Body mass index and alcohol consumption: Family history of alcoholism as a moderator.

Recent research suggests that excess food consumption may be conceptualized as an addictive behavior. Much of the evidence comes from neurobiological similarities between drug and food consumption. In addition, an inverse relation between alcohol consumption and body mass index (BMI) has been observed. Previous research has hypothesized that this inverse relation is attributable to competition between food and alcohol for similar neurotransmitter receptors. The current study explored this neurobiological hypothesis further by examining the influence of an indicator of biological risk associated with alcohol problems (family history of alcoholism) on the relationship between alcohol and food intake. Data from 37,259 participants in the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC) were included in the study. BMI, family history of alcoholism, gender, and race/ethnicity were assessed as predictors of typical drinking frequency and estimated blood alcohol concentration (BAC). An inverse relationship between alcohol consumption and BMI was demonstrated. An attenuation of family history effects on drinking behavior was evident for obese compared to nonobese participants. The results suggest a neurobiological link between alcohol use and food consumption, consistent with theories characterizing excess food consumption as an addictive behavior. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Brief motivational intervention with homeless adolescents: Evaluating effects on substance use and service utilization.

A brief motivational intervention with 117 homeless adolescents was evaluated using a randomized design and 3-month follow-up. The intervention was designed to raise youths' concerns about their substance use, support harm reduction, and encourage greater service utilization at a collaborating agency. The study was designed to strengthen initial promising results of an earlier study (P. L. Peterson, J. S. Baer, E. A. Wells, J. A. Ginzler, & S. B. Garrett, 2006). Several modifications in the clinical protocol were included to enhance engagement with the intervention. Analyses revealed no significant benefits for intervention participants when homeless youths' substance use rates were compared with those of control participants. Service utilization during the intervention period increased for those receiving the intervention but returned to baseline levels at follow-up. Participants reported overall reductions in substance use over time. Differences between sampling methods for the current and previous study are discussed, as are the limitations of brief interventions with this population. Future research needs to elucidate mechanisms of change and service engagement for highly vulnerable youth. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Review of Psychopathology and addictive disorders.

Reviews the book, Psychopathology and addictive disorders edited by Roger E. Meyer (see record 1986-98775-000). This volume is divided into six sections that are intended to reflect the possible interactions or relationships between psychopathology and the addictive disorders. I found this book to be informative, enjoyable, and stimulating for the most part. It appealed to both the clinician and the researcher in me and I would recommend it to both types of readers. There are several less favorable aspects of the book about which the potential purchaser and reader needs to be forewarned. First, clinical implications abound in many chapters and clinical applications are directly addressed in several. However, the book is not a clinical handbook by any means nor are treatment discussions the primary focus of many of the chapters. Secondly, the authors do a better job describing the various sorts of psychopathological conditions that are seen in conjunction with addictive disorders than they do in covering the full range of abused substances. A final caution concerns the lack of a road map to guide the reader through the book. However, this book should serve as a solid summary of the relatively current status of the questions as well as a springboard for future research ideas. I commend the editor and authors and recommend it as a valuable addition to the bookshelf of clinician and researcher involved with substance use problems. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Pathological gamblers, with and without substance abuse disorders, discount delayed rewards at high rates.

Pathological gambling is classified as a disorder of impulse control, yet little research has evaluated behavioral indices of impulsivity in gamblers. The rates at which rewards delayed in time are subjectively devalued may be a behavioral marker of impulsivity. This study evaluated delay discounting in 60 pathological gamblers and 26 control participants. Gamblers were divided into those with (n?=?21) and without (n?=?39) substance use disorders. A hypothetical $1,000 reward was delayed at intervals ranging from 6 hr to 25 years, and immediate rewards varied from $1 to $999. Pathological gamblers discounted delayed rewards at higher rates than control participants, and gamblers with substance use disorders discounted delayed rewards at higher rates than non-substance-abusing gamblers. These data provide further evidence that rapid discounting of delayed rewards may be a feature central to impulse control and addictive disorders, including pathological gambling. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Models of addiction: Introduction to the Special Issue.

