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Dace S. Svikis

Bio: Dace S. Svikis is an academic researcher from Virginia Commonwealth University. The author has contributed to research in topics: Substance abuse & Population. The author has an hindex of 41, co-authored 170 publications receiving 5773 citations. Previous affiliations of Dace S. Svikis include Johns Hopkins Bayview Medical Center & Lund University.


Papers
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Journal ArticleDOI
TL;DR: Genetic influence on risk for alcoholism was examined in a US treatment sample of 50 monozygotic (MZ) and 64 dizygotic (DZ) male and 31 MZ and 24 DZ female same-sex twin pairs, suggesting forms of alcoholism that may be moderately to highly heritable.
Abstract: • Genetic influence on risk for alcoholism was examined in a US treatment sample of 50 monozygotic (MZ) and 64 dizygotic (DZ) male and 31 MZ and 24 DZ female same-sex twin pairs. For theDSM-IIIcomposite diagnosis of Alcohol Abuse and/or Dependence, statistically significant MZ/DZ differences in concordance were found with male, but not female, twins. For specific diagnoses, MZ/DZ differences were found in male subjects for both Alcohol Abuse and Alcohol Dependence, while MZ/DZ differences in female subjects were found only for Alcohol Dependence. The male MZ/DZ concordance difference for composite diagnosis but not for Alcohol Dependence could be accounted for statistically by differences in age of onset between MZ and DZ probands. As with alcohol, differences in MZ/DZ concordance were found forDSM-IIIcomposite diagnoses of Other Substance Abuse and/or Dependence with male, but not female, twins. Using Epidemiological Catchment Area data to estimate the population base rates of both alcohol and other substance use disorders allowed for heritability analyses that showed genetic factors to have only a modest influence on overall risk in both sexes (heritability estimates of approximately 0.35 for male subjects and O.24 for female subjects). However, evidence for heterogeneity in the pattern of inheritance was also found, suggesting forms of alcoholism that may be moderately to highly heritable.

494 citations

Journal ArticleDOI
TL;DR: Findings suggest that genetic influences may be substantial only in the etiology of early-onset male alcoholism.
Abstract: Male monozygotic cotwins of probands with Alcohol Abuse-Dependence (n = 85) were more likely than male same-sex dizygotic cotwins (n = 96) to report alcohol, drug, and conduct disorder problems. For women, rates of problem behavior did not differ between monozygotic (n = 44) and same-sex dizygotic (n = 43) cotwins. Opposite-sex dizygotic twin data (n = 88) revealed significant cross-sex transmission; alcohol problems were greatest among male cotwins of female probands. For men, proportion of liability variance associated with additive genetic factors was significantly greater when proband had an early (h2 = .73 +/- .18) rather than late (h2 = .30 +/- .26) age of onset. For women, heritability did not vary as a function of proband's age of onset, and the pooled estimate suggested little genetic influence (h2 = .00, SE not computable). Findings suggest that genetic influences may be substantial only in the etiology of early-onset male alcoholism.

352 citations

Journal ArticleDOI
TL;DR: Type of substance abuse may be overemphasized as a predictor of outpatient drug-free treatment retention, and that greater emphasis should be placed on tailoring treatment to patients' cultural, gender and vocational needs.

229 citations

Journal ArticleDOI
TL;DR: Of the 37 measures of tobacco withdrawal employed in this study, nine showed significant changes following tobacco deprivation, and these changes include decreased heart rate and increased caloric intake, weight, craving for tobacco, confusion, depression-dejection, number of awakenings, duration of awakeningings, and increased poor concentrations as observed by others.
Abstract: This study was a prospective examination of tobacco withdrawal symptoms in a controlled environment. Smokers (N=27) were hospitalized for a 7-day period during which a battery of tests was administered. Smokers were assigned to either an experimental group (N=20) or a control group (N=7). Subjects in the experimental group smoked ad libitum for a 3-day baseline period and then underwent 4 days of tobacco deprivation. Subjects in the control group continued to smoke ad libitum throughout the study. Of the 37 measures of tobacco withdrawal employed in this study, nine showed significant changes following tobacco deprivation. These changes include decreased heart rate and increased caloric intake, weight, craving for tobacco, confusion, depression-dejection, number of awakenings, duration of awakenings, and increased poor concentrations as observed by others.

