A brief abstinence test for college student smokers: A feasibility study.

Cigarette smoking among college students is prevalent and correlated with other unhealthy behaviors. Reinforced abstinence (e.g., contingency management) has been demonstrated to be an effective method for reducing substance use in a variety of populations and across a variety of drugs, including cigarettes. Reinforced abstinence has seldom been used specifically targeting a college student population. A Brief Abstinence Test (BAT) has been used to effectively reduce cocaine use among methadone maintenance patients (Robles, Silverman, Preston, Cone, Katz, Bigelow, & Stitzer, 2000). However, no published studies have investigated the use of a BAT to reduce the use of cigarettes. The current study implemented a 3-week intervention (Baseline 1, BAT, and Baseline 2 weeks) for smoking abstinence among college students. Forty-two percent of the sample met abstention criteria during the BAT. Carbon monoxide and urinalysis scores decreased significantly from Baseline 1 to the BAT phase but did not differ significantly from BAT to Baseline 2. These results suggest that the BAT may have utility initiating abstinence in both clinical and research contexts. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Cognitive-behavioral intervention to reduce African American adolescents' risk for HIV infection.

Two hundred forty-six African American adolescents were randomly assigned to an educational program or an 8-week intervention that combined education with behavior skills training including correct condom use, sexual assertion, refusal, information provision, self-management, problem solving, and risk recognition. Skill-trained participants (a) reduced unprotected intercourse, (b) increased condom-protected intercourse, and (c) displayed increased behavioral skills to a greater extent than participants who received information alone. The patterns of change differed by gender. Risk reduction was maintained 1 year later for skill-trained youths. It was found that 31.1% of youths in the education program who were abstinent at baseline had initiated sexual activity 1 year later, whereas only 11.5% of skills training participants were sexually active. The results indicate that youths who were equipped with information and specific skills lowered their risk to a greater degree, maintained risk reduction changes better, and deferred the onset of sexual activity to a greater extent than youths who received information alone. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Effects of tobacco abstinence on food intake among cigarette smokers.

The total caloric and specific nutrient intakes of smokers who became abstinent were compared with those of a control group. Both groups were composed of volunteer inpatients housed in a research ward for 7 days. After smoking ad libitum for 3 days, the experimental group was required to abstain from tobacco for the next 4 days while the control group continued to smoke. Significant increases in total caloric intake and in grams of carbohydrates, protein, fat, and sucrose were observed in the experimental relative to the control group, whereas no significant differences were found in fructose intake. The increase in caloric intake was not specific to increases in snacking. Preliminary analyses showed gender differences in food intake as a result of tobacco abstinence. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Eating orientation, postcessation weight gain, and continued abstinence among female smokers receiving an unsolicited smoking cessation intervention.

Predictors of weight gain following smoking cessation were assessed among 1,219 female smokers enrolled in a health maintenance organization. Women randomized to the treatment group received a cessation intervention without regard to their interest in quitting smoking. It was hypothesized that cessation would result in subsequent weight gain and postcessation weight gain would be associated with scores on a modified Restraint Scale, the Disinhibition Scale, and a scale assessing tendency to eat during periods of negative affect. Persons who abstained from smoking over the 18-month study gained more weight than did intermittent smokers and continuous smokers, and among 762 women who reported at least 1 on-study attempt to quit smoking, 36% gained weight. Weight gain was associated with disinhibited eating and negative affect eating but not with restrained eating. Weight gain also was associated with continued abstinence from smoking. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Misclassification rates for current smokers misclassified as nonsmokers

OBJECTIVES: This paper provides misclassification rates for current cigarette smokers who report themselves as nonsmokers. Such rates are important in determining smoker misclassification bias in the estimation of relative risks in passive smoking studies. METHODS: True smoking status, either occasional or regular, was determined for individual current smokers in 3 existing studies of nonsmokers by inspecting the cotinine levels of body fluids. The new data, combined with an approximately equal amount in the 1992 Environmental Protection Agency (EPA) report on passive smoking and lung cancer, yielded misclassification rates that not only had lower standard errors but also were stratified by sex and US minority majority status. RESULTS: The misclassification rates for the important category of female smokers misclassified as never smokers were, respectively, 0.8%, 6.0%, 2.8%, and 15.3% for majority regular, majority occasional, US minority regular, and US minority occasional smokers. Misclassification rates for males were mostly somewhat higher. CONCLUSIONS: The new information supports EPA's conclusion that smoker misclassification bias is small. Also, investigators are advised to pay attention to minority/majority status of cohorts when correcting for smoker misclassification bias.     