This Special Issue contains articles that highlight empirical approaches to addiction that have clear theoretical relevance as well as articles that present significant theoretical perspectives on addiction. This collection reflects the implicit assumption that types of addiction are more similar than dissimilar. The characteristics of drug exposure that promote physical dependence, the occurrence of tolerance, the associative elicitation of tolerance, the time course of relapse to drug use, the phenomenology of drug urges or cravings, the precipitants of relapse, the obsessive concern with securing and using drugs are all commonalities among addictive disorders that underscore the fact that addiction is expressed through universal motivational mechanisms and processes. Diverse addictive disorders are phenotypically similar because their motivational bases are similar; if not in particular, then in principle. The selections in this Special Issue reflect a set of assumptions that can be seen as promising areas for future research and theorizing. The first area concerns the application of traditional motivational models and concepts to addictive disorders. The second area for future research and theorizing deals with cognitive or information processing models of addiction. The third area covered in this Special Issue concerns interpersonal/social context. The final area covered in this issue deals with genetics. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Rasch-modeling the Portuguese SOCRATES in a clinical sample.

The Stages of Change Readiness and Treatment Eagerness Scale (SOCRATES) assesses motivation for treatment in the drug-dependent population. The development of adequate measures of motivation is needed in order to properly understand the role of this construct in rehabilitation. This study probed the psychometric properties of the SOCRATES in the Portuguese population by means of the Rasch Rating Scale Model, which allows the conjoint measurement of items and persons. The participants were 166 substance abusers under treatment for their addiction. Results show that the functioning of the five response categories is not optimal; our re-analysis indicates that a three-category system is the most appropriate one. By using this response category system, both model fit and estimation accuracy are improved. The discussion takes into account other factors such as item format and content in order to make suggestions for the development of better motivation-for-treatment scales. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Psychosocial treatment of the addictions: Problems in specific populations.

Psychosocial treatment programs have made recent advances in understanding and intervening with the problems of addiction. This article reviews the contributions included in this special series, which encompasses several specific issues facing psychologists who conduct treatment, research, and teaching in the field of addictive behaviors. These topics include a mood management intervention for Spanish-speaking substance abusers, factors influencing crack cocaine use by African-American teens, development of culturally sensitive treatment models, patients with the dual diagnoses of mental illness and substance abuse, and recent developments regarding substance abusers and human immunodeficiency virus and acquired immunodeficiency syndrome. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Cognitive maps not used by humans (Homo sapiens) during a dynamic navigational task.

To account for the impressive navigational ability of animals, some researchers have suggested that animals might use a cognitive map. Two groups of human participants (Homo sapiens) were tested for cognitive mapping using procedures similar to those used by B. M. Gibson and A. C. Kamil (2001). Participants who had to acquire spatial information about a hidden goal from the experimental contingencies alone showed patterns of search most like nutcrackers in the companion study (B. M. Gibson & A. C. Karnil, 2001). Surprisingly, postexperimental questionnaires revealed that most participants used an alternative strategy of vector integration rather than cognitive mapping during search for the hidden goal. The current study and its companion indicate that some simpler mechanisms of navigation are flexible enough to account for what appears to be map-based behavior in human and nonhuman species. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Screening for addiction in patients with chronic pain and "problematic" substance use: evaluation of a pilot assessment tool

Assessing for the presence of addiction in the chronic pain patient receiving chronic opioid analgesia is a challenging clinical task. This paper presents a recently developed screening tool for addictive disease in chronic pain patients, and pilot efficacy data describing its ability to do so. In a small sample of patients (n = 52) referred from a multidisciplinary pain center for "problematic" medication use, responses to the screening questionnaire were compared between patients who met combined diagnostic criteria for a substance use disorder and those who did not, as assessed by a trained addiction medicine specialist. Responses of addicted patients significantly differed from those of nonaddicted patients on multiple screening items, with the two groups easily differentiated by total questionnaire score. Further, three key screening indicators were identified as excellent predictors for the presence of addictive disease in this sample of chronic pain patients.     

Emotion-focused coping as a mediator of maternal cocaine abuse and antisocial behavior.