220 citations

Journal ArticleDOI
TL;DR: The Therapeutic Workplace can effectively treat heroin and cocaine abuse in pregnant and postpartum women and nearly doubled patients' abstinence from opiates and cocaine.
Abstract: Long-term Therapeutic Workplace effects were evaluated in heroin- and cocaine-dependent, unemployed, treatment-resistant young mothers. Participants were paid to work or to train in the Therapeutic Workplace but had to provide drug-free urine samples to gain daily access. Participants (N 40) were randomly assigned to a Therapeutic Workplace or usual care control group. Therapeutic Workplace participants could work for 3 years. Relative to controls, Therapeutic Workplace participants increased cocaine (28% vs. 54% negative; p .04) and opiate (37% vs. 60% negative; p .05) abstinence on the basis of monthly urine samples collected until 3 years after intake. The Therapeutic Workplace can be an effective long-term treatment of cocaine and heroin addiction in poor and chronically unemployed young mothers.

205 citations


Cited by
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Journal ArticleDOI
TL;DR: The authors review evidence that self-control may consume a limited resource and conclude that the executive component of the self--in particular, inhibition--relies on a limited, consumable resource.
Abstract: The authors review evidence that self-control may consume a limited resource. Exerting self-control may consume self-control strength, reducing the amount of strength available for subsequent self-control efforts. Coping with stress, regulating negative affect, and resisting temptations require self-control, and after such self-control efforts, subsequent attempts at self-control are more likely to fail. Continuous self-control efforts, such as vigilance, also degrade over time. These decrements in self-control are probably not due to negative moods or learned helplessness produced by the initial self-control attempt. These decrements appear to be specific to behaviors that involve self-control; behaviors that do not require self-control neither consume nor require self-control strength. It is concluded that the executive component of the self--in particular, inhibition--relies on a limited, consumable resource.

3,892 citations

Journal ArticleDOI
TL;DR: Comorbidity of alcohol dependence with other substance disorders appears due in part to unique factors underlying etiology for each pair of disorders studied while comorbidities of alcohol addiction with mood, anxiety, and personality disorders appears more attributable to factors shared among these other disorders.
Abstract: Background Current and comprehensive information on the epidemiology of DSM-IV 12-month and lifetime drug use disorders in the United States has not been available. Objectives To present detailed information on drug abuse and dependence prevalence, correlates, and comorbidity with other Axis I and II disorders. Design, Setting, and Participants Face-to-face interviews using the Alcohol Use Disorder and Associated Disabilities Interview Schedule of the National Institute on Alcohol Abuse and Alcoholism in a large representative sample of US adults (N = 43 093). Main Outcome Measures Twelve-month and lifetime prevalence of drug abuse and dependence and the associated correlates, treatment rates, disability, and comorbidity with other Axis I and II disorders. Results Prevalences of 12-month and lifetime drug abuse (1.4% and 7.7%, respectively) exceeded rates of drug dependence (0.6% and 2.6%, respectively). Rates of abuse and dependence were generally greater among men, Native Americans, respondents aged 18 to 44 years, those of lower socioeconomic status, those residing in the West, and those who were never married or widowed, separated, or divorced (all P Conclusions Most individuals with drug use disorders have never been treated, and treatment disparities exist among those at high risk, despite substantial disability and comorbidity. Comorbidity of drug use disorders with other substance use disorders and antisocial personality disorder, as well as dependence with mood disorders and generalized anxiety disorder, appears to be due in part to unique factors underlying each pair of these disorders studied. The persistence of low treatment rates despite the availability of effective treatments indicates the need for vigorous educational efforts for the public and professionals.