Cognitive-behavioral intervention with aggressive boys: Three-year follow-up and preventive effects.

Examined the longer term preventive effects of a school-based intervention with boys referred by classroom teachers as highly aggressive and disruptive. Three yrs after intervention, boys who had received an anger coping (AC) program were compared with a group of untreated boys. The AC boys had lower rates of drug and alcohol involvement and had higher levels of self-esteem and social problem-solving skills. The AC boys were not significantly different from previously nonaggressive boys on these variables at follow-up. Although the overall intervention did not have longer term effects on delinquency rates or classroom behavior, a subset of boys who also received booster sessions did display maintenance of certain classroom behavior improvement. Implications for intensification of cognitive-behavioral interventions are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Cognitive-behavioral therapy for pathological gamblers.

Few studies have evaluated efficacy of psychotherapies for pathological gambling. Pathological gamblers (N = 231) were randomly assigned to (a) referral to Gamblers Anonymous (GA), (b) GA referral plus a cognitive- behavioral (CB) workbook, or (c) GA referral plus 8 sessions of individual CB therapy. Gambling and related problems were assessed at baseline, 1 month later, posttreatment, and at 6- and 12-month follow-ups. CB treatment reduced gambling relative to GA referral alone during the treatment period and resulted in clinically significant improvements, with some effects maintained throughout follow-up ( ps = .05). Individual CB therapy improved some outcomes compared with the CB workbook. Attendance at GA and number of CB therapy sessions or workbook exercises completed were associated with gambling abstinence. These data suggest the efficacy of this CB therapy approach. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Surfing the urge: Brief mindfulness-based intervention for college student smokers.

The current study investigates effects of a brief mindfulness-based instruction set, based on Marlatt’s “urge surfing” technique (Marlatt & Gordon, 1985), on smoking-related urges and behavior. Undergraduate smokers (N = 123) who were interested in changing their smoking, but not currently involved in a cessation program, participated in a cue exposure paradigm designed to elicit urges to smoke. They were randomly assigned either to a group receiving brief mindfulness-based instructions or to a no-instruction control group. Results suggest that groups did not differ significantly on measures of urges. However, those in the mindfulness group smoked significantly fewer cigarettes over a 7-day follow-up period as compared to those in the control group. These findings suggest that the mindfulness techniques may not initially reduce urges to smoke but may change the response to urges. The study provides preliminary data for future studies examining both mechanisms and effectiveness of mindfulness-based interventions for cigarette smoking. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Comparing intervention outcomes in smokers treated for single versus multiple behavioral risks.

This study examined treatment outcomes among smokers with single versus multiple behavioral risks. Data were drawn from smokers (N = 2,326) participating in 3 population-based, multibehavioral studies targeting cigarette smoking, high-fat diets, and high-risk sun exposure. Outcomes were compared for participants at risk for smoking only (13%), smoking plus 1 additional risk factor (37%), and smoking plus 2 additional risk factors (50%). The smoking only group tended to be female, older, more educated, lighter smokers, in the preparation stage of change for smoking, with more previous quit attempts and longer periods of abstinence. At 12 and 24 months follow-up, treatment of 1 or 2 coexisting risk factors did not decrease the effectiveness of smoking cessation treatment, and treatment for the coexisting factors was effective. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Preliminary observations on an intervention program for heavy smokers

Each of 571 smokers selected one of three methods of smoking cessation: group therapy, individual counseling, and hypnosis. One-year results suggest little difference between the three methods in producing ex-smokers. All methods produced an average success rate of approximately 20%. It should be noted, however, that with all types of verbal or verbally related therapy it is not known precisely how these techniques work or whether the outcomes are really a function of what is put into the therapy by the treatment agent and/or the recipient. It was generally found that younger, more educated smokers chose hypnosis; older, more educated smokers chose group therapy; and older, less-formally educated smokers chose individual counseling while the youngest and generally less educated smokers chose to become nonattenders and not take part in therapy. These results have important implications for designing optimal treatment programs which will be acceptable and effective for the greatest number of smokers.     

