Showing papers by "Richard A. Brown published in 2005"
TL;DR: The authors argue that how one reacts to the discomfort of Nicotine withdrawal is a more promising avenue of investigation than severity of withdrawal and that inability to tolerate the distress of nicotine withdrawal and associated negative affect is a key factor in early smoking lapse and subsequent relapse.
313 citations
TL;DR: In a sample of 122 individuals entering a residential substance abuse treatment facility, level of psychological distress tolerance was predictive of early treatment dropout above and beyond relevant self-report variables.
Abstract: A large percentage of individuals who enter residential substance abuse treatment drop out before completing treatment. Given that early treatment dropout places individuals at an increased risk for relapse, identifying the mechanisms underlying treatment dropout would have several important theoretical and clinical implications. In the current study, the authors examined levels of psychological and physical distress tolerance as a predictor of early treatment dropout in a residential substance abuse treatment facility. In a sample of 122 individuals entering a residential substance abuse treatment facility, level of psychological distress tolerance was predictive of early treatment dropout above and beyond relevant self-report variables. There was no relationship between physical distress tolerance and early treatment dropout. Implications for future studies and treatment development or modification are discussed.
312 citations
TL;DR: Results indicated that most recent abstinence duration was related to persistence on the psychological stressor, beyond the influence of demographics, substance use level, and negative affect, suggesting that common processes account for relapse across addictions.
Abstract: This study investigated the relationship between duration of most recent drug and alcohol abstinence attempt and psychological distress tolerance, as indexed by persistence on a mental arithmetic task (the Paced Auditory Serial Addition Task; D. M. A. Gronwall, 1977), in 89 individuals in an inner-city residential substance abuse treatment facility. Results indicated that most recent abstinence duration was related to persistence on the psychological stressor, beyond the influence of demographics, substance use level, and negative affect. These findings extend previous work (T. H. Brandon et al., 2003; R. A. Brown, C. W. Lejuez, C. W. Kahler, & D. Strong, 2002) reporting significant relationships between persistence on laboratory challenge procedures and duration of abstinence following a quit attempt in smokers, suggesting that common processes account for relapse across addictions. Systematic replications including a prospective design are recommended.
190 citations
TL;DR: Immediate relapsers showed higher levels of negative affect and stress reactivity, and were less likely to persist on the psychological stressor, suggesting that one’s ability to tolerate the initial discomfort of an abstinence attempt may play an important role in gambling treatment outcome.
Abstract: The present study tested the theory that negative affect and one’s ability to tolerate distress is associated with failure to quit gambling during an abstinence attempt. Specifically, 16 current pathological gamblers who had at least one sustained period of gambling abstinence lasting a minimum of 3 months (i.e., delayed relapsers) and 16 current pathological gamblers who had never remained abstinent for a period longer than 2 weeks (i.e., immediate relapsers), were assessed for baseline levels of negative affect and stress reactivity, as well as faced with a psychological (mental arithmetic) and physical (breath holding) stressor. Compared to the delayed relapsers, the immediate relapsers displayed higher levels of negative affect and stress reactivity. Immediate relapsers also were less likely to persist on the psychological stressor, suggesting that one’s ability to tolerate the initial discomfort of an abstinence attempt may play an important role in gambling treatment outcome.
76 citations
TL;DR: In this article, a reanalysis of data from a prior study describing the event history of quitting smoking aided by bupropion, using recurrent-event models to determine the effect of the drug on occurrence of lapses and recoveries from lapse (resumption of abstinence).
Abstract: We report a reanalysis of data from a prior study describing the event history of quitting smoking aided by bupropion, using recurrent-event models to determine the effect of the drug on occurrence of lapses and recoveries from lapse (resumption of abstinence). Data were collected on 1,070 subjects across two similar double-blind randomized clinical trials of bupropion versus placebo and fitted with separate Cox regression models for lapse and recovery. Analyses were split using discrete time-varying covariates between the treatment (weeks 1-10) and follow-up phases (end of treatment to 12 months). Bupropion was associated with slower lapse during treatment for both sexes, and being female was associated with faster lapse across both phases. Drug did not affect time to recovery for males but was associated with faster recovery among females, allowing women to recover as quickly as men. High levels of nicotine dependence did not affect time to lapse but were associated with slower recovery from lapse across treatment and follow-up phases. During the treatment phase, higher levels of baseline depression symptoms had no effect on time to lapse but were associated with slower recovery from lapse. Results highlight the asymmetry in factors preventing lapse versus promoting recovery. Specifically, dependence, depression symptoms, and a sex x drug interaction were found to affect recovery but not lapse. Further research disentangling lapse and recovery events from summary abstinence measures is needed to help us develop interventions that take advantage of bupropion at its best and that compensate where it is weak.
44 citations
TL;DR: The RT-PD rat model is associated with large long-term sleep disruption, however, the vehicle, DMSO/PEG had as large an effect as RT on sleep, thus changes in sleep cannot be ascribed to loss of dopaminergic cells.
43 citations
TL;DR: It is concluded that the SSctx and Vctx EEGs are differentially affected by light during subsequent sleep, providing support for the notion that regional sleep intensity is dependent on prior regional afferent input.
