167 results on '"Marlatt Ga"'
Search Results
2. Interventions to reduce harm associated with adolescent substance use
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Toumbourou, JW, Stockwell, T, Neighbors, C, Marlatt, GA, Sturge, J, and Rehm, J
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- 2007
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3. Maintenance of Smoking Cessation
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Baer Js and Marlatt Ga
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Pulmonary and Respiratory Medicine ,Coping (psychology) ,medicine.medical_specialty ,business.industry ,medicine.medical_treatment ,media_common.quotation_subject ,Office visits ,Debriefing ,Limiting ,Abstinence ,Risk profile ,medicine ,Smoking cessation ,business ,Psychiatry ,Goal setting ,media_common - Abstract
SUMMARY Relapse is a frequently encountered problem in smoking cessation. With a cognitive-behavioral model of the relapse process, we can describe high-risk situations where smoking first recurs, the process by which people end up in these situations, and typical responses to violations of abstinence. The model posits that individuals are actively coping with situation-specific urges to smoke that result from prior conditioning. Individuals’ beliefs in their ability to cope with urges are critical. Clinical strategies based on the model include assessment of risk profiles, understanding and anticipating high-risk situations, debriefing and reinterpreting lapses in abstinence, and limiting risk through lifestyle changes. These strategies can be incorporated into brief medical office visits. Recommended procedures include systematic but brief assessment, encouragement, goal setting, planning for risk, reinterpreting lapses, recommendations for lifestyle changes, and follow-up appointments.
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- 1991
4. Maintaining Sobriety: Stopping Is Starting
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Marlatt Ga and Mackay Pw
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Adult ,Male ,medicine.medical_specialty ,Psychotherapist ,Psychological intervention ,Aftercare ,Social Support ,Medicine (miscellaneous) ,Context (language use) ,Models, Psychological ,Relapse prevention ,Treatment failure ,Primary Prevention ,Alcoholism ,Crisis Intervention ,Sobriety ,Predictive Value of Tests ,Recurrence ,Risk Factors ,Intervention (counseling) ,medicine ,Humans ,Effective treatment ,Psychiatry ,Psychology - Abstract
Treatment of alcohol problems typically focuses on the cessation of drinking. Although cessation is necessary and important to achieving sobriety, this article suggests that maintenance of sobriety is a crucial, but oft ignored, component of effective treatment. Alcohol relapse is discussed in the context of aftercare treatment employing a relapse prevention approach. Within this model, relapse is not automatically defined as a treatment failure but as an opportunity for intervention and the interruption of the relapse process. Determinants and predictors of relapse are discussed, and assessment and intervention strategies provided. A case study illustrates the components of the relapse process and the interventions employed to maintain continued sobriety. [Translations are provided; see the International Abstracts at the end of this issue.]
- Published
- 1991
5. Mindfulness and metaphor in relapse prevention: An interview with G. Alan Marlatt
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Marlatt Ga
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Nutrition and Dietetics ,Mindfulness ,Psychotherapist ,Metaphor ,media_common.quotation_subject ,Psychology ,Relapse prevention ,Food Science ,media_common - Published
- 1994
6. Health Care Workers and Addiction
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Marlatt Ga and Joseph O. Merrill
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Addiction medicine ,medicine.medical_specialty ,business.industry ,Addiction ,media_common.quotation_subject ,Health care ,Self care ,Medicine ,General Medicine ,business ,Psychiatry ,media_common - Published
- 2002
7. Integrating contingency management with relapse prevention skills: Comment on Silverman et al. (2001)
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Marlatt Ga
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Pharmacology ,Research design ,medicine.medical_specialty ,Psychotherapist ,media_common.quotation_subject ,Contingency management ,Abstinence ,medicine.disease ,Relapse prevention ,Substance abuse ,Voucher ,Psychiatry and Mental health ,Sobriety ,Intervention (counseling) ,medicine ,Pharmacology (medical) ,Psychology ,Psychiatry ,media_common - Abstract
The study by K. Silverman, D. Svikis, E. Robles, M. L. Stitzer, and G. E. Bigelow (2001) demonstrates the effectiveness of a voucher-based reinforcement intervention in the treatment of pregnant women in treatment for substance abuse. The effects of prolonged initial abstinence as a form of "sobriety sampling" may serve to enhance long-term recovery by providing patients with rewards for maintaining abstinence. Several limitations to the study are addressed, including selection of the treatment sample and the absence of any follow-up data on drug use or relapse following completion of the 24-week treatment program. Recommendations are made to enhance maintenance of abstinence by providing coping-skill training for relapse prevention as an addition to the contingency management approach.
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- 2001
8. Update on harm-reduction policy and intervention research.
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Marlatt GA and Witkiewitz K
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- 2010
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9. Regular tobacco use among American Indian and Alaska Native adolescents: an examination of protective mechanisms.
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Osilla KC, Lonczak HS, Mail PD, Larimer ME, and Marlatt GA
- Abstract
American Indian and Alaska Native (AIAN) adolescents use tobacco at earlier ages and in larger quantities compared to nonAIAN peers. Regular tobacco use was examined against five protective factors (peer networks supportive of not using drugs, college aspirations, team sports, playing music, and volunteerism). Participants consisted of 112 adolescents between the ages of 13 and 19 who participated in a study testing the efficacy of a life-skills program aimed at reducing substance-related consequences. Findings indicated that, with the exception of prosocial peer networks and volunteerism, each of the above factors was significantly associated with a reduced probability of being a regular tobacco user. Gender differences were notable. These results hold important treatment implications regarding the reduction and prevention of tobacco use among AIAN youth. [ABSTRACT FROM AUTHOR]
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- 2007
10. New developments in prevention and early intervention for alcohol abuse in youths.
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Stewart SH, Conrod PJ, Marlatt GA, Comeau MN, Thush C, and Krank M
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This article summarizes a symposium held at the 2004 Annual Meeting of the Research Society on Alcoholism in Vancouver, British Columbia, Canada. It was prepared by the conference co-organizers/co-chairs with substantial input from each of the symposium participants. Increasingly, alcohol abuse interventions focus on preventing alcohol problems or intervening early before risky drinking behavior becomes ingrained. Universal prevention programs have produced no or only modest effects on the drinking behavior of youths. Although some existing targeted prevention programs have proved effective, they have not tapped the full range of potential intervention targets, such as the underlying motivations for alcohol misuse in youths who are at greatest risk. The set of papers presented in this symposium outline exciting new developments in the field of targeted prevention and early intervention programs for adolescent drinking problems, presented by an international panel of researchers. These developments include attention to making interventions relevant to adolescents' lives, focus on personality and motivational factors underlying alcohol misuse, and combining existing cognitive behavioral programs with expectancy challenge and motivational interviewing techniques. [ABSTRACT FROM AUTHOR]
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- 2005
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11. New constructs and assessments for relapse and continued use potential in the ASAM Patient Placement Criteria.
