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APA Journal: Psychology of Addictive Behaviors

Inaugural editorial.Open in a New Window

The new editor discusses their plans for the journal, Psychology of Addictive Behaviors (PAB). Their aim is to bring PAB to the forefront of journals addressing substance use and addictive disorders. To realize this goal, the new editor plans to continue to expand PAB’s reach and attract the best research related to addictive disorders in established as well as emerging areas. This journal has a unique niche. It is one of the few outlets for research related to the broader class of addictions, including substance use and gambling disorders, as well as other excessive behaviors such as Internet use, exercise, and food addiction. It includes research of psychological, biological, epidemiological, and social aspects of addiction. (PsycINFO Database Record (c) 2015 APA, all rights reserved)

 

Randomized controlled trial of brief alcohol screening and intervention for college students for heavy-drinking mandated and volunteer undergraduates: 12-month outcomes.Open in a New Window

This is the first randomized trial testing whether heavy-drinking undergraduates mandated to the Brief Alcohol Screening and Intervention for College Students (BASICS) program following a campus alcohol violation would benefit as much as heavy-drinking volunteers up to 1 year postintervention using control groups with high-risk drinkers to model disciplinary-related and naturalistic changes in drinking. Participants (61% male; 51% mandated; 84% Caucasian; M age = 20.14 years) were screened for heavy drinking and randomized to BASICS (n = 115) or assessment-only control (n = 110). Outcome measures (drinking, alcohol problems) were collected at baseline, 4 weeks, 3, 6, and 12 months postintervention. At 4 weeks postintervention, intent-to-treat multilevel longitudinal models showed that regardless of referral group (mandated or volunteer), BASICS significantly decreased weekly drinking, typical drinks, and peak drinks relative to controls (ds = .41–.92). BASICS had a large effect on decreases in alcohol problems (d = .87). At 12 months postintervention, BASICS participants (regardless of referral group) reported significantly fewer alcohol problems (d = .56) compared with controls. Significant long-term intervention gains for peak and typical drinks were sustained in both referral groups relative to controls (ds = .42; .11). Referral group had no significant main effect and did not interact with intervention condition to predict outcomes. Given that BASICS was associated with less drinking and fewer alcohol problems (even among heavier drinking mandated students up to 1 year postintervention), provision of BASICS-style programs within disciplinary settings may help reduce heavy and problematic drinking among at-risk students. (PsycINFO Database Record (c) 2015 APA, all rights reserved)

 

Correction to Frone and Trinidad (2014).Open in a New Window

Reports an error in "Perceived physical availability of alcohol at work and workplace alcohol use and impairment: Testing a structural model" by Michael R. Frone and Jonathan R. Trinidad (Psychology of Addictive Behaviors, 2014[Dec], Vol 28[4], 1271-1277). There are several mistakes in the text and tables, which are given in the erratum. The online version of this article has been corrected. (The following abstract of the original article appeared in record 2014-39083-001.) This study develops and tests a new conceptual model of perceived physical availability of alcohol at work that provides unique insight into 3 dimensions of workplace physical availability of alcohol and their direct and indirect relations to workplace alcohol use and impairment. Data were obtained from a national probability sample of 2,727 U.S. workers. The results support the proposed conceptual model and provide empirical support for a positive relation of perceived physical availability of alcohol at work to workplace alcohol use and 2 dimensions of workplace impairment (workplace intoxication and workplace hangover). Ultimately, the findings suggest that perceived physical availability of alcohol at work is a risk factor for alcohol use and impairment during the workday, and that this relation is more complex than previously hypothesized. (PsycINFO Database Record (c) 2015 APA, all rights reserved)

 

An assessment of an automated EEG biofeedback system for attention deficits in a substance use disorders residential treatment setting.Open in a New Window

Attention deficits are prevalent among individuals with substance use disorders and may interfere with recovery. The present study evaluated the effectiveness of an automated electroencephalogram (EEG) biofeedback system in recovering illicit substance users who had attention deficits upon admission to a comprehensive residential treatment facility. All participants (n = 95) received group, family, and individual counseling. Participants were randomly assigned to 1 of 3 groups that either received 15 sessions of automated EEG biofeedback (AEB), 15 sessions of clinician guided EEG biofeedback (CEB), or 15 additional therapy sessions (AT). For the AEB and CEB groups, operant contingencies reinforced EEG frequencies in the 15–18 Hz (β) and 12–15 Hz (sensorimotor rhythm, “SMR”) ranges and reduce low frequencies in the 1–12 Hz (Δ, θ, and α) and 22–30 Hz (high β) ranges. The Test of Variables of Attention (TOVA), a “Go-NoGo” task, was the outcome measure. Attention scores did not change on any TOVA measure in the AT group. Reaction time variability, omission errors, commission errors, and d′ improved significantly (all p values < .01) in the AEB and CEB groups. AEB and CEB did not differ significantly from each other on any measure. The results demonstrate that automated neurofeedback can effectively improve attention in recovering illicit substance users in the context of a comprehensive residential substance abuse treatment facility. (PsycINFO Database Record (c) 2015 APA, all rights reserved)

 

Web-based coping skills training for women whose partner has a drinking problem.Open in a New Window

