Print Page   |   Contact Us   |   Your Cart   |   Report Abuse   |   Sign In   |   Register
APA Journal: Psychology of Addictive Behaviors

Alcohol consumption and partner violence among women entering substance use disorder treatment.Open in a New Window

To test the hypothesized role of alcohol consumption as a proximal risk factor for partner violence, a within-subjects analysis compared levels of alcohol consumption in violent versus nonviolent conflict events among substance-abusing women and their male partners. Participants were married or cohabiting women (N = 145) who had recently begun a substance abuse treatment program and reported both a violent and a nonviolent relationship conflict event with their male partner in the prior 6 months. The average age was 38, and 83% were White. Male partners did not participate in the study. The female participant provided information about the male partner. Women were interviewed regarding a violent conflict event in which physical violence occurred and a nonviolent conflict event in which psychological aggression occurred without physical violence. The interview assessed quantity of alcohol consumed and use of other drugs prior to each conflict. Alcohol consumption was significantly greater prior to violent versus nonviolent conflict events for all measures of women’s alcohol consumption examined: any drinking, heavy drinking, number of drinks in the 12 hr preceding the conflict event, and estimated blood alcohol concentration at time of the event. Male partners’ alcohol consumption showed similar results. Use of other drugs in women, but not men, was significantly more likely prior to physical conflicts. These within-subject comparisons help to rule out individual difference explanations for the alcohol–violence association and indicate that the quantity of alcohol consumption is an important proximal risk factor for partner violence in substance-abusing women and their male partners. (PsycINFO Database Record (c) 2014 APA, all rights reserved)

 

Alcohol use disorder in women: Risks and consequences of an adolescent onset and persistent course.Open in a New Window

Women are more vulnerable to the deleterious effects of both acute and protracted alcohol use than men, but women’s lower levels of alcohol consumption and alcohol use disorder (AUD) have resulted in a paucity of investigations on the development of alcohol problems in women. In particular, it is not clear to what extent the cascading effects of key etiological factors that contribute to an especially severe course of AUD in men also underlie the development of AUD in women. To fill this gap, we examined the adolescent risk factors and adult consequences associated with an adolescent onset and persistent course of AUD in a community sample of women (n = 636) from ages 17 to 29. Women with AUD exhibited greater psychopathology and psychosocial impairment than those without, with an adolescent onset and persistent course indicative of the greatest severity. Notably, high levels of impairment across all women with AUD reduced the utility of onset and course to differentiate profiles of risk and impairment. In contrast to previous work in men, even women whose AUD symptoms desisted continued to exhibit impairment, suggesting that an adolescent onset of AUD is associated with enduring consequences for women’s health and functioning, even after ostensible “recovery.” (PsycINFO Database Record (c) 2014 APA, all rights reserved)

 

The role of alcohol perceptions as mediators between personality and alcohol-related outcomes among incoming college-student drinkers.Open in a New Window

After high school, college students escalate their drinking at a faster rate than their noncollege-attending peers, and alcohol use in high school is one of the strongest predictors of alcohol use in college. Therefore, an improved understanding of the role of predictors of alcohol use during the critical developmental period when individuals transition to college has direct clinical implications to reduce alcohol-related harms. We used path analysis in the present study to examine the predictive effects of personality (e.g., impulsivity, sensation seeking, hopelessness, and anxiety sensitivity) and three measures of alcohol perception: descriptive norms, injunctive norms, and perceptions regarding the perceived role of drinking in college on alcohol-related outcomes. Participants were 490 incoming freshmen college students. Results indicated that descriptive norms, injunctive norms, and the role of drinking largely mediated the effects of personality on alcohol outcomes. In contrast, both impulsivity and hopelessness exhibited direct effects on alcohol-related problems. The perceived role of drinking was a particularly robust predictor of outcomes and mediator of the effects of personality traits, including sensation seeking and impulsivity on alcohol outcomes. The intertwined relationships observed in this study between personality factors, descriptive norms, injunctive norms, and the role of drinking highlight the importance of investigating these predictors simultaneously. Findings support the implementation of interventions that target these specific perceptions about the role of drinking in college. (PsycINFO Database Record (c) 2014 APA, all rights reserved)

 

Young adult social development as a mediator of alcohol use disorder symptoms from age 21 to 30.Open in a New Window

Little research has examined social development in the young adult years relative to childhood and adolescence. This study tested the hypothesized pathways of the social development model (SDM) in young adulthood for predicting symptoms of alcohol use disorder (AUD) and positive functioning at age 30. A longitudinal panel study originally drawn from Seattle, Washington, elementary schools was examined. The sample included 808 participants with high retention and was gender balanced and ethnically diverse. Analyses focused on ages 21, 27, and 30. SDM constructs were assessed with self-reports of past-year behavior and combined multiple life domains. AUD symptoms corresponding to the Diagnostic and Statistical Manual of Mental Disorders, fourth edition (American Psychiatric Association, 1994) criteria were assessed using the Diagnostic Interview Schedule. Positive functioning combined measures of constructive engagement in work and school, civic engagement, physical exercise, and lack of depressive symptoms. The study found that AUD symptoms were moderately stable from age 21 to 30; however, developmental pathways hypothesized by the SDM at age 27 played a significant role in partially mediating this association. Alcohol-specific factors were key mediating mechanisms, whereas prosocial factors played little role. Conversely, prosocial factors had an important role in predicting positive functioning at age 30, whereas there were no significant pathways involving alcohol-specific factors. Findings suggest that age 27 is not too late for interventions targeting adult social development to help diminish alcohol use disorder symptoms by age 30. Alcohol-specific factors such as reducing perceived opportunities or rewards for heavy alcohol use or challenging beliefs accepting of drunkenness are likely to be key ingredients of effective adult interventions. (PsycINFO Database Record (c) 2014 APA, all rights reserved)

 

Anxiety, sedation, and simulated driving in binge drinkers.Open in a New Window

The current study evaluated the relationships among trait anxiety, subjective response to alcohol, and simulated driving following a simulated alcohol binge. Sixty drinkers with a binge history completed the State Trait Anxiety Inventory (STAI), the Alcohol Use Questionnaire, and subsequently completed a driving simulation. Participants were then administered 0.2 g/kg ethanol at 30-min intervals (cumulative dose 0.8 g/kg). Following alcohol consumption, the Biphasic Alcohol Effects Scale (BAES) and visual analog scales of subjective impairment and driving confidence were administered, after which simulated driving was reassessed. Due to the emphasis on simulated driving after drinking in the current study, subjective response to alcohol (i.e., self-reported sedation, stimulation, impairment, and confidence in driving ability) was assessed once following alcohol consumption, as this is the time when drinkers tend to make decisions regarding legal driving ability. Alcohol increased driving speed, speeding tickets, and collisions. Sedation following alcohol predicted increased subjective impairment and decreased driving confidence. Subjective impairment was not predicted by sensitivity to stimulation or trait anxiety. High trait anxiety predicted low driving confidence after drinking and this relationship was mediated by sedation. Increased speed after alcohol was predicted by sedation, but not by trait anxiety or stimulation. Anxiety, combined with the sedating effects of alcohol, may indicate when consumption should cease. However, once driving is initiated, sensitivity to sedation following alcohol consumption is positively related to simulated driving speed. (PsycINFO Database Record (c) 2014 APA, all rights reserved)

