-tobacco (vs. mono-tobacco) use included lower confidence to remain tobacco-free, low harm perceptions, and receiving tobacco products free at bars or social events. Rates of dual and poly-tobacco use are high among trainees, and while these groups are similar to mono users in some ways, there are a number of differences that need to be considered when developing targeted interventions to address use of multiple tobacco products.
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Derefinko KJ, Klesges RC, Bursac Z, Little MA, Hryshko-Mullen A, Talcott GW. Alcohol issues prior to training in the United States Air Force. Addict Behav 2016; 58:142-8. [PMID: 26945450 DOI: 10.1016/j.addbeh.2016.02.028] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [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: 07/29/2015] [Revised: 01/15/2016] [Accepted: 02/14/2016] [Indexed: 11/30/2022]
Abstract
The negative impact of alcohol is a significant concern to the US military given the costs associated with alcohol-related offenses. Despite considerable research in active duty personnel, relatively little is known about the current extent of alcohol use among incoming recruits. We examined the history of alcohol use and harmful patterns of alcohol consumption among recruits entering the United States Air Force (USAF; N=50,549) over the span of 4 years (2010-2014). Across all years, drinking rates reflected national average trends for those aged 18-24 (NIDA, 2014). However, when abstainers were excluded, those under 21 (n=10,568) reported an average of 18.4 drinks per week, whereas those age 21 and over (n=14,188) reported an average of 14.1 drinks per week, suggesting that for those who drink, those under 21 are exhibiting more risky drinking rates. Alcohol Use Disorders Identification Task (AUDIT) scores for drinkers reflected these same trends. For those under 21, 58% scored in risk categories of 2 or higher (risky drinking warranting attention), compared with 40% for those age 21 and over. These scores indicate that for recruits in the USAF, approximately half report alcohol use immediately prior to basic training, resulting in the inheritance of these potential alcohol related issues for those conducting training of these recruits. Based upon these numbers, brief alcohol interventions could have a potential positive impact on individuals in their initial training stages of the USAF to prevent these baseline issues from resulting in problems later in their military careers.
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Affiliation(s)
- Karen J Derefinko
- University of Tennessee Health Sciences Center, Department of Preventive Medicine, 66 N. Pauline St., Memphis, TN 38163-2181, United States.
| | - Robert C Klesges
- University of Tennessee Health Sciences Center, Department of Preventive Medicine, 66 N. Pauline St., Memphis, TN 38163-2181, United States
| | - Zoran Bursac
- University of Tennessee Health Sciences Center, Department of Preventive Medicine, 66 N. Pauline St., Memphis, TN 38163-2181, United States
| | - Melissa A Little
- University of Tennessee Health Sciences Center, Department of Preventive Medicine, 66 N. Pauline St., Memphis, TN 38163-2181, United States
| | - Ann Hryshko-Mullen
- Lackland Air Force Base, 59th Medical Wing, San Antonio, TX 78236-9908, United States
| | - Gerald W Talcott
- University of Tennessee Health Sciences Center, Department of Preventive Medicine, 66 N. Pauline St., Memphis, TN 38163-2181, United States; Lackland Air Force Base, 59th Medical Wing, San Antonio, TX 78236-9908, United States
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Derefinko KJ, Eisenlohr-Moul TA, Peters JR, Roberts W, Walsh EC, Milich R, Lynam DR. Physiological response to reward and extinction predicts alcohol, marijuana, and cigarette use two years later. Drug Alcohol Depend 2016; 163 Suppl 1:S29-36. [PMID: 27306728 PMCID: PMC5399675 DOI: 10.1016/j.drugalcdep.2016.01.034] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2015] [Revised: 01/14/2016] [Accepted: 01/26/2016] [Indexed: 11/18/2022]
Abstract
BACKGROUND Physiological responses to reward and extinction are believed to represent the behavioral activation system (BAS) and behavioral inhibition system (BIS) constructs of Reinforcement Sensitivity Theory and underlie externalizing behaviors, including substance use. However, little research has examined these relations directly. METHODS We assessed individuals' cardiac pre-ejection periods (PEP) and electrodermal responses (EDR) during reward and extinction trials through the "number elimination game" paradigm. Responses represented BAS and BIS, respectively. We then examined whether these responses provided incremental utility in the prediction of future alcohol, marijuana, and cigarette use. RESULTS Zero-inflated Poisson (ZIP) regression models were used to examine the predictive utility of physiological BAS and BIS responses above and beyond previous substance use. Physiological responses accounted for incremental variance over previous use. Low BAS responses during reward predicted frequency of alcohol use at year 3. Low BAS responses during reward and extinction and high BIS responses during extinction predicted frequency of marijuana use at year 3. For cigarette use, low BAS response during extinction predicted use at year 3. CONCLUSIONS These findings suggest that the constructs of Reinforcement Sensitivity Theory, as assessed through physiology, contribute to the longitudinal maintenance of substance use.