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Gastfriend DR, Rubin A, Sharon E, Turner WM, Anton RF, Donovan DM, Gorski T, Marlatt GA, Maisto S, Schultz TK, and Shulman GD
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One area of intensive study in recent years in addiction research is the characterization and prediction of relapse risk. Given the growing list of findings and assessment tools in this area, in preparation for the second edition, revised volume of the Patient Placement Criteria (PPC) of the American Society of Addiction Medicine (ASAM), a workgroup of the Coalition for National Criteria was assigned the task of creating a revised conceptual organization for Dimension 5: Relapse/ Continued Use Potential. The workgroup conducted a review of the previous Dimension 5 constructs and criteria, including a decision analysis of the previous Dimension 5 decision rules. Following that analysis, field data from the ASAM Criteria Validity Study at Massachusetts General Hospital and Harvard Medical School were analyzed from a large cohort of public and indigent patients in eastern Massachusetts. After determining the concurrent validity of the Dimension 5 decision rules and their limitations, the decision rules were rewritten to gain improved validity. This exercise revealed techniques that can and should be used to improve the discrimination of levels of care among all Dimensions. Finally, the workgroup expanded and refined the constructs that should comprise a revised Dimension 5. This revised list of constructs is sequential and hierarchical. It offers face validity on several levels of current basic and clinical research knowledge: behavioral pharmacology, behavioral psychology, learning theory and psychopathology. While the Second Edition-Revised volume of the ASAM PPC (PPC-2R) does not go so far as to propose final decision rules for Dimension 5 based on these new constructs, it does recommend pilot adoption of several new assessment tools for this dimension and provides the framework incorporating those constructs and assessments in the next complete PPC edition. [ABSTRACT FROM AUTHOR]
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- 2003
12. Drinking among young adults: prevalence, patterns, and consequences.
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Quigley LA and Marlatt GA
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Young adults have a higher prevalence of alcohol consumption and binge drinking than any other age group. They also drink more heavily and experience more negative consequences of drinking. Rates of alcohol abuse and dependence are disproportionately higher among those between the ages of 18 and 29 compared with other age groups. Young adults are also overrepresented among alcohol-related traffic fatalities. Over time, distinct patterns of change in frequent binge drinking occur, and most heavydrinking young adults appear to 'mature out' of abusive drinking patterns as the responsibilities of later adulthood supervene. Drinking patterns are affected by demographic, psychological, behavioral, and social factors as well as minimum drinking age legislation and the cost of alcohol Motivational programs designed to reduce risks and consequences associated with young-adult drinking may help in reducing alcohol consumption and its consequences. [ABSTRACT FROM AUTHOR]
- Published
- 1996
13. Effects of anxiety arousal on the consumption of alcohol by alcoholics and social drinkers
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Higgins Rl and Marlatt Ga
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Male ,Alcohol Drinking ,Personality Inventory ,Poison control ,Alcohol ,Anxiety ,Suicide prevention ,Arousal ,chemistry.chemical_compound ,Injury prevention ,medicine ,Humans ,Social Behavior ,Consumption (economics) ,Electroshock ,Ethanol ,Human factors and ergonomics ,medicine.disease ,Alcoholism ,Psychiatry and Mental health ,Clinical Psychology ,chemistry ,Test Anxiety Scale ,Medical emergency ,medicine.symptom ,Psychology ,Stress, Psychological ,Personality ,Clinical psychology - Published
- 1973
14. Effects of varied extinction conditions with alcoholics and social drinkers
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Okulitch Pv and Marlatt Ga
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Adult ,Male ,Alcohol Drinking ,Punishment (psychology) ,medicine.medical_treatment ,Aversive Therapy ,Aversion therapy ,Poison control ,Hangovers ,Suicide prevention ,Extinction, Psychological ,Punishment ,Reward ,Injury prevention ,medicine ,Humans ,Social Behavior ,Reinforcement ,Biological Psychiatry ,Extinction (psychology) ,Middle Aged ,medicine.disease ,Alcoholism ,Clinical Psychology ,Psychiatry and Mental health ,Conditioning, Operant ,Psychology ,Social psychology ,Clinical psychology - Abstract
The persistence of drinking behavior in the alcoholic has been described in terms of modern learning theory by a number of investigators (e.g., Kepner, 1964; Kingham, 1958). Although unpleasant and noxious consequences (ranging from hangovers to general disruption in the life of the drinker) are typically associated with prolonged drinking in the alcoholic, it is assumed that the immediate reinforcement effects of alcohol consumption exert greater influence than the delayed punishment effects (Conger, 1956). A basic assumption of aversion therapy procedures in the treatment of alcoholism is that presentation of immediate punishment (emetic drugs, electric shock) in contiguity with alcohol will produce a conditioned fear response leading to the suppression of drinking or the avoidance of alcohol (Rachman & Teasdale, 1969). A question which remains to be studied, however, is the extent to which alcoholics respond to conditions of immediate punishment, compared to nonalcoholics. Any differences which might obtain from such a comparison would have important implications for the use of aversion therapy with alcoholics. In an investigation of the effects of immediate and delayed punishment in alcoholics and normal controls, Vogel-Sprott and Banks
- Published
- 1972
15. Journeys of the Circle: a culturally congruent life skills intervention for adolescent Indian drinking.
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Marlatt GA, Larimer ME, Mail PD, Hawkins EH, Cummins LH, Blume AW, Lonczak HS, Burns KM, Chan KK, Cronce JM, La Marr CJ, Radin S, Forquera R, Gonzales R, Tetrick C, and Gallion S
- Abstract
There has been an increasing call for and development of culturally appropriate substance prevention/intervention for ethnic minorities in schools and communities, especially among reservation and in urban American Indian and Alaska Native (AIAN) communities. Past attempts to intervene in and reduce misuse of alcohol and other drugs have not had great success. The Journeys of the Circle Project utilized innovative programs with a strong emphasis on historic cultural traditions. [ABSTRACT FROM AUTHOR]
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- 2003
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16. Study examines self-medication hypothesis in teen substance abusers
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McCarthy, D.M., Marlatt, GA, and Tomlinson, K.L.
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Teenagers -- Drug use -- Psychological aspects -- Health aspects ,Youth -- Drug use -- Psychological aspects -- Health aspects ,Self medication -- Health aspects -- Psychological aspects ,Drugs and youth -- Causes of -- Care and treatment -- Prevention ,Substance abuse -- Care and treatment ,Health ,Psychology and mental health - Abstract
Psychiatric symptoms are one factor influencing substance choice in posttreatent relapse for alcohol- and drug-disordered teens with comorbid mental health disorders, according to research published in the Psychology of Addictive [...]
- Published
- 2006
17. Female dignity as a motivational force
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Løberg, T, Miller, WR, Nathan, PE, Marlatt, GA, Ødegård, Tone, Skinstad, Anne Helene, Hansen, Ebba Holme, Løberg, T, Miller, WR, Nathan, PE, Marlatt, GA, Ødegård, Tone, Skinstad, Anne Helene, and Hansen, Ebba Holme
- Published
- 1989
18. Commentary. Why and how do substance abuse treatments work? Investigating mediated change.
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Witkiewitz K and Marlatt GA
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- 2008
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19. Health care workers and addiction.
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Merrill JO, Marlatt GA, and Verghese A
- Published
- 2002
20. Relapse prevention: an overview of Marlatt's Cognitive-Behavioral Model.
- Author
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Larimer ME, Palmer RS, and Marlatt GA
- Abstract
Relapse prevention (RP) is an important component of alcoholism treatment. The RP model proposed by Marlatt and Gordon suggests that both immediate determinants (e.g., high-risk situations, coping skills, outcome expectancies, and the abstinence violation effect) and covert antecedents (e.g., lifestyle factors and urges and cravings) can contribute to relapse. The RP model also incorporates numerous specific and global intervention strategies that allow therapist and client to address each step of the relapse process. Specific interventions include identifying specific high-risk situations for each client and enhancing the client's skills for coping with those situations, increasing the client's self-efficacy, eliminating myths regarding alcohol's effects, managing lapses, and restructuring the client's perceptions of the relapse process. Global strategies comprise balancing the client's lifestyle and helping him or her develop positive addictions, employing stimulus control techniques and urge-management techniques, and developing relapse road maps. Several studies have provided theoretical and practical support for the RP model. [ABSTRACT FROM AUTHOR]
- Published
- 1999
21. Enactment of home practice following mindfulness-based relapse prevention and its association with substance-use outcomes.