A great deal of data implicate parental drug use as a potential risk factor for child abuse, however, theories for understanding the links between maternal drug use and antisocial behavior have yet to be examined empirically. This case-control study investigated correlates of adult antisocial behavior among 279 inner-city mothers in 3 comparison groups: drug abusers, (n = 112), depressed mothers (n = 73), and nonsubstance abusing controls (n = 94). Using hierarchical regression techniques and mediational analyses controlling for ethnicity, current depression, and family history of substance abuse, support was provided for an emotion-focused coping style as a link between addictive and antisocial behavior. These results highlight the importance of focusing on emotion regulation models in the prevention and treatment of violence in drug-abusing women. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Effects of suppressing the urge to drink on smoking topography: A preliminary study.

Recent studies on the co-occurrent use of alcohol and tobacco have suggested that efforts to control the use of one substance may influence the use of the other. However, little is known about how cognitive strategies used to regulate the use of one substance may affect cross-substance use. In this study, 50 social drinkers who were daily smokers were exposed to the sight and smell of their favorite alcoholic beverage under instructions to either monitor or suppress their urge for alcohol. During a subsequent trial, participants were permitted to smoke while smoking topography was assessed. Although urge ratings were not influenced by instructional set, participants who had previously suppressed their urge to drink alcohol showed more intense smoking behavior than those who had monitored. Results are discussed in terms of the cross-substance effects of urge suppression and their implications for polysubstance treatment. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Subtypes of cocaine abusers: Support for a Type A–Type B distinction.

The dysfunction and generalizability of a multidimensional alcoholism typological system was systematically assessed in 399 inpatient, outpatient, and non-treatment-seeking cocaine abusers. Two different cluster-analytic procedures supported the construct, concurrent, and predictive validity of the Type A–Type B distinction in cocaine abusers. Participants classified as Type B (33%) cocaine abusers exhibited higher rates of premorbid risk factors (family history, childhood behavior problems, personality, age of onset), more severe drug and alcohol abuse, more addiction-related psychosocial impairment, more antisocial behavior, and more comorbid psychiatric problems than Type A participants (67%). Multidimensional typological systems have had a major impact on the alcoholism field and may be equally important for the assessment, prevention, treatment, and theoretical understanding of other substance use disorders. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Parallel process as transference-countertransference interaction.

Suggests that parallel process is a chain reaction that may occur in any interconnected series of interpersonal situations that are structurally and dynamically similar in significant respects. Typically it involves intertwined concerns about authority and dependency, and the participants need to conceal their attempted solutions to those concerns, leading to an interlocking series of parallel transference–countertransference integrations. The best understanding of these processes is achieved when the motivations of all the participants are examined and overlaps in their character structures are identified. A clinical vignette of a parallel process sequence is provided. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A Meta-Analysis of Smoking Cessation Interventions With Individuals in Substance Abuse Treatment or Recovery.

This meta-analysis examined outcomes of smoking cessation interventions evaluated in 19 randomized controlled trials with individuals in current addictions treatment or recovery. Smoking and substance use outcomes at posttreatment and long-term follow-up (≥ 6 months) were summarized with random effects models. Intervention effects for smoking cessation were significant at posttreatment and comparable for participants in addictions treatment and recovery; however, intervention effects for smoking cessation were nonsignificant at long-term follow-up. Smoking cessation interventions provided during addictions treatment were associated with a 25% increased likelihood of long-term abstinence from alcohol and illicit drugs. Short-term smoking cessation effects look promising, but innovative strategies are needed for long-term cessation. Contrary to previous concerns, smoking cessation interventions during addictions treatment appeared to enhance rather than compromise long-term sobriety. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Predicting attendance and expectations for group therapy.

Inconsistent membership is one of the leading problems in groups. Group therapy participants (N=310) from 2 university counseling centers were studied over a period of 7 years to examine interpersonal style, expectations, and attendance in group therapy. The Group Therapy Questionnaire (R. R. MacNair & J. Corazzini, 1994; R. R. MacNair-Semands, 1996, 1997, 2001) assessed client goals, substance use, and interpersonal problems in relation to expectations for group and attendance. A discriminant analysis demonstrated that angry hostility and social inhibition were predictive of low attendance. Additionally, clients with previous therapy reported more positive expectations about group, whereas those reporting greater substance use and more somatic symptoms had fewer positive expectations about group. Implications for treatment decisions are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Stress, habits, and drug addiction: A psychoneuroendocrinological perspective.