Contingent reinforcement increases cocaine abstinence during outpatient treatment and 1 year of follow-up.

This study assessed whether contingent incentives can be used to reinforce cocaine abstinence in dependent outpatients. Seventy cocaine-dependent outpatients were randomized into 2 conditions. All participants received 24 weeks of treatment and 1 year of follow-up. The treatment provided to all participants combined counseling based on the community reinforcement approach with incentives in the form of vouchers exchangeable for retail items. In 1 condition, incentives were delivered contingent on cocaine-free urinalysis results, whereas in the other condition incentives were delivered independent of urinalysis results. Abstinence-contingent incentives significantly increased cocaine abstinence during treatment and 1 year of follow-up compared with noncontingent incentives. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Cognitive-behavioral and response-prevention treatments for bulimia nervosa.

This study was designed to assess the additive effects of major components of cognitive-behavioral treatment for bulimia nervosa. Seventy-seven female patients with bulimia nervosa were allocated at random to one of four conditions: wait-list control, self-monitoring of caloric intake and purging behaviors, cognitive-behavioral treatment, and cognitive-behavioral treatment combined with response prevention of vomiting. In the treatment conditions, participants were seen individually for fourteen 1-hr sessions over a 4-month period. All the treatment groups showed significant improvement, whereas the wait-list control group did not. Cognitive-behavioral treatment was, however, the most successful in reducing purging and in promoting positive psychological changes. Fifty-six percent of participants in this condition ceased binge eating and purging by the end of treatment, and the frequency of purging declined by 77.2% during the same period. Of the three treatment conditions, only cognitive-behavioral treatment was superior to the wait-list control. At the 6-month follow-up, 59% of the cognitive-behavioral group were abstinent, and purging had declined by 80%. Cognitive-behavioral treatment was significantly superior to the other treatment groups at this time. Thus, the addition of response prevention of vomiting did not enhance the efficacy of cognitive-behavioral treatment, and the evidence suggests that it may have had a deleterious effect. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Cognitive-behavioral body image therapy for body dysmorphic disorder.

Body dysmorphic disorder (BDD) is a distressing body image disorder that involves excessive preoccupation with physical appearance in a normal appearing person. Prior case reports of behavior therapy were encouraging, but no controlled evaluation of behavior therapy or any other type of treatment had been conducted. In the present study, 54 BDD subjects were randomly assigned to cognitive behavior therapy or no treatment. Patients were treated in small groups for eight 2-hour sessions. Therapy involved modification of intrusive thoughts of body dissatisfaction and overvalued beliefs about physical appearance, exposure to avoided body image situations, and elimination of body checking. Body dysmorphic disorder symptoms were significantly decreased in therapy subjects and the disorder was eliminated in 82% of cases at posttreatment and 77% at follow-up. Overall psychological symptoms and self-esteem also improved in therapy subjects. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Cognitive-behavioral prevention of adolescent pregnancy.

Assigned 36 high school sophomores to a no-training control condition or to a small group training condition in which Ss received contraceptive information, steps for solving problems, and practice in communicating decisions about sexual behavior. Compared with controls, trained Ss had more positive posttest scores on measures of sexual knowledge, interpersonal problem solving, and in vivo performance. At a 6-mo follow-up, Ss who participated in training groups had better attitudes toward family planning and were practicing more effective contraception than were controls. (32 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Effect of depressive symptoms on smoking abstinence and treatment adherence among smokers with a history of alcohol dependence.

This study examined the effect of depressive symptoms on smoking abstinence and treatment adherence among smokers with a past history of alcohol dependence. Participants (24 women, 27 men) were randomly assigned to behavioral counseling (BC) or behavioral counseling plus cognitive-behavioral mood management training (CBT). The Hamilton -Rating Scale for Depression (HRSD; A Hamilton, 1967) was administered to assess baseline depressive symptoms. Participants who received CBT and had higher HRSD scores were more likely to achieve short-term abstinence from smoking and attend more treatment sessions than those with lower depression scores, whereas for BC participants the effect of HRSD scores was the opposite. Smokers with a history of alcohol dependence reporting high levels of depressive symptoms may benefit from a mood management intervention. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Cognitive-behavioral treatment of panic disorder.

