Reducing alcohol consumption among heavily drinking women: Evaluating the contributions of life-skills training and booster sessions.

Problem-drinking women (N?=?144) without histories of severe physical dependence on alcohol received drinking-reduction training and were assigned to receive (or not receive) 2 treatment enhancements: life-skills training and booster sessions. The design resulted in 4 treatment conditions: drinking-reduction treatment (DRT) plus life-skills training, DRT plus booster sessions, DRT plus life-skills training and booster sessions, or DRT only. The interventions entailed 13 hr of DRT, 7 hr devoted to the life-skills training or to a no-life-skills training educational module, plus 8 hr of booster sessions for those receiving them. Participants evidenced significant reductions in alcohol use during the 18 months after treatment. Those with greater pretreatment drinking evidenced differential response to the experimental manipulations: The treatment enhancements (life skills and booster sessions) led to significantly improved drinking outcomes among women who were heavier drinkers at pretreatment. There were no significant effects of the treatment enhancements among lighter drinkers at pretreatment. The results provide support for use of treatment enhancements in interventions designed to moderate women problem drinkers' alcohol use. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Archetypal patterns, mental representations, and replicative processes in infancy

This study was designed to identify the expectancies held by Mexican Americans toward the drinking of alcoholic beverages as well as toward excessive drinking. Random samples of 534 Mexican American and 616 non-Hispanic White residents of San José, California and of San Antonio, Texas were interviewed over the telephone. Mexican Americans were found to have unique expectancies toward drinking of alcoholic beverages and toward excessive drinking that differed from those held by non-Hispanic Whites. In addition, Mexican Americans expected the various outcomes in greater proportion than non-Hispanic Whites and the Mexican American respondents classified as high in acculturation tended to respond in a manner similar to that of non-Hispanic White respondents. Multivariate analyses of variance with common (across ethnic groups) factor scales with ethnicity, gender, and drinking status as independent variables showed main effects for drinking status and for ethnicity. The group differences in expectancies identified here support the need for culturally appropriate interventions that target group-specific beliefs.     

Community mental health services to minority groups: Some optimism, some pessimism.

Notes that for many years, researchers and practitioners have found that minority-group clients who seek psychotherapeutic services receive discriminatory treatment from White therapists. Underlying this finding is the implicit assumption that the mental health delivery system should strive to provide equal and nondiscriminatory services for all clients. An analysis of the services received by 13,198 minority clients in 17 community mental health facilities suggested that Blacks received differential treatment and poorer outcomes than Whites. However, Asian-American, Chicano, and native American clients who tended to receive treatment equal to that of White clients also had poorer outcomes as measured by premature termination rates. It is suggested that a time may well come when minority clients receive equal but unresponsive services, and that primary attention should be placed on the delivery of responsive services rather than on the demonstration of inequities. (17 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Recruitment and retention of African American patients for clinical research: An exploration of response rates in an urban psychiatric hospital.

The issues related to recruiting African American psychiatric inpatients are discussed in the context of a study on the influence of ethnicity on psychiatric diagnosis. Ethnically diverse psychiatric residents interviewed 960 Black and White inpatients in 2 urban psychiatric hospitals. Despite the obstacles cited in the literature about recruiting and retaining African Americans into research, 78% of this sample were African American. In addition, interview completion and refusal rates did not differ by patient ethnicity. Results suggest that matching interviewer and patient ethnicity did not influence African Americans' likelihood of participating in or of refusing an interview. This article summarizes a number of guidelines that others may find useful in conducting clinical research with African Americans, ranging from the formation of academic-public liaisons to interviewer training. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Individuation, peers, and adolescent alcohol use: A latent growth analysis.

The study used latent growth modeling to investigate longitudinal relationships between individuation, peer alcohol use, and adolescent alcohol use among African American, Mexican American, and non-Hispanic White adolescents (N=6,048) from 7th, 8th, and 9th grades over a 3-year period. Initial levels of peer alcohol use were significantly related to changes in adolescents' alcohol use, whereas initial adolescent alcohol use also significantly related to changes in peers' alcohol use, suggesting a bidirectional relationship. Higher levels of intergenerational individuation were related to smaller increases in adolescent alcohol use and higher levels of separation were related to larger increases in youth drinking. The findings were similar across ethnic groups. Implications for development of prevention and intervention programs are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Developmental, family, and ethnic in influences on adolescent alcohol usage: A growth curve approach.