Spouses whose partner has an alcohol use disorder can experience considerable psychological distress. Yet, because of social, financial, relationship, and psychological barriers they often remain hidden and underserved. To partially reduce treatment barriers for this population, this study evaluated the short-term efficacy of a self-paced, web-delivered coping skills training program for women experiencing distress as a result of living with a partner with an alcohol use disorder. Participants (N = 89) were randomly assigned to either 8 weeks of an Internet-administered coping skills training program (iCST), or an 8-week delayed treatment control (DTC). Participation in, and satisfaction with iCST was high. At the end of the 8-week access/delay period, iCST participants exhibited a significantly higher level of coping skills relative to DTC, d = 1.02, 95% confidence interval [CI; .64, 1.51], and reported significantly fewer depressive symptoms, d = −.65, 95% CI [−1.21, −.35], and situational anger, d = −.70, 95% CI [−1.62, −.64]. Moreover, iCST appeared to prevent an increase in symptoms among those with low baseline symptom levels; DTC did not. Skill acquisition appeared to partially mediate changes observed. Online coping skills training may be an effective way of reaching and helping a large number of this frequently underserved population. (PsycINFO Database Record (c) 2015 APA, all rights reserved)

 

Project INTEGRATE: An integrative study of brief alcohol interventions for college students.Open in a New Window

This article provides an overview of a study that synthesizes multiple, independently collected alcohol intervention studies for college students into a single, multisite longitudinal data set. This research embraced innovative analytic strategies (i.e., integrative data analysis or meta-analysis using individual participant-level data), with the overall goal of answering research questions that are difficult to address in individual studies such as moderation analysis, while providing a built-in replication for the reported efficacy of brief motivational interventions for college students. Data were pooled across 24 intervention studies, of which 21 included a comparison or control condition and all included one or more treatment conditions. This yielded a sample of 12,630 participants (42% men; 58% first-year or incoming students). The majority of the sample identified as White (74%), with 12% Asian, 7% Hispanic, 2% Black, and 5% other/mixed ethnic groups. Participants were assessed 2 or more times from baseline up to 12 months, with varying assessment schedules across studies. This article describes how we combined individual participant-level data from multiple studies, and discusses the steps taken to develop commensurate measures across studies via harmonization and newly developed Markov chain Monte Carlo (MCMC) algorithms for 2-parameter logistic item response theory models and a generalized partial credit model. This innovative approach has intriguing promises, but significant barriers exist. To lower the barriers, there is a need to increase overlap in measures and timing of follow-up assessments across studies, better define treatment and control groups, and improve transparency and documentation in future single intervention studies. (PsycINFO Database Record (c) 2015 APA, all rights reserved)

 

A retrospective analysis of dissemination biases in the brief alcohol intervention literature.Open in a New Window

This study examined dissemination and reporting biases in the brief alcohol intervention literature. We used retrospective data from 179 controlled trials included in a meta-analysis on brief alcohol interventions for adolescents and young adults. We examined whether the magnitude and direction of effect sizes were associated with publication type, identification source, language, funding, time lag between intervention and publication, number of reports, journal impact factor, and subsequent citations. Results indicated that effect sizes were larger for studies that had been funded (b = 0.14, 95% confidence interval [CI] [0.04, 0.23]), had a shorter time lag between intervention and publication (b = −0.03, 95% CI [−0.05, −.001]), and were cited more frequently (b = 0.01, 95% CI [+0.00, 0.01]). Studies that were cited more frequently by other authors also had greater odds of reporting positive effects (odds ratio = 1.10, 95% CI [1.02, 1.18]). Results indicated that time lag bias has increased recently: Larger and positive effect sizes were published more quickly in recent years. We found no evidence, however, that the magnitude or direction of effects was associated with location source, language, or journal impact factor. We conclude that dissemination biases may indeed occur in the social and behavioral science literature, as has been consistently documented in the medical literature. As such, primary researchers, journal reviewers, editors, systematic reviewers, and meta-analysts must be cognizant of the causes and consequences of these biases, and commit to engage in ethical research practices that attempt to minimize them. (PsycINFO Database Record (c) 2015 APA, all rights reserved)

 

Attentional bias to alcohol-related stimuli as an indicator of changes in motivation to drink.Open in a New Window

Heavy drinkers show an attentional bias toward alcohol-related visual cues. A recent study in our laboratory (Weafer & Fillmore, 2013) showed that alcohol decreases attentional bias among heavy drinkers, suggesting that alcohol satiates motivation to drink in heavy drinkers. Little is known, however, about how this satiety effect might change across the time course of the blood alcohol concentration (BAC) curve. It is possible that attentional bias may return later in the time course if the satiety effect begins to diminish. The current study tested this hypothesis in a group of high-risk binge drinkers (n = 20). Participants completed a visual-probe task to measure their attentional bias and a self-report measure of their desire for alcohol after receiving 0.64 g/kg and 0.0 g/kg alcohol (placebo) during separate dose challenge sessions. The measures were obtained during the ascending limb of the BAC curve under alcohol (Test 1) and again during the descending limb (Test 2) at a comparable BAC. The measures also were obtained at the same times following placebo. Under alcohol, no attentional bias was observed during Test 1, but drinkers reported increased desire to drink. During Test 2, attentional bias was evident, but participants reported less desire to drink. Attentional bias was not correlated with desire to drink at any time point. Following placebo, attentional bias was evident during both tests. These findings show that alcohol causes a temporary reduction of attentional bias among heavy drinkers. These changes do not correspond with their self-reported motivation to drink. (PsycINFO Database Record (c) 2015 APA, all rights reserved)

 