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Affiliation(s)
- Karen J Derefinko
- Department of Preventive Medicine, Center for Population Sciences, University of Tennessee Health Science Center, 66 North Pauline Street, Suite 462, Memphis, TN 38163-2181, United States.
| | - Tory A Eisenlohr-Moul
- Department of Psychiatry, University of North Carolina at Chapel Hill, 101 Manning Drive, Chapel Hill, NC 27514, United States
| | - Jessica R Peters
- Department of Psychology, University of Kentucky, 115 Kastle Hall, Lexington, KY 40506-0044, United States; Department of Psychiatry and Human Behavior, Brown University, Providence, RI 02912, United States
| | - Walter Roberts
- Department of Psychology, University of Kentucky, 115 Kastle Hall, Lexington, KY 40506-0044, United States
| | - Erin C Walsh
- Department of Physical Medicine and Rehabilitation, University of North Carolina at Chapel Hill, CB# 7200, Chapel Hill, NC 27599-7200, United States
| | - Richard Milich
- Department of Psychology, University of Kentucky, 115 Kastle Hall, Lexington, KY 40506-0044, United States
| | - Donald R Lynam
- Department of Psychological Sciences, Purdue University, 703 Third Street, West Lafayette, IN 47907-2081, United States
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Babinski DE, Pelham WE, Molina BS, Gnagy EM, Waschbusch DA, Wymbs BT, Sibley MH, Derefinko KJ, Kuriyan AB. Maternal ADHD, Parenting, and Psychopathology Among Mothers of Adolescents With ADHD. J Atten Disord 2016; 20:458-68. [PMID: 23160485 PMCID: PMC3582708 DOI: 10.1177/1087054712461688] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE This study describes the parenting and psychopathology of mothers with ADHD of adolescents with ADHD (MCA), non-ADHD mothers of adolescents with ADHD (CA), and non-ADHD mothers of adolescents without ADHD (COMP). METHOD Two sets of pairwise comparisons: (a) COMP versus CA and (b) CA versus MCA were conducted. We hypothesized that CA would experience greater distress in parenting and psychopathology compared with COMP and that MCA would experience even more impairment compared with CA. RESULTS Few differences emerged in comparisons of CA and COMP, with the exception of CA reporting greater parent-adolescent conflict and internalizing problems. In contrast, differences consistently emerged in comparisons of MCA and CA showing more difficulty for MCA in parenting and psychopathology. CONCLUSION These findings underscore the need for treatments that address parental ADHD when adolescent ADHD is the intended target.
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Affiliation(s)
- Dara E. Babinski
- Florida International University,University of Pittsburgh Medical Center
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Little MA, Derefinko KJ, Bursac Z, Ebbert JO, Colvin L, Talcott GW, Hryshko-Mullen AS, Richey PA, Klesges RC. Prevalence and Correlates of Tobacco and Nicotine Containing Product Use in a Sample of United States Air Force Trainees. Nicotine Tob Res 2016; 18:416-23. [PMID: 25895952 PMCID: PMC4854492 DOI: 10.1093/ntr/ntv090] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [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] [Received: 02/19/2015] [Accepted: 04/10/2015] [Indexed: 11/13/2022]
Abstract
INTRODUCTION Although there is increasing attention to the prevalence of new and emerging tobacco products in the civilian population, remarkably little is known about the current prevalence of these products in a military population. METHODS The current investigation was designed to determine the prevalence of tobacco and nicotine containing products (TNCP) and correlates of use across multiple cohorts of trainees undergoing Technical Training in the US Air Force between April 2013 and December 2014. Chi-square test, Cochran-Armitage test for linear trend, and logistic regression models were applied to test differences and linear trends across time for TNCP use as well as correlates of use in a cross-sectional sample of 13 685 Airmen (final analytic sample). RESULTS Over a quarter (26.9%) of Airmen reported regular use of a TNCP. The two most prevalent products were cigarettes (11.2%) and hookah (10.5%). Among correlates of use, Airmen that regularly use TNCPs were more likely to be male, younger, non-Hispanic white, and single with a high school degree or General Education Development. Hookah was the most endorsed for intentions to use, and along with e-cigarettes, had the lowest perception of harm. While prevalence of most products remained constant across entering cohorts, the prevalence of e-cigarettes showed significant linear increase. CONCLUSIONS The prevalence of TNCP use is high across cohorts of Airmen. Remarkably high estimates of future intentions to use and low perceptions of harm for emerging products suggest that intervention efforts should be directed at multiple forms of TNCP use to address this important public health issue.