- Author
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Grow JC, Collins SE, Harrop EN, and Marlatt GA
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- Adult, Aged, Female, Humans, Male, Meditation methods, Middle Aged, Recurrence, Treatment Outcome, Young Adult, Craving, Mindfulness methods, Self Care methods, Substance-Related Disorders rehabilitation
- Abstract
Introduction: Mindfulness-based treatments have received increasing interest and empirical support in the clinical psychology literature. There are, however, no studies to date that have systematically examined treatment enactment, which is the amount and type of home practice participants incorporate into their daily lives. Because treatment enactment has been cited as a key aspect of treatment fidelity, this study examined the relationships between treatment enactment (i.e., home mindfulness practice) and alcohol and other drug (AOD) use and craving in the context of a larger study of mindfulness-based relapse prevention (MBRP)., Methods: Participants (N=93) in this secondary analysis had been randomized in the parent study to receive MBRP. AOD use, craving, and home mindfulness practice were assessed at baseline, post-treatment, 2-month and 4-month follow-up time points., Results: MBRP participants significantly increased the amount of time spent in home mindfulness practice over the course of the study. Further, greater time spent in home practice was associated with less AOD use and craving at the 2- and 4-month follow-ups. Of note, the significant treatment gains in home practice faded somewhat at the 2- and 4-month follow-ups as participants returned to standard aftercare, which did not involve mindfulness-based practice., Conclusions: Participation in MBRP was associated with a significant increase in home mindfulness practice, and increased involvement in home practice was associated with significantly lower AOD use and craving over the course of the study. This suggests that treatment enactment, which entails building mindfulness practice into one's daily life, plays a key role in ongoing recovery following MBRP treatment. Teaching mindfulness skills for daily use versus for only in high-risk situations has the potential to boost the longevity of MBRP treatment effects. These findings also suggest that MBRP clinicians should target the post-intervention decline in home practice (e.g., with ongoing mindfulness practice groups) to maximize the benefits of mindfulness meditation in decreasing AOD use and craving., (Copyright © 2014 Elsevier Ltd. All rights reserved.)
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- 2015
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22. Overlooked and underestimated? Problematic alcohol use in clients recovering from drug dependence.
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Staiger PK, Richardson B, Long CM, Carr V, and Marlatt GA
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- Humans, Recurrence, Substance-Related Disorders rehabilitation, Treatment Outcome, Alcohol Drinking epidemiology, Alcohol-Related Disorders epidemiology, Substance-Related Disorders epidemiology
- Abstract
Aims: Despite recognition of the harms related to alcohol misuse and its potential to interfere substantially with sustained recovery from drug dependency, research evaluating drug treatment outcomes has not addressed the issue comprehensively. It has been overlooked possibly because treatment research has been framed according to the primary drug of choice, rather than investigating the interactions between different combinations of drugs and/or alcohol use. This paper reports on a systematic review investigating whether concurrent alcohol use could impede recovery from illicit drug use in two potential ways: first, alcohol could become a substitute addiction and/or secondly, alcohol misuse post-treatment may place an individual at risk for relapse to their primary drug problem., Method: A systematic search of four relevant databases was undertaken to identify peer-reviewed, quantitative drug treatment outcome studies that reported alcohol use pre-, post-treatment and follow-up., Results: The search revealed 567 papers, of which 13 were assessed as fulfilling the key inclusion criteria.The review indicated inconsistent and therefore inconclusive support for the substitution hypothesis. However, the data revealed consistent support for the hypothesis that alcohol use increases relapse to drug use., Conclusions: (i) The potential negative impact of alcohol misuse on drug treatment outcomes remains under-researched and overlooked; (ii) alcohol consumption post-drug treatment may increase the likelihood that an individual will relapse to their primary drug; (ii) existing evidence regarding the substitution hypothesis is inconclusive, although there was an indication that a subgroup of participants will be vulnerable to alcohol becoming the primary addiction instead of drugs. We argue that future drug treatment outcome studies need to include detailed analysis of the influence of alcohol use pre- and post-drug treatment., (© 2012 The Authors, Addiction © 2012 Society for the Study of Addiction.)
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- 2013
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23. How can we develop a more precise examination of the role of alcohol in recovery from drug dependence?
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Staiger PK, Richardson B, Long C, Carr V, and Marlatt GA
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- Humans, Alcohol Drinking epidemiology, Alcohol-Related Disorders epidemiology, Substance-Related Disorders epidemiology
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- 2013
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24. Examining psychometric properties of distress tolerance and its moderation of mindfulness-based relapse prevention effects on alcohol and other drug use outcomes.
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Hsu SH, Collins SE, and Marlatt GA
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- Adolescent, Adult, Aged, Alcohol-Related Disorders prevention & control, Alcohol-Related Disorders psychology, Female, Humans, Male, Middle Aged, Poisson Distribution, Psychometrics, Secondary Prevention, Substance-Related Disorders psychology, Treatment Outcome, Young Adult, Adaptation, Psychological, Stress, Psychological psychology, Substance-Related Disorders prevention & control
- Abstract
Distress tolerance refers to the degree to which an individual is able to withstand negative psychological and/or physical states. Empirical literature has indicated that lower distress tolerance is associated with a number of negative alcohol and other drug (AOD) use outcomes and psychopathology. Mindfulness meditation focuses on enhancing affect regulation, and may be particularly beneficial for individuals with lower distress tolerance. This secondary analysis evaluated the basic psychometric properties of the Distress Tolerance Scale (DTS) in a clinical sample of individuals with AOD-use disorders and tested whether distress tolerance for negative psychological states moderated treatment effects on AOD outcomes in an initial efficacy trial of mindfulness-based relapse prevention (MBRP). It was hypothesized that participants with lower distress tolerance would report fewer AOD use days over the 4-month follow-up if they received MBRP versus treatment as usual (TAU). Participants (N=168) in the parent RCT were recruited from a private, nonprofit agency providing inpatient and outpatient care for individuals with AOD-use disorders. Assessments of 60-day frequency of AOD use, as measured by the Timeline Followback, were conducted at baseline, immediately postintervention, and 2months and 4months following the intervention. Distress tolerance, as measured by the DTS, was assessed at baseline. Results indicated a one-factor solution, which is consistent with how the DTS has been implemented in other studies. As predicted, DTS was positively associated with all mindfulness subscales, suggesting its convergent validity in this clinical sample. Findings showed the hypothesized time×treatment×distress tolerance interaction, and thereby indicated that participants with lower distress tolerance who received MBRP treatment experienced a greater curvilinear decrease in AOD use days over time than those with lower distress tolerance who received TAU. However, the observed plateau effect suggests that these effects were not maintained at the 4-month follow-up. Findings suggest that distress tolerance is a clinically relevant client characteristic to consider in matching participants to aftercare treatment and that MBRP may be particularly helpful for individuals with lower distress tolerance., (Copyright © 2012 Elsevier Ltd. All rights reserved.)
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- 2013
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25. Primary outcome indices in illicit drug dependence treatment research: systematic approach to selection and measurement of drug use end-points in clinical trials.