 

Perceptions of relative risk of disease and addiction from cigarettes and snus.Open in a New Window

The public is largely unaware of the lower global risk associated with snus compared with that of cigarettes, but little is known of perceptions of relative risks for specific diseases. Inveterate, daily, and nondaily smokers’ perceptions of the relative snus/cigarette risk of cardiovascular disease, and of cancer of the lung, stomach, and oral cavity, and perceptions among smokers, snus users, and dual users of the relative risk of nicotine addiction, was studied in a pooled sample from annual national surveys (2008–2011) performed by Statistics Norway. The total sample included 2,661 ever smokers and snus users aged 15–79 years old. Fifty-three percent were men, and the average age was 46.1 year. Compared with medical consensus, all smoker groups overestimated the relative risks of diseases from snus use, and inveterate smokers overestimated them significantly more than other groups. For all diseases except lung cancer, the majority of smokers thought snus users were running a higher or equal risk. For lung cancer, 22% believed that snus use gave a higher or equal risk. Smokers, snus users, and dual users tended to think that snus and cigarettes were equally addictive products, while a somewhat higher proportion of those who had quit both products thought that cigarettes were more addictive. Increased knowledge of the relative health risks might give smokers an incitement to switch to snus and prompt current dual users to stop smoking completely. Awareness could be improved by tailoring information at targeted groups, for example via the health care system. (PsycINFO Database Record (c) 2014 APA, all rights reserved)

 

Relations among affect, abstinence motivation and confidence, and daily smoking lapse risk.Open in a New Window

This study tested the hypothesis that changes in momentary affect, abstinence motivation, and confidence would predict lapse risk over the next 12–24 hr using Ecological Momentary Assessment (EMA) data from smokers attempting to quit smoking. One hundred and three adult, daily, treatment-seeking smokers recorded their momentary affect, motivation to quit, abstinence confidence, and smoking behaviors in near real time with multiple EMA reports per day using electronic diaries postquit. Multilevel models indicated that initial levels of negative affect were associated with smoking, even after controlling for earlier smoking status, and that short-term increases in negative affect predicted lapses up to 12, but not 24, hr later. Positive affect had significant effects on subsequent abstinence confidence, but not motivation to quit. High levels of motivation appeared to reduce increases in lapse risk that occur over hours although momentary changes in confidence did not predict lapse risk over 12 hr. Negative affect had short-lived effects on lapse risk, whereas higher levels of motivation protected against the risk of lapsing that accumulates over hours. An increase in positive affect was associated with greater confidence to quit, but such changes in confidence did not reduce short-term lapse risk, contrary to expectations. Relations observed among affect, cognitions, and lapse seem to depend critically on the timing of assessments. (PsycINFO Database Record (c) 2014 APA, all rights reserved)

 

Staff commitment to providing tobacco dependence in drug treatment: Reliability, validity, and results of a national survey.Open in a New Window

Although most people in treatment for illicit drug use smoke cigarettes, few facilities offer any form of treatment for tobacco dependence. One reason for this may be that drug treatment staff have varying levels of commitment to treat tobacco. We developed and validated a 14-item Tobacco Treatment Commitment Scale (TTCS), using 405 participants in leadership positions in drug treatment facilities. We first conducted a confirmatory factor analysis to evaluate 4 a priori domains suggested by our original set of 38 items—this did not produce a good fit (comparative fit index [CFI] = 0.782, root mean square error of approximation [RMSEA] = 0.067). We then conducted a series of exploratory factor analyses to produce a more precise and reliable scale. The final confirmatory factor analysis indicated a 3-factor solution, produced a good fit (CFI = 0.950, RMSEA = 0.058), and had substantial unified reliability of 0.975. The final TTCS contained 14 items in 3 domains: “Tobacco is less harmful than other drugs,” “It’s not our job to treat tobacco,” and “Tobacco treatment will harm clients.” These constructs account for most of the variance in the survey items and emerged as major sentiments driving staff commitment to providing tobacco services. The TTCS can be used to understand the role of staff attitudes in the adoption of tobacco services in this important treatment setting. (PsycINFO Database Record (c) 2014 APA, all rights reserved)

 

Breadth and depth involvement: Understanding Internet gambling involvement and its relationship to gambling problems.Open in a New Window

[Correction Notice: An Erratum for this article was reported in Vol 28(2) of Psychology of Addictive Behaviors (see record 2014-12580-001). The article incorrectly stated under the Procedures heading on page 3 that “The Cambridge Health Alliance Institutional Review Board approved our application to conduct the Web-based BBGS survey and secondary data analyses of the bwin.party subscriber database.” The authors alerted the journal that this project would have been exempt from IRB review and under this circumstance the IRB would not have issued any formal approval. Consequently, the published statement is inaccurate.] The “involvement effect” refers to the finding that controlling for gambling involvement often reduces or eliminates frequently observed game-specific associations with problem gambling. In other words, broader patterns of gambling behavior, particularly the number of types of games played over a defined period, contribute more to problem gambling than playing specific games (e.g., lottery, casino, Internet gambling). This study extends this burgeoning area of inquiry in three primary ways. First, it tests independently and simultaneously the predictive power of two gambling patterns: breadth involvement (i.e., the number of games an individual plays) and depth involvement (i.e., the number of days an individual plays). Second, it includes the first involvement analyses of actual betting activity records that are associated with clinical screening information. Third, it evaluates and compares the linearity of breadth and depth effects. We conducted analyses of the actual gambling activity of 1,440 subscribers to the bwin.party gambling service who completed an online gambling disorder screen. In all, 11 of the 16 games we examined had a significant univariate association with a positive screen for gambling disorder. However, after controlling for breadth involvement, only Live Action Internet sports betting retained a significant relationship with potential gambling-related problems. Depth involvement, though significantly related to potential problems, did not impact game-based gambling disorder associations as much as breadth involvement. Finally, breadth effects appeared steeply linear, with a slight quadratic component manifesting beyond four games played, but depth effects appeared to have a strong linear component and a slight cubic component. (PsycINFO Database Record (c) 2014 APA, all rights reserved)

 