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Affiliation(s)
- Melissa A Little
- Department of Preventive Medicine, University of Tennessee Health Science Center, Memphis, TN;
| | - Karen J Derefinko
- Department of Preventive Medicine, University of Tennessee Health Science Center, Memphis, TN
| | - Zoran Bursac
- Department of Preventive Medicine, University of Tennessee Health Science Center, Memphis, TN
| | - Jon O Ebbert
- Department of Primary Care Internal Medicine, Mayo Clinic, Rochester, MN
| | - Lauren Colvin
- Department of Preventive Medicine, University of Tennessee Health Science Center, Memphis, TN
| | - Gerald W Talcott
- Department of Preventive Medicine, University of Tennessee Health Science Center, Memphis, TN
| | | | - Phyllis A Richey
- Department of Preventive Medicine, University of Tennessee Health Science Center, Memphis, TN
| | - Robert C Klesges
- Department of Preventive Medicine, University of Tennessee Health Science Center, Memphis, TN
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Chester DS, DeWall CN, Derefinko KJ, Estus S, Lynam DR, Peters JR, Jiang Y. Looking for reward in all the wrong places: dopamine receptor gene polymorphisms indirectly affect aggression through sensation-seeking. Soc Neurosci 2015; 11:487-94. [PMID: 26592425 DOI: 10.1080/17470919.2015.1119191] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Individuals with genotypes that code for reduced dopaminergic brain activity often exhibit a predisposition toward aggression. However, it remains largely unknown how dopaminergic genotypes may increase aggression. Lower-functioning dopamine systems motivate individuals to seek reward from external sources such as illicit drugs and other risky experiences. Based on emerging evidence that aggression is a rewarding experience, we predicted that the effect of lower-functioning dopaminergic functioning on aggression would be mediated by tendencies to seek the environment for rewards. Caucasian female and male undergraduates (N = 277) were genotyped for five polymorphisms of the dopamine D2 receptor (DRD2) gene; they reported their previous history of aggression and their dispositional reward-seeking. Lower-functioning DRD2 profiles were associated with greater sensation-seeking, which then predicted greater aggression. Our findings suggest that lower-functioning dopaminergic activity puts individuals at risk for violence because it motivates them to experience aggression's hedonically rewarding qualities.
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Affiliation(s)
- David S Chester
- a Department of Psychology , University of Kentucky , Lexington , KY , USA
| | - C Nathan DeWall
- a Department of Psychology , University of Kentucky , Lexington , KY , USA
| | - Karen J Derefinko
- b Department of Preventive Medicine , University of Tennessee Health Science Center , Memphis , TN , USA
| | - Steven Estus
- c Department of Physiology , University of Kentucky , Lexington , KY , USA.,d Sanders-Brown Center on Aging , University of Kentucky , Lexington , KY , USA
| | - Donald R Lynam
- e Department of Psychological Sciences , Purdue University , West Lafayette , IN , USA
| | - Jessica R Peters
- a Department of Psychology , University of Kentucky , Lexington , KY , USA.,f Department of Psychiatry and Human Behavior , Alpert Medical School of Brown University , Providence , RI , USA
| | - Yang Jiang
- d Sanders-Brown Center on Aging , University of Kentucky , Lexington , KY , USA.,g Department of Behavioral Science , University of Kentucky , Lexington , KY , USA
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Little MA, Derefinko KJ, Colvin L, Ebbert JO, Bursac Z, Talcott GW, Richey PA, Klesges RC. The Prevalence of E-cigarette Use in a Sample of U.S. Air Force Recruits. Am J Prev Med 2015; 49:402-8. [PMID: 25896193 PMCID: PMC4546868 DOI: 10.1016/j.amepre.2015.02.019] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [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: 10/21/2014] [Revised: 02/17/2015] [Accepted: 02/26/2015] [Indexed: 01/24/2023]
Abstract
