17 results on '"Christina D. Dutcher"'
Search Results
2. Approach bias retraining to augment smoking cessation: Study protocol for a randomized controlled trial
- Author
-
Jasper A.J. Smits, Scarlett O. Baird, Mike Rinck, David Rosenfield, Christopher G. Beevers, Richard A. Brown, Haley E. Conroy, Noura Alavi, Christina D. Dutcher, and Slaton Z. Freeman
- Subjects
Medicine (General) ,R5-920 - Abstract
Heavy users and addicted individuals have shown to develop an approach action tendency – or approach bias – toward stimuli related to the substance of interest. Emerging evidence points to approach bias retraining (ABR) as an effective aid for the treatment of addictive behaviors. The current study seeks to extend this work by testing, in a pilot study, whether standard smoking cessation treatment involving cognitive-behavioral therapy (CBT) and nicotine replacement therapy can be augmented by ABR. To this end, we will randomly assign 100 adult smokers to either ABR-augmented treatment or placebo-augmented treatment and compare the two conditions on short-term and long-term abstinence rates. The hope is that the findings of this study can inform treatment development for adult smokers.
- Published
- 2019
- Full Text
- View/download PDF
3. Effect of d-cycloserine on fear extinction training in adults with social anxiety disorder.
- Author
-
Stefan G Hofmann, Santiago Papini, Joseph K Carpenter, Michael W Otto, David Rosenfield, Christina D Dutcher, Sheila Dowd, Mara Lewis, Sara Witcraft, Mark H Pollack, and Jasper A J Smits
- Subjects
Medicine ,Science - Abstract
Preclinical and clinical data have shown that D-cycloserine (DCS), a partial agonist at the N-methyl-d-aspartate receptor complex, augments the retention of fear extinction in animals and the therapeutic learning from exposure therapy in humans. However, studies with non-clinical human samples in de novo fear conditioning paradigms have demonstrated minimal to no benefit of DCS. The aim of this study was to evaluate the effects of DCS on the retention of extinction learning following de novo fear conditioning in a clinical sample. Eighty-one patients with social anxiety disorder were recruited and underwent a previously validated de novo fear conditioning and extinction paradigm over the course of three days. Of those, only 43 (53%) provided analyzable data. During conditioning on Day 1, participants viewed images of differently colored lamps, two of which were followed by with electric shock (CS+) and a third which was not (CS-). On Day 2, participants were randomly assigned to receive either 50 mg DCS or placebo, administered in a double-blind manner 1 hour prior to extinction training with a single CS+ in a distinct context. Day 3 consisted of tests of extinction recall and renewal. The primary outcome was skin conductance response to conditioned stimuli, and shock expectancy ratings were examined as a secondary outcome. Results showed greater skin conductance and expectancy ratings in response to the CS+ compared to CS- at the end of conditioning. As expected, this difference was no longer present at the end of extinction training, but returned at early recall and renewal phases on Day 3, showing evidence of return of fear. In contrast to hypotheses, DCS had no moderating influence on skin conductance response or expectancy of shock during recall or renewal phases. We did not find evidence of an effect of DCS on the retention of extinction learning in humans in this fear conditioning and extinction paradigm.
- Published
- 2019
- Full Text
- View/download PDF
4. Embedding Aphasia-Modified Cognitive Behavioral Therapy in Script Training for Primary Progressive Aphasia: A Single-Case Pilot Study
- Author
-
Kristin M. Schaffer, Christina D. Dutcher, Maya L. Henry, William S. Evans, and Christina Philburn
- Subjects
Linguistics and Language ,medicine.medical_treatment ,Pilot Projects ,Speech Therapy ,Attunement ,Primary progressive aphasia ,030507 speech-language pathology & audiology ,03 medical and health sciences ,Speech and Hearing ,0302 clinical medicine ,Aphasia ,Intervention (counseling) ,Developmental and Educational Psychology ,medicine ,Humans ,Research Articles ,Cognitive Behavioral Therapy ,Interpretative phenomenological analysis ,medicine.disease ,Cognitive behavioral therapy ,Aphasia, Primary Progressive ,Multiple baseline design ,Otorhinolaryngology ,Female ,medicine.symptom ,0305 other medical science ,Psychology ,Psychosocial ,030217 neurology & neurosurgery ,Clinical psychology - Abstract