2,855 citations

Journal ArticleDOI
04 Oct 2000-JAMA
TL;DR: Evidence that drug (including alcohol) dependence is a chronic medical illness is examined and results suggest that long-term care strategies of medication management and continued monitoring produce lasting benefits.
Abstract: The effects of drug dependence on social systems has helped shape the generally held view that drug dependence is primarily a social problem, not a health problem. In turn, medical approaches to prevention and treatment are lacking. We examined evidence that drug (including alcohol) dependence is a chronic medical illness. A literature review compared the diagnoses, heritability, etiology (genetic and environmental factors), pathophysiology, and response to treatments (adherence and relapse) of drug dependence vs type 2 diabetes mellitus, hypertension, and asthma. Genetic heritability, personal choice, and environmental factors are comparably involved in the etiology and course of all of these disorders. Drug dependence produces significant and lasting changes in brain chemistry and function. Effective medications are available for treating nicotine, alcohol, and opiate dependence but not stimulant or marijuana dependence. Medication adherence and relapse rates are similar across these illnesses. Drug dependence generally has been treated as if it were an acute illness. Review results suggest that long-term care strategies of medication management and continued monitoring produce lasting benefits. Drug dependence should be insured, treated, and evaluated like other chronic illnesses.

2,329 citations

Journal ArticleDOI
TL;DR: The results suggest that comorbidity results from common, underlying core psychopathological processes, and argue for focusing research on these core processes themselves, rather than on their varied manifestations as separate disorders.
Abstract: Background This report presents the results of confirmatory factor analyses of patterns of comorbidity among 10 common mental disorders in the National Comorbidity Survey, a national probability sample of US civilians who completed structured diagnostic interviews. Methods Patterns of comorbidity among DSM-III-R mental disorders were analyzed via confirmatory factor analyses for the entire National Comorbidity Survey sample (N=8098; age range, 15-54 years), for random halves of the sample, for men and women separately, and for a subsample of participants who were seeing a professional about their mental health problems. Four models were compared: a 1-factor model, a 2-factor model in which some disorders represented internalizing problems and others represented externalizing problems, a 3-factor variant of the 2-factor model in which internalizing was modeled as having 2 subfactors (anxious-misery and fear), and a 4-factor model in which the disorders represented separate affective, anxiety, substance dependence, and antisocial factors. Results The 3-factor model provided the best fit in the entire sample. This result was replicated across random halves of the sample as well as across women and men. The substantial empirical intercorrelation between anxious-misery and fear (0.73) suggested that these factors were most appropriately conceived as subfactors of a higher-order internalizing factor. In the treatment sample, the 2-factor model fit best. Conclusions The results offer a novel perspective on comorbidity, suggesting that comorbidity results from common, underlying core psychopathological processes. The results thereby argue for focusing research on these core processes themselves, rather than on their varied manifestations as separate disorders.

1,698 citations

Journal ArticleDOI
TL;DR: Observer and subject ratings of the DSM-III symptoms of craving for tobacco, irritability, anxiety, difficulty concentrating, and restlessness increased after cessation, and bradycardia, impatience, somatic complaints, insomnia, increased hunger, and increased eating occurred after cessation.
Abstract: • To test the validity, magnitude, and clinical significance of the signs and symptoms of tobacco withdrawal defined byDSM-III, both observed and reported signs and symptoms were measured in 50 smokers during two days of ad lib smoking and then during the first four days of abstinence. Observer and subject ratings of theDSM-IIIsymptoms of craving for tobacco, irritability, anxiety, difficulty concentrating, and restlessness increased after cessation. In addition, bradycardia, impatience, somatic complaints, insomnia, increased hunger, and increased eating occurred after cessation. The frequency and intensity of these symptoms varied across subjects; however, the average distress from tobacco withdrawal was similar to that observed in psychiatric outpatients. Subjects who had more withdrawal discomfort were more tolerant to the cardiovascular effects of nicotine. Subjects who had more withdrawal discomfort did not have a lower rate of smoking cessation.

1,562 citations