INTRODUCTION The prevalence of electronic cigarette (e-cigarette) use is increasing markedly in the general population. Yet, remarkably little research exists to examine these ongoing trends in at-risk populations, and nothing is known about the prevalence of e-cigarette use among military personnel. The purpose of the current study is to provide recent (2013-2014) data on the prevalence of regular e-cigarette use in a population of recruits prior to their entry into the U.S. military. METHODS The study utilized a cross-sectional assessment of e-cigarette and other tobacco and nicotine-containing product (TNCP) use in 2013-2014 among 10,043 U.S. Air Force (USAF) recruits in Technical Training. Chi-square tests, the Cochran-Armitage test for trend, and logistic regression models tested differences and trends across time for e-cigarette use. RESULTS The rate of e-cigarette use among recruits was 5.2%, which doubled (3% to 6.5%, p<0.0001) across a 1-year period. E-cigarette use was associated with increased odds of all measured TNCPs, as well as dual and poly use (all p<0.0001). CONCLUSIONS Rates of e-cigarette use are slightly higher in young USAF recruits than in the general population, and e-cigarette users are likely to be using other TNCPs in tandem. Although additional work is needed to understand the reasons for this concomitant use, this is a necessary first step to understanding e-cigarette use prevalence in military populations. Historic trends suggest that, like general populations, e-cigarette use is on the rise for those entering the USAF and should be monitored to inform future prevention programming.
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Affiliation(s)
- Melissa A Little
- Department of Preventive Medicine and Center for Population Sciences, University of Tennessee Health Science Center, Memphis, Tennessee.
| | - Karen J Derefinko
- Department of Preventive Medicine and Center for Population Sciences, University of Tennessee Health Science Center, Memphis, Tennessee
| | - Lauren Colvin
- Department of Preventive Medicine and Center for Population Sciences, University of Tennessee Health Science Center, Memphis, Tennessee
| | | | - Zoran Bursac
- Department of Preventive Medicine and Center for Population Sciences, University of Tennessee Health Science Center, Memphis, Tennessee
| | - Gerald W Talcott
- Department of Preventive Medicine and Center for Population Sciences, University of Tennessee Health Science Center, Memphis, Tennessee
| | - Phyllis A Richey
- Department of Preventive Medicine and Center for Population Sciences, University of Tennessee Health Science Center, Memphis, Tennessee
| | - Robert C Klesges
- Department of Preventive Medicine and Center for Population Sciences, University of Tennessee Health Science Center, Memphis, Tennessee
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Chester DS, DeWall CN, Derefinko KJ, Estus S, Peters JR, Lynam DR, Jiang Y. Monoamine oxidase A (MAOA) genotype predicts greater aggression through impulsive reactivity to negative affect. Behav Brain Res 2015; 283:97-101. [PMID: 25637908 PMCID: PMC4351151 DOI: 10.1016/j.bbr.2015.01.034] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.6] [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: 07/24/2014] [Revised: 12/19/2014] [Accepted: 01/20/2015] [Indexed: 11/22/2022]
Abstract
Low functioning MAOA genotypes have been reliably linked to increased reactive aggression, yet the psychological mechanisms of this effect remain largely unknown. The low functioning MAOA genotype's established link to diminished inhibition and greater reactivity to conditions of negative affect suggest that negative urgency, the tendency to act impulsively in the context of negative affect, may fill this mediating role. Such MAOA carriers may have higher negative urgency, which may in turn predict greater aggressive responses to provocation. To test these hypotheses, 277 female and male participants were genotyped for an MAOA SNP yet to be linked to aggression (rs1465108), and then reported their negative urgency and past aggressive behavior. We replicated the effect of the low functioning MAOA genotype on heightened aggression, which was mediated by greater negative urgency. These results suggest that disrupted serotonergic systems predispose individuals towards aggressive behavior by increasing impulsive reactivity to negative affect.