Correction to LaPlante, Nelson, and Gray (2013).Open in a New Window

Reports an error in "Breadth and Depth Involvement: Understanding Internet Gambling Involvement and Its Relationship to Gambling Problems" by Debi A. LaPlante, Sarah E. Nelson and Heather M. Gray (Psychology of Addictive Behaviors, Advanced Online Publication, Aug 5, 2013, np). The article incorrectly stated under the Procedures heading on page 3 that “The Cambridge Health Alliance Institutional Review Board approved our application to conduct the Web-based BBGS survey and secondary data analyses of the bwin.party subscriber database.” The authors alerted the journal that this project would have been exempt from IRB review and under this circumstance the IRB would not have issued any formal approval. Consequently, the published statement is inaccurate. (The following abstract of the original article appeared in record 2013-28000-001.) The “involvement effect” refers to the finding that controlling for gambling involvement often reduces or eliminates frequently observed game-specific associations with problem gambling. In other words, broader patterns of gambling behavior, particularly the number of types of games played over a defined period, contribute more to problem gambling than playing specific games (e.g., lottery, casino, Internet gambling). This study extends this burgeoning area of inquiry in three primary ways. First, it tests independently and simultaneously the predictive power of two gambling patterns: breadth involvement (i.e., the number of games an individual plays) and depth involvement (i.e., the number of days an individual plays). Second, it includes the first involvement analyses of actual betting activity records that are associated with clinical screening information. Third, it evaluates and compares the linearity of breadth and depth effects. We conducted analyses of the actual gambling activity of 1,440 subscribers to the bwin.party gambling service who completed an online gambling disorder screen. In all, 11 of the 16 games we examined had a significant univariate association with a positive screen for gambling disorder. However, after controlling for breadth involvement, only Live Action Internet sports betting retained a significant relationship with potential gambling-related problems. Depth involvement, though significantly related to potential problems, did not impact game-based gambling disorder associations as much as breadth involvement. Finally, breadth effects appeared steeply linear, with a slight quadratic component manifesting beyond four games played, but depth effects appeared to have a strong linear component and a slight cubic component. (PsycINFO Database Record (c) 2014 APA, all rights reserved)

 

Risk, compensatory, protective, and vulnerability factors related to youth gambling problems.Open in a New Window

This study explores the additive (i.e., risk or compensatory) or moderating (i.e., protective or exacerbating) role of individual resources (social bonding, personal competence, and social competence) and environmental risk (family, peers, and neighborhood) in regard to the association between established personal risk attributes (i.e., impulsivity, anxiety) and youth gambling problems. Using a cross-sectional design, regression analyses indicated that among a sample of mostly first-generation immigrant adolescents from low-income homes (N = 1,055; M = 15.03; SD = 1.64), social bonding was associated with a decrease in gambling problems (odds ratio [OR] = 0.15, p < .01) while peer and neighborhood risk were associated with an increase in gambling problems (OR = 2.24, p = .01 and OR = 2.31, p = .01, respectively), net of personal risk attributes. In terms of protective processes, no putative moderating effect was found for composite individual resources. The findings are discussed with respect to the roles of compensatory, risk, and protective processes. (PsycINFO Database Record (c) 2014 APA, all rights reserved)

 

Stages of change, clinical presentation, retention, and treatment outcomes in treatment-seeking outpatient problem gambling clients.Open in a New Window

Specific stages of change have been associated with clinical variables before and during the course of addiction treatment. However, few studies have specifically focused on these relationships for problem and pathological gamblers. The present study examined the relationships between pretreatment stages of change and clinical treatment variables in a sample of 71 treatment-seeking problem and pathological gamblers. The participants were administered the following instruments: the University of Rhode Island Change Assessment (URICA), the NORC DSM–IV Screen for Gambling Problems (NODS), and the Outcome Questionnaire 45 (OQ-45). The researchers hypothesized that there would be a relationship among pretreatment stages of change and (a) severity of gambling problems at onset of treatment, (b) severity of psychosocial problems at onset of treatment, (c) retention in treatment, and (d) level of psychosocial improvement through therapy. The results indicate that (a) precontemplation was negatively related to reported gambling problems at outset of treatment, and contemplation and maintenance were positively related to reported gambling problems at the outset of treatment; (b) action was positively associated with level of psychosocial functioning at outset of treatment; (c) action was negatively associated with retention in treatment; and (d) maintenance was negatively associated with level of improvement in psychosocial functioning through therapy. Implications for treatment of this population include the ability to adjust treatment plans and interventions with increased awareness of potential barriers and obstacles unique to pretreatment stages of change. (PsycINFO Database Record (c) 2014 APA, all rights reserved)

 

Parallel demand–withdraw processes in family therapy for adolescent drug abuse.Open in a New Window

Isomorphism, or parallel process, occurs in family therapy when patterns of therapist–client interaction replicate problematic interaction patterns within the family. This study investigated parallel demand–withdraw processes in brief strategic family therapy (BSFT) for adolescent drug abuse, hypothesizing that therapist-demand/adolescent-withdraw interaction (TD/AW) cycles observed early in treatment would predict poor adolescent outcomes at follow-up for families who exhibited entrenched parent-demand/adolescent-withdraw interaction (PD/AW) before treatment began. Participants were 91 families who received at least four sessions of BSFT in a multisite clinical trial on adolescent drug abuse (Robbins et al., 2011). Prior to receiving therapy, families completed videotaped family interaction tasks from which trained observers coded PD/AW. Another team of raters coded TD/AW during two early BSFT sessions. The main dependent variable was the number of drug-use days that adolescents reported in timeline follow-back interviews 7 to 12 months after family therapy began. Zero-inflated Poisson regression analyses supported the main hypothesis, showing that PD/AW and TD/AW interacted to predict adolescent drug use at follow-up. For adolescents in high PD/AW families, higher levels of TD/AW predicted significant increases in drug use at follow-up, whereas for low PD/AW families, TD/AW and follow-up drug use were unrelated. Results suggest that attending to parallel demand–withdraw processes in parent–adolescent and therapist–adolescent dyads may be useful in family therapy for substance-using adolescents. (PsycINFO Database Record (c) 2014 APA, all rights reserved)

 

Do peer perceptions mediate the effects of ADHD symptoms and conduct problems on substance use for college students?Open in a New Window

