Social environmental selection as a mediator of gender, ethnic, and personality effects on college student drinking.

Structural equation modeling was used to test the mediational role of social environmental selection on alcohol use in cross-sectional samples of 447 students from a rural state university and 421 students from an urban private university. Results showed that male gender, White ethnicity, and sensation seeking were uniquely associated with greater alcohol use. Mediational analyses indicated that socioenvironmental factors (i.e., Greek involvement, friends' approval of drinking/getting drunk) were positively associated with alcohol use and significantly accounted for parts of the effects of ethnicity and sensation seeking, but not gender, on alcohol use. Results suggest that White students and those high on sensation seeking may drink more heavily in college, in part because they select social environments in which alcohol use is encouraged. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Twelve-Week Outcomes From an Investigation of High-Dose Nicotine Patch Therapy for Heavy Smokers With a Past History of Alcohol Dependence.

This study reports findings from an investigation of the efficacy of high-dose nicotine patch (NP) therapy for heavy smokers with a past history of alcohol dependence. One hundred thirty participants were randomly assigned to 42 mg or 21 mg of transdermal nicotine for 4 weeks, followed by an 8-week dose titration. Follow-up assessments were conducted at 4 and 12 weeks. Differences between dose conditions were nonsignificant, although unexpectedly, outcomes favored participants in the 21-mg NP condition. Nicotine abstinence at follow-up was related to longer length of alcohol abstinence at time of enrollment. Future research should investigate ways to improve smoking quit rates in this population, including more frequent counseling sessions and/or other pharmacotherapies. These investigations should focus primarily on smokers in early alcohol recovery. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Alcoholics Anonymous and Relapse Prevention as Maintenance Strategies After Conjoint Behavioral Alcohol Treatment for Men: 18-Month Outcomes.

Ninety men with alcohol problems and their female partners were randomly assigned to 1 of 3 outpatient conjoint treatments: alcohol behavioral couples therapy (ABCT), ABCT with relapse prevention techniques (RP/ABCT), or ABCT with interventions encouraging Alcoholics Anonymous (AA) involvement (AA/ABCT). Couples were followed for 18 months after treatment. Across the 3 treatments, drinkers who provided follow-up data maintained abstinence on almost 80% of days during follow-up, with no differences in drinking or marital happiness outcomes between groups. AA/ABCT participants attended AA meetings more often than ABCT or RP/ABCT participants, and their drinking outcomes were more strongly related to concurrent AA attendance. For the entire sample, AA attendance was positively related to abstinence during follow-up in both concurrent and time-lagged analyses. In the RP/ABCT treatment, attendance at posttreatment booster sessions was related to posttreatment abstinence. Across treatment conditions, marital happiness was related positively to abstinence in concurrent but not time-lagged analyses. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Psychiatric disorders, familial factors, and cigarette smoking: III. Associations with cessation by young adulthood among daily smokers.

The present study examined whether lifetime psychopathology, regular smoking and psychopathology in family members, and smoking characteristics were associated with successful cessation among daily smokers. A sample of 941 young adults was interviewed for lifetime psychopathology and smoking at three time points; biological parents and siblings were interviewed once for lifetime psychopathology and regular smoking. Within the subset of 242 daily smokers with complete data, most (83%) had tried to quit at least once, although only 22% met our definition of successful cessation (no smoking during the 12 months prior to turning age 25 years). Successful cessation was positively associated with being married and having a higher household income in young adulthood, and negatively associated with lifetime major depressive disorder, elevated antisocial personality disorder symptoms, a family history of drug and alcohol use disorder, and nicotine dependence (for women but not men). Marital status, nicotine dependence (for women but not men), and male gender were significant in multivariate analyses; the effect for major depressive disorder approached significance (p=.052). None of the measures of familial smoking were associated with successful smoking cessation. In conclusion, whereas almost all Axis I disorders in our two previous papers were associated with smoking initiation and progression to daily smoking, major depressive disorder and antisocial personality disorder symptoms were the only psychiatric conditions negatively associated with successful cessation. The causal nature of the significant associations and the degree to which modification of these factors increases the probability of future smoking cessation deserve further attention.     

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)     

Impact of Posttraumatic Stress Disorder on early smoking lapse and relapse during a self-guided quit attempt among community-recruited daily smokers

The present investigation examined whether daily smokers with posttraumatic stress disorder (PTSD), as compared to daily smokers with either anxiety psychopathology or no current Axis I psychopathology, have decreased success in the early phases of a self-guided smoking quit attempt. Participants were 140 daily smokers (81 women; M (age) = 29.5; SD = 11.9; range = 18-65 years); approximately one-third of the sample met criteria for current PTSD (n = 47), one-third met criteria for other current anxiety disorders (without PTSD; n = 33), and one-third did not meet criteria for any current Axis I disorder (n = 60). Consistent with prediction, membership in the PTSD group, compared to membership in the other anxiety disorders group and the group with no current Axis I psychopathology, was associated with increased risk of lapse during the first week following quit day. Additionally, daily smokers with PTSD and other anxiety disorders were at significantly increased risk of relapse during the first week post-cessation compared to persons without Axis I psychopathology. However, the PTSD group and the other anxiety disorders group did not differ from one another in terms of relapse. Results suggest that PTSD is associated with increased risk of smoking lapse and relapse compared to smokers with no current Axis I psychiatric problems, and increased risk of early smoking lapse but not relapse, as compared to those with other anxiety disorders. Findings provide novel evidence that PTSD, and perhaps anxiety disorders more generally, may be important factors in reducing the odds of successful unaided quit attempts in the early phases of cessation.     