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Donovan DM, Bigelow GE, Brigham GS, Carroll KM, Cohen AJ, Gardin JG, Hamilton JA, Huestis MA, Hughes JR, Lindblad R, Marlatt GA, Preston KL, Selzer JA, Somoza EC, Wakim PG, and Wells EA
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- Alcoholism rehabilitation, Consensus, Endpoint Determination, Humans, Self Report, Substance Abuse Detection methods, Substance Withdrawal Syndrome diagnosis, Tobacco Use Disorder rehabilitation, Treatment Outcome, Biomedical Research methods, Clinical Trials as Topic methods, Illicit Drugs, Substance-Related Disorders rehabilitation
- Abstract
Aims: Clinical trials test the safety and efficacy of behavioral and pharmacological interventions in drug-dependent individuals. However, there is no consensus about the most appropriate outcome(s) to consider in determining treatment efficacy or on the most appropriate methods for assessing selected outcome(s). We summarize the discussion and recommendations of treatment and research experts, convened by the US National Institute on Drug Abuse, to select appropriate primary outcomes for drug dependence treatment clinical trials, and in particular the feasibility of selecting a common outcome to be included in all or most trials., Methods: A brief history of outcomes employed in prior drug dependence treatment research, incorporating perspectives from tobacco and alcohol research, is included. The relative merits and limitations of focusing on drug-taking behavior, as measured by self-report and qualitative or quantitative biological markers, are evaluated., Results: Drug-taking behavior, measured ideally by a combination of self-report and biological indicators, is seen as the most appropriate proximal primary outcome in drug dependence treatment clinical trials., Conclusions: We conclude that the most appropriate outcome will vary as a function of salient variables inherent in the clinical trial, such as the type of intervention, its target, treatment goals (e.g. abstinence or reduction of use) and the perspective being taken (e.g. researcher, clinical program, patient, society). It is recommended that a decision process, based on such trial variables, be developed to guide the selection of primary and secondary outcomes as well as the methods to assess them., (© 2011 Society for the Study of Addiction. No claim to original US government works.)
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- 2012
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26. Project-based Housing First for chronically homeless individuals with alcohol problems: within-subjects analyses of 2-year alcohol trajectories.
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Collins SE, Malone DK, Clifasefi SL, Ginzler JA, Garner MD, Burlingham B, Lonczak HS, Dana EA, Kirouac M, Tanzer K, Hobson WG, Marlatt GA, and Larimer ME
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- Adult, Female, Follow-Up Studies, Humans, Logistic Models, Male, Middle Aged, Northwestern United States epidemiology, Urban Population, Alcohol Drinking epidemiology, Alcoholism, Ill-Housed Persons, Public Housing
- Abstract
Objectives: Two-year alcohol use trajectories were documented among residents in a project-based Housing First program. Project-based Housing First provides immediate, low-barrier, nonabstinence-based, permanent supportive housing to chronically homeless individuals within a single housing project. The study aim was to address concerns that nonabstinence-based housing may enable alcohol use., Methods: A 2-year, within-subjects analysis was conducted among 95 chronically homeless individuals with alcohol problems who were allocated to project-based Housing First. Alcohol variables were assessed through self-report. Data on intervention exposure were extracted from agency records., Results: Multilevel growth models indicated significant within-subjects decreases across alcohol use outcomes over the study period. Intervention exposure, represented by months spent in housing, consistently predicted additional decreases in alcohol use outcomes., Conclusions: Findings did not support the enabling hypothesis. Although the project-based Housing First program did not require abstinence or treatment attendance, participants decreased their alcohol use and alcohol-related problems as a function of time and intervention exposure.
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- 2012
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27. Mindfulness and modification therapy for behavioral dysregulation: results from a pilot study targeting alcohol use and aggression in women.
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Wupperman P, Marlatt GA, Cunningham A, Bowen S, Berking M, Mulvihill-Rivera N, and Easton C
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- Adult, Alcoholism psychology, Attention physiology, Awareness physiology, Domestic Violence legislation & jurisprudence, Emotions physiology, Female, Humans, Middle Aged, Pilot Projects, Treatment Outcome, Young Adult, Aggression psychology, Alcoholism therapy, Cognitive Behavioral Therapy methods, Domestic Violence psychology
- Abstract
Objectives: Increasing evidence suggests that deficits in mindfulness (awareness, attentiveness, and acceptance of the present moment) play a role in a range of disorders involving behavioral dysregulation. This paper adds to that literature by describing a transdiagnostic psychotherapy (Mindfulness & Modification Therapy; MMT) developed to target behavioral dysregulation., Design: An open-treatment pilot-trial investigated the feasibility, acceptability, and pre-post effects of MMT targeting women (N = 14) court-referred for alcohol abuse/dependence and aggression., Results: Pre-post comparisons revealed significant decreases in alcohol use, drug use, and aggression. In addition, the retention rate was 93%., Conclusion: Preliminary evidence suggests that MMT is a feasible and acceptable treatment that decreases dysregulated behaviors such as substance use and aggression, while also potentially increasing retention., (© 2011 Wiley Periodicals, Inc.)
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- 2012
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28. Relapse prevention for addictive behaviors.
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Hendershot CS, Witkiewitz K, George WH, and Marlatt GA
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- Forecasting, Humans, Models, Psychological, Tertiary Prevention trends, Behavior, Addictive prevention & control, Secondary Prevention, Tertiary Prevention methods
- Abstract
The Relapse Prevention (RP) model has been a mainstay of addictions theory and treatment since its introduction three decades ago. This paper provides an overview and update of RP for addictive behaviors with a focus on developments over the last decade (2000-2010). Major treatment outcome studies and meta-analyses are summarized, as are selected empirical findings relevant to the tenets of the RP model. Notable advances in RP in the last decade include the introduction of a reformulated cognitive-behavioral model of relapse, the application of advanced statistical methods to model relapse in large randomized trials, and the development of mindfulness-based relapse prevention. We also review the emergent literature on genetic correlates of relapse following pharmacological and behavioral treatments. The continued influence of RP is evidenced by its integration in most cognitive-behavioral substance use interventions. However, the tendency to subsume RP within other treatment modalities has posed a barrier to systematic evaluation of the RP model. Overall, RP remains an influential cognitive-behavioral framework that can inform both theoretical and clinical approaches to understanding and facilitating behavior change.
- Published
- 2011
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29. Posttraumatic stress and alcohol use coping motives among a trauma-exposed community sample: the mediating role of non-judgmental acceptance.
- Author
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Vujanovic AA, Bonn-Miller MO, and Marlatt GA
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- Adolescent, Adult, Aged, Behavior, Diagnostic and Statistical Manual of Mental Disorders, Female, Humans, Life Change Events, Male, Middle Aged, Vermont, Young Adult, Adaptation, Psychological, Alcohol Drinking psychology, Alcohol-Related Disorders psychology, Stress Disorders, Post-Traumatic psychology
- Abstract
The current investigation evaluated (1) the incremental predictive validity of non-judgmental acceptance in terms of alcohol use coping motives and (2) the mediating role of non-judgmental acceptance in the association between posttraumatic stress symptom severity and alcohol use coping motives. Participants included 153 (79 women) adults who reported exposure to at least one DSM-IV PTSD Criterion A traumatic life event and alcohol use in the past month. Non-judgmental acceptance emerged as a significant incremental predictor of alcohol use coping motives. Furthermore, non-judgmental acceptance partially mediated the association between posttraumatic stress symptom severity and alcohol use coping motives. Theoretical and clinical implications of the findings are discussed with regard to better understanding the co-occurrence of posttraumatic stress and alcohol use disorders., (Published by Elsevier Ltd.)
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- 2011
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30. Relationships Among Premenstrual Symptom Reports, Menstrual Attitudes, and Mindfulness.