It is well known that stress is a significant risk factor for the development of drug addiction and addiction relapse. Remarkably, the cognitive processes involved in the effects of stress on addictive behavior remain poorly understood. Here it is proposed that stress-induced changes in the neural circuits controlling instrumental action provide a potential mechanism by which stress affects the development of addiction and relapse vulnerability. Instrumental action can be controlled by two anatomically distinct systems: a goal-directed system that involves learning of action-outcome associations, and a habit system that learns stimulus–response associations. The transition from initial voluntary drug use to subsequent involuntary, compulsive drug use represents a switch from goal-directed to habitual control of action. Recent evidence indicates that this switch from goal-directed to habit action can be prompted by stress and stress hormones. We argue (i) that acute stressors reinstate habitual responding to drug-related cues and thus trigger relapse to addictive behavior, and (ii) that prolonged or repeated stress may accelerate the transition from voluntary to involuntary drug use and thus promote the development of addiction. The suggested mechanism encompasses cognitive processes that may contribute to the effects of stress on addictive behavior and could have important implications for the treatment of addiction and the prevention of relapse. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

A multisite randomized effectiveness trial of motivational enhancement therapy for Spanish-speaking substance users.

Hispanic individuals are underrepresented in clinical and research populations and are often excluded from clinical trials in the United States. Hence, there are few data on the effectiveness of most empirically validated therapies for Hispanic substance users. The authors conducted a multisite randomized trial comparing the effectiveness of 3 individual sessions of motivational enhancement therapy with that of 3 individual sessions of counseling as usual on treatment retention and frequency of substance use; all assessment and treatment sessions were conducted in Spanish among 405 individuals seeking treatment for any type of current substance use. Treatment exposure was good, with 66% of participants completing all 3 protocol sessions. Although both interventions resulted in reductions in substance use during the 4-week therapy phase, there were no significant Treatment Condition × Time interactions nor Site × Treatment Condition interactions. Results suggest that the individual treatments delivered in Spanish were both attractive to and effective with this heterogeneous group of Hispanic adults, but the differential effectiveness of motivational enhancement therapy may be limited to those whose primary substance use problem is alcohol and may be fairly modest in magnitude. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Medications for stimulant abuse: Agonist-based strategies and preclinical evaluation of the mixed-action D? partial agonist aripiprazole (Abilify?).

The utility of full and partial agonists for the management of opioid addiction and smoking behavior has encouraged the development of dopamine partial agonist-based medications for treating monoaminergic stimulant abuse and addiction. Aripiprazole, a recently introduced atypical antipsychotic with D? partial agonist actions, has been studied in mice, rats, and man, but its ability to attenuate abuse- and addiction-related effects of cocaine or methamphetamine remains controversial. The present studies in monkeys were conducted to further evaluate aripiprazole as a candidate medication. The effects of aripiprazole on overt behavior were first compared with those of other dopamine-related drugs. In contrast to D? full agonists, aripiprazole did not induce self-scratching. Like D? receptor blockers, however, aripiprazole occasioned dose-related increases in catalepsy-associated behavior that, at the highest doses, were characterized most prominently by periods of stillness and immobility. In methamphetamine-discrimination experiments, aripiprazole did not engender responding on the methamphetamine-associated lever; rather, aripiprazole antagonized the discriminative-stimulus effects of methamphetamine by shifting its dose-effect function rightward. In self-administration "choice" experiments, acute or chronic treatment with aripiprazole did not attenuate the reinforcing strength of intravenous cocaine relative to food delivery. However, like D? full agonists, priming injections of aripiprazole prior to sessions of intravenous saline availability engendered comparable levels of responding on levers leading to food delivery and intravenous injections. The present findings indicate that agonist and antagonist effects of aripiprazole are evident under different experimental conditions and that, like D? full agonists, aripiprazole may have limited value for treating monoaminergic stimulant abuse and addiction. (PsycINFO Database Record (c) 2010 APA, all rights reserved)