Purpose This study sought to determine the initial feasibility and benefit of a novel intervention that combines speech-language treatment with counseling treatment for an individual with the nonfluent/agrammatic variant of primary progressive aphasia (PPA). Method Using a single-case experimental design, we evaluated the utility of modified script training paired with aphasia-modified cognitive behavioral therapy. The study employed a multiple baseline design across scripts for the primary linguistic outcome measure and a mixed methods approach for analyzing counseling outcomes. Psychosocial and communicative functioning scales were administered in conjunction with a phenomenological analysis of semi-structured interviews. Results The participant completed all study phases and participated in all treatment components. She met the criterion of 90% correct, intelligible scripted words on all trained scripts through 12 months post-treatment. Treatment outcomes were comparable to a comparison cohort that received script training without counseling ( Henry et al., 2018 ). At post-treatment, the participant demonstrated stability or improvement on all measures of psychosocial and communicative functioning, with stability documented on seven out of 11 scales at follow-ups through 12 months post-treatment. A phenomenological analysis revealed pervasive themes of loss and resilience at both time points, and emerging themes of positive self-perception, sense of agency, and emotional attunement following treatment. Conclusions Results indicate that script training with aphasia-modified cognitive behavioral therapy is a feasible treatment for an individual with the nonfluent/agrammatic variant of PPA, with immediate and lasting benefits to speech-language production and psychosocial functioning. These findings are the first to support the integration of personal adjustment counseling techniques within a speech-language treatment paradigm for PPA. Supplemental Material https://doi.org/10.23641/asha.14925330
- Published
- 2021
5. Community‐based smoking cessation treatment for adults with high anxiety sensitivity: a randomized clinical trial
- Author
-
Santiago Papini, Christina D. Dutcher, Richard A. Brown, Michael W. Otto, Annabelle DiVita, Slaton Z. Freeman, Lorra Garey, Michael J. Zvolensky, Alex Perrone, Jasper A. J. Smits, and David Rosenfield
- Subjects
Adult ,medicine.medical_specialty ,medicine.medical_treatment ,media_common.quotation_subject ,030508 substance abuse ,Medicine (miscellaneous) ,Anxiety ,Article ,law.invention ,03 medical and health sciences ,0302 clinical medicine ,Randomized controlled trial ,law ,medicine ,Humans ,Aerobic exercise ,030212 general & internal medicine ,Child ,Exercise ,media_common ,business.industry ,Abstinence ,Nicotine replacement therapy ,Anxiety Disorders ,Tobacco Use Cessation Devices ,Psychiatry and Mental health ,Distress ,Physical therapy ,Anxiety sensitivity ,Smoking cessation ,Female ,Smoking Cessation ,medicine.symptom ,0305 other medical science ,business - Abstract
BACKGROUND AND AIMS People with anxiety disorders are more likely to smoke and less likely to succeed when they try to quit. Anxiety sensitivity may underlie both phenomena, such that people with high anxiety sensitivity react to interoceptive distress by avoidance. This study aimed to test the efficacy of an exercise program that induced interoceptive distress and thereby created tolerance to this distress in a safe environment. DESIGN, SETTING AND PARTICIPANTS Randomized clinical trial at four YMCA branches in Austin, Texas, USA. Participants [n = 150; 130 (86.7%) white; 101 (67.3%) female; meanage = 38.6, standard deviation (SD)age = 10.4] were adult, daily smokers with high anxiety sensitivity motivated to quit smoking, who reported no regular moderate-intensity exercise. INTERVENTIONS Participants were assigned a YMCA personal trainer who guided them through a 15-week intervention aerobic exercise program. Participants assigned to the personalized intervention trained at 60-85% of their heart rate reserve (HRR), whereas participants assigned to the control intervention trained at 20-40% of their HRR. Participants in both groups received standard behavioral support and nicotine replacement therapy. MEASUREMENTS The primary outcome was biologically verified 7-day point prevalence abstinence (PPA) at 6-month follow-up. FINDINGS Sixty-one per cent of participants were available at the 6-month follow-up. PPA at 6 months was higher in the personalized intervention than the control intervention [27.6 versus 14.8%; odds ratio (OR) = 2.20, 95% confidence interval (CI) = 1.28, 3.80, P = 0.005], assuming missing at random. Anxiety sensitivity declined in both groups with no evidence that this differed between groups. CONCLUSIONS An exercise program of high intensity increased abstinence from smoking in people with high anxiety sensitivity, but may not have done so by reducing anxiety sensitivity.