Although extensive research suggests that attention-deficit/hyperactivity disorder (ADHD) and conduct problems (CP; symptoms of oppositional defiant disorder, conduct disorder, and antisocial personality disorder) contribute to risk for substance use, why these symptoms increase risk for substance use remains unclear. Given that research indicates that perceived peer tolerance and perceived peer substance use affect substance use, we evaluated the degree to which these peer-perception constructs mediated the association that ADHD symptoms, CP symptoms, and their interaction share with substance use (i.e., alcohol use, marijuana use, and illicit drug use). Participants were college students (N = 627; 60% female; 47% European American) with a mean age of 20.23 years. Results indicated that perceived peer use significantly mediated the association of ADHD symptoms with alcohol, marijuana, and illicit drug use, whereas perceived peer use only mediated the association between CP symptoms and alcohol use. Perceived peer tolerance significantly mediated the association that both CP and ADHD symptoms had with marijuana use, but not alcohol or illicit drug use. Finally, CP symptoms moderated the indirect effect that ADHD symptoms had on alcohol use through perceived peer tolerance. At low levels of CP symptoms, increases in ADHD symptoms corresponded to increases in perceived peer tolerance, which was related to increased alcohol use. However, at high levels of CP symptoms, increases in ADHD symptoms corresponded to decreases in perceived peer tolerance, which was associated with decreased alcohol use. Implications of findings are discussed. (PsycINFO Database Record (c) 2014 APA, all rights reserved)

 

Posttraumatic stress disorder and substance use disorder comorbidity in homeless adults: Prevalence, correlates, and sex differences.Open in a New Window

Substance use disorders (SUDs) are highly prevalent in homeless populations, and rates are typically greater among males. Posttraumatic stress disorder (PTSD) is a common co-occurring condition among individuals with SUDs; however, little attention has been directed to examining this comorbidity in homeless populations. Although some studies indicate considerable sex differences among individuals with PTSD, it has also been suggested that sex differences in PTSD rates diminish in populations with severe SUDs. This cross-sectional study investigated SUD–PTSD comorbidity and its associations with indicators of psychosocial functioning in a sample of 500 homeless individuals from Canada. Sex-related patterns of SUD, PTSD, and their comorbidity were also examined. Males and females had similar SUD prevalence rates, but the rates of PTSD and PTSD–SUD comorbidity were higher in females. PTSD and sex were found to have significant main effects on suicidality, psychological distress, somatic symptoms, and incarceration among individuals with SUD. Sex also moderated the association of PTSD with suicide risk and psychological distress. Our results contradict assumptions that sex differences in PTSD rates attenuate in samples with severe SUDs. Organizations providing SUD treatment for homeless people should address PTSD as an integrated part of their services. SUD and integrated treatment programs may benefit from sex-specific components. (PsycINFO Database Record (c) 2014 APA, all rights reserved)

 

Adolescent substance use in Israel: The roles of exposure to political traumas and posttraumatic stress symptoms.Open in a New Window

Previous studies have not examined the potential mediating role of posttraumatic stress symptoms (PTS) and moderating roles of gender and ethnicity among adolescents in the aftermath of political traumas, especially in the Middle East. This study of Israeli adolescents aimed to begin bridging these gaps in knowledge. We addressed the following hypotheses: (a) greater exposure to multiple political traumas would be associated with adolescent substance use; (b) greater PTS would be associated with adolescent substance use; (c) PTS would mediate the association of exposure to multiple political traumas on substance use; and (d) gender and ethnicity would moderate the pathways from exposure and PTS to substance use. A nationally representative sample included 4,733 Grade 10 and 11 students (half were females; 36.8% were Arabs). Results of bootstrapping estimations found a significant direct link between exposure to multiple political traumas and substance use, as well as an indirect link through PTS. Gender moderated the relationship between PTS and substance use, while ethnicity moderated the association between exposure and substance use. Specifically, female adolescent substance use decreased when their PTS increased. Arab adolescents who had greater exposure to multiple political traumas used more substances. PTS may be an important mechanism by which trauma exposure is associated with increased substance use. Screening adolescents for PTS and substance use, shortly after political trauma, is essential to address the potential risk factors in vulnerable adolescents. (PsycINFO Database Record (c) 2014 APA, all rights reserved)

 

One-year outcomes and mediators of a brief intervention for drug abusing adolescents.Open in a New Window

Two manually guided brief interventions were evaluated with a randomized, controlled trial. Adolescents (aged 13–17 years) suspected of abusing alcohol and other drugs and their parent were randomly assigned to receive either a 2-session adolescent only (BI-A), 2-session adolescent and additional parent session (BI-AP), or assessment only control condition (CON). Adolescents were identified in a school setting, and the intervention was delivered by trained counselors. Outcome analyses (N = 284; 90% of those enrolled) of relative change (from intake to 12 months) and absolute status (at 12 months) revealed a general pattern of reductions in drug use behaviors, particularly with the cannabis outcome measures, in both active conditions (BI-A and BI-AP). Students in the control condition showed worse outcome compared with the BI-A and BI-AP groups. Among the 4 mediating variables measured at 6 months, use of additional services, motivation to change, and parenting practices had significant influences on 12-month outcome; problem-solving skills approached significance as a mediator. The potential value of a brief intervention for drug abusing adolescents is discussed. (PsycINFO Database Record (c) 2014 APA, all rights reserved)

 

Bidirectional effects of parenting and youth substance use during the transition to middle and high school.Open in a New Window

The current study assessed bidirectional relationships between supportive parenting behaviors (i.e., involvement, positive parenting), parental control strategies (i.e., parental monitoring, effective discipline), and youth substance use in a sample of aggressive youth during the transitions to middle and high school. Participants were drawn from the control group of a larger longitudinal study and were followed from 4th through 9th grade. Cross-lagged developmental models were evaluated using structural equation modeling. Youth substance use at 6th, 7th, and 8th grade influenced positive parenting at 7th, 8th, and 9th grade, but did not influence parental involvement or monitoring at any grade. Parental involvement, monitoring, and positive parenting at earlier grades did not influence youth substance use at later grades. Reciprocal relationships were observed between effective discipline and youth substance use at all grades. Results are consistent with models of bidirectionality that suggest that parents and children adjust their behavior based on the response of the other. Findings may impact our understanding of the development of youth substance use across time and improve interventions designed to reduce this behavior during periods of transition. (PsycINFO Database Record (c) 2014 APA, all rights reserved)

 

Urgency traits and problematic substance use in adolescence: Direct effects and moderation of perceived peer use.Open in a New Window

Negative and positive urgency are facets of trait impulsivity that have been identified as possible risk factors for problematic substance use. Relationships between these traits and substance use measures have not yet been widely investigated in adolescents. In the current study, a sample of 270 adolescent students completed self-report measures of impulsivity-related traits, their alcohol and cannabis use, problematic use, and perceived peer use. Zero-inflated negative binomial regression models indicated that both urgency traits accounted for significant variance in problematic alcohol and cannabis use scores, even after accounting for nonurgency impulsivity traits and typical substance consumption. Furthermore, both urgency traits moderated the positive association between perceived peer alcohol use and individual problematic use. Results indicate that the urgency traits show a direct association with problematic substance use in adolescence, and that high urgency adolescents who believe their peers drink high levels of alcohol may be at increased risk of problematic alcohol use. (PsycINFO Database Record (c) 2014 APA, all rights reserved)