Psychological symptoms, smoking lapse behavior, and the mediating effects of nicotine withdrawal symptoms: A laboratory study.Open in a New Window

The influence of psychological symptoms on smoking-lapse behavior is critical to understand. However, this relationship is obscured by comorbidity across multiple forms of psychological symptoms and their overlap with nicotine withdrawal. To address these challenges, we constructed a structural model of latent factors underlying 9 manifest scales of affective and behavioral symptoms and tested relations between latent factors and manifest scale residuals with nicotine withdrawal and smoking lapse in a laboratory analog task. Adult daily smokers (N = 286) completed a baseline session at which several forms of affective and behavioral symptoms were assessed and 2 experimental sessions (i.e., following 16 hr of smoking abstinence and following regular smoking), during which withdrawal symptoms and delay of smoking in exchange for monetary reinforcement, as an analogue for lapse propensity, were measured. A single second-order factor of general psychological maladjustment associated with more severe withdrawal-like symptoms, which in turn associated with shorter delay of smoking. The first-order factors, which tapped qualitatively unique domains of psychological symptoms (low positive affect, negative affect, disinhibition), and the manifest scale residuals provided little predictive power beyond the second-order factor with regard to lapse behavior. Relations among general psychological maladjustment, withdrawal-like symptoms, and lapse were significant in both abstinent and nonabstinent conditions, suggesting that psychological maladjustment, and not nicotine withdrawal per se, accounted for the relation with lapse. These results highlight the potential for smoking-cessation strategies that target general psychological maladjustment processes and have implications for addressing withdrawal-like symptoms among individuals with psychological symptoms. (PsycINFO Database Record (c) 2015 APA, all rights reserved)

 

The effects of repeated exposure to graphic fear appeals on cigarette packages: A field experiment.Open in a New Window

Experimental studies on the effects of graphic fear appeals on cigarette packages typically expose smokers in a single session to a fear appeal, although in practice the exposure is always repeated. The present study applied an improved study design with repeated exposure to fear appeals on cigarette packages. In this field-experiment, 118 smokers were assigned to 1 of 2 conditions with either graphic fear appeals or textual warnings on their cigarette packages. During 3 weeks, fear and disgust were assessed 6 times. The intention to quit smoking after 3 weeks and quitting activity during the 3 weeks were the dependent measures. The effects of 3 pretest individual difference moderators were tested: disengagement beliefs, number of cigarettes smoked a day, and readiness to quit. Three weeks of exposure to the graphic fear appeals led to a stronger intention to quit, but only when smokers scored low on disengagement beliefs, or were heavier smokers. In addition, smokers low in disengagement more often reported to have cut down on smoking in the graphic condition. There were no indications of habituation of fear and disgust over the 3 weeks. The effects of graphic fear appeals depended on smokers’ characteristics: The moderators may explain the mixed findings in the literature. The lack of habituation may be caused by the renewal of the graphics every few days. The used field-experimental design with natural repeated exposure to graphics is promising. (PsycINFO Database Record (c) 2015 APA, all rights reserved)

 

Olfactory cue reactivity in nicotine-dependent adult smokers.Open in a New Window

Cue-elicited reactivity is a significant factor in relapse during smoking quit attempts. Previous research has focused primarily on visual smoking cues, with very limited research examining reactivity to olfactory triggers. Twenty-six adult non-treatment-seeking, nicotine-dependent smokers were exposed to 7 odorants during a cue-reactivity session measuring heart rate, skin conductance, and subjective craving. Cues included 2 cigarette odors (fresh tobacco and cigarette smoke), 2 odors previously identified as smoking-related (freshly mowed grass and coffee), 2 odors previously identified as unrelated to smoking (lavender and burned rubber), and 1 odorless control (propylene glycol). Pairwise comparisons demonstrated that subjective intensity of craving was significantly higher following exposure to the fresh tobacco odor compared with the odorless control (p p = .25). The results of the present study indicate that cigarette odor is an effective olfactory cue that heightens both subjective craving and increases skin conductance in smokers. Future research is needed to evaluate whether avoidance of these odors, or extinction of responses to them, can reduce relapse risk during smoking quit attempts. (PsycINFO Database Record (c) 2015 APA, all rights reserved)

 

Changes in mental and physical well-being among problematic alcohol and drug users in 12-month Internet-based intervention trials.Open in a New Window

Twelve-month well-being outcomes were investigated for 835 participants in 1 of 2 randomized controlled trials offering online assessment and brief intervention for either problematic alcohol (n = 633) or drug use (n = 202). The well-being of participants who had reduced their substance use to a less problematic level (regardless of intervention) over 12 months was compared with that of participants who had maintained or increased their use. At a 12-month follow-up, the 227 alcohol trial participants with reduced use showed better well-being in comparison to the 406 with stable or increased use, in physical health and sleep quality, as well as general well-being, ability to concentrate, lower stress, better social life satisfaction and sense of control, and a lower rate of depressed mood. Among the 70 drug trial participants who had reduced their drug use over 12 months, 80% had ceased all drug use, and at follow-up they had fewer alcohol-related problems than the stable group. No differences in well-being between these groups were identified. Self-reported access to additional treatment modalities beyond the trial interventions (e.g., speaking to someone about problematic use and accessing additional Internet-based interventions) was higher among participants in both cohorts with reduced substance use in comparison to those with stable/increased use. Drug users who reduced their use accessed prescribed medication to a larger extent than those whose use remained stable or increased. Points to consider when conducting future research on well-being and problematic substance use are discussed. (PsycINFO Database Record (c) 2015 APA, all rights reserved)