- Published
- 2021
6. Sleep quality and outcome of exposure therapy in adults with social anxiety disorder
- Author
-
David Rosenfield, Daniel J. Taylor, Stefan G. Hofmann, Christina D. Dutcher, Alyson K. Zalta, Mark H. Pollack, Jasper A. J. Smits, Sheila M. Dowd, Alexander Perrone, and Michael W. Otto
- Subjects
6.6 Psychological and behavioural ,Phobia ,d-cycloserine ,medicine.medical_treatment ,Exposure therapy ,Psychological intervention ,social anxiety disorder ,exposure therapy ,treatment outcomes ,Extinction, Psychological ,law.invention ,0302 clinical medicine ,Randomized controlled trial ,law ,Psychology ,Depression (differential diagnoses) ,Psychiatry ,Depression ,Social anxiety ,Extinction ,sleep quality ,Fear ,Anxiety Disorders ,Sleep in non-human animals ,cycloserine ,Cognitive behavioral therapy ,Psychiatry and Mental health ,Clinical Psychology ,Mental Health ,Sleep Quality ,Treatment Outcome ,Sleep Research ,Clinical psychology ,Adult ,Clinical Sciences ,Implosive Therapy ,Affect (psychology) ,Article ,03 medical and health sciences ,Social ,Clinical Research ,Behavioral and Social Science ,medicine ,Humans ,d‐ ,business.industry ,Evaluation of treatments and therapeutic interventions ,Phobia, Social ,sleep difficulties ,cognitive behavioral therapy ,030227 psychiatry ,Psychological ,business ,Mind and Body ,030217 neurology & neurosurgery - Abstract
INTRODUCTION: Poor sleep is prevalent among individuals with social anxiety disorder (SAD) and may negatively affect exposure therapy outcomes. Poor sleep may impair memory and learning, and thus compromise fear extinction learning thought to take place in exposure therapy. We examined poor sleep as a predictor of exposure therapy outcomes for SAD and the moderating role of D-cycloserine (DCS) on this relationship. METHODS: Participants were 152 individuals with a primary diagnosis of SAD. As part of a randomized clinical trial evaluating the efficacy of DCS for enhancing the effects of exposure therapy, they completed self-report baseline measure of sleep quality, and self-report sleep diaries assessing sleep duration (total sleep time [TST]) and sleep quality the nights prior to and after treatment sessions. RESULTS: Poorer baseline sleep quality was significantly associated with slower improvement over time and worse symptom outcomes at the end of treatment and follow-up after controlling for baseline symptoms of depression and social anxiety. Greater TST the night prior to treatment predicted lower SAD symptoms at the next session, after controlling for symptoms at the previous session. There was no relation between prior or subsequent night sleep quality on symptoms at the next session. No associations were moderated by DCS. CONCLUSIONS: We replicated and extended findings indicating that poor sleep quality is associated with poorer exposure therapy outcomes for SAD. Assessing for sleep difficulties prior to treatment initiation and incorporating sleep interventions into treatment may enhance exposure therapy outcomes for SAD.
- Published
- 2021
7. Approach bias retraining to augment smoking cessation: A pilot randomized controlled trial
- Author
-
Jasper A.J. Smits, Mike Rinck, David Rosenfield, Christopher G. Beevers, Richard A. Brown, Haley E. Conroy Busch, Christina D. Dutcher, Alex Perrone, Michael J. Zvolensky, and Lorra Garey
- Subjects
Adult ,Pharmacology ,Experimental Psychopathology and Treatment ,Psychiatry and Mental health ,Smoking ,Humans ,Pilot Projects ,Smoking Cessation ,Pharmacology (medical) ,Tobacco Use Disorder ,Toxicology ,Tobacco Use Cessation Devices ,Article - Abstract