Cognitive-behavioral therapy can be effective for many clients with panic disorder. Therapy can be conceptualized in terms of four central components. First, the initial preparation for therapy involves establishing a working alliance, educating the client about panic symptoms and treatments, and conducting a diagnostic assessment. Second, skills training is used to cultivate active coping skills that the client can use to tolerate symptoms of emotional distress. Third, exposure is used to encourage clients to test and refine their newly developed coping skills. Fourth, relapse prevention is used to help clients discontinue psychological and biological treatments without suffering lasting setbacks. Through the use of cognitive-behavioral therapy, most clients can learn to control their symptoms of panic and reduce their anticipatory anxiety. Treatment gains can be maintained after therapy is discontinued. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Cognitive-behavioral treatment for severe anger in posttraumatic stress disorder.

With a randomized group design, a 12-session anger treatment was evaluated with severely angry Vietnam War veterans suffering combat-related posttraumatic stress disorder (PTSD). Eight participants in anger treatment and 7 in a routine clinical care control condition completed multiple measures of anger control, anger reaction, and anger disposition, as well as measures of anxiety, depression, and PTSD at pre- and posttreatment. Controlling for pretreatment scores, significant effects were found on anger reaction and anger control measures but not on anger disposition or physiological measures. Eighteen-month follow-up (for both completers and dropouts) supported the posttreatment anger control findings. The challenges of treatment research with this refractory population are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Cognitive-behavioral factors in seasonal affective disorder.

To longitudinally examine cognitive-behavioral correlates of seasonal affective disorder (SAD), the authors assessed women with a history of SAD and nondepressed, matched controls across fall, winter, and summer. SAD history participants reported more automatic negative thoughts throughout the year than controls and demonstrated a progression from decreased activity enjoyment during fall to reduced activity frequency during winter. Ruminative response style, measured in fall, predicted symptom severity during the winter. Across assessments, SAD history women endorsed greater depressive affect in response to low light intensity stimuli than to bright or ambiguous intensity stimuli, but less depressed mood to bright light stimuli than controls. These results suggest that the cognitive-behavioral factors related to nonseasonal depression may play a role in SAD. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Cognitive-behavioral treatment of women's body-image dissatisfaction.

Body-image dissatisfaction is a problem that affects a substantial minority of women and cuts across various diagnostic groups. College women with a significant level of body-image dissatisfaction were randomly assigned to either a cognitive–behavioral treatment (CBT) program (n?=?15) or to a waiting-list control group (n?=?16). The CBT program consisted of six structured, individual sessions that applied cognitive–behavioral procedures to the problem of negative body image. At pretest, posttest, and 7-week follow-up, multiple aspects of body image and other areas of psychosocial functioning were assessed. Relative to the control condition, the CBT program successfully improved affective body image, weakened maladaptive body-image cognitions, and enhanced social self-esteem and feelings about physical fitness and sexuality. Treatment effects were largely maintained at follow-up. After posttest, the control group received a 3-week treatment with immediate effects that generally replicated those obtained in the 6-week program. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Cognitive-behavioral therapy for bulimia: An initial outcome study.

Examined the efficacy of a cognitive-behavioral therapy for bulimia with 20 18–30 yr old bulimic females who were randomly assigned in equal numbers to either full- or brief-intervention therapy programs. Three Ss reported a previous history of anorexia nervosa; 3 of the Ss had previously received treatment for bulimia. The full intervention was based on a cognitive-behavioral conceptualization in which bulimia is viewed as a type of obsessive-compulsive problem, and it involved cognitive restructuring, exposure with response prevention, behavioral contracting, and process-oriented psychotherapy. Results indicate that the full-intervention Ss, relative to the brief-intervention Ss, substantially reduced the frequency of their bingeing-vomiting; improved their general psychological adjustment; and changed their attitudes about food, dieting, and their bodies. In addition, data collected in an actual eating situation demonstrated a dramatic reduction in the urge to vomit and level of discomfort for the full-intervention Ss. (42 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)