 

The relationship of therapeutic alliance and treatment delivery fidelity with treatment retention in a multisite trial of twelve-step facilitation.Open in a New Window

This study examined associations of therapeutic alliance and treatment delivery fidelity with treatment retention in Stimulant Abusers to Engage in Twelve-Step (STAGE-12), a community-based trial of 12-Step Facilitation (TSF) conducted within the National Drug Abuse Treatment Clinical Trials Network (CTN). The STAGE-12 trial randomized 234 stimulant abusers enrolled in 10 outpatient drug treatment programs to an eight-session, group and individual TSF intervention. During the study, TSF participants rated therapeutic alliance using the Helping Alliance questionnaire-II. After the study, independent raters evaluated treatment delivery fidelity of all TSF sessions on adherence, competence, and therapist empathy. Poisson regression modeling examined relationships of treatment delivery fidelity and therapeutic alliance with treatment retention (measured by number of sessions attended) for 174 participants with complete fidelity and alliance data. Therapeutic alliance (p = .005) and therapist competence (p = .010) were significantly associated with better treatment retention. Therapist adherence was associated with poorer retention in a nonsignificant trend (p = .061). In conclusion, stronger therapeutic alliance and higher therapist competence in the delivery of a TSF intervention were associated with better treatment retention whereas treatment adherence was not. Training and fidelity monitoring of TSF should focus on general therapist skills and therapeutic alliance development to maximize treatment retention. (PsycINFO Database Record (c) 2015 APA, all rights reserved)

 

Reasons for quitting cigarette smoking and electronic cigarette use for cessation help.Open in a New Window

Despite the lack of clarity regarding their safety and efficacy as smoking cessation aids, electronic cigarettes (e-cigarettes) are commonly used to quit smoking. Currently, little is understood about why smokers may use e-cigarettes for help with smoking cessation compared with other, proven cessation aids. This study aimed to determine the reasons for wanting to quit cigarettes that are associated with the use of e-cigarettes for cessation help versus the use of conventional nicotine replacement therapy (NRT) products (e.g., gums). Cross-sectional, self-report data were obtained from 1,988 multiethnic current daily smokers (M age = 45.1, SD = 13.0; 51.3% women) who had made an average of 8.5 (SD = 18.7) lifetime quit attempts but were not currently engaged in a cessation attempt. Reasons for wanting to quit smoking were assessed by using the Reasons for Quitting scale. Path analyses suggested that among reasons for quitting cigarettes, “immediate reinforcement”—a measure of wanting to quit cigarettes for extrinsic reasons such as bad smell, costliness and untidiness—was significantly associated with having tried e-cigarettes for cessation help, and “concerns about health” was associated with having tried NRT-only use. E-cigarettes appear to provide an alternative “smoking” experience to individuals who wish to quit cigarette smoking because of the immediate, undesirable consequences of tobacco smoking (e.g., smell, ash, litter) rather than concerns about health. Provided that the safety of e-cigarette use is ensured, e-cigarettes may be effectively used to reduce tobacco exposure among smokers who may not want to quit cigarettes for intrinsic motivation. (PsycINFO Database Record (c) 2015 APA, all rights reserved)

 

Using ecological measures of smoking trigger exposure to predict smoking cessation milestones.Open in a New Window

This study used ecological momentary assessment data from adult daily smokers attempting to quit smoking to assess relations between exposure to contextual risk factors and cessation failure, latency to a first smoking lapse, or progression from lapse to relapse (smoking 7 days in a row). Participants were adult, daily smokers enrolled in a randomized controlled clinical trial of bupropion SR and individual counseling who were followed to 1 year postquit. Participants reported exposure to high-risk contexts and behaviors, including being where cigarettes were available or smoking was permitted, being around others smoking in prospective, real-time assessment for 2 weeks pre- and 4 weeks postquit. Results showed that greater exposure to contextual risk factors during the prequit did not predict cessation failure. However, Cox regression survival analyses revealed that spending a greater proportion of time where cigarettes were easily available following at least 1 day of abstinence predicted shorter latency to a first lapse, even after controlling for baseline risk factors such as gender, nicotine dependence, depressive symptoms, and living with a smoker. Greater cigarette availability following a lapse was not associated with progression from lapse to relapse with or without baseline risk factors in the model. This suggests that postquit environmental risk factors, such as cigarette availability, increase lapse risk, and stable risk factors, such as living with smokers and higher baseline carbon monoxide level or depressive symptoms, remain potent predictors of progression to relapse. Real-time contextual risk assessments postquit predict lapse above and beyond stable, baseline risk factors. (PsycINFO Database Record (c) 2015 APA, all rights reserved)

 

The effects of therapeutic bond within a brief intervention for alcohol moderation for problem drinkers.Open in a New Window

The quality of the relationship between a therapist and his or her client can make a significant contribution to recovery from substance use disorders. Treatments often harness aspects of therapeutic relationships (e.g., therapeutic bond) to positively affect therapeutic outcomes. Within motivational interviewing (MI), for example, authors theorize that a relational component is 1 active component that affects change. The present study aims to examine the effects of relationships within a treatment setting on drinking. A secondary data analysis was performed on data collected from problem drinkers in a randomized controlled trial. Participants were assigned to MI or relational MI without directive elements (spirit-only MI). Participants answered questions about alcohol use and therapeutic bond before, during, and at the end of an 8-week treatment period. High levels of therapeutic bond and empathic resonance predicted decreased alcohol use at the end of treatment for participants in both conditions. This study highlights the importance of relational components in treatments for substance abuse. (PsycINFO Database Record (c) 2015 APA, all rights reserved)