Item does not contain fulltext Background: Approach tendency to smoking-related cues has been associated with greater cravings, nicotine dependence, and the likelihood of relapse. In this pilot randomized clinical trial, we examined the efficacy of approach bias retraining (ABR; i.e., increasing avoidance tendency) for enhancing standard smoking cessation treatment (ST). Methods: Adult smokers (N = 96) motivated to quit were randomly assigned to 7 weekly in-person treatment sessions consisting of either (1) cognitive-behavioral therapy for smoking cessation (ST) and ABR (ST+ABR) or ST and sham retraining (ST+Sham). All participants also received optional nicotine replacement therapy for up to 8 weeks following the scheduled quit date (week 6). We measured avoidance tendency from weeks 1-7. Point prevalence abstinence (PPA) and prolonged abstinence (PA) were measured up to 3 months following the quit attempt (week 18 follow-up). Results: Consistent with our hypothesis, participants in ST+ABR evidenced higher abstinence rates than those in ST+Sham at the final follow-up (b=0.71, 95 % CI: [0.14, 1.27], t[1721]=2.46, p = 0.014, OR=2.03, 95 % CI: [1.15, 3.57]). Specifically, PPA and PA rates were 50 % and 66 % in ST+ABR compared to 31 % and 47 % in ST+Sham. As expected, participants assigned to the ST+ABR condition also showed a greater training-compatible increase in avoidance tendency scores relative to those assigned to the ST+Sham condition (b=248.06, 95 % CI: [148.51, 347,62], t[84]=4.96, p
- Published
- 2022
8. Effect of d-cycloserine on fear extinction training in adults with social anxiety disorder
- Author
-
David Rosenfield, Sheila M. Dowd, Mark H. Pollack, Jasper A. J. Smits, Christina D. Dutcher, Mara Lewis, Joseph K. Carpenter, Michael Otto, Stefan G. Hofmann, Sara M. Witcraft, and Santiago Papini
- Subjects
Male ,Receptor complex ,Light ,Antimetabolites ,medicine.medical_treatment ,Exposure therapy ,Social Sciences ,Audiology ,Extinction, Psychological ,0302 clinical medicine ,Cognition ,Learning and Memory ,Behavioral Conditioning ,Medicine and Health Sciences ,Medicine ,Psychology ,Fear conditioning ,Multidisciplinary ,Physics ,Electromagnetic Radiation ,Social anxiety ,Galvanic Skin Response ,Anxiety Disorders ,Artificial Light ,Physical Sciences ,Memory Recall ,Female ,Research Article ,Social Anxiety Disorder ,Adult ,medicine.medical_specialty ,Science ,Context (language use) ,Neuropsychiatric Disorders ,Neuroses ,03 medical and health sciences ,Human Learning ,Double-Blind Method ,Memory ,Mental Health and Psychiatry ,Learning ,Humans ,Behavior ,Recall ,business.industry ,Cognitive Psychology ,Biology and Life Sciences ,Phobia, Social ,Extinction (psychology) ,Placebo Effect ,030227 psychiatry ,Cycloserine ,Mental Recall ,Conditioning ,Conditioned Response ,Cognitive Science ,business ,Fear Conditioning ,030217 neurology & neurosurgery ,Photic Stimulation ,Neuroscience - Abstract
Preclinical and clinical data have shown that D-cycloserine (DCS), a partial agonist at the N-methyl-d-aspartate receptor complex, augments the retention of fear extinction in animals and the therapeutic learning from exposure therapy in humans. However, studies with non-clinical human samples in de novo fear conditioning paradigms have demonstrated minimal to no benefit of DCS. The aim of this study was to evaluate the effects of DCS on the retention of extinction learning following de novo fear conditioning in a clinical sample. Eighty-one patients with social anxiety disorder were recruited and underwent a previously validated de novo fear conditioning and extinction paradigm over the course of three days. Of those, only 43 (53%) provided analyzable data. During conditioning on Day 1, participants viewed images of differently colored lamps, two of which were followed by with electric shock (CS+) and a third which was not (CS-). On Day 2, participants were randomly assigned to receive either 50 mg DCS or placebo, administered in a double-blind manner 1 hour prior to extinction training with a single CS+ in a distinct context. Day 3 consisted of tests of extinction recall and renewal. The primary outcome was skin conductance response to conditioned stimuli, and shock expectancy ratings were examined as a secondary outcome. Results showed greater skin conductance and expectancy ratings in response to the CS+ compared to CS- at the end of conditioning. As expected, this difference was no longer present at the end of extinction training, but returned at early recall and renewal phases on Day 3, showing evidence of return of fear. In contrast to hypotheses, DCS had no moderating influence on skin conductance response or expectancy of shock during recall or renewal phases. We did not find evidence of an effect of DCS on the retention of extinction learning in humans in this fear conditioning and extinction paradigm.