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Lustyk MK, Gerrish WG, Douglas H, Bowen S, and Marlatt GA
- Abstract
The physical and affective symptoms of a broad range of conditions are improved following mindfulness-based practices. One set of symptoms that has yet to be explored through the lens of mindfulness, however, is that associated with the premenstruum. Also, given the relationships among negative attitudes towards menstruation and amplified symptom reporting, it is reasonable to expect that mindfulness qualities cultivated through practices aimed at dispelling negative anticipatory and judgmental thinking will moderate these relationships. Thus, in this study we examined interrelationships among premenstrual symptom severity reports (PMSR), menstrual attitudes, and mindfulness qualities in a sample of 127 women (age range 18-26 years). Results revealed several statistically significant positive relationships between menstrual attitudes and PMSR. Also, higher scores on measures of mindfulness were significantly associated with lower PMSR. Moderating effects revealed that mindfulness significantly buffered the relationships between menstrual attitudes and PMSR, specifically between: anticipation of menses onset and PMSR as well as anticipation of menses onset and premenstrual water retention. These results may offer the first empirical evidence of relationships among menstrual attitudes, PMSR, and mindfulness qualities. Results from this study align with the body of research showing that mindfulness is predictive of improved symptomatology and well-being across varied conditions. We conclude with discussion supporting the development of a mindfulness-based intervention aimed at reducing symptom severity in premenstrual symptom sufferers.
- Published
- 2011
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31. Preventing Relapse Following Smoking Cessation.
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Collins SE, Witkiewitz K, Kirouac M, and Marlatt GA
- Abstract
Cigarette smoking is the leading cause of preventable deaths worldwide. Long-term smoking cessation can drastically reduce people's risk for developing smoking-related disease. The research literature points to a need for clearer operationalization and differentiation between smoking cessation and relapse prevention interventions and outcomes. That said, extensive meta-analyses and research studies have indicated that there are various efficacious smoking interventions that can both support smoking cessation and relapse prevention efforts. Specifically, behavioral treatments, relapse prevention psychotherapy, pharmacologic interventions, motivational enhancement, smoking reduction to quit, brief advice, alternative intervention modes (telephone, Internet, computer), self-help, and tailored treatments can help prepare smokers for longer-term abstinence. Although these methods vary on reach, they are relatively efficacious, particularly in combined formats.
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- 2010
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32. Mindfulness-based treatments for co-occurring depression and substance use disorders: what can we learn from the brain?
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Brewer JA, Bowen S, Smith JT, Marlatt GA, and Potenza MN
- Subjects
- Affect, Depressive Disorder, Major physiopathology, Depressive Disorder, Major psychology, Diagnosis, Dual (Psychiatry), Humans, Meditation psychology, Mind-Body Relations, Metaphysical, Neural Pathways, Secondary Prevention, Stress, Psychological psychology, Substance-Related Disorders physiopathology, Substance-Related Disorders psychology, Thinking, Attention, Brain physiopathology, Cognitive Behavioral Therapy methods, Depressive Disorder, Major therapy, Meditation methods, Substance-Related Disorders rehabilitation
- Abstract
Both depression and substance use disorders represent major global public health concerns and are often co-occurring. Although there are ongoing discoveries regarding the pathophysiology and treatment of each condition, common mechanisms and effective treatments for co-occurring depression and substance abuse remain elusive. Mindfulness training has been shown recently to benefit both depression and substance use disorders, suggesting that this approach may target common behavioral and neurobiological processes. However, it remains unclear whether these pathways constitute specific shared neurobiological mechanisms or more extensive components universal to the broader human experience of psychological distress or suffering.We offer a theoretical, clinical and neurobiological perspective of the overlaps between these disorders, highlight common neural pathways that play a role in depression and substance use disorders and discuss how these commonalities may frame our conceptualization and treatment of co-occurring disorders. Finally, we discuss how advances in our understanding of potential mechanisms of mindfulness training may offer not only unique effects on depression and substance use, but also offer promise for treatment of co-occurring disorders.
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- 2010
- Full Text
- View/download PDF
33. The mindfulness-based relapse prevention adherence and competence scale: development, interrater reliability, and validity.
- Author
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Chawla N, Collin S, Bowen S, Hsu S, Grow J, Douglass A, and Marlatt GA
- Subjects
- Adult, Female, Humans, Male, Meditation methods, Mental Disorders prevention & control, Mental Disorders psychology, Observer Variation, Psychological Tests standards, Randomized Controlled Trials as Topic methods, Reproducibility of Results, Secondary Prevention, Meditation psychology, Mental Disorders therapy, Patient Compliance psychology
- Abstract
The present study describes the development of the Mindfulness-Based Relapse Prevention Adherence and Competence Scale (MBRP-AC), a measure of treatment integrity for mindfulness-based relapse prevention (MBRP). MBRP is a newly developed treatment integrating core aspects of relapse prevention with mindfulness practices. The MBRP-AC was developed in the context of a randomized controlled trial (RCT) of MBRP efficacy and consists of two sections: Adherence (adherence to individual components of MBRP and discussion of key concepts) and Competence (ratings of therapist style/approach and performance). Audio recordings from 44 randomly selected group treatment sessions (50%) were rated by independent raters for therapist adherence and competence in the RCT. Findings evinced high interrater reliability for all treatment adherence and competence ratings, and adequate internal consistency for Therapist Style/Approach and Therapist Performance summary scales. Ratings on the MBRP-AC suggested that therapists in the recent RCT adhered to protocol, discussed key concepts in each session, and demonstrated the intended style and competence in treatment delivery. Finally, overall ratings on the Adherence section were positively related to changes in mindfulness over the course of the treatment.
- Published
- 2010
- Full Text
- View/download PDF
34. The comorbidity of substance use disorders and eating disorders in women: prevalence, etiology, and treatment.
- Author
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Harrop EN and Marlatt GA
- Subjects
- Behavior, Addictive epidemiology, Behavior, Addictive etiology, Behavior, Addictive therapy, Comorbidity, Feeding and Eating Disorders etiology, Feeding and Eating Disorders therapy, Female, Humans, Prevalence, Risk Factors, Substance-Related Disorders etiology, Substance-Related Disorders therapy, Feeding and Eating Disorders epidemiology, Substance-Related Disorders epidemiology
- Abstract
Substance use disorders often co-occur with eating disorders in female populations. This review addresses the prevalence and etiology of this comorbidity in women. Thirteen peer-reviewed journal articles are reviewed. Conclusions are drawn concerning prevalence rates, theory, and implications for treatment. Current research supports distinct etiologies and growth trajectories for both disorders. Thus, comorbidity presents with unique challenges, and often, worse outcomes. Though comorbidity rates are high, little research has been done concerning treatment. Given the high prevalence rates of these comorbid disorders, a specific treatment needs to be developed that targets both disorders simultaneously., (Copyright (c) 2009 Elsevier Ltd. All rights reserved.)
- Published
- 2010
- Full Text
- View/download PDF
35. Testing the incentive-sensitization theory with at-risk drinkers: wanting, liking, and alcohol consumption.
- Author
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Ostafin BD, Marlatt GA, and Troop-Gordon W
- Subjects
- Adult, Female, Humans, Male, Risk Factors, Young Adult, Alcohol Drinking epidemiology, Attitude, Motivation, Psychological Theory
- Abstract
Motivational models of addiction typically propose that alcohol and drugs are desired because of their hedonic effects (i.e., increasing pleasure or reducing distress). In contrast, the incentive-sensitization theory proposes that wanting motivation and liking motivation are separable and that after repeated substance use, motivation shifts from liking to wanting. Using a sample of 85 at-risk drinkers (as defined by the National Institute on Alcohol Abuse and Alcoholism), in the current study we examined the separability of liking motivation and wanting motivation for alcohol and whether years of drinking experience was associated with an increased role for wanting motivation and a decreased role for liking motivation. Consumption was measured with a free-drinking task. Wanting motivation was assessed immediately before drinking, and liking was assessed immediately after drinking had begun. The results indicated that (a) wanting motivation predicted variance of consumption unique from that accounted for by liking motivation, (b) longer drinking experience was associated with a decreased relation between liking motivation and consumption, and (c) longer drinking experience was not associated with an increased relation between wanting motivation and consumption. The results provide partial support for the incentive-sensitization theory.