 

Which facets of mindfulness predict the presence of substance use disorders in an outpatient psychiatric sample?Open in a New Window

There have been inconsistent findings regarding the relationship of mindfulness to substance use disorders, which may be attributable in part to measurement issues and the use of nonclinical samples. The current study examined the relationship between specific facets of mindfulness and substance use disorders (SUD) in a clinical sample. The sample consisted of 867 patients seeking outpatient treatment and who completed diagnostic interviews and self-report assessments. Results indicated that deficits in acting with awareness, being nonjudgmental, and nonreactivity were related to the presence of a current SUD relative to those with no history of SUD, although only acting with awareness and being nonjudgmental were related when all of the facets were included in a logistic regression. Patients with a past history of SUD had greater deficits in acting with awareness relative to those with no history of SUD. Results were similar when examining alcohol use and drug use disorders separately. Current nicotine users had greater deficits in being nonjudgmental, but not on other mindfulness facets. The observing facet was not related to current or past history of SUD. The results of the study and future directions are discussed in relation to research on mindfulness-based treatments for addiction. (PsycINFO Database Record (c) 2014 APA, all rights reserved)

 

Longitudinal change mechanisms for substance use and illegal activity for adolescents in treatment.Open in a New Window

The current study investigated: (a) the relationships of exposure to the Adolescent Community Reinforcement Approach (A-CRA) with reductions in substance use, illegal activity, and juvenile justice system involvement in adolescents diagnosed with a substance use disorder, and (b) the pathways by which reductions in the target behaviors were achieved. This study is a secondary data analysis of longitudinal data from a large-scale implementation effort for A-CRA. The sample consisted of 1,467 adolescents who presented to substance use treatment and reported past-year engagement in illegal activity. Participants had an average age of 15.8 years (SD = 1.3) and were 25% female, 14% African American, 29% Hispanic, 35% Caucasian, 16% mixed ethnicity, and 6% other ethnicity. Path analyses provided support that participation in A-CRA had a significant, direct association with reduced substance use; a significant, indirect association with reduced illegal activity through reductions in substance use; and a significant indirect association with reduced juvenile justice system involvement through reductions in both substance use and illegal activity. In addition, post hoc analyses using a bootstrapping strategy provided evidence that reductions in substance use partially mediated the relationship between A-CRA and illegal activity. (PsycINFO Database Record (c) 2014 APA, all rights reserved)

 

The temporal relationship between alcohol, marijuana, angry affect, and dating violence perpetration: A daily diary study with female college students.Open in a New Window

Although a robust literature documents a positive association between alcohol and intimate partner violence (IPV), there is limited temporal research on this relation. Moreover, the role of marijuana in influencing IPV has been mixed. Thus, the primary aim of the current study was to examine the temporal relationship between alcohol and marijuana use and dating violence perpetration. A secondary aim was to examine whether angry affect moderated the temporal relation between alcohol and marijuana use and IPV perpetration. Participants were college women who had consumed alcohol in the previous month and were in a dating relationship (N = 173). For up to 90 consecutive days, women completed daily surveys that assessed their alcohol use, marijuana use, angry affect (anger, hostility, and irritation), and violence perpetration (psychological and physical). On alcohol use days, marijuana use days, and with increases in angry affect, the odds of psychological aggression increased. Only alcohol use days and increases in angry affect increased the odds of physical aggression. Moreover, the main effects of alcohol and marijuana use on aggression were moderated by angry affect. Alcohol was positively associated with psychological and physical aggression when angry affect was high, but was unrelated to aggression when angry affect was low. Marijuana use was associated with psychological aggression when angry affect was high. Findings advance our understanding of the proximal effect of alcohol and marijuana use on dating violence, including the potential moderating effect of angry affect on this relation. (PsycINFO Database Record (c) 2014 APA, all rights reserved)

 

Predictors of motivation to change in mandated college students following a referral incident.Open in a New Window

The purpose of present study was to understand factors that are related to a desire or motivation to change (MTC) alcohol use in a sample of college students mandated to receive an alcohol intervention. We examined characteristics of and reactions to the referral event, typical alcohol use involvement, and alcohol beliefs about the perceived importance of drinking in college assessed by the College Life Alcohol Salience Scale (CLASS; Osberg et al., 2010) as predictors of MTC following referral to an alcohol intervention. College students (N = 932) who presented for a mandatory alcohol intervention following a referral event (e.g., citation for underage drinking, medical attention for an alcohol-related incident, or driving under the influence) completed an assessment prior to receiving an alcohol intervention. Higher perceived aversiveness of the referral event and higher personal responsibility one felt for the occurrence of the event were positively related to higher MTC. Although alcohol beliefs about the role of drinking in college were not significantly related to either event aversiveness or responsibility, it was negatively related to MTC even after controlling for alcohol use involvement variables. Alcohol beliefs about the role of drinking in college represent an important construct that is related to increased alcohol use and alcohol-related problems and decreased MTC in a sample of college students. Interventions aimed at reducing alcohol beliefs about the role of drinking in college may be an effective strategy to reduce alcohol use and alcohol-related problems by college students. (PsycINFO Database Record (c) 2014 APA, all rights reserved)

 

Childhood sexual abuse, distress, and alcohol-related problems: Moderation by drinking to cope.Open in a New Window

Previous studies have found relationships between childhood sexual abuse (CSA) and problem alcohol use. However, few studies have explored mechanisms that may explain this relationship. The present study examined whether (a) distress mediated the relationship between CSA and both heavy drinking and alcohol consequences, (b) coping motives for drinking moderated the paths between distress and both heavy drinking and alcohol consequences, and (c) these relationships remained significant after controlling for other forms of abuse/trauma. Three hundred ninety-five undergraduate women completed survey measures of childhood abuse/trauma, alcohol use/consequences, distress, and drinking motives. Data were analyzed using path analyses. Results supported a moderated-mediation model in which distress mediated the relationship between CSA and alcohol consequences, but only among those who endorsed coping motives for drinking. After controlling for other forms of abuse/maltreatment, the moderated-mediated pathway was no longer significant, but there remained a direct path between CSA and alcohol consequences. The present study provides support for tension-reduction models of alcohol use among CSA-exposed women and demonstrates the moderating role of coping motives. The present study also highlights the need for future studies to control for other forms of abuse/trauma and suggests that other mechanisms and contextual variables need to be explored to explain the CSA/alcohol-use pathway. (PsycINFO Database Record (c) 2014 APA, all rights reserved)

 

Effects of normative feedback for drinkers who consume less than the norm: Dodging the boomerang.Open in a New Window