- Published
- 2019
9. Childhood trauma and distress tolerance in a trauma-exposed acute-care psychiatric inpatient sample
- Author
-
Kenneth S. Kendler, Christina D. Dutcher, R. Emily Gonzalez, Nadia Chowdhury, Salpi Kevorkian, Lance M. Rappaport, Erin C. Berenz, Anka A. Vujanovic, Ananda B. Amstadter, and Danielle M. Dick
- Subjects
Adult ,Male ,Child abuse ,050103 clinical psychology ,medicine.medical_specialty ,Adolescent ,Social Psychology ,media_common.quotation_subject ,Article ,Neglect ,Young Adult ,03 medical and health sciences ,0302 clinical medicine ,medicine ,Humans ,0501 psychology and cognitive sciences ,Risk factor ,Psychiatry ,Psychological abuse ,Child neglect ,Aged ,Retrospective Studies ,media_common ,Inpatients ,business.industry ,Mental Disorders ,05 social sciences ,Middle Aged ,Resilience, Psychological ,030227 psychiatry ,Hospitalization ,Clinical Psychology ,Distress ,Cross-Sectional Studies ,Physical abuse ,Adult Survivors of Child Adverse Events ,Sexual abuse ,Female ,business ,Clinical psychology - Abstract
Objective Distress tolerance (DT; the perceived or actual ability to withstand negative internal states) has emerged as a promising transdiagnostic risk factor in clinically severe populations. However, little is known about etiological factors associated with the development of DT. We hypothesized that greater levels of childhood trauma would be associated with lower perceived and behavioral DT, beyond theoretically relevant covariates. Method The current investigation evaluated several childhood trauma types (i.e., physical abuse, sexual abuse, emotional abuse, physical neglect, and emotional neglect) in relation to perceived (i.e., self-report) and behavioral DT in a sample of 87 trauma-exposed adults in acute-care psychiatric inpatient treatment. Results Results of hierarchical linear regression models indicated that greater childhood physical abuse and emotional neglect were significantly associated with higher perceived DT. Greater levels of emotional abuse were associated with lower perceived DT, and greater physical neglect was associated with lower behavioral DT. Conclusions DT may be differentially influenced by different forms of childhood trauma. (PsycINFO Database Record
- Published
- 2018
10. A Multimodal Study of Childhood Trauma and Distress Tolerance in Young Adulthood
- Author
-
Kenneth S. Kendler, Christina D. Dutcher, Ananda B. Amstadter, Lance M. Rappaport, Erin C. Berenz, Rose Emily Gonzalez, Salpi Kevorkian, Anka A. Vujanovic, Danielle M. Dick, and Nadia Chowdhury
- Subjects
Child abuse ,050103 clinical psychology ,medicine.medical_specialty ,medicine.diagnostic_test ,Paced Auditory Serial Addition Test ,05 social sciences ,Poison control ,Health Professions (miscellaneous) ,Article ,Psychiatry and Mental health ,Clinical Psychology ,Physical abuse ,Sexual abuse ,Injury prevention ,medicine ,Domestic violence ,0501 psychology and cognitive sciences ,Young adult ,Psychology ,Psychiatry ,050104 developmental & child psychology - Abstract
Individuals with a history of childhood trauma experience deficits in emotion regulation. However, few studies have investigated childhood trauma and both perceived (i.e., self-report) and behavioral measures of distress tolerance. The current study evaluated associations between childhood trauma (i.e., physical abuse, sexual abuse, and witnessing family violence) and measures of perceived (Distress Tolerance Scale) and behavioral distress tolerance (i.e., Paced Auditory Serial Addition Test, breath-holding). Participants were 320 undergraduate students with a history of interpersonal trauma (e.g., sexual/physical assault). Structural equation modeling was used to evaluate associations between frequency of childhood trauma type and distress tolerance. Greater childhood physical abuse was associated with higher perceived distress tolerance. Greater levels of witnessing family violence were associated with lower behavioral distress tolerance on the breath-holding task. No significant effects were found for Paced Auditory Serial Addition Test performance. Associations between childhood trauma and emotion regulation likely are complex and warrant further study.
- Published
- 2017
11. Approach bias retraining to augment smoking cessation: Study protocol for a randomized controlled trial
- Author
-
David Rosenfield, Christopher G. Beevers, Christina D. Dutcher, Mike Rinck, Haley E. Conroy, Jasper A. J. Smits, Scarlett O. Baird, Noura Alavi, Richard A. Brown, and Slaton Z. Freeman
- Subjects
medicine.medical_specialty ,medicine.medical_treatment ,media_common.quotation_subject ,Article ,law.invention ,03 medical and health sciences ,0302 clinical medicine ,Physical medicine and rehabilitation ,Randomized controlled trial ,law ,medicine ,030212 general & internal medicine ,media_common ,Pharmacology ,Protocol (science) ,lcsh:R5-920 ,business.industry ,Addiction ,Retraining ,General Medicine ,Abstinence ,Nicotine replacement therapy ,3. Good health ,Smoking cessation ,Augment ,lcsh:Medicine (General) ,business ,030217 neurology & neurosurgery - Abstract
Heavy users and addicted individuals have shown to develop an approach action tendency – or approach bias – toward stimuli related to the substance of interest. Emerging evidence points to approach bias retraining (ABR) as an effective aid for the treatment of addictive behaviors. The current study seeks to extend this work by testing, in a pilot study, whether standard smoking cessation treatment involving cognitive-behavioral therapy (CBT) and nicotine replacement therapy can be augmented by ABR. To this end, we will randomly assign 100 adult smokers to either ABR-augmented treatment or placebo-augmented treatment and compare the two conditions on short-term and long-term abstinence rates. The hope is that the findings of this study can inform treatment development for adult smokers.