- Published
- 2010
- Full Text
- View/download PDF
36. Exploring productivity outcomes from a brief intervention for at-risk drinking in an employee assistance program.
- Author
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Osilla KC, dela Cruz E, Miles JN, Zellmer S, Watkins K, Larimer ME, and Marlatt GA
- Subjects
- Absenteeism, Adult, Alcohol Drinking therapy, Female, Humans, Male, Occupational Health Services methods, Treatment Outcome, Workplace economics, Workplace statistics & numerical data, Alcohol Drinking economics, Efficiency, Occupational Health Services economics
- Abstract
Brief intervention (BI) research has traditionally examined alcohol and drug use outcomes; however it is unknown whether BIs can also impact on-the-job productivity. This exploratory study examines changes in workplace productivity and related costs for clients receiving a BI for at-risk drinking in the employee assistance program (EAP). Participants were 44 clients attending the EAP for behavioral health concerns, screened for at-risk drinking, assigned to BI+Usual Care (n=25) or UC alone (n=19), and who completed 3-month follow-up. Absenteeism, presenteeism, and productivity costs were derived as outcomes. At follow-up, participants in the BI+UC group had improved productivity when at work (presenteeism) compared to the UC group. The estimated cost savings from improved productivity for the BI+UC group was $1200 per client over the UC group. Groups did not differ by absenteeism (missed days of work). Preliminary evidence suggests the broad impact BIs may have. Implications for future BI research are discussed., (Copyright 2009 Elsevier Ltd. All rights reserved.)
- Published
- 2010
- Full Text
- View/download PDF
37. Harm reduction therapy: a practice-friendly review of research.
- Author
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Logan DE and Marlatt GA
- Subjects
- Adult, Alcoholism prevention & control, Female, Humans, Male, Outcome Assessment, Health Care, Psychotherapy, Substance-Related Disorders prevention & control, Young Adult, Empirical Research, Harm Reduction
- Abstract
Harm reduction is an umbrella term for interventions aiming to reduce the problematic effects of behaviors. Although harm reduction was originally and most frequently associated with substance use, it is increasingly being applied to a multitude of other behavioral disorders. This article reviews the state of empirical research on harm reduction practices including alcohol interventions for youth, college students, and a variety of other adult interventions. We also review nicotine replacement and opioid substitution, as well as needle exchanges and safe injection sites for intravenous drug users. Dozens of peer-reviewed controlled trial publications provide support for the effectiveness of harm reduction for a multitude of clients and disorders without indications of iatrogenic effects. Harm reduction interventions provide additional tools for clinicians working with clients who, for whatever reason, may not be ready, willing, or able to pursue full abstinence as a goal., ((c) 2010 Wiley Periodicals, Inc.)
- Published
- 2010
- Full Text
- View/download PDF
38. State of the art in harm reduction psychotherapy: an emerging treatment for substance misuse.
- Author
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Tatarsky A and Marlatt GA
- Subjects
- Guidelines as Topic, History, 20th Century, History, 21st Century, Humans, Psychotherapy history, Substance-Related Disorders psychology, United States, Harm Reduction, Psychotherapy methods, Substance-Related Disorders therapy
- Abstract
Harm reduction psychotherapy is an exciting and emerging treatment for a broad spectrum of substance use problems. This article introduces an issue of the Journal of Clinical Psychology: In Session devoted to the state of the art of harm reduction psychotherapy. We describe the harm reduction paradigm, the context for and history of the development of harm reduction psychotherapy, and its clinical principles. We then outline and frame the contributions to the issue. Our goal is that this issue will encourage psychotherapists to employ more harm reduction principles in practice and will provide many evidence-based methods to do so., ((c) 2010 Wiley Periodicals, Inc.)
- Published
- 2010
- Full Text
- View/download PDF
39. The virtuous drinker: character virtues as correlates and moderators of college student drinking and consequences.
- Author
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Logan DE, Kilmer JR, and Marlatt GA
- Subjects
- Adolescent, Adult, Alcohol Drinking prevention & control, Alcoholism epidemiology, Altruism, Empirical Research, Female, Humans, Male, Qualitative Research, Social Justice, Statistics as Topic, Surveys and Questionnaires, Temperance statistics & numerical data, Washington epidemiology, Young Adult, Alcohol Drinking epidemiology, Alcoholism prevention & control, Ethical Theory, Risk-Taking, Students statistics & numerical data, Universities statistics & numerical data, Virtues
- Abstract
Objective: The present study examined the relationship between alcohol use and positive psychology's character virtues1 in a college student sample. Each of the virtues of wisdom, courage, humanity, justice, temperance, and transcendence were examined as protective factors and moderators of drinking consequences., Participants: This sample included 425 undergraduate students at a large Northwest University (69% female; 52% Caucasian, 34% Asian)., Methods: Participants completed paper and pencil questionnaires during October and November 2006 in exchange for extra credit in psychology classes., Results: Higher temperance scores were associated with abstinence, lower risk drinking, and fewer consequences among heavy drinkers; both increased justice and transcendence were independently associated with abstinence only; and wisdom, courage, and humanity were not associated with any outcomes., Conclusions: The associations between virtues and college student drinking support a collaboration between addictive behaviors and positive psychology to address college student drinking and minimize consequences.
- Published
- 2010
- Full Text
- View/download PDF
40. Language-based measures of mindfulness: initial validity and clinical utility.
- Author
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Collins SE, Chawla N, Hsu SH, Grow J, Otto JM, and Marlatt GA
- Subjects
- Adult, Attention, Female, Humans, Male, Middle Aged, Reproducibility of Results, Secondary Prevention, Surveys and Questionnaires, Treatment Outcome, Adaptation, Psychological, Language, Mind-Body Relations, Metaphysical, Substance-Related Disorders prevention & control
- Abstract
This study examined relationships among language use, mindfulness, and substance-use treatment outcomes in the context of an efficacy trial of mindfulness-based relapse prevention (MBRP) for adults with alcohol and other drug use (AOD) disorders. An expert panel generated two categories of mindfulness language (ML) describing the mindfulness state and the more encompassing "mindfulness journey," which included words describing challenges of developing a mindfulness practice. MBRP participants (n = 48) completed baseline sociodemographic and AOD measures, and participated in the 8-week MBRP program. AOD data were collected during the 4-month follow-up. A word count program assessed the frequency of ML and other linguistic markers in participants' responses to open-ended questions about their postintervention impressions of mindfulness practice and MBRP. Findings supported concurrent validity of ML categories: ML words appeared more frequently in the MBRP manual compared to the 12-step Big Book. Further, ML categories correlated with other linguistic variables related to the mindfulness construct. Finally, predictive validity was supported: greater use of ML predicted fewer AOD use days during the 4-month follow-up. This study provided initial support for ML as a valid, clinically useful mindfulness measure. If future studies replicate these findings, ML could be used in conjunction with self-report to provide a more complete picture of the mindfulness experience., (Copyright 2009 APA)
- Published
- 2009
- Full Text
- View/download PDF
41. The role of executive cognitive functions in changing substance use: what we know and what we need to know.
- Author
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Blume AW and Marlatt GA
- Subjects
- Cognition physiology, Humans, Problem Solving, Substance-Related Disorders therapy, Attitude to Health, Cerebral Cortex physiology, Cognitive Behavioral Therapy, Health Behavior, Substance-Related Disorders psychology
- Abstract
Background: Executive cognitive functions (ECF) have been linked to skills such as planning, organizing, problem solving, decision-making, initiating and self-regulating behavior, working memory, and motivation; critical activities needed to monitor and change substance use behavior., Purpose: The purpose of this study is to investigate how ECF may impact important variables associated with changing substance use behavior., Methods: This study is a critical review of the extant literature about how ECF may influence substance abuse treatment outcomes and behavior change., Results: A review of the literature found evidence that poorer ECF likely hinders substance use behavior change and is often associated with behavior labeled as denial. However, the relationship between ECF and substance abuse appears to be highly complex., Conclusions: Traditional methods of substance abuse assessment, interpretation of behavior, and intervention may need to be reconsidered in light of new research about executive cognitive dysfunction. Implications for future research are discussed.
