Background
Measures of hangover are associated with current and future problematic alcohol use. At present, it is not known whether these associations reflect any direct influence of hangover events ...on near‐term drinking behaviors. The current study aimed to determine whether hangover following a drinking episode influences time to next drink (TTND) and, if so, to determine the direction of this effect and identify any moderating personal or contextual factors.
Methods
Community‐recruited, frequent drinkers oversampled for current smoking (N = 386) carried electronic diaries for 21 days, reporting on drinking behaviors and other experiences. Survival analysis was used to model data from 2,276 drinking episodes, including 463 episodes that were followed by self‐reported hangover in morning diary entries.
Results
When tested as the sole predictor in a survival model, hangover was associated with increased TTND. The median survival time was approximately 6 hours longer after episodes with hangovers compared to those without. In a multivariate model, hangover was only significant in the presence of interaction effects involving craving at the end of the index drinking episode and the occurrence of financial stressors. Additional predictors of TTND in the final multivariate model included age, lifetime alcohol use disorder diagnosis, typical drinking frequency, day of the week, and morning reports of craving, negative affect, and stressors after the index episode. There was no association between morning reports of hangover and contemporaneous diary ratings of likelihood of drinking later the same day.
Conclusions
The findings suggest that hangover has, at best, a modest or inconsistent influence on the timing of subsequent alcohol use among frequent drinkers.
We assessed the effect of DBT skills utilization on features of borderline personality disorder as measured by the Personality Assessment Inventory-Borderline Features Scale (PAI-BOR). Participants ...were outpatients (N = 27) enrolled in a dialectical behavior therapy (DBT) program in a university-affiliated community mental health clinic. Diary cards were collected each week to track self-reported skills use. At the beginning of each new skills training module, patients completed another PAI-BOR. Univariate and multilevel analyses indicated significant improvement on the total PAI-BOR score and on several PAI-BOR subscale scores. Results also revealed that overall DBT skills use increased significantly over time, as did individual skills related to mindfulness, interpersonal effectiveness, emotion regulation, and distress tolerance. Multilevel modeling results indicated that overall skills use showed a significant effect on PAI-BOR total scores, Affective Instability scores, Identity Problems scores, and Negative Relationships scores, even after controlling for initial levels of distress and diary card compliance.
Reasons for Abstaining or Limiting Drinking Epler, Amee J; Sher, Kenneth J; Piasecki, Thomas M
Psychology of addictive behaviors,
09/2009, Letnik:
23, Številka:
3
Journal Article
Recenzirano
Odprti dostop
The cross-sectional and longitudinal relations between reasons for abstaining or limiting drinking (RALD) and abstention were examined in a 16-year longitudinal study (
N
= 489) of college students ...with and without a family history of alcohol problems. Results indicated that RALD based upon upbringing or religiosity were associated with increased rates of abstention, whereas RALD based upon perceived or experienced negative consequences of drinking were associated with lower rates of abstention and increased alcohol consumption among drinkers. In addition, changes in RALD over time coincided with alcohol consumption transitions. Abstainers who began drinking after turning 21 reported a decrease in the importance of RALD associated with loss of control and upbringing or religiosity compared to abstainers who continued to abstain after turning 21. Conversely, drinkers who began abstaining after leaving college reported an increase in the importance of RALD associated with loss of control and upbringing or religiosity compared to drinkers who continued to drink after leaving college. Examining the reciprocal influences of RALD on drinking outcomes extends previous research and may inform prevention and intervention programs among college drinkers.
We evaluated the screening validity of a self-report measure for post traumatic stress disorder (PTSD), the PTSD Checklist (PCL), in female Veterans Affairs (VA) patients. All women seen for care at ...the VA Puget Sound Health Care system from October 1996–January 1999 (
n=2,545) were invited to participate in a research interview. Participants (
n=282) completed the 17-item PCL, followed by a gold standard diagnostic interview for PTSD, the Clinician Administered PTSD Scale (CAPS). Thirty-six percent of the participants (
n=100) met CAPS diagnostic criteria for current PTSD. Receiver Operating Characteristic (ROC) analysis was used to evaluate the screening performance of the PCL. The area under the ROC curve was 0.86 (95% CI 0.82–0.90). A PCL score of 38 optimized the performance of the PCL as a screening test (sensitivity 0.79, specificity 0.79). The PCL performed well as a screening measure for the detection of PTSD in female VA patients.
Motivational interviewing (MI) is an evidence-based intervention with considerable support for promoting behavior change across a broad range of health and mental health issues. Despite its ...effectiveness, challenges associated with learning the approach may limit its full implementation in many clinical settings. The aim of the present study was to evaluate a supervised MI training practicum implemented within a doctoral internship/postdoctoral fellowship training program. The goal of the practicum was to enable each trainee to achieve expert competence in MI. Participants were 29 psychology doctoral interns and 1 postdoctoral fellow who participated in the training as part of their internship or fellowship program. Training included an initial workshop followed by a supervised practicum during which progress toward an a priori established expert competence benchmark was tracked through the use of an established coding system. Results indicated that trainees were satisfied with the supervision received. Three trainees did not achieve the a priori benchmark due to schedule conflicts. The 27 trainees who achieved the benchmark required between 4 and 20 supervision sessions to do so (M = 9.22, SD = 3.77). With the exception of reflective listening skill, prior training, baseline skill, and self-reported motivation were not associated with number of supervision sessions required to achieve the benchmark. Implications for training and dissemination of MI in clinical settings are discussed.