 

Implicit identification with drug and alcohol use predicts retention in residential rehabilitation programs.Open in a New Window

Research has identified numerous factors associated with successful treatment in alcohol and drug rehabilitation programs, yet treatment completion rates are often low and subsequent relapse rates very high. We propose that people’s implicit identification with drugs and alcohol may be an additional factor that impacts their ability to complete abstinence-based rehabilitation programs. In the current research, we measured implicit identification with drugs and alcohol using the Implicit Association Test (Greenwald, McGhee, & Schwartz, 1998) among 137 members of a residential rehabilitation program for drugs and alcohol (104 men; mean age = 35 years old, 47 of whom were court-ordered to attend). Implicit identification with drugs and alcohol was measured within 1 week of arrival and again 3 weeks later, prior to the onset of the treatment phase of the program. Duration in rehabilitation was assessed 1 year later. Consistent with predictions, implicit identification with drugs and alcohol predicted the duration that people remained in residential rehabilitation even though a self-report measure of identification with drugs and alcohol did not. These results suggest that implicit identification with drugs and alcohol might be an important predictor of treatment outcomes, even among those with serious problems with drug and alcohol use. (PsycINFO Database Record (c) 2015 APA, all rights reserved)

 

The role of goals and alcohol behavior during the transition out of college.Open in a New Window

Personal goals are desired outcomes that guide behavior (Palfai, Ralston, & Wright, 2011), and are typically oriented around age-appropriate developmental tasks (e.g., college graduation, employment). Goals and their pursuit take on much salience during senior year of college as individuals prepare for the transition into adult roles. This also is a time during which naturalistic changes in alcohol consumption are occurring. These changes may impact the relationship between age-related goals and their attainment, thus compromising the likelihood of a successful transition out of college. The present study examined whether and how changes in drinking over senior year moderate the association between achievement goals and related developmental task attainment as students move toward transitioning out of college. Alcohol-involved college seniors (N = 437; 62.5% female) were assessed via web survey in September of their senior year and again 1 year later (T4). Results of multinomial logistic regression revealed that greater achievement goals were predictive of college graduation (vs. remaining a continuing undergraduate), but only for those whose drinking decreased during senior year. Among those graduated by T4 (n = 307), achievement goals predicted pursuing graduate education (vs. being unemployed), but only for students whose drinking increased during senior year. Thus, achievement goals are important predictors of goal attainment as students prepare to transition out of college, and these goals can interact with drinking in complex ways during this time. Findings suggest that interventions aimed at bolstering personal goals and reducing drinking during senior year may increase the likelihood of successful transitions out of the college environment. (PsycINFO Database Record (c) 2015 APA, all rights reserved)

 

The diversion of stimulant medications among a convenience sample of college students with current prescriptions.Open in a New Window

Diversion is defined as the unlawful channeling of regulated pharmaceuticals from legal sources to the illicit marketplace. Persons with legal prescriptions often give away or sell their medications to others. The misuse of prescription stimulant medications continues to be a problem on college campuses and a need to understand how students are obtaining stimulant medications exists. The object of the study was to identify the prevalence, correlates, and motivations associated with diversion of prescription stimulants among current prescription holders. A large sample of undergraduates (n = 1,022) between the ages of 18 and 24 enrolled at a large public university in the southeastern United States completed an in class questionnaire. Among those respondents, we identified 151 current stimulant prescription holders and analyzed the prevalence, motivations, and correlates associated with lifetime and current diversion. Overall, 58.9% of current prescription holders had given away or sold their stimulant medication during their lifetime. Those with a history of nonmedical use of prescription stimulants were almost 5 times more likely to divert their medication during their lifetime. The majority of those engaging in lifetime and current diversion medication did so infrequently. The most common motivations reported for both lifetime and current diversion were “to make extra money” and to “help during a time of high academic stress.” Students who reported a history of prescription misuse were also more likely to engage in current diversion. Diversion-related behaviors should be explored further and programs aimed at the reducing these behaviors should be considered. (PsycINFO Database Record (c) 2015 APA, all rights reserved)

 

An examination of college student activities and attentiveness during a web-delivered personalized normative feedback intervention.Open in a New Window

Both heavy drinking and related risky sexual behavior among college students are common and are often associated with a number of negative consequences. A previously reported randomized controlled trial showed that a brief personalized normative feedback (PNF) intervention reduced the alcohol consumption and alcohol-related risky sexual behavior of heavy drinking, sexually active college students (Lewis et al., 2014). For the present study, we examined what activities students were engaged in when viewing the feedback, as well as who they were with and where they were when receiving the intervention. Furthermore, we conducted supplemental analyses with perceived attentiveness as a hypothesized predictor of change using the same sample (N = 480). Findings indicated that most students were engaged in activities when viewing the feedback and that most students viewed the feedback alone and at home. Furthermore, results revealed PNF to be most effective in reducing drinks per week among participants who reported greater attention. Clinical implications and suggestions for additional research examining how attentiveness can be increased during Web-based interventions are discussed. (PsycINFO Database Record (c) 2015 APA, all rights reserved)

 