- Published
- 2009
- Full Text
- View/download PDF
42. Health care and public service use and costs before and after provision of housing for chronically homeless persons with severe alcohol problems.
- Author
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Larimer ME, Malone DK, Garner MD, Atkins DC, Burlingham B, Lonczak HS, Tanzer K, Ginzler J, Clifasefi SL, Hobson WG, and Marlatt GA
- Subjects
- Adult, Community Health Services economics, Community Health Services statistics & numerical data, Community Mental Health Services economics, Community Mental Health Services statistics & numerical data, Emergency Medical Services economics, Emergency Medical Services statistics & numerical data, Female, Humans, Male, Middle Aged, Prisons economics, Prisons statistics & numerical data, Program Evaluation, Substance Abuse Treatment Centers economics, Substance Abuse Treatment Centers statistics & numerical data, Time Factors, Washington, Alcoholism economics, Health Care Costs statistics & numerical data, Health Services economics, Health Services statistics & numerical data, Ill-Housed Persons statistics & numerical data, Public Housing statistics & numerical data
- Abstract
Context: Chronically homeless individuals with severe alcohol problems often have multiple medical and psychiatric problems and use costly health and criminal justice services at high rates., Objective: To evaluate association of a "Housing First" intervention for chronically homeless individuals with severe alcohol problems with health care use and costs., Design, Setting, and Participants: Quasi-experimental design comparing 95 housed participants (with drinking permitted) with 39 wait-list control participants enrolled between November 2005 and March 2007 in Seattle, Washington., Main Outcome Measures: Use and cost of services (jail bookings, days incarcerated, shelter and sobering center use, hospital-based medical services, publicly funded alcohol and drug detoxification and treatment, emergency medical services, and Medicaid-funded services) for Housing First participants relative to wait-list controls., Results: Housing First participants had total costs of $8,175,922 in the year prior to the study, or median costs of $4066 per person per month (interquartile range [IQR], $2067-$8264). Median monthly costs decreased to $1492 (IQR, $337-$5709) and $958 (IQR, $98-$3200) after 6 and 12 months in housing, respectively. Poisson generalized estimating equation regressions using propensity score adjustments showed total cost rate reduction of 53% for housed participants relative to wait-list controls (rate ratio, 0.47; 95% confidence interval, 0.25-0.88) over the first 6 months. Total cost offsets for Housing First participants relative to controls averaged $2449 per person per month after accounting for housing program costs., Conclusions: In this population of chronically homeless individuals with high service use and costs, a Housing First program was associated with a relative decrease in costs after 6 months. These benefits increased to the extent that participants were retained in housing longer.
- Published
- 2009
- Full Text
- View/download PDF
43. Mindfulness meditation research: issues of participant screening, safety procedures, and researcher training.
- Author
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Lustyk MK, Chawla N, Nolan RS, and Marlatt GA
- Subjects
- Attention, Biomedical Research education, Humans, Meditation methods, Spirituality, Biomedical Research methods, Meditation psychology, Mental Disorders etiology, Mental Health, Mind-Body Therapies adverse effects, Patient Selection, Research Personnel education
- Abstract
Increasing interest in mindfulness meditation (MM) warrants discussion of research safety. Side effects of meditation with possible adverse reactions are reported in the literature. Yet participant screening procedures, research safety guidelines, and standards for researcher training have not been developed and disseminated in the MM field of study. The goal of this paper is to summarize safety concerns of MM practice and offer scholars some practical tools to use in their research. For example, we offer screener schematics aimed at determining the contraindication status of potential research participants. Moreover, we provide information on numerous MM training options. Ours is the first presentation of this type aimed at helping researchers think through the safety and training issues presented herein. Support for our recommendations comes from consulting 17 primary publications and 5 secondary reports/literature reviews of meditation side effects. Mental health consequences were the most frequently reported side effects, followed by physical health then spiritual health consequences. For each of these categories of potential adverse effects, we offer MM researchers methods to assess the relative risks of each as it pertains to their particular research programs.
- Published
- 2009
44. The Community Pulling Together: A Tribal Community–University Partnership Project to Reduce Substance Abuse and Promote Good Health in a Reservation Tribal Community.
- Author
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Thomas LR, Donovan DM, Sigo RL, Austin L, and Marlatt GA
- Subjects
- Adult, Community-Based Participatory Research, Cooperative Behavior, Cultural Characteristics, Female, Humans, Indians, North American psychology, Male, Middle Aged, Program Evaluation, Substance-Related Disorders psychology, Washington, Young Adult, Attitude to Health ethnology, Community Networks organization & administration, Community-Institutional Relations, Health Promotion organization & administration, Indians, North American statistics & numerical data, Substance-Related Disorders ethnology
- Abstract
Alcohol and drug abuse are major areas of concern for many American Indian=Alaska Native communities. Research on these problems has often been less than successful, in part because many researchers are not sensitive to the culture and traditions of the tribes and communities with which they are working. They alsooften fail to incorporate tribal customs, traditions, and values into the interventions developed to deal with substance abuse. The authors describe the use of community-based participatory research and tribal participatory research approaches to develop a culturally sensitive substance abuse prevention program for Native youth. This project, The Community Pulling Together: Healing of the Canoe, is a collaboration between the Suquamish Tribe and the Alcohol and Drug Abuse Institute at the University of Washington, Seattle, Washington.
- Published
- 2009
- Full Text
- View/download PDF
45. Drinking without thinking: an implicit measure of alcohol motivation predicts failure to control alcohol use.
- Author
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Ostafin BD, Marlatt GA, and Greenwald AG
- Subjects
- Adult, Affect, Female, Humans, Internal-External Control, Male, Prognosis, Psychometrics, Self Efficacy, Taste Perception, Young Adult, Alcohol Drinking psychology, Alcoholism psychology, Motivation
- Abstract
Addiction is characterized by dyscontrol - substance use despite intentions to restrain. Using a sample of at-risk drinkers, the present study examined whether an implicit measure of alcohol motivation (the Implicit Association Test [IAT]; Greenwald, A.G., McGhee, D.E., & Schwartz, J.L.K. (1998). Measuring individual differences in implicit cognition: the Implicit Association Test. Journal of Personality and Social Psychology, 74, 1464-1480) would predict dyscontrol of alcohol use. Participants completed an IAT and, to elicit motivation to restrain alcohol use, were instructed that greater consumption in a taste test would impair performance on a later task for which they could win a prize. All participants viewed aversive slides and then completed a thought-listing task. Participants either exerted self-control by suppressing negative affect and thoughts regarding the slides or did not exert self-control. Post-manipulation, the groups did not differ in mood, urge to drink or motivation to restrain consumption. During the subsequent taste test, participants whose self-control resources were depleted consumed more alcohol than did those in the control group. Additionally, the IAT, but not an explicit measure of alcohol motivation, more strongly predicted alcohol use when self-control resources were depleted. The results indicate that the IAT may have utility in predicting dyscontrolled alcohol use.