Focused Acceptance & Commitment Therapy (FACT) is a brief intervention based on traditional Acceptance and Commitment Therapy (ACT). Although there is a growing body of research on the efficacy of ...ACT for a variety of populations and disorders, there is little research to date on the use of FACT in group settings. This project is 1 of the first of its kind, as it examines data on psychological flexibility, health and mental health status, and symptom reduction from a 4-week FACT group. Participants in this study were 51 patients who attended this group as part of routine clinical care in a VA integrated primary care and mental health setting. They completed pre- and posttreatment measures of well-being, depression, anxiety, stress, psychological flexibility, and perceptions of physical and mental health functioning. Pre- to posttreatment analyses of variance demonstrated large effects for quality of life, F(1, 51) = 21.29, p < .001, η2 = 0.30, moderate effects for depressive symptoms, F(1, 51) = 11.47, p < .001, η2 = 0.08, and perceptions of mental health functioning (MCS scale), F(1, 51) = 9.67, p = .003, η2 = 0.11, and small effects for perceptions of perceived stress, F(1, 51) = 4.08, p = .04, η2 = 0.03, and physical health functioning (PCS scale), F(1, 51) = 6.60, p = .01, η2 = 0.08. There was a statistical trend for reductions in anxiety, F(1, 51) = 3.29, p = .07, η2 = 0.01, and a nonsignificant effect for psychological flexibility, F(1, 51) = 2.05, p = .16, η2 = 0.04. These data provide initial support for the implementation of a group-based FACT protocol within a VA primary care setting and help to lay a foundation for further, more controlled studies on Group FACT in future research.
Motivational interviewing (MI) is an evidence based intervention with considerable support for promoting behavior change across a broad range of health and mental health issues. Despite its ...effectiveness, challenges associated with learning the approach may limit its full implementation in many clinical settings. The aim of the present study was to evaluate a supervised MI training practicum implemented within a doctoral internship/postdoctoral fellowship training Program. The goal of the practicum was to enable each trainee to achieve expert competence in MI. Participants were 29 psychology doctoral interns and 1 postdoctoral fellow who participated in the training as part of their internship or fellowship program. Training included an initial workshop followed by a supervised practicum during which progress towards an
established expert competence benchmark was tracked through the use of an established coding system. Results indicated that trainees were satisfied with the supervision received. Three trainees did not achieve the
benchmark due to schedule conflicts. The 27 trainees who achieved the benchmark required between 4 and 20 supervision sessions to do so (mean = 9.22,
= 3.77). With the exception of reflective listening skill, prior training, baseline skill, and self-reported motivation were not associated with number of supervision sessions required to achieve the benchmark. Implications for training and dissemination of MI in clinical settings are discussed.
Alcohol and tobacco use covary at multiple levels of analysis, and co-use of the 2 substances may have profound health consequences. To characterize the motivationally relevant processes contributing ...to co-use, the current study used ecological momentary assessment (EMA) to examine the subjective consequences of naturally occurring simultaneous use of alcohol and tobacco. Current smokers who reported frequently drinking alcohol (N = 259) used electronic diaries to monitor their daily experiences for 21 days. Participants responded to prompted assessments and also initiated recordings when they smoked a cigarette or completed the first drink in a drinking episode. Momentary reports of smoking and alcohol consumption were associated with one another, and these effects remained after adjustment for occasion- and person-level covariates. When participants consumed alcohol, they reported increased pleasure and decreased punishment from the last cigarette. Smoking was associated with small increases in pleasure from the last drink. Ratings of buzzed and dizzy were synergistically affected by co-use of alcohol and tobacco. Co-use was also followed by higher levels of craving for both alcohol and tobacco. Results point to the importance of reward and incentive processes in ongoing drug use and suggest that alcohol intensifies real-time reports of the motivational consequences of smoking more strongly than smoking affects corresponding appraisals of alcohol effects.
Objective: Heavy episodic drinking remains a significant problem on college campuses. Although most interventions for college students are behavioral, pharmacological treatments, such as naltrexone, ...could provide additional options. Participants: The authors evaluated receptivity to various alcohol treatment options in a general population of college student drinkers (N = 2,084), assessed in 2005. Methods: The authors asked participants to indicate which of 8 treatment options (ie, self-help book, self-help computer program, self-help group, group therapy, individual therapy, monthly injection, targeted oral medication, or daily oral medication) they would be willing to consider if they were going to cut down on or stop drinking. Results: Over 50% of drinkers expressed receptiveness to self-help options or psychotherapy options, and over 25% of drinkers expressed receptiveness to medication options. Conclusions: Increasing treatment options for students interested in reducing or stopping drinking by offering pharmacological interventions such as naltrexone could provide an important unmet need among college students.
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