- Published
- 2018
12. Network analysis reveals the associations of past quit experiences on current smoking behavior and motivation to quit
- Author
-
Christina D. Dutcher, Catherine S. Gebhardt, Santiago Papini, and Jasper A. J. Smits
- Subjects
Motivation ,Smokers ,media_common.quotation_subject ,Smoking ,Psychological intervention ,Medicine (miscellaneous) ,Smoking Prevention ,Craving ,Negative association ,Abstinence ,Toxicology ,United States ,Article ,Smoking behavior ,Psychiatry and Mental health ,Clinical Psychology ,Digestive problems ,behavior and behavior mechanisms ,medicine ,Humans ,Smoking Cessation ,medicine.symptom ,Psychology ,Clinical psychology ,media_common - Abstract
Introduction Smoking is a leading cause of morbidity and mortality in the United States. While most smokers endorse a desire to quit, achieving abstinence is notoriously difficult. Network analysis is a method for understanding the complex relationships of factors that maintain smoking behavior and impact motivation to quit. Methods This study examined self-report prescreen data from treatment-seeking smokers (N = 3913). The number of prior quit attempts and withdrawal symptoms experienced, as well as current smoking behavior and motivation to quit were modeled as interconnected nodes in a network. Two key network metrics were examined: 1) edge weights, which quantify the strength and direction of the associations of interest, and 2) the sum of each node’s edge weights, which quantifies the expected influence of a node on the overall network. Results The withdrawal symptom of craving, r = 0.10, 95% CI [0.07, 0.13] and digestive problems, r = −0.06, 95% CI [−0.09, −0.03], had the strongest positive and negative association with daily cigarettes, respectively. The number of prior quit attempts, r = 0.17, 95% CI [0.14, 0.20], concentration problems, r = −0.04, 95% CI [−0.027, −0.01], showed the strongest positive and negative associations, respectively, with current motivation to quit. Nodes with significant links to current smoking and motivation to quit were also among the most influential in the overall network. Conclusions Findings suggest prior quit experiences and consequences associated with withdrawal symptoms may differentially relate to maintenance of smoking behavior and motivation to quit in treatment-seeking smokers. Interventions targeting key withdrawal symptoms may enhance motivation to quit.
- Published
- 2021
13. Dose Timing of <scp>D</scp>-Cycloserine to Augment Exposure Therapy for Social Anxiety Disorder
- Author
-
Mark H. Pollack, Stefan G. Hofmann, Christina D. Dutcher, Shelley Kind, Kristina Conroy, Leigh A. Andrews, David Rosenfield, Joshua Curtiss, Sheila M. Dowd, Sara M. Witcraft, Elizabeth M. Lewis, Santiago Papini, Joseph K. Carpenter, Jasper A. J. Smits, and Michael Otto
- Subjects
medicine.medical_specialty ,business.industry ,medicine.medical_treatment ,Exposure therapy ,Social anxiety ,Psychological intervention ,Liebowitz social anxiety scale ,General Medicine ,Placebo ,law.invention ,Randomized controlled trial ,law ,Pill ,medicine ,Physical therapy ,Dosing ,business - Abstract
Importance Findings suggest that the efficacy of D-cycloserine (DCS) for enhancing exposure therapy may be strongest when administered after sessions marked by low fear at the conclusion of exposure practice. These findings have prompted investigation of DCS dosing tailored to results of exposure sessions. Objective To compare tailored postsession DCS administration with presession DCS administration, postsession DCS administration, and placebo augmentation of exposure therapy for social anxiety disorder. Design, Setting, and Participants This double-blind randomized clinical trial involved adults with social anxiety disorder enrolled at 3 US university centers. Symptom severity was assessed at baseline, weekly during treatment, and at 1-week and 3-month follow-up. Data analysis was performed from September 2019 to March 2020. Interventions Participants completed a 5-session treatment and received pills commensurate with their condition assignment at sessions 2 through 5, which emphasized exposure practice. Main Outcomes and Measures Symptom severity was evaluated by the Liebowitz Social Anxiety Scale and Social Phobic Disorders-Severity Form as administered by independent evaluators. Results A total of 152 participants were enrolled (mean [SD] age, 29.24 [10.16] years; 84 men [55.26%]). Compared with placebo, presession and postsession conditions showed greater symptom improvement (b = −0.25; 95% CI, −0.37 to −0.13;P Conclusions and Relevance Administration of DCS enhanced exposure therapy for social anxiety disorder when given before or after the exposure session. However, the study failed to achieve the aim to develop a tailored clinical application. Trial Registration ClinicalTrials.gov Identifier:NCT02066792