Abstract: Somatosensory (SSctx) and visual cortex (Vctx) EEG were evaluated in rats under a 12:12-h light-dark (LD) cycle and under constant light (LL) or constant dark (DD) in each sleep or wake state. Under LD conditions during light period, relative Vctx EEG slow-wave activity (SWA) was higher than that of the SSctx, whereas during dark period, relative Vctx EEG SWA was lower than in the SSctx. These effects were state specific, occurring only during non-rapid eye movement sleep (NREMS). Under LL conditions, the duration of REMS and NREMS during the period that would have been dark if the LD cycle had continued (subjective dark period) was greater than under LD conditions. DD conditions had little effect on the duration of NREMS and REMS. SSctx and Vctx EEG SWA were suppressed by LL during the subjective dark period; however, the degree of Vctx SWA suppression was smaller than that of the SSctx. DD conditions during the subjective light period enhanced SSctx SWA, whereas Vctx SWA was suppressed. Under LL conditions during the subjective dark period, Vctx EEG power was higher than that of the SSctx across a broad frequency range during NREMS, REMS, and wakefulness. During DD, SSctx EEG power during NREMS was higher than that of the Vctx in the delta wave band, whereas SSctx power during REMS and wakefulness was higher than that of the Vctx in frequencies higher than 8 Hz. We concluded that the SSctx and Vctx EEGs are differentially affected by light during subsequent sleep. Results provide support for the notion that regional sleep intensity is dependent on prior regional afferent input.
31 citations
TL;DR: Significant interactions suggested that ADHD symptoms among boys and CD symptoms among girls were related to frequency of any type of substance use prior to inpatient hospitalization, and ADHD inattention symptoms, but not hyperactivity/impulsivity symptoms, were associated with marijuana and nicotine dependence.
Abstract: Attention deficit hyperactivity disorder (ADHD) and/or conduct disorder (CD) have been found to be associated with substance use disorders and cigarette smoking among adolescents. However, studies have often failed to explore these relationships among females from a dimensional perspective, taking into account comorbidity between ADHD and CD symptomatology, and examining ADHD symptom subtypes (i.e., inattention and hyperactivity/impulsivity) separately as they relate to substance involvement and smoking characteristics. This study takes each of the above into consideration when examining the relationship between externalizing symptomatology and substance involvement characteristics in a sample of 191 (62.3% female, mean age = 15.4 years) inpatient adolescent smokers. The results of this study suggest that ADHD and CD symptoms may be related to different types of substance use characteristics. CD symptoms were associated with early onset of substance involvement and ADHD symptoms were related to alcohol and marijuana frequency. ADHD inattention symptoms, but not hyperactivity/impulsivity symptoms, were associated with marijuana and nicotine dependence. Lastly, significant interactions suggested that ADHD symptoms among boys and CD symptoms among girls were related to frequency of any type of substance use prior to inpatient hospitalization. The results of this study point to potentially important clinical implications such as tailoring prevention and intervention efforts according to type of externalizing symptomatology and gender.
25 citations
TL;DR: Combined psychotherapy and pharmacotherapy did not produce a significant reduction in HIV drug risk beyond that seen in an assessment-only control group, and depression remission was significantly associated with lower HIV drugrisk scores at follow-ups.
Abstract: Objective: To determine if, by reducing depressive symptoms, combined psychotherapy and pharmacotherapy reduces HIV drug risk behavior compared to an assessment-only condition for active drug injectors over 9 months. Design: Randomized controlled trial. Setting: Outpatient academic research office. Patients: Active injection drug users with a DSM-IV diagnosis of major depression, dysthymia, substance-induced mood disorder with depressive features persisting for at least 3 months, or major depression plus dysthymia. In addition, participants had a Hamilton Rating Scale for Depression (MHRSD) score > 13. Intervention: Psychotherapy (8 sessions of cognitive behavioral therapy) plus antidepressant pharmacotherapy over 3 months. Main Outcome Measures: HIV Risk Assessment Battery (RAB) drug scale scores measured at three, six and nine months, and depression remission (MHRSD score ≤ 8). Results: Participants (n = 109) were 64% male, 82% Caucasian, with a mean baseline MHRSD score of 20.7. Depression subtypes inc...
13 citations
TL;DR: Combined treatment is superior to an assessment-only condition in depression remission rates at the end-of-treatment, but this difference does not persist.
Abstract: The objective of this study was to determine if combined psychotherapy and pharmacotherapy reduces reported depressive symptoms compared to an assessment only condition for active drug injectors over nine months. Using a randomized controlled trial at an outpatient academic research office, the researchers applied psychotherapy (eight sessions of cognitive behavioral therapy) plus pharmacotherapy (citalopram) to active injection drug users with a DSM-IV diagnosis of major depression, dysthymia, substance-induced mood disorder with symptoms persisting for at least three months, or major depression plus dysthymia, and a Modified Hamilton Rating Scale for Depression (MHRSD) score greater than 13. The MHRSD scale scores were then assessed at the completion of three, six, and nine months. Participants (n = 109) were 64% male and 82% Caucasian, with a mean baseline MHRSD score of 20.7. Depression subtypes included major depression only (63%), substance-induced depression (17%), and double-depression (17%). Stud...
10 citations
TL;DR: The results suggest that adolescent smoking cessation treatment for psychiatric populations may need to be intensive in nature and directly target other substance use.
Abstract: The purpose of the current study was to add to our understanding of the association between smoking and substance use among adolescents in psychiatric treatment. Data were collected from 191 (119 females and 72 males) adolescent smokers who were hospitalized at a private psychiatric hospital. On average, study participants smoked on 91.03% (SD = 19.34) of the days during the three months leading up to hospitalization and smoked 13.94 (SD = 9.80) cigarettes per smoking day. Age of first cigarette use was correlated significantly with age of first alcohol use and with age of first marijuana use. Recent marijuana use was associated with frequency of cigarette smoking while recent binge drinking was associated with intensity of cigarette smoking. In addition, adolescents smoked significantly more cigarettes on days in which they consumed alcohol or drugs than they smoked on abstinent days. The results suggest that adolescent smoking cessation treatment for psychiatric populations may need to be inten...