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Affiliation(s)
- David S Chester
- Department of Psychology, University of Kentucky, 0003 Kastle Hall, Lexington, KY 40506, USA.
| | - C Nathan DeWall
- Department of Psychology, University of Kentucky, 0003 Kastle Hall, Lexington, KY 40506, USA
| | - Karen J Derefinko
- Department of Psychology, University of Kentucky, 0003 Kastle Hall, Lexington, KY 40506, USA
| | - Steven Estus
- Department of Physiology, University of Kentucky, Lexington, KY, USA; Sanders-Brown Center on Aging, University of Kentucky, Lexington, KY, USA
| | - Jessica R Peters
- Department of Psychology, University of Kentucky, 0003 Kastle Hall, Lexington, KY 40506, USA
| | - Donald R Lynam
- Department of Psychological Sciences, Purdue University, West Lafayette, IN, USA
| | - Yang Jiang
- Sanders-Brown Center on Aging, University of Kentucky, Lexington, KY, USA; Department of Behavioral Science, University of Kentucky, Lexington, KY, USA
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Derefinko KJ, Hayden A, Sibley MH, Duvall J, Milich R, Lorch EP. A Story Mapping Intervention to Improve Narrative Comprehension Deficits in Adolescents with ADHD. School Ment Health 2014; 6:251-263. [PMID: 25436018 DOI: 10.1007/s12310-014-9127-7] [Citation(s) in RCA: 6] [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] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
The current study examined the effects of an 8-week Story Mapping Intervention (SMI) to improve narrative comprehension in adolescents with ADHD. Thirty 12 - 16 year-old adolescents with ADHD who were participating in a summer treatment program for adolescents with ADHD received the SMI instruction ten times and completed SMI homework ten times in a structured environment with teacher feedback. Recall of fables and story creation were assessed before and after the SMI. At post-test, fable recalls included more of the most important events, were more coherent, and included a greater number of plausible inferences than pre-test fable recalls. SMI homework scores accounted for increases in recall of important events and plausible inferences, suggesting that consistent practice and feedback with story mapping could contribute to important recall gains. In contrast, the inclusion of goal-based events and the rated coherence of created stories did not improve, suggesting that more explicit instruction in applying story mapping to story creation may be required.
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Derefinko KJ, Peters JR, Eisenlohr-Moul TA, Walsh EC, Adams ZW, Lynam DR. Relations between trait impulsivity, behavioral impulsivity, physiological arousal, and risky sexual behavior among young men. Arch Sex Behav 2014; 43:1149-58. [PMID: 24958252 PMCID: PMC4134401 DOI: 10.1007/s10508-014-0327-x] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.7] [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] [Received: 11/02/2012] [Revised: 05/20/2014] [Accepted: 05/24/2014] [Indexed: 05/10/2023]
Abstract
The current study examined how impulsivity-related traits (negative urgency, sensation seeking, and positive urgency), behavioral measures of risk taking and reward seeking, and physiological reactivity related to three different risky sexual behaviors in sexually active undergraduate men (N = 135). Regression analyses indicated that sensation seeking and behavioral risk-taking predicted unique variance in number of sexual partners. These findings suggest that, for young men, acquisition of new partners is associated with need for excitement and reward and willingness to take risks to meet those needs. Sensation seeking, behavioral risk-taking, and skin conductance reactivity to arousing stimuli was related to ever having engaged in sex with a stranger, indicating that, for men, willingness to have sex with a stranger is related not only to the need for excitement and risk-taking but also with innate responsiveness to arousing environmental triggers. In contrast, regression analyses indicated that young men who were impulsive in the context of negative emotions were less likely to use condoms, suggesting that emotion-based impulsivity may be an important factor in negligent prophylactic use. This study adds to the current understanding of the divergence between the correlates of risky sexual behaviors and may lend utility to the development of individualized HIV prevention programming.
