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Biomedical subjects

A D Sirota

Publications and source records attributed to A D Sirota.

At least 19 recordsLinked to original sources
PubMed1997

Effects of alcohol cues on smoking urges and topography among alcoholic men.

Although the prevalence of smoking among alcoholics ranges up to 97%, little is known about mechanisms underlying the co-occurrence of smoking and alcohol use, or the role tobacco may play in alcohol treatment recovery. Adult male alcoholics in treatment (n = 30) were randomly assigned to visual and olfactory exposure either to alcohol cues or to control cues, and then were allowed to smoke while continuing visual exposure to the same cues. Exposure to alcohol cues resulted in significantly greater self-reported urge to drink and urge to smoke but had no significant effect on the topography of smoking behavior. When variance due to urge to smoke was controlled, greater urge to drink correlated negatively with number of cigarette puffs. The results provide some support for a priming hypothesis of tobacco's role on alcoholism recovery. Clinical and theoretical implications are discussed.

Adult↗
PubMed1996

A Cocaine Negative Consequences Checklist: development and validation.

Awareness of negative consequences of cocaine use is theoretically important for motivation for treatment and relapse prevention. This study reports on the development of an instrument designed to assess cocaine users' self-reported negative consequences of cocaine use. Two samples of cocaine users in treatment for substance abuse completed the Cocaine Negative Consequences Checklist (CNCC). The measure, which is unidimensional in nature with four content area subscales that may be scored, was found to possess excellent reliability across the two samples. The convergent and discriminant validity of the CNCC was supported by the pattern of relationships with other measures of cocaine consequences, cocaine use, the Addiction Severity Index, and with demographic measures. Further research is needed on the utility of this measure in treatment and research.

Adult↗
PubMed1994

Cue reactivity as a predictor of drinking among male alcoholics.

Social learning theories suggest that conditioned responses may increase the risk for relapse. Responses to alcohol use cues (cue reactivity) are associated with variables suggestive of risk but little research exists on the relationship of cue reactivity to treatment outcome. Alcoholic men admitted for detoxification to a treatment program (n = 45) underwent a cue reactivity assessment protocol, and 91% received 3-month follow-up interviews. Greater salivary reactivity predicted greater frequency of drinking during follow-up. Attentional factors added independent variance to the prediction of drinking outcome, with greater attention to stimulus or to response predicting less drinking. Cue reactivity did not predict length of hospital stay or latency to first drink. Results are discussed in the context of information processing, social learning theories, and clinical implications for relapse prevention.

Adult↗
PubMed1994

Alcohol cue reactivity and mood induction in male and female alcoholics.

The purpose of this study was twofold: to investigate gender differences in alcohol cue reactivity, and to study the effect of individualized mood induction on cue reactivity. Male (n = 38) and female (n = 19) alcoholics were exposed to an alcoholic beverage before and after mood induction to assess their reactivity to the beverage cues. The mood induction was based on a situation the subject had identified as being high risk for relapse. Subjects showed urge and salivary reactivity in response to alcohol beverage cues prior to mood induction, and the induction of mood enhanced urge reactivity in both men and women. Analyses with alcohol urge reactors (subjects that demonstrate an increased urge to drink alcohol in response to an alcoholic beverage cue) suggested that women show more urge reactivity in response to negative moods than do men. No gender differences were seen in reactivity to beverage cues alone. These results identify an important gender difference in the effect of negative moods on cue reactivity and suggest that negative mood situations may place women at a higher risk for relapse than men.

Adolescent↗
PubMed1994

The effects of cue exposure on reaction time in male alcoholics.

The present study investigates reaction time (RT) as a measure of attentional deficits produced during alcohol cue exposure. Twenty-four male alcoholic patients responded to a series of computer-generated tones as rapidly as possible during baseline and again during either an alcohol cue exposure period or exposure to a control beverage (water). Patients required increased time to respond to the tones when exposed to alcohol cues. No such increase in RT was found during exposure to a control beverage. In addition, RT was significantly correlated with self-reported urge to drink. These data provide initial validation for the use of RT as an objective measure of cue reactivity. Both theoretical and clinical implications for the use of RT as a measure of the effects of cue exposure are discussed.

Adolescent↗
PubMed1993

Cue exposure with coping skills treatment for male alcoholics: a preliminary investigation.

Although early investigations were promising, no controlled follow-up studies have investigated the effectiveness of cue exposure treatment for alcoholics. In this study, inpatient alcoholics received either cue exposure integrated with urge coping skills training (CET, n = 22) or a contrast condition (CC) involving daily contact with assessment only (n = 18) in addition to standard treatment. Comprehensive assessment measures were used to investigate change in process and outcome variables. In the second 3 months after treatment, the CET group included more patients who were completely abstinent, had a higher percentage of abstinent days, and tended to report fewer drinks per day than did patients in the contrast condition. The significantly greater use of coping skills during follow-up by the CET group and the significant relationship of these coping skills to decreased drinking suggest that treatment effects were due, at least in part, to the coping skills training, consistent with recent formulations. Theoretical and treatment implications are discussed.

Adaptation, Psychological↗
PubMed1993

Alcohol cue reactivity: effects of detoxification and extended exposure.

Alcoholics' reactions to drinking-related stimuli (cue reactivity) have been well documented and alcohol cue exposure treatment has been conducted recently in several clinical trials. Prior to conducting large-scale clinical trials it is important to know what effects detoxification may have on cue reactivity. However, no information is available about the effects of stage of detoxification or of detoxification medication on alcohol cue reactivity. In this study, 45 male alcoholics, detoxified without medication, were assessed during either their second, fourth or sixth day of withdrawal. Further, their reactivity was compared to