- Published
- 2020
14. Enhancing panic and smoking reduction treatment with D-Cycloserine: A pilot randomized clinical trial
- Author
-
David Rosenfield, Eunjung Lee-Furman, Michael J. Zvolensky, Santiago Papini, Christina D. Dutcher, Megan E. Piper, Benjamin Rosenfield, Jasper A. J. Smits, Brooke Y. Kauffman, Michael Otto, Scarlett O. Baird, and Noura Alavi
- Subjects
Adult ,Male ,medicine.medical_specialty ,Adolescent ,Interoceptive exposure ,medicine.medical_treatment ,Pilot Projects ,Toxicology ,Placebo ,Article ,law.invention ,Young Adult ,03 medical and health sciences ,0302 clinical medicine ,Double-Blind Method ,Randomized controlled trial ,law ,Internal medicine ,Humans ,Medicine ,Pharmacology (medical) ,030212 general & internal medicine ,Smoking Reduction ,Pharmacology ,Smokers ,Cognitive Behavioral Therapy ,business.industry ,Smoking ,Panic ,Middle Aged ,Nicotine replacement therapy ,Anxiety Disorders ,Combined Modality Therapy ,Psychiatry and Mental health ,Treatment Outcome ,Cycloserine ,Anxiety sensitivity ,Panic Disorder ,Smoking cessation ,Female ,Smoking Cessation ,medicine.symptom ,business ,030217 neurology & neurosurgery - Abstract
In this placebo-controlled randomized clinical trial, we examined the efficacy of 250 mg d-cycloserine (DCS) for enhancing the effects of cognitive behavior therapy targeting anxiety sensitivity reduction in the context of smoking cessation treatment among adults with a history of panic attacks. We hypothesized that DCS would enhance treatment of our mechanistic targets-anxiety sensitivity and panic and related symptoms-and result in greater smoking abstinence. A total of 53 smokers were randomized to a 7-week integrated treatment and received study medication (DCS or placebo) prior to sessions 3-5; these sessions emphasized interoceptive exposure practice. Nicotine replacement therapy was initiated at session 5 (quit date). We found that DCS augmentation led to greater reductions of one (anxiety sensitivity) of two of our mechanistic targets at early but not late assessments, and that engaging that target predicted better smoking outcomes. However, there was no evidence of group (DCS vs. placebo) differences in smoking cessation success at treatment endpoint or follow-up evaluations. Hence, although we found that DCS can enhance treatment targeting a smoking maintaining factor, additional strategies appear to be needed to significantly affect smoking outcomes.
- Published
- 2020
15. YMCA exercise intervention to augment smoking cessation treatment in adults with high anxiety sensitivity: Study protocol for a randomized controlled trial
- Author
-
David Rosenfield, Christina D. Dutcher, Michael J. Zvolensky, Richard A. Brown, Haley E. Conroy, Slaton Z. Freeman, Jasper A. J. Smits, and Noura Alavi
- Subjects
Research design ,Adult ,Counseling ,Male ,medicine.medical_specialty ,Adolescent ,medicine.medical_treatment ,MEDLINE ,Anxiety ,law.invention ,03 medical and health sciences ,Young Adult ,0302 clinical medicine ,Sex Factors ,Randomized controlled trial ,law ,medicine ,Humans ,Pharmacology (medical) ,030212 general & internal medicine ,Young adult ,030505 public health ,business.industry ,Age Factors ,General Medicine ,Middle Aged ,Nicotine replacement therapy ,Tobacco Use Cessation Devices ,Exercise Therapy ,Socioeconomic Factors ,Research Design ,Physical therapy ,Anxiety sensitivity ,Smoking cessation ,Female ,Smoking Cessation ,medicine.symptom ,0305 other medical science ,business - Abstract
Extant evidence suggests that exercise can reduce anxiety related vulnerability factors, such as anxiety sensitivity (AS), or fear of bodily sensations related to anxiety, that negatively impact smoking cessation outcomes. Building upon emerging evidence supporting the efficacy of exercise as an aid for smoking cessation in adults with high AS, we are conducting a trial to examine the efficacy and feasibility of this clinical application when implemented in a community setting. Partnering with the YMCA, this study aims to enroll 150 adults in a standard smoking cessation protocol (i.e. counseling and nicotine replacement therapy) and randomly assign them to either 15 weeks of programmed vigorous-intensity or low-intensity exercise. Smoking abstinence data will be collected up to 6 months following the quit attempt.