The influence of the developmental process of individuation, family conflict and cohesion, and ethnicity on adolescent alcohol use was examined in a 3-year longitudinal study. Participants included non-Hispanic White, Mexican American, and African American adolescents (n?=?6,522) from 6th, 7th, and 8th grades. They were surveyed annually for 3 years. Depending on which aspect of individuation was measured, hierarchical linear modeling indicated that changes in adolescent individuation were related to either increases or decreases in alcohol use over the 3-year period. Separation and family conflict were related to increases in alcohol use, and intergenerational individuation and family cohesion were related to decreases in alcohol use. White and Mexican American adolescents had a faster rate of increase in alcohol use than did African American youth. Separation and family process similarly influenced adolescent alcohol use from different ethnic groups. Implications for prevention and intervention programs are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Binge drinking among underage college students: A test of a restraint-based conceptualization of risk for alcohol abuse.

The authors tested a restraint-based model that binge drinking is a function of being tempted to drink alcohol while also being concerned about avoiding excessive alcohol intake. Underage (18-to 20-year-olds, 204 men and 225 women) college student drinkers completed measures that assessed the attraction to alcohol (e.g., temptation to drink, alcohol expectancies), concern about regulating alcohol intake (e.g., restriction of alcohol intake, reasons for limiting drinking), and alcohol-related outcomes (binge drinking, alcohol problems). In separate hierarchical multiple regressions, the attraction to alcohol accounted for significant amounts of additional variance in each of the alcohol outcomes. Concern about regulating alcohol intake accounted for additional variance, above that explained by attraction to alcohol. The results suggest that interventions for underage binge drinking should include training in the skills for regulating alcohol intake. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

American = White?

Six studies investigated the extent to which American ethnic groups (African, Asian, and White) are associated with the category "American." Although strong explicit commitments to egalitarian principles were expressed in Study 1, Studies 2-6 consistently revealed that both African and Asian Americans as groups are less associated with the national category "American" than are White Americans. Under some circumstances, a dissociation between mean levels of explicit beliefs and implicit responses emerged such that an ethnic minority was explicitly regarded to be more American than were White Americans, but implicit measures showed the reverse pattern (Studies 3 and 4). In addition, Asian American participants themselves showed the American = White effect, although African Americans did not (Study 5). The American = White association was positively correlated with the strength of national identity in White Americans. Together, these studies provide evidence that to be American is implicitly synonymous with being White. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Racial differences in eligibility and enrollment in a smoking cessation clinical trial.

Objective: The purpose of this study was to compare the recruitment, eligibility screening, and enrollment of African American and White smokers into an intensive smoking cessation intervention trial [The Chicago STOP Smoking Trial (C-STOP)]. Methods: We compared demographic, smoking, substance use, and medical/psychiatric screening data from the recruitment records of 1,189 non-Hispanic, African American and White smokers screened for eligibility in the last year of a randomized pharmacological and behavioral smoking cessation trial. The study took place at a large urban medical center and two satellite locations within the Chicago metropolitan area. Results: Interest levels in the study were high among African American smokers, with twice as many African Americans as Whites contacting study staff for information and an initial screening. However, African Americans were nearly three times as likely not to be enrolled in the trial as Whites, because of higher ineligibility rates, failure to attend a screening session, and lower participation rates even among those meeting eligibility requirements. Conclusions: Racial differences were observed nearly at all levels of enrollment determination. These critical barriers to inclusion of African Americans in smoking cessation research limit our understanding of treatment efficacy and ultimately the ability to reduce the health disparities in tobacco-related disease experienced by African Americans. (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)     

A meta-analysis of controlled research on social skills training for schizophrenia.

A meta-analysis of randomized, controlled trials of social skills training for schizophrenia was conducted. Outcome measures from 22 studies including 1,521 clients were categorized according to a proximal-distal continuum in relation to the presumed site of action of skills training interventions, with content mastery tests and performance-based measures of skills assumed to be most proximal, community functioning and negative symptoms intermediate, and general symptoms and relapse most distal. Results reveal a large weighted mean effect size for content-mastery exams (d = 1.20), a moderate mean effect size for performance-based measures of social and daily living skills (d = 0.52), moderate mean effect sizes for community functioning (d = 0.52) and negative symptoms (d = 0.40), and small mean effect sizes for other symptoms (d = 0.15) and relapse (d = 0.23). These results support the efficacy of social skills training for improving psychosocial functioning in schizophrenia. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Self-efficacy change as a mediator of associations between therapeutic bond and one-year outcomes in treatments for alcohol dependence.