Religiosity as a moderator of the relation between sensation seeking and substance use for college-aged individuals.Open in a New Window

Substance use has been identified as a major problem on college campuses across the country, with excessive use often leading to unintended and unwanted negative health outcomes. Sensation seeking has been shown to be a consistent predictor of engagement in various health risk behaviors, including substance use. Religiosity has been shown to negatively predict substance use. However, there is mixed evidence on the relations among these risk and protective factors. This may be due to the operational definitions of religiosity in previous research. The current study investigated religiosity as a moderator of the relation between sensation seeking and substance use using robust measures of religiosity. The primary hypotheses were (a) sensation seeking would be positively associated with higher levels of heavy episodic drinking and marijuana use; (b) religiosity would be negatively associated with higher levels of substance use; and (c) religiosity would moderate the relation between sensation seeking and substance use such that, when religiosity was high, there would be no association between sensation seeking and substance use, but at low and moderate levels of religiosity, there would be a positive association between them. Religiosity was a significant moderator of the relation between risk seeking and marijuana use (p < .01), but it was less effective as a moderator between sensation seeking and heavy episodic drinking. Religiosity appears to have a stronger buffering effect for illegal drug use compared with alcohol use, perhaps in part because of the relative acceptance of alcohol consumption across major U.S. religious orientations. (PsycINFO Database Record (c) 2015 APA, all rights reserved)

 

Drinking motives mediate the negative associations between mindfulness facets and alcohol outcomes among college students.Open in a New Window

Mindfulness and drinking motives have both been linked to affect regulation, yet the relationship between mindfulness and drinking motives is poorly understood. The present study examined whether drinking motives, particularly mood regulatory motives, mediated the associations between facets of mindfulness and alcohol-related outcomes among college students (N = 297). We found 3 specific facets of mindfulness (describing, nonjudging of inner experience, and acting with awareness) to have negative associations with alcohol outcomes. Importantly, specific drinking motives mediated these associations such that lower levels of mindfulness were associated with drinking for distinct reasons (enhancement, coping, conformity), which in turn predicted alcohol use and/or alcohol problems. Our findings suggest that drinking motives, especially mood regulatory and negative reinforcement motives, are important to examine when studying the role of mindfulness in college student drinking behavior. (PsycINFO Database Record (c) 2015 APA, all rights reserved)

 

A prospective study of adolescents’ nonmedical use of anxiolytic and sleep medication.Open in a New Window

The purpose of this longitudinal study (N = 2,745) was to determine whether adolescents’ recent medical use of anxiolytic or sleep medication was associated with increased incidence of using someone else’s prescription for these classes of medication (nonmedical use). Data were collected from adolescents attending 5 Detroit area secondary schools between December and April in 3 consecutive academic years between 2009 and 2012. Respondents were assigned to the following 3 mutually exclusive groups for the analyses: (1) never prescribed anxiolytic or sleep medication (in their lifetime); (2) prescribed anxiolytic or sleep medication in their lifetime, but not during the study period; or (3) prescribed anxiolytic or sleep medication during the study period. Almost 9% of the sample had received a prescription for anxiolytic or sleep medication during their lifetime, and 3.4% had received at least 1 prescription during the 3-year study period. Compared with adolescents never prescribed anxiolytic or sleep medication, adolescents prescribed these medicines during the study period were 10 times more likely to engage in nonmedical use for reasons such as “to get high” or “to experiment” (adjusted odds ratio [ORadj.] = 10.15; 95% CI [3.97–25.91]), and 3 times more likely to engage in nonmedical use to self-treat anxiety or to sleep (ORadj. = 3.24; 95% CI [1.67–6.29]). Adolescents prescribed anxiolytics during their lifetime but not during the 3-year study were 12 times more likely to use another’s anxiolytic medication, compared with adolescents never prescribed anxiolytics (ORadj. = 12.17; 95% CI [3.98–37.18]). These risk factors have significant implications for later substance use problems. (PsycINFO Database Record (c) 2015 APA, all rights reserved)

 

Childhood stress exposure among preadolescents with and without family histories of substance use disorders.Open in a New Window

Having a family history of substance use disorders (FH+) increases risk for developing a substance use disorder. This risk may be at least partially mediated by increased exposure to childhood stressors among FH+ individuals. However, measures typically used to assess exposure to stressors are narrow in scope and vary across studies. The nature of stressors that disproportionately affect FH+ children and how these stressors relate to later substance use in this population are not well understood. The purpose of this study was to assess exposure to a broad range of stressors among FH+ and FH− children to better characterize how exposure to childhood stressors relates to increased risk for substance misuse among FH+ individuals. A total of 386 children (305 FH+, 81 FH−; ages 10–12) were assessed using the Stressful Life Events Schedule before the onset of regular substance use. Both the number and severity of stressors were compared. Preliminary follow-up analyses were done for 53 adolescents who subsequently reported initiation of substance use. FH+ children reported more frequent and severe stressors than did FH- children, specifically in the areas of housing, family, school, crime, peers, and finances. Additionally, risk for substance use initiation during early adolescence was influenced directly by having a family history of substance use disorders and also indirectly through increased exposure to stressors among FH+ individuals. In conclusion, FH+ children experience greater stress across multiple domains, which contributes to their risk for substance misuse and related problems during adolescence and young adulthood. (PsycINFO Database Record (c) 2015 APA, all rights reserved)

 

Longitudinal test of a reciprocal model of smoking expectancies and smoking experience in youth.Open in a New Window