Source water quality effects on monochloramine inactivation of adenovirus, coxsackievirus, echovirus, and murine norovirus

There is a need for more information regarding monochloramine disinfection efficacy for viruses in water. In this study, monochloramine disinfection efficacy was investigated for coxsackievirus B5 (CVB5), echovirus 11 (E11), murine norovirus (MNV), and human adenovirus 2 (HAdV2) in one untreated ground water and two partially treated surface waters. Duplicate disinfection experiments were completed at pH 7 and 8 in source water at concentrations of 1 and 3 mg/L monochloramine at 5 and 15 °C. The Efficiency Factor Hom (EFH) model was used to calculate CT values (mg-min/L) required to achieve 2-, 3-, and 4-log₁₀ reductions in viral titers. In all water types, monochloramine disinfection was most effective for MNV, with 3-log₁₀ CT values at 5 °C ranging from 27 to 110. Monochloramine disinfection was least effective for HAdV2 and E11, depending on water type, with 3-log₁₀ CT values at 5 °C ranging from 1200 to 3300 and 810 to 2300, respectively. Overall, disinfection proceeded faster at 15 °C and pH 7 for all water types. Inactivation of the study viruses was significantly different between water types, but there was no indication that overall disinfection efficacy was enhanced or inhibited in any one water type. CT values for HAdV2 in two types of source water exceeded federal CT value recommendations in the US. The results of this study demonstrate that water quality impacts the inactivation of viruses and should be considered when developing chloramination plans.     

Do treatment process factors mediate the relationship between type A-type B and outcome in 12-Step oriented substance abuse treatment?

AIMS: One underutilized strategy for enhancing treatment research is to examine intervening factors that link client characteristics to endpoint outcomes. This study tested the hypothesis that Type B substance abusers would demonstrate difficulties engaging in the treatment process, and that these problems would mediate their poorer outcomes. DESIGN: Longitudinal naturalistic study. SETTING: Two intensive 12-Step substance abuse treatment programs. PARTICIPANTS: A sample of 115 men and women seeking treatment. MEASUREMENT: Empirical clustering techniques were used to divide the sample, and the link between type, process factors, and 12-month outcomes was examined. FINDINGS: Hypotheses were not supported. Type Bs did not demonstrate difficulties with the treatment process, but had greater problems sustaining gains posttreatment. Contrary to prediction, Type Bs were better matched to self-help affiliation than Type As. CONCLUSIONS: Findings argue for a more optimistic perspective on treating Type Bs, and for the utility of Type A-Type B in informing treatment research.     

Dimensions of depressive symptoms and smoking cessation.

Because different psychopathologic components of depressive symptoms may have distinct etiologies, examining their differential effects on smoking cessation may elucidate mechanisms underlying the smoking-depression relationship. Negative affect (NA), somatic features (SF), low positive affect/anhedonia (PA), and interpersonal disturbance (IP) have been identified as unique dimensions of depression that can be measured using the Center for Epidemiologic Studies Depression Scale (CESD). This study examined common and unique associations between CESD subscales and baseline smoking characteristics, nicotine withdrawal, and relapse in 157 participants enrolled in a smoking cessation trial for heavy social drinkers. Each dimension was univariately associated with negative and positive reinforcement smoking motives. Only SF had unique relations with tolerance smoking motives and univariate associations with nicotine dependence severity. Only PA predicted cessation-related changes in withdrawal symptoms on quit day. Analyses predicting abstinence at 8, 16, and 26 weeks post quit date showed that NA, SF, and PA each univariately predicted relapse, ps< or =.0083. Only low PA predicted poorer outcomes incrementally to the other dimensions, even when controlling for level of nicotine dependence, smoking frequency, and history of major depression, p = .0018. Interventions targeting anhedonia and low positive affect may be useful for smokers trying to quit.     

Bupropion and cognitive-behavioral treatment for depression in smoking cessation.

This study is a randomized, double-blind, placebo-controlled clinical trial examining the effects of an intensive cognitive-behavioral mood management treatment (CBTD) and of bupropion, both singularly and in combination, on smoking cessation in adult smokers. As an extension of our previous work, we planned to examine the synergistic effects of CBTD and bupropion on smoking cessation outcomes in general and among smokers with depression vulnerability factors. Participants were 524 smokers (47.5% female, M (age) = 44.27 years) who were randomized to one of four 12-week treatments: (a) standard, cognitive-behavioral smoking cessation treatment (ST) plus bupropion (BUP), (b) ST plus placebo (PLAC), (c) standard cessation treatment combined with cognitive-behavioral treatment for depression (CBTD) plus BUP, and (d) CBTD plus PLAC. Follow-up assessments were conducted 2, 6, and 12 months after treatment, and self-reported abstinence was verified biochemically. Consistent with previous studies, bupropion, in comparison with placebo, resulted in better smoking outcomes in both intensive group treatments. Adding CBTD to standard intensive group treatment did not result in improved smoking cessation outcomes. In addition, neither CBTD nor bupropion, either alone or in combination, was differentially effective for smokers with single-past-episode major depressive disorder (MDD), recurrent MDD, or elevated depressive symptoms. However, findings with regard to recurrent MDD and elevated depressive symptoms should be interpreted with caution given the low rate of recurrent MDD and the low level of depressive symptoms in our sample. An a priori test of treatment effects in smokers with these depression vulnerability factors is warranted in future clinical trials.