Empirically-supported treatments for alcohol dependence exist, yet understanding of influences contributing to the intended behavior change is limited. The current study, a secondary analysis of the recent multisite COMBINE trial (The COMBINE Study Research Group, 2003), tested a mediational model wherein change in client self-efficacy for abstinence was examined as a potential mediator of associations between client report of the therapeutic bond and one-year outcomes of drinking frequency, drinking consequences, and psychiatric functioning. For analyses, the 1383 COMBINE trial participants were grouped as follows: 1) those receiving study medications (naltrexone, acamprosate, naltrexone + acamprosate, placebo) and enrolled in medication management (MM) only (n = 607), 2) those receiving study medications/MM and also enrolled in a combination behavioral intervention (CBI) as well (n = 619), and 3) those enrolled in CBI only (n = 157). Mediation analyses using the product-of-coefficients approach indicated self-efficacy change during treatment significantly mediated associations between the therapeutic bond with the CBI therapist and each of the three one-year outcomes among those exclusively receiving CBI, but failed to do so among those receiving pills/MM (with or without CBI). Effect sizes were small, but indicated that variance in bond-outcome associations was partially mediated by self-efficacy change for trial participants. Findings advance understanding of proximal client change processes during delivery of treatments for alcohol dependence. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Coping skills and treatment outcomes in cognitive-behavioral and interactional group therapy for alcoholism.

In the present study 128 alcohol dependent men and women received 26 weeks of group treatment in one of two modalities: Cognitive-behavioral treatment (CBT) intended specifically to develop coping skills or interactional therapy intended to examine interpersonal relationships. Coping skills and drinking were assessed prior to and after treatment and up to 18 months after intake. Results indicated that both treatments yielded very good drinking outcomes throughout the follow-up period. Increased coping skills was a significant predictor of outcome. However, neither treatment effected greater increases in coping than the other. Specific coping-skills training was not essential for increasing the use of coping skills. The results raise questions about the efficacy of specific treatment elements of CBT in treatment of alcohol dependence. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A randomized controlled trial of goal choice interventions for alcohol use disorders among men who have sex with men.

This study tested the efficacy of behavioral treatments for alcohol use disorders (AUD) among men who have sex with men (MSM) and who are at risk for HIV transmission. HIV-negative MSM with current AUD (N = 198) were recruited, offered treatment focused on reducing drinking and HIV risk, and followed during treatment and 12 months posttreatment. Participants (n = 89) accepted treatment and were randomized to either 4 sessions of motivational interviewing (MI) or 12 sessions of combined MI and coping skills training (MI + CBT). Other participants (n = 109) declined treatment but were followed, forming a non-help-seeking group (NHS). MI yielded significantly better drinking outcomes during the 12-week treatment period than MI + CBT, but posttreatment outcomes were equivalent. NHS participants significantly reduced their drinking as well. Service delivery and treatment research implications are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A school-randomized clinical trial of an integrated social–emotional learning and literacy intervention: Impacts after 1 school year.

Objective: To report experimental impacts of a universal, integrated school-based intervention in social–emotional learning and literacy development on change over 1 school year in 3rd-grade children's social–emotional, behavioral, and academic outcomes. Method: This study employed a school-randomized, experimental design and included 942 3rd-grade children (49% boys; 45.6% Hispanic/Latino, 41.1% Black/African American, 4.7% non-Hispanic White, and 8.6% other racial/ethnic groups, including Asian, Pacific Islander, Native American) in 18 New York City public elementary schools. Data on children's social–cognitive processes (e.g., hostile attribution biases), behavioral symptomatology (e.g., conduct problems), and literacy skills and academic achievement (e.g., reading achievement) were collected in the fall and spring of 1 school year. Results: There were main effects of the 4Rs Program after 1 year on only 2 of the 13 outcomes examined. These include children's self-reports of hostile attributional biases (Cohen's d = 0.20) and depression (d = 0.24). As expected based on program and developmental theory, there were impacts of the intervention for those children identified by teachers at baseline with the highest levels of aggression (d = 0.32–0.59) on 4 other outcomes: children's self-reports of aggressive fantasies, teacher reports of academic skills, reading achievement scaled scores, and children's attendance. Conclusions: This report of effects of the 4Rs intervention on individual children across domains of functioning after 1 school year represents an important first step in establishing a better understanding of what is achievable by a schoolwide intervention such as the 4Rs in its earliest stages of unfolding. The first-year impacts, combined with our knowledge of sustained and expanded effects after a second year, provide evidence that this intervention may be initiating positive developmental cascades both in the general population of students and among those at highest behavioral risk. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The Strong African American Families Program: A cluster-randomized prevention trial of long-term effects and a mediational model.