This article reports on a longitudinal test of a developmental model of early smoking that specifies reciprocal predictive relationships between smoking expectancies and smoking behavior in youth. The model was tested on 1,906 children during the transition from elementary school to middle school across 3 time points: the spring of 5th grade, the fall of 6th grade, and the spring of 6th grade. Key findings were (a) elementary school expectancies for reinforcement from smoking predicted smoking behavior during middle school; (b) smoking experience predicted increased subsequent smoking expectancies; and (c) among children who had never smoked, smoking expectancies predicted subsequent smoking onset. The finding that smoking expectancies and smoking behavior predicted each other reciprocally and positively across time in children this young may prove important in developing and refining early intervention and prevention efforts. (PsycINFO Database Record (c) 2015 APA, all rights reserved)

 

Does DSM-5 nomenclature for inhalant use disorder improve upon DSM-IV?Open in a New Window

Among drug classes, substance use disorder (SUD) consequent to using inhalants (SUD-I) has perhaps the smallest evidence base. This study compared DSM-IV versus DSM-5 nomenclatures, testing whether 4 traditional categories of inhalants (aerosols, gases, nitrites, solvents) are manifestations of a single pathology, obtaining item parameters of SUD-I criteria, and presenting evidence that SUD can result from using nitrites. An urban, Midwestern, community sample of 162 inhalant users was recruited. Participants were 2/3 male, nearly 85% White, and had a mean age of 20.3 years (SD = 2.4 years), spanning the ages of greatest incidence of SUD and slightly older than the primary ages of inhalants use initiation. Analyses consisted of bivariate associations, principle components analysis, and item response theory analysis. Validity was demonstrated for SUD-I consequent to each inhalant type as well as for aggregating all inhalant types into a single drug class. Results supported DSM-5 nomenclature over DSM-IV in multiple ways except that occurrence of diagnostic orphans was not statistically smaller using DSM-5. (PsycINFO Database Record (c) 2015 APA, all rights reserved)

 

Evaluating training of screening, brief intervention, and referral to treatment (SBIRT) for substance use: Reliability of the MD3 SBIRT Coding Scale.Open in a New Window

Screening, brief intervention, and referral to treatment (SBIRT) has become an empirically supported and widely implemented approach in primary and specialty care for addressing substance misuse. Accordingly, training of providers in SBIRT has increased exponentially in recent years. However, the quality and fidelity of training programs and subsequent interventions are largely unknown because of the lack of SBIRT-specific evaluation tools. The purpose of this study was to create a coding scale to assess quality and fidelity of SBIRT interactions addressing alcohol, tobacco, illicit drugs, and prescription medication misuse. The scale was developed to evaluate performance in an SBIRT residency training program. Scale development was based on training protocol and competencies with consultation from Motivational Interviewing coding experts. Trained medical residents practiced SBIRT with standardized patients during 10- to 15-min videotaped interactions. This study included 25 tapes from the Family Medicine program coded by 3 unique coder pairs with varying levels of coding experience. Interrater reliability was assessed for overall scale components and individual items via intraclass correlation coefficients. Coder pair-specific reliability was also assessed. Interrater reliability was excellent overall for the scale components (>.85) and nearly all items. Reliability was higher for more experienced coders, though still adequate for the trained coder pair. Descriptive data demonstrated a broad range of adherence and skills. Subscale correlations supported concurrent and discriminant validity. Data provide evidence that the MD3 SBIRT Coding Scale is a psychometrically reliable coding system for evaluating SBIRT interactions and can be used to evaluate implementation skills for fidelity, training, assessment, and research. Recommendations for refinement and further testing of the measure are discussed. (PsycINFO Database Record (c) 2015 APA, all rights reserved)

 

The validity of different measures of automatic alcohol action tendencies.Open in a New Window

Previous studies have demonstrated that automatic alcohol action tendencies are related to alcohol consumption and hazardous drinking. These action tendencies are measured with reaction time tasks in which the latency to make an approach response to alcohol pictures is compared with the latency to make an avoidance response. In the literature, 4 different tasks have been used, and these tasks differ on whether alcohol is a relevant (R) or irrelevant (IR) feature for categorization and on whether participants must make a symbolic approach response (stimulus-response compatibility [SRC] tasks) or an overt behavioral response (approach avoidance tasks [AAT]) to the pictures. Previous studies have shown positive correlations between measures of action tendencies and hazardous drinking and weekly alcohol consumption. However, results have been inconsistent and the different measures have not been directly compared with each other. Therefore, it is unclear which task is the best predictor of hazardous drinking and alcohol consumption. In the present study, 80 participants completed all 4 measures of action tendencies (i.e., R-SRC, IR-SRC, R-AAT, and IR-AAT) and measures of alcohol consumption and hazardous drinking. Stepwise regressions showed that the R-SRC and R-AAT were the only significant predictors of hazardous drinking, whereas the R-AAT was the only reliable predictor of alcohol consumption. Our results confirm that drinking behavior is positively correlated with automatic alcohol approach tendencies, but only if alcohol-relatedness is the relevant feature for categorization. Theoretical implications and methodological issues are discussed. (PsycINFO Database Record (c) 2015 APA, all rights reserved)

 

Two alternative approaches to conventional person-mean imputation scoring of the Self-Rating of the Effects of Alcohol Scale (SRE).Open in a New Window