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Affiliation(s)
- Karen J. Derefinko
- Department of Psychology, University of Kentucky, 115 Kastle Hall, Lexington, KY 40506-0044, USA;
| | - Jessica R. Peters
- Department of Psychology, University of Kentucky, 115 Kastle Hall, Lexington, KY 40506-0044, USA;
| | | | - Erin C. Walsh
- Department of Psychiatry, University of Wisconsin-Madison, Madison, WI, USA
| | - Zachary W. Adams
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC, USA
| | - Donald R. Lynam
- Department of Psychological Sciences, Purdue University, Lafayette, IN, USA
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Sibley MH, Pelham WE, Derefinko KJ, Kuriyan AB, Sanchez F, Graziano PA. A Pilot Trial of Supporting teens’ Academic Needs Daily (STAND): A Parent-Adolescent Collaborative Intervention for ADHD. J Psychopathol Behav Assess 2013. [DOI: 10.1007/s10862-013-9353-6] [Citation(s) in RCA: 52] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Sibley MH, Pelham WE, Molina BSG, Gnagy EM, Waxmonsky JG, Waschbusch DA, Derefinko KJ, Wymbs BT, Garefino AC, Babinski DE, Kuriyan AB. When diagnosing ADHD in young adults emphasize informant reports, DSM items, and impairment. J Consult Clin Psychol 2012; 80:1052-1061. [PMID: 22774792 PMCID: PMC3919146 DOI: 10.1037/a0029098] [Citation(s) in RCA: 164] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVE This study examined several questions about the diagnosis of attention-deficit/hyperactivity disorder (ADHD) in young adults using data from a childhood-diagnosed sample of 200 individuals with ADHD (age M = 20.20 years) and 121 demographically similar non-ADHD controls (total N = 321). METHOD We examined the use of self- versus informant ratings of current and childhood functioning and evaluated the diagnostic utility of adult-specific items versus items from the Diagnostic and Statistical Manual of Mental Disorders (DSM). RESULTS Results indicated that although a majority of young adults with a childhood diagnosis of ADHD continued to experience elevated ADHD symptoms (75%) and clinically significant impairment (60%), only 9.6%-19.7% of the childhood ADHD group continued to meet DSM-IV-TR (DSM, 4th ed., text rev.) criteria for ADHD in young adulthood. Parent report was more diagnostically sensitive than self-report. Young adults with ADHD tended to underreport current symptoms, while young adults without ADHD tended to overreport symptoms. There was no significant incremental benefit beyond parent report alone to combining self-report with parent report. Non-DSM-based, adult-specific symptoms of ADHD were significantly correlated with functional impairment and endorsed at slightly higher rates than the DSM-IV-TR symptoms. However, DSM-IV-TR items tended to be more predictive of diagnostic group membership than the non-DSM adult-specific items due to elevated control group item endorsement. CONCLUSIONS Implications for the assessment and treatment of ADHD in young adults are discussed (i.e., collecting informant reports, lowering the diagnostic threshold, emphasizing impairment, and cautiously interpreting retrospective reports).
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Bailey UL, Derefinko KJ, Milich R, Lorch EP, Metze A. The Effects of Stimulant Medication on Free Recall of Story Events among Children with ADHD. J Psychopathol Behav Assess 2011. [DOI: 10.1007/s10862-011-9249-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Miller DJ, Derefinko KJ, Lynam DR, Milich R, Fillmore MT. Impulsivity and Attention Deficit-Hyperactivity Disorder: Subtype Classification Using the UPPS Impulsive Behavior Scale. J Psychopathol Behav Assess 2009; 32:323-332. [PMID: 21765593 DOI: 10.1007/s10862-009-9155-z] [Citation(s) in RCA: 49] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
This study examined the classification accuracy of the UPPS Impulsive Behavior Scale (UPPS) in discriminating several attention deficit/hyperactivity disorder (ADHD) subtypes, including predominantly inattentive type (ADHD/I), combined type (ADHD/C), and combined type with behavioral problems (ADHD/ODD), between each other and a non-ADHD control group using logistic regression analyses. The sample consisted of 88 children ranging in age from 9.0 years to 12.8 years, with a mean of 10.9 years. Children were predominantly male (74%) and Caucasian (86%) and in grades 3-7. Results indicated that the UPPS performed well in classifying ADHD subtypes relative to traditional diagnostic measures. In addition, analyses indicated that differences in symptoms between subtypes can be explained by specific pathways to impulsivity. Implications for the assessment of ADHD and conceptual issues are discussed.