Several alcohol interventions designed for college students attempt to correct exaggerated perceptions of alcohol use on college campuses through the use of personalized normative feedback. Personalized normative feedback has been shown to be effective in reducing drinking as a stand-alone intervention and as a part of a multicomponent intervention. This feedback is typically targeted to heavier drinkers to create a discrepancy between their personal beliefs and behavior and the actual lower levels of use on campus. However, little is known about how this form of normative feedback might affect lighter drinkers who learn that they are drinking less than the typical student at their school. The risk is a potential boomerang effect, or an increase in drinking among lighter drinkers receiving personalized feedback. The current study examined four samples from three geographic locations: two using computer-delivered personalized normative feedback alone and two delivering personalized feedback in the context of a brief motivational intervention. We found no evidence for a boomerang effect among lighter drinkers receiving personalized normative feedback in any of the four samples. These findings help to assuage fears of increasing drinking among lighter drinkers through widespread implementation of normative interventions for college students in the absence of screening for current drinking status. (PsycINFO Database Record (c) 2014 APA, all rights reserved)

 

College drinking problems and social anxiety: The importance of drinking context.Open in a New Window

Social anxiety more than quadruples the risk of developing an alcohol use disorder, yet it is inconsistently linked to heavy alcohol use. Elucidation of the relation between social anxiety and alcohol use is an important next step in treating and preventing risky drinking. College students routinely face potentially anxiety-provoking social situations (e.g., meeting new people) and socially anxious undergraduates are especially vulnerable to alcohol-related impairment. Drinking to cope with social anxiety is thought to reinforce alcohol use, yet research on coping-motivated drinking among socially anxious students has yielded inconsistent findings. Further, undergraduate drinking varies by drinking context, yet the role of context in drinking behaviors among socially anxious individuals remains unclear. The current study sought to examine the relationship of social anxiety and drinking quantity in specific drinking contexts among undergraduates (N = 611). We also evaluated whether relevant drinking contexts mediated the relationship between social anxiety and alcohol-related problems. Clinically elevated social anxiety was related to heavier consumption in negative emotion (e.g., feeling sad or angry) and personal/intimate (e.g., before sexual intercourse) contexts, but not social/convivial contexts (e.g., parties, bars). Quantity of alcohol consumed in negative emotion and personal/intimate contexts mediated the relationship between social anxiety and drinking problem severity. Drinking in personal/intimate contexts demonstrated a unique mediational role. Findings suggest that heavy drinking in particular contexts (especially personal/intimate and negative emotion) may play an important role in drinking problems among socially anxious individuals. (PsycINFO Database Record (c) 2014 APA, all rights reserved)

 

Drinking reductions following alcohol-related sanctions are associated with social norms among college students.Open in a New Window

Students mandated for intervention following an alcohol-related sanction event often reduce their drinking prior to intervention. Knowing the determinants of self-initiated change may help identify intervention targets for individuals who do not reduce their drinking. Guided by self-regulation theory, we tested whether fewer past alcohol consequences and higher descriptive and injunctive norms would be associated with higher levels of postsanction drinking. College students referred for a campus alcohol violation (N = 658, 64% male) reported on their drinking during the month before and after their sanction event. Results show that postsanction drinking was significantly lower than presanction drinking across 4 outcomes: (a) drinks per drinking day, (b) drinks per week, (c) peak drinks, and (d) peak blood alcohol concentration. Hypothesized social influence variables (i.e., descriptive and injunctive norms) were consistently associated with all 4 drinking outcomes; that is, students who perceived that their friends drank more and held more accepting views of drinking were less reactive to alcohol-related sanctions. Past consequences of drinking did not consistently predict subsequent drinking. Therefore, we conclude that alcohol interventions for mandated students should target both descriptive and injunctive norms to optimize their efficacy. (PsycINFO Database Record (c) 2014 APA, all rights reserved)

 

Computer-delivered, home-based, attentional retraining reduces drinking behavior in heavy drinkers.Open in a New Window

To examine the impact of a computer-delivered, home-based, alcohol-specific attention modification program (AMP), 41 heavy drinking college students were randomly assigned to AMP or an attention control condition (ACC). Participants selected 10 alcohol-related words most relevant to their own drinking experience as well as 10 neutral words not related to alcohol. These personalized stimuli were used in an attention retaining program based upon the probe detection paradigm twice weekly for 4 weeks. Participants in the AMP condition reported decreased drinking, whereas those in the ACC condition reported no change in their drinking. These preliminary data suggest that a computer-delivered, home-delivered, attention-retraining for alcohol treatment may be an inexpensive and efficacious adjunct to standard alcohol treatments. (PsycINFO Database Record (c) 2014 APA, all rights reserved)

 

Cocaine use disorder prevalence: From current DSM-IV to proposed DSM-5 diagnostic criteria with both a two and three severity level classification system.Open in a New Window

This article presents a secondary analysis from a study investigating the compatibility of the current DSM–IV and previously proposed DSM-5 cocaine use disorder (CUD) criteria (S. L. Proctor, A. M. Kopak, & N. G. Hoffmann, 2012, Compatibility of current DSM–IV and proposed DSM-5 diagnostic criteria for cocaine use disorders. Addictive Behaviors, 37, 722–728). The current analyses examined the compatibility of the current DSM–IV and two sets of proposed DSM-5 diagnostic criteria for CUDs among adult male inmates (N = 6,871) recently admitted to the Minnesota Department of Corrections state prison system from 2000–2003. Initially proposed DSM-5 criteria (DSM-5.0) featured only two diagnostic designations (i.e., moderate and severe). A subsequent revision (DSM-5.1) included the addition of a mild designation and required a greater number of positive findings for the severe designation. A computer-prompted structured diagnostic interview was administered to all inmates as part of routine clinical assessments. The past 12-month prevalence of DSM–IV CUDs was 12.70% (Abuse, 3.78%, Dependence, 8.92%), while 10.98% met past 12-month DSM-5.1 criteria for a CUD (Mild [MiCUD], 1.72%; Moderate [MCUD], 1.12%; and Severe [SCUD], 8.14%). The vast majority of those with no diagnosis (99.6%) continued to have no diagnosis, and most of those with a dependence diagnosis (91.2%) met SCUD criteria of the proposed DSM-5.1. Most of the variation in DSM-5.1 diagnostic classifications was accounted for by those with a current abuse diagnosis. DSM-5.0 MCUD cases were most affected when DSM-5.1 criteria were applied. The proposed diagnostic changes might translate to reduced access to treatment for those individuals evincing symptoms consistent with DSM–IV cocaine abuse. (PsycINFO Database Record (c) 2014 APA, all rights reserved)

 

Social anxiety and coping motives for cannabis use: The impact of experiential avoidance.Open in a New Window