The Strong African American Families Program, a universal preventive intervention to deter alcohol use among rural African American adolescents, was evaluated in a cluster-randomized prevention trial. This 7-week family skills training program is based on a contextual model in which intervention effects on youth protective factors lead to changes in alcohol use. African American 11-year-olds and their primary caregivers from 9 rural communities (N = 332 families) were randomly selected for study participation. Communities were randomized to prevention and control conditions. Intent-to-treat analyses indicated that fewer prevention than control adolescents initiated alcohol use; those who did evinced slower increases in use over time. Intervention-induced changes in youth protective factors mediated the effect of group assignment on long-term changes in use. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Comparable efficacy of contingency management for cocaine dependence among African American, Hispanic, and White methadone maintenance clients.

Cocaine use is a significant problem among methadone maintenance clients. Contingency management (CM) is a reinforcement-based approach with demonstrated efficacy for reducing cocaine use. This study examines whether the efficacy of CM treatment for cocaine-dependent individuals receiving methadone maintenance for opioid dependence differs by ethnicity. Participants were 191 African American, Hispanic, and White cocaine-dependent methadone maintenance clients, randomly assigned to standard methadone treatment or standard methadone treatment plus CM for 12 weeks. Hispanic participants were younger, less educated, and reported fewer years of cocaine use than did African American and White participants and reported fewer years of heroin use than did African American participants. African American participants were less likely to report a history of psychiatric symptoms or treatment in comparison with Hispanic and White participants. While CM was associated with longer duration of continuous cocaine abstinence and a greater proportion of submitted urine samples negative for cocaine, ethnicity was not related to treatment outcomes, and there was no significant interaction between treatment and ethnicity. CM appears to be an efficacious treatment for cocaine dependence among methadone maintenance clients, regardless of ethnicity. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

African Americans and boys: Understanding the literacy gap, tracing academic trajectories, and evaluating the role of learning-related skills.

In this study, the authors examined the racial and gender gap in the academic development of African American and White children from kindergarten to 5th grade. Their main goal was to determine the extent to which social and behavioral factors, including learning-related skills, problem behaviors, and interpersonal skills, explain these gaps and shed light on the academic difficulties specifically experienced by African American boys. The authors utilized the Early Childhood Longitudinal Study–Kindergarten Cohort (ECLS-K) sample and applied growth curve modeling. Learning-related skills explained the literacy development of African American boys over and above the effects of problem behaviors, socioeconomic status, and home literacy environment. Results suggest that emphasis placed on the behavior problems and the social risk factors associated with African American boys needs to be refocused and should be accompanied by increased efforts to improve learning-related skills in the classroom context and beyond. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Challenging conventional wisdom about who quits: Revelations from corporate America.

Findings from 20 corporations from the Attrition and Retention Consortium, which collects quit statistics about 475,458 professionals and managers, extended and disputed established findings about who quits. Multilevel analyses revealed that company tenure is curvilinearly related to turnover and that a job's past attrition rate strengthens the (negative) performance- exit relationship. Further, women quit more than men, while African Americans, Hispanic Americans, and Asian Americans quit more than White Americans, though racial differences disappeared after confounds were controlled for. African American, Hispanic American, and Asian American women quit more than men of the same ethnicities and White Americans, but statistical controls nullified evidence for dual discrimination toward minority women. Greater corporate flight among women and minorities during early employment nonetheless hampers progress toward a more diversified workforce in corporate America. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Moderating effects of a craving intervention on the relation between negative mood and heavy drinking following treatment for alcohol dependence.

Objective: Negative affect is a significant predictor of alcohol relapse, and the relation between negative affect and drinking has been shown to be strongly mediated by alcohol craving. Thus, targeting craving during treatment could potentially attenuate the relation between negative affect and drinking. Method: The current study is a secondary analysis of data from the COMBINE study, a randomized clinical trial that combined pharmacotherapy with behavioral intervention in the treatment of alcohol dependence. Our goal in the current study was to examine whether a treatment module that targeted craving would predict changes in negative mood during the 16-week combined behavioral intervention (n = 776) and the relation among changes in mood, craving, and changes in heavy drinking during treatment and 1 year posttreatment. Results: Changes in negative mood were significantly associated with changes in heavy drinking during treatment (f2 = 0.78). Participants (n = 432) who received the craving module had significantly fewer heavy drinking days during treatment (d = 0.31), and receiving the module moderated the relation between negative mood and heavy drinking during treatment (f2 = 0.92) and 1 year posttreatment (f2 = 0.03). Moderating effects of the craving module were mediated by changes in craving during treatment. Within-subject analyses indicated significant pre- to postmodule reductions in negative mood. Additionally, postmodule craving significantly mediated the association between negative mood and heavy drinking during treatment and at posttreatment. Conclusions: The craving module of the combined behavioral intervention may weaken the relation between negative affect and heavy drinking by fostering greater decreases in craving during treatment. (PsycINFO Database Record (c) 2010 APA, all rights reserved)