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Affiliation(s)
- Drew J Miller
- Department of Psychological Sciences, Purdue University, West Lafayette, IN 47907, USA
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Adams ZW, Derefinko KJ, Milich R, Fillmore MT. Inhibitory functioning across ADHD subtypes: recent findings, clinical implications, and future directions. ACTA ACUST UNITED AC 2009; 14:268-75. [PMID: 19072751 DOI: 10.1002/ddrr.37] [Citation(s) in RCA: 48] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Although growing consensus supports the role of deficient behavioral inhibition as a central feature of the combined subtype of ADHD (ADHD/C; Barkley 1997 Psychol Bull 121:65-94; Nigg 2001 Psychol Bull 127:571-598), little research has focused on how this finding generalizes to the primarily inattentive subtype (ADHD/I). This question holds particular relevance in light of recent work suggesting that ADHD/I might be better characterized as a disorder separate from ADHD/C (Diamond 2005 Dev Psychopathol 17:807-825; Milich et al. 2001 Clin Psychol Sci Pract 8:463-488). This article describes major findings in the area of inhibitory performance in ADHD and highlights recent research suggesting important areas of divergence between the subtypes. In particular, preliminary findings point to potential differences between the subtypes with respect to how children process important contextual information from the environment, such as preparatory cues that precede responses and rewarding or punishing feedback following behavior. These suggestive findings are discussed in the context of treatment implications, which could involve differential intervention approaches for each subtype targeted to the specific deficit profiles that characterize each group of children. Future research avenues aimed toward building a sound theoretical model of ADHD/I and a better understanding of its relation to ADHD/C are also presented. Specifically, investigators are encouraged to continue studying the complex interplay between inhibitory and attentional processes, as this area seems particularly promising in its ability to improve our understanding of the potentially distinct pathologies underlying the ADHD subtypes.
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Affiliation(s)
- Zachary W Adams
- Department of Psychology, University of Kentucky, Lexington, Kentucky 40506-0044, USA
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Derefinko KJ, Adams ZW, Milich R, Fillmore MT, Lorch EP, Lynam DR. Response Style Differences in the Inattentive and Combined Subtypes of Attention-Deficit/Hyperactivity Disorder. J Abnorm Child Psychol 2008; 36:745-58. [DOI: 10.1007/s10802-007-9207-3] [Citation(s) in RCA: 54] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2007] [Accepted: 12/13/2007] [Indexed: 11/28/2022]
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Abstract
The present study examined whether psychopathy can be understood as a constellation of traits from the Five Factor Model (FFM) of personality. Using a prototype matching approach, we examined the ability of the Revised NEO Personality Inventory (NEO PI-R; Costa & McCrae, 1992) to represent psychopathy in a sample of 297 male and female known crack cocaine abusers. Importantly, we examined the convergence and divergence between FFM psychopathy and other personality disorders assessed using the FFM. FFM psychopathy was correlated with self-reports of antisocial behavior, drug use, risky sex, and externalizing and internalizing disorder symptoms. As expected, there was overlap in the relations between psychopathy and several Cluster B personality disorders, but there were also important points of divergence. These results further extend the nomological network of FFM psychopathy and provide additional support for considering psychopathy a constellation of personality traits from a general model.
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Affiliation(s)
- Karen J Derefinko
- Department of Psychology, University of Kentucky, Lexington, KY 40506-0044, USA.
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Abstract
This study examined the content validity of a juvenile psychopathy measure, the Childhood Psychopathy Scale (CPS; D. R. Lynam, 1997), based on a downward translation of an adult instrument, the Hare Psychopathy Checklist-Revised (PCL-R; R. D. Hare, 1991). The CPS was compared with two other indices of juvenile psychopathy: (a) an index derived from expert ratings and (b) an empirical index based on correlations with adult psychopathy. The 100 items of the Common Language Q-Sort (CLQ; A. Caspi et al., 1992) provided a common metric for the comparison. Psychopathy and personality were assessed at age 13 years with the mother-reported CPS and the CLQ. Psychopathy was assessed at age 24 years with the interviewer-rated Psychopathy Checklist: Screening Version (PCL:SV; S. D. Hart, D. N. Cox, & R. D. Hare, 1995). Data from over 250 participants of the middle sample of the Pittsburgh Youth Study were used to examine these relations. Item content analyses demonstrated considerable overlap among the three indices, indicating that the downward translation utilizes criteria similar to those of experts and the empirically-derived measure. In addition, these indices, even after removing overlapping items, demonstrated considerable convergence, also supporting the content validity of the downward translation. These results suggest that the downward translation method is adequate for understanding the juvenile psychopathy construct.
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Affiliation(s)
- Donald R Lynam
- Department of Psychological Sciences, Purdue University, 703 Third Street, West Lafayette, IN 47907, USA.
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Acevedo-Polakovich ID, Reynaga-Abiko G, Garriott PO, Derefinko KJ, Wimsatt MK, Gudonis LC, Brown TL. Beyond instrument selection: Cultural considerations in the psychological assessment of U.S. Latinas/os. ACTA ACUST UNITED AC 2007. [DOI: 10.1037/0735-7028.38.4.375] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.1] [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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