Social anxiety is robustly associated with cannabis-related problems. This relation appears to be largely explained by coping-oriented motives for cannabis use. Yet, factors associated with coping motives among socially anxious individuals have yet to be identified. The current study tested whether experiential avoidance (i.e., unwillingness to experience distressing internal states) and its subfacets mediated the relation between social anxiety and coping motives for cannabis use. The sample consisted of current (past-month) cannabis-using adults (n = 103). Results indicated that social anxiety was robustly related to experiential avoidance, which was robustly related to coping motives. Follow-up analyses indicated that behavioral avoidance was the only experiential avoidance subtype to be related to both social anxiety and coping motives after controlling for theoretically relevant variables. Experiential avoidance (globally) and behavioral avoidance (specifically) mediated the relation between social anxiety and coping motives. Together, the results suggest experiential avoidance (especially behavioral avoidance) may play an important role in cannabis use behaviors, particularly among socially anxious users. (PsycINFO Database Record (c) 2014 APA, all rights reserved)

 

Development and evaluation of the Marijuana Reduction Strategies Self-Efficacy Scale.Open in a New Window

To evaluate several psychometric properties of a questionnaire designed to assess college students’ self-efficacy to employ 21 cognitive–behavioral strategies intended to reduce the amount and/or frequency with which they consume marijuana, we recruited 273 marijuana-using students to rate their confidence that they could employ each of the strategies. Examination of frequency counts for each item, principal components analysis, internal consistency reliability, and mean interitem correlation supported retaining all 21 items in a single scale. In support of criterion validity, marijuana use-reduction self-efficacy scores were significantly positively correlated with cross-situational confidence to abstain from marijuana, and significantly negatively correlated with quantity and frequency of marijuana use and marijuana-related problems. In addition, compared with respondents whose use of marijuana either increased or remained stable, self-efficacy was significantly higher among those who had decreased their use of marijuana over the past year. This relatively short and easily administered questionnaire could be used to identify college students who have low self-efficacy to employ specific marijuana reduction strategies and as an outcome measure to evaluate educational and skill-training interventions. (PsycINFO Database Record (c) 2014 APA, all rights reserved)

 

Mindfulness predicts lower affective volatility among African Americans during smoking cessation.Open in a New Window

Recent research suggests that mindfulness benefits emotion regulation and smoking cessation. However, the mechanisms by which mindfulness affects emotional and behavioral functioning are unclear. One potential mechanism, lower affective volatility, has not been empirically tested during smoking cessation. This study examined longitudinal associations among mindfulness and emotional responding over the course of smoking cessation treatment among predominantly low-socioeconomic status (SES) African American smokers, who are at high risk for relapse to smoking and tobacco-related health disparities. Participants (N = 399, 51% female, mean age = 42, 48% with annual income <$10,000) completed a baseline measure of trait mindfulness. Negative affect, positive affect, and depressive symptoms were assessed at five time points during smoking cessation treatment (up to 31 days postquit). Volatility indices were calculated to quantify within-person instability of emotional symptoms over time. Over and above demographic characteristics, nicotine dependence, and abstinence status, greater baseline trait mindfulness predicted lower volatility of negative affect and depressive symptoms surrounding the quit attempt and up to 1 month postquit, ps < 0.05. Although volatility did not mediate the association between greater mindfulness and smoking cessation, these results are the first to show that mindfulness is linked to lower affective volatility (or greater stability) of negative emotions during the course of smoking cessation. The present study suggests that mindfulness is linked to greater emotional stability and augments the study of mindfulness in diverse populations. Future studies should examine the effects of mindfulness-based interventions on volatility and whether lower volatility explains effects of mindfulness-based treatments on smoking cessation. (PsycINFO Database Record (c) 2014 APA, all rights reserved)

 

Concordance between gambling disorder diagnoses in the DSM-IV and DSM-5: Results from the National Epidemiological Survey of Alcohol and Related Disorders.Open in a New Window

The fifth edition of the Diagnostic and Statistic Manual for Mental Disorders (DSM-5) eliminates the committing illegal acts criterion and reduces the threshold for a diagnosis of gambling disorder to 4 of 9 criteria. This study compared the DSM-5 “4 of 9” classification system to the “5 of 10” DSM–IV system, as well as other permutations (i.e., just lowing the threshold to 4 criteria or just eliminating the illegal acts criterion) in 43,093 respondents to the National Epidemiological Survey of Alcohol and Related Conditions. Subgroups were analyzed to ascertain whether changes will impact differentially diagnoses based on gender, age, or race/ethnicity. In the full sample and each subpopulation, prevalence rates were higher when the DSM-5 classification system was employed relative to the DSM–IV system, but the hit rate between the two systems ranged from 99.80% to 99.96%. Across all gender, age, and racial/ethnic subgroups, specificity was greater than 99% when the DSM-5 system was employed relative to the DSM–IV system, and sensitivity was 100%. Results from this study suggest that eliminating the illegal acts criterion has little impact on diagnosis of gambling disorder, but lowering the threshold for diagnosis does increase the base rate in the general population and each subgroup, even though overall rates remain low and sensitivity and specificity are high. (PsycINFO Database Record (c) 2014 APA, all rights reserved)

 

Descriptive and injunctive social norms’ interactive role in gambling behavior.Open in a New Window

Social norms have a fundamental impact on behavior, yet little research has examined social norms regarding gambling and no research has examined possible interaction effects. The current study examined the interaction between perceived approval of gambling by others (i.e., injunctive norms) and perceived prevalence of gambling by others (i.e., descriptive norms) on the respondent’s gambling frequency and problems, in a sample of relatively frequent gamblers. The current study examined 2 distinct reference groups: 1 close in proximity (i.e., family and friends) and 1 distally located (i.e., other students). The sample consisted of 252 undergraduates who gambled at least twice a month. Two interactions were observed on gambling frequency based on the proximity of the reference groups; however, only descriptive norms significantly predicted gambling problems. When the reference group was closer in proximity, the positive relationship between perceptions of family and friends’ gambling frequency and the individual’s own gambling was stronger for individuals who believed that their friends and family members highly approved of gambling. When the reference group was distally located, differences in respondents’ gambling frequency emerged only in contexts in which they perceived other students to gamble infrequently. Specifically, when respondents perceived that other students gambled infrequently and disapproved of gambling, respondents gambled the most frequently. The results suggest that individuals are influenced by their perceptions of others’ attitudes and behaviors, regardless of proximity, and that these perceptions of others’ behavior are strongly associated with gambling problems. (PsycINFO Database Record (c) 2014 APA, all rights reserved)

 

White problem gamblers discount delayed rewards less steeply than their African American and Hispanic counterparts.Open in a New Window