- Published
- 2018
16. The effects of exercise on transdiagnostic treatment targets: A meta-analytic review
- Author
-
Emily Carl, Aliza T. Stein, Mike Dinh, Christina D. Dutcher, Jasper A. J. Smits, Jolene Jacquart, and Slaton Z. Freeman
- Subjects
Distress tolerance ,050103 clinical psychology ,medicine.medical_specialty ,Experimental and Cognitive Psychology ,Cochrane Library ,Anxiety ,law.invention ,03 medical and health sciences ,0302 clinical medicine ,Treatment targets ,Randomized controlled trial ,law ,Medicine ,Humans ,0501 psychology and cognitive sciences ,Exercise ,Randomized Controlled Trials as Topic ,Self-efficacy ,Exercise intervention ,business.industry ,05 social sciences ,Self Efficacy ,Psychiatry and Mental health ,Clinical Psychology ,Anxiety sensitivity ,Physical therapy ,business ,Stress reactivity ,030217 neurology & neurosurgery ,Stress, Psychological - Abstract
The present study meta-analytically reviewed the effects of exercise on four transdiagnostic treatment targets: anxiety sensitivity (AS), distress tolerance (DT), stress reactivity (SR), and general self-efficacy (GSE).We conducted systematic searches of peer-reviewed studies in bibliographical databases (Cochrane Library, psychINFO, PubMed) before April 1, 2018. Only randomized controlled trials (RCT) evaluating the effect of exercise on AS, DT, SR, or GSE using at least one validated outcome instrument in a sample of adolescents (≥13 years old) or adults were selected. We employed a meta-analysis of effects using random-effects pooling modeling for each treatment target.The systematic search yielded 28 RCTs meeting eligibility criteria. Exercise interventions had a large effect on reducing AS (six studies, Hedges's g = 0.72, p = .001), a medium effect on increasing GSE (eight studies, Hedges's g = 0.59, p .001), and a small effect on reducing SR (ten studies, Hedges's g = 0.32, p .001). Evidence from four studies suggested that exercise interventions had a small but non-significant effect on increasing DT (Hedges's g = 0.21, p = .26).This meta-analysis provides preliminary evidence exercise can engage certain transdiagnostic targets. Further research is required to optimize exercise intervention parameters to achieve the strongest effects on these important mechanistic variables.
- Published
- 2018
17. Childhood maltreatment severity and alcohol use in adult psychiatric inpatients: The mediating role of emotion regulation difficulties
- Author
-
Christina D. Dutcher, Daniel J. Paulus, Brooke A. Bartlett, and Anka A. Vujanovic
- Subjects
Adult ,Male ,050103 clinical psychology ,medicine.medical_specialty ,Alcohol Drinking ,Poison control ,Alcohol ,Psychological Trauma ,Suicide prevention ,Severity of Illness Index ,Occupational safety and health ,Self-Control ,03 medical and health sciences ,chemistry.chemical_compound ,Young Adult ,0302 clinical medicine ,Injury prevention ,medicine ,Humans ,0501 psychology and cognitive sciences ,Affective Symptoms ,Association (psychology) ,Psychiatry ,Inpatients ,Adult Survivors of Child Abuse ,Mental Disorders ,05 social sciences ,Human factors and ergonomics ,Checklist ,030227 psychiatry ,Psychiatry and Mental health ,chemistry ,Female ,Psychology ,Alcohol-Related Disorders ,Clinical psychology - Abstract
Objective Emotion regulation difficulties are a potentially key mechanism underlying the association between childhood maltreatment and alcohol use in adulthood. The current study examined the mediating role of emotion regulation difficulties in the association between childhood maltreatment severity (i.e., Childhood Trauma Questionnaire total score) and past-month alcohol use severity, including alcohol consumption frequency and alcohol-related problems (i.e., number of days of alcohol problems, ratings of “bother” caused by alcohol problems, ratings of treatment importance for alcohol problems). Method Participants included 111 acute-care psychiatric inpatients (45.0% female; Mage = 33.5, SD = 10.6), who reported at least one DSM-5 posttraumatic stress disorder Criterion A traumatic event, indexed via the Life Events Checklist for DSM-5. Participants completed questionnaires regarding childhood maltreatment, emotion regulation difficulties, and alcohol use. Results A significant indirect effect of childhood maltreatment severity via emotion regulation difficulties in relation to alcohol use severity (β = 0.07, SE = 0.04, 99% CI [0.01, 0.21]) was documented. Specifically, significant indirect effects were found for childhood maltreatment severity via emotion regulation difficulties in relation to alcohol problems (β's between 0.05 and 0.12; all 99% bootstrapped CIs with 10,000 resamples did not include 0) but not alcohol consumption. Conclusion Emotion regulation difficulties may play a significant role in the association between childhood maltreatment severity and alcohol outcomes. Clinical implications are discussed.
- Published
- 2016
Catalog
Discovery Service for Jio Institute Digital Library
For full access to our library's resources, please sign in.