A low level of response to alcohol is considered a significant risk factor for alcohol use disorder. Survey measures of this construct assess the number of drinks required to experience various alcohol effects, so data will be missing for effects participants have not experienced. Furthermore, missingness will likely be more common for items with higher means, as more severe effects are likely experienced both less commonly and at higher consumption levels. We explored whether these atypical characteristics of response-to-alcohol survey data cause problems when using conventional person-mean imputation scoring. This scoring approach involves averaging across nonmissing items for each participant, implicitly assuming that missing items have similar distributional properties (e.g., means) as nonmissing items. Analyses used data from the most commonly utilized response-to-alcohol survey measure: The Self-Rating of the Effects of Alcohol Scale (SRE). Results (a) revealed a strong relationship between higher item means and greater item missingness, (b) established that this relation causes person-mean imputation to produce more downwardly biased response-to-alcohol summary scores for participants with more missing data, (c) established that this induced a spurious relationship between higher response-to-alcohol summary scores and higher alcohol-effect endorsement (i.e., the number of SRE alcohol effects experienced), and (d) found that these biases can be reduced with 2 alternative scoring approaches. We discuss these and other potential problems with person-mean imputation, and common and unique advantages of the 2 alternative approaches. We consider generalizability, including how the problems shown here may vary in practical significance across different populations and measures. (PsycINFO Database Record (c) 2015 APA, all rights reserved)

 

Topiramate impairs cognitive function in methadone-maintained individuals with concurrent cocaine dependence.Open in a New Window

Topiramate is being investigated as a potential pharmacotherapy for the treatment of addictive disorders. However, its cognitive side effects raise concerns about its use, especially in populations with cognitive impairment, such as persons with chronic substance use disorders. This study investigated topiramate’s cognitive effects in individuals dually dependent on cocaine and opioids as part of a double-blind, randomized, controlled trial of topiramate for cocaine dependence treatment. After 5 weeks of stabilization on daily oral methadone (M = 96 mg), participants were randomized to topiramate (n = 18) or placebo (n = 22). Cognitive testing took place at 2 time points: study weeks 4 through 5 to assess baseline performance and 10 to 13 weeks later to assess performance during stable dosing (300 mg topiramate or placebo). All participants were maintained on methadone at both testing times, and testing occurred 2 hours after the daily methadone plus topiramate/placebo administration. The topiramate and placebo groups did not differ on sex, level of education, premorbid intelligence, methadone dose, or illicit drug use. Topiramate slowed psychomotor and information processing speed, worsened divided attention, reduced n-back working memory accuracy, and increased the false alarm rate in recognition memory. Topiramate had no effects on visual processing, other measures of psychomotor function, risk-taking, self-control, Sternberg working memory, free recall, and metamemory. These findings indicate that topiramate may cause cognitive impairment in this population. This effect may limit its acceptability and use as a treatment in individuals with chronic opioid and cocaine use disorders, among whom preexisting cognitive impairments are common. (PsycINFO Database Record (c) 2015 APA, all rights reserved)

 

Assessing sexual motives for drinking alcohol among HIV-positive men who have sex with men.Open in a New Window

Individuals who drink alcohol for the explicit motive of facilitating or enhancing sex may be more likely to engage in risky sexual behavior, including having sex under the influence of alcohol. However, efforts to assess sexual motives for drinking (SMDs) have been very limited to date. We examined the psychometric properties of a 5-item measure of SMDs in a sample of HIV-positive heavy drinking men who have sex with men. Findings provided excellent support for the scale’s internal consistency and concurrent validity with a well-established measure of sexual alcohol expectancies (SAEs). Good discriminant validity was also established, as SMDs were correlated with other drinking motives but uniquely predicted the proportion of sex acts occurring under the influence of alcohol and other drugs, over and above other drinking motives and SAEs. SMDs were not significantly associated with unprotected anal intercourse. Adjusting for alcohol problem severity, higher SMDs were associated with lower willingness to consider changing drinking. Results suggest this measure of SMDs exhibits sound psychometric properties and may be useful in studies examining the association between alcohol use and sexual behavior. (PsycINFO Database Record (c) 2015 APA, all rights reserved)

 

Characteristics of smoking used cigarettes among an incarcerated population.Open in a New Window

Little is known about smoking behaviors involving shared and previously used cigarettes, which we refer to as “smoking used cigarettes.” Examples include: cigarette sharing with strangers, smoking discarded cigarettes (“butts”), or remaking cigarettes from portions of discarded cigarettes. The current study focuses on the prevalence of and factors associated with smoking used cigarettes prior to incarceration among a U.S. prison population. Questionnaires were administered to 244 male and female inmates at baseline. Prevalence of smoking used cigarettes was assessed using 3 questions; 1 about sharing cigarettes with strangers, 1 about smoking a “found” cigarette, and 1 about smoking previously used cigarettes. Factors associated with those who engaged in smoking used cigarettes were then compared with those who did not engage in smoking used cigarettes. A majority of participants (61.5%) endorsed engaging in at least 1 smoking used cigarette behavior in the past prior to incarceration. Those who engaged in these behaviors were more likely to have a higher degree of nicotine dependence, to have started smoking regularly at a younger age, and to have lived in an unstable living environment prior to incarceration. Our results indicate that a history of smoking used cigarettes is common among incarcerated persons in the United States. Consistent with our hypothesis, engaging in smoking used cigarettes was found to be associated with a higher degree of nicotine dependence. (PsycINFO Database Record (c) 2015 APA, all rights reserved)
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