Impulsivity is a core process underlying addictive behaviors, including nonpharmacological addictive behaviors such as problem gambling. Although considerable attention has been given to the investigation of delay discounting within the context of addiction-related behaviors, relatively little research has examined the relationship between discounting and individual variables, such as race/ethnicity. The purpose of this study was to compare discounting rates in the three most prevalent racial/ethnic groups in the United States: Whites, African Americans, and Hispanics. The study was conducted with 315 problem gamblers. Participants completed a delay-discounting questionnaire involving choices between a smaller amount of money delivered immediately and a larger amount delivered later. A hyperbolic discounting function estimated delay-discounting rates based on participants’ indifference points obtained via the questionnaires. Results showed significant effects of race/ethnicity on delay discounting. White gamblers discounted delayed money at lower rates than African Americans and Hispanics, even after controlling for confounding variables. These data suggest that among individuals who develop problem gambling, Whites are less impulsive than African Americans and Hispanics, at least in terms of choosing between delayed and immediate reinforcers. These results have implications for evaluating the onset and treatment of addictive disorders from a health-disparities perspective. (PsycINFO Database Record (c) 2014 APA, all rights reserved)

 

An intervention to improve mental health and family well-being of injecting drug users and family members in Vietnam.Open in a New Window

Family plays an important role in the lives of injecting drug users (IDUs) in Vietnam. This study examined the preliminary outcomes of an intervention targeting IDUs and their family members in Vietnam. Eighty-three families, including 83 IDUs and 83 family members, were recruited from 4 communes in Phú Tḥo Province, Vietnam. The 4 communes were randomized to either an intervention condition or a standard care condition. The IDUs and their family members in the intervention condition completed 4 group sessions, with the aims to improve their mental health and family relations and to promote positive behavioral change. The intervention effect was evaluated at baseline and 3- and 6-month follow-up assessments. A significant reduction in depressive symptoms and improvement in family functioning were reported for IDUs in the intervention group compared with those in the standard care group. The family members in the intervention group reported better coping skills at 3 months, fewer depressive symptoms at 6 months, and improved family function at both 3 and 6 months compared with those in the standard care group. However, no significant intervention effect was observed for IDUs in terms of drug-using behavior. This study demonstrates the feasibility and preliminary outcomes of an intervention that simultaneously targets IDUs and their family members in Vietnam. Study findings highlight the importance of including family members and enhancing their role in drug use intervention efforts. (PsycINFO Database Record (c) 2014 APA, all rights reserved)

 

Student perceptions of specific components within a personalized feedback intervention.Open in a New Window

Previous research suggests that personalized feedback interventions (PFI) can be an effective tool in reducing risky alcohol use among college students; however, little is known about how students perceive the individual components that are typically used during PFIs. In the current study, participants (N = 219, 63.5% female, 84% Caucasian, undergraduates enrolled in introductory psychology courses) reported their drinking behavior in the past month, and then immediately received a computerized PFI based on their self-reported alcohol use. The PFI was modeled from the Brief Alcohol Screening and Intervention for College Students (BASICS) approach and included 10 separate feedback components presented in random order. Participants provided acceptability ratings on each of the 10 components. Overall, participants found the PFI generally acceptable, with females rating the PFI as more acceptable than males, and binge drinkers (defined as 5 or more drinks on an occasion for males and 4 or more drinks for females) rating the PFI more acceptable than nonbinge drinkers. Differences in acceptability emerged across the 10 components, as participants rated the practical cost components (e.g., money spent on alcohol, calories consumed) as more acceptable than didactic information (e.g., impact of blood alcohol levels) and personal negative consequences. The results are similar to a previous study that examines student reactions to PFIs (Miller & Leffingwell, 2013). Overall, the findings suggest that college students prefer certain feedback components to others. Moreover, the findings indicate that future research is needed to examine the relationship between preferred components and treatment outcomes to determine which components are most effective for reducing risky drinking. (PsycINFO Database Record (c) 2014 APA, all rights reserved)

 

Ecological momentary assessment of the effects of craving and affect on risk for relapse during substance abuse treatment.Open in a New Window

The primary goals of this study were to use ecological momentary assessment (EMA) to examine the extent to which proximal factors (cravings and affect) were temporally associated with relapse, and to assess the role of distal factors (e.g., coping styles) in moderating these associations. We also examined whether using EMA procedures impacted relapse rates. A sample of 100 male (n = 66) and female (n = 34) patients entering outpatient treatment for substance abuse completed a baseline assessment of substance dependence, stress, social support, coping styles, family history of substance abuse, and self-efficacy. Half of the participants were randomly assigned to receive training in using a handheld computer to respond to 3 random prompts each day for 4 months regarding cravings, affect, and substance use. All participants completed 2- and 4-month follow-up assessments of substance use. Results showed that using EMA procedures did not influence relapse rates. Hierarchical linear modeling showed that individuals who reported an increase in cravings on a given prompt were 14 times more likely to report relapse on the subsequent prompt than individuals who did not experience an increase in cravings. In addition, women, older individuals, and individuals who use distraction and disengagement as coping styles were at increased risk for relapse when experiencing an increase in cravings. Individuals who use acceptance as a coping style were at decreased risk for relapse when experiencing an increase in cravings. The study highlights the importance of tailoring treatments to address the needs of particular individuals and risk factors. (PsycINFO Database Record (c) 2014 APA, all rights reserved)

 

Prevalence and correlates of transactional sex among an urban emergency department sample: Exploring substance use and HIV risk.Open in a New Window

Men and women involved in transactional sex (TS) report increased rates of HIV risk behaviors and substance use problems as compared with the general population. When people engaged in TS seek health care, they may be more likely to utilize the emergency department (ED) rather than primary care services. Our goal was to examine the prevalence and correlates of TS involvement among an ED sample of men and women. Adults ages 18–60 were recruited from an urban ED, as part of a larger randomized control trial. Participants (n = 4,575; 3,045 women, 1,530 men) self-administered a screening survey that assessed past 3-month substance use (including alcohol, marijuana, illicit drugs, and prescription drugs) and HIV risk behaviors, including TS (i.e., being paid in exchange of a sexual behavior), inconsistent condom use, multiple partners, and anal sex. Of the sample, 13.3% (n = 610) reported TS within the past 3 months (64.4% were female). Bivariate analysis showed TS was significantly positively associated with alcohol use severity, marijuana use, and both illicit and prescription drug use, and multiple HIV risk behaviors. These variables (except marijuana) remained significantly positively associated with TS in a binary logistic regression analysis. The prevalence of recent TS involvement among both male and female ED patients is substantial. These individuals were more likely to report higher levels of alcohol/drug use and HIV risk behaviors. The ED may be a prime location to engage both men and women who are involved in TS in behavioral interventions for substance use and sexual risk reduction. (PsycINFO Database Record (c) 2014 APA, all rights reserved)
Sign In


Forgot your password?

Haven't registered yet?