- Published
- 2008
- Full Text
- View/download PDF
46. [Cognitive-behavioral therapy for alcohol and drug use disorders].
- Author
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Rangé BP and Marlatt GA
- Subjects
- Alcoholism psychology, Alcoholism therapy, Behavior, Addictive psychology, Diagnostic and Statistical Manual of Mental Disorders, Humans, Secondary Prevention, Self Care methods, Self Efficacy, Substance-Related Disorders psychology, Treatment Outcome, Cognitive Behavioral Therapy methods, Substance-Related Disorders therapy
- Abstract
Objective: Cognitive-behavioral therapies have been successfully used to treat addiction. This article is in part a review on addiction models such as relapse prevention by Marlatt & Gordon, stages of change by Prochaska, DiClemente & Norcross, deriving from motivational interview, developed by Miller & Rollnick, as well as the cognitive models by Beck et al., Method: Based on literature evidence for the development of effective treatment programs, we report on a group treatment model used in a group of alcoholics referred by the Department of Worker's Health Surveillance at Universidade Federal do Rio de Janeiro to the Alcoholism Rehabilitation and Research Center., Results: Results are presented indicating that this type of treatment could be one alternative to others treatments in use., Conclusions: New research is needed to better validate cognitive-behavioral approach to alcohol and drug problems.
- Published
- 2008
- Full Text
- View/download PDF
47. The impact of adolescent tobacco-related associative memory on smoking trajectory: an application of negative binomial regression to highly skewed longitudinal data.
- Author
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Kelly AB, Haynes MA, and Marlatt GA
- Subjects
- Adolescent, Adolescent Behavior psychology, Binomial Distribution, Cues, Female, Humans, Longitudinal Studies, Male, Peer Group, Queensland epidemiology, Smoking epidemiology, Association, Memory, Smoking psychology
- Abstract
Tobacco use is prevalent in adolescents and understanding factors that contribute to smoking uptake remains a critical public health priority. While there is now good support for the role of implicit (preconscious) cognitive processing in accounting for changes in drug use, these models have not been applied to tobacco use. Longitudinal analysis of smoking data presents unique problems, because these data are usually highly positively skewed (with excess zeros) and render conventional statistical tools (e.g., OLS regression) largely inappropriate. This study advanced the application of implicit memory theory to adolescent smoking by adopting statistical methods that do not rely on assumptions of normality, and produce robust estimates from data with correlated observations. The study examined the longitudinal association of implicit tobacco-related memory associations (TMAs) and smoking in 114 Australian high school students. Participants completed TMA tasks and behavioural checklists designed to obscure the tobacco-related focus of the study. Results showed that the TMA-smoking association remained significant when accounting for within-subject variability, and TMAs at Time 1 were modestly associated with smoking at Time 2 after accounting for within subject variability. Students with stronger preconscious smoking-related associations appear to be at greater risk of smoking. Strategies that target implicit TMAs may be an effective early intervention or prevention tool. The statistical method will be of use in future research on adolescent smoking, and for research on other behavioural distributions that are highly positively skewed.
- Published
- 2008
- Full Text
- View/download PDF
48. Why and how do substance abuse treatments work? Investigating mediated change.
- Author
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Witkiewitz K and Marlatt GA
- Subjects
- Cognitive Behavioral Therapy methods, Female, Humans, Male, Outcome and Process Assessment, Health Care, Self Efficacy, Substance Abuse Treatment Centers standards, Substance Abuse Treatment Centers statistics & numerical data, Substance-Related Disorders drug therapy, Health Services Research methods, Substance-Related Disorders rehabilitation
- Published
- 2008
- Full Text
- View/download PDF
49. Risk, resilience, and natural recovery: a model of recovery from alcohol abuse for Alaska Natives.
- Author
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Mohatt GV, Rasmus SM, Thomas L, Allen J, Hazel K, and Marlatt GA
- Subjects
- Adult, Alaska ethnology, Alcoholics Anonymous, Alcoholism ethnology, Cross-Sectional Studies, Culture, Female, Health Knowledge, Attitudes, Practice, Humans, Life Change Events, Male, Middle Aged, Models, Theoretical, Qualitative Research, Temperance psychology, Alcohol Drinking psychology, Alcoholism psychology, Alcoholism rehabilitation, Inuit psychology
- Abstract
Aim: The People Awakening (PA) study explored an Alaska Native (AN) understanding of the recovery process from alcohol abuse and consequent sobriety., Design: PA utilized a cross-sectional, qualitative research design and community-based participatory research methods., Setting and Participants: The study included a state-wide convenience sample of 57 participants representing all five major AN groups: Aleut/Alutiiq, Athabascan, Inupiaq, Yup'ik/Cup'ik and Tlingit/Haida/Tsimshian. Participants were nominated and self-identified as being alcohol-abstinent at least five years following a period of problem drinking., Measurements: Open-ended and semistructured interviews gathered extensive personal life histories. A team of university and community co-researchers analyzed narratives using grounded theory and consensual data analysis techniques., Findings: A heuristic model of AN recovery derived from our participants' experiences describes recovery as a development process understood through five interrelated sequences: (i) the person entered into a reflective process of continually thinking over the consequences of his/her alcohol abuse; (ii) that led to periods of experimenting with sobriety, typically, but not always, followed by repeated cycling through return to drinking, thinking it over, and experimenting with sobriety; culminating in (iii) a turning point, marked by the final decision to become sober. Subsequently, participants engaged in (iv) Stage 1 sobriety, active coping with craving and urges to drink followed for some participants, but not all, by (v) Stage 2 sobriety, moving beyond coping to what one participant characterized as 'living life as it was meant to be lived., Conclusions: The PA heuristic model points to important cultural elements in AN conceptualizations of recovery.
- Published
- 2008
- Full Text
- View/download PDF
50. A brief intervention for at-risk drinking in an employee assistance program.
- Author
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Osilla KC, Zellmer SP, Larimer ME, Neighbors C, and Marlatt GA
- Subjects
- Adult, Alcoholism epidemiology, Female, Follow-Up Studies, Humans, Male, Motivation, Pilot Projects, Risk Factors, Alcoholism rehabilitation, Employment, Occupational Health Services, Risk-Taking
- Abstract
Objective: The current pilot study examined the preliminary efficacy of a brief intervention (BI) for at-risk drinking in an employee assistance program., Method: Clients (N = 107) entering the employee assistance program (EAP) for mental health services were screened and met criteria for at-risk drinking. EAP therapists were randomly assigned to deliver either the BI plus EAP services as usual (SAU) or SAU only. Participants in the final analyses consisted of 44 BI + SAU (30 women, 14 men) and 30 SAU (21 women, 9 men) EAP clients who completed a 3-month follow-up., Results: Results suggested that participants in the BI + SAU group had significant reductions in peak blood alcohol concentration, peak quantity, and alcohol-related consequences compared with the SAU group. Men in the BI + SAU group had greater reductions in alcohol-related problems compared with men in the SAU group. Groups did not differ by number of total EAP sessions attended or rates of presenting problem resolution., Conclusions: Results provide preliminary evidence to support the integration of alcohol screening and BI as a low-cost method of intervening with clients with at-risk drinking in the context of co-occurring presenting problems.
- Published
- 2008
- Full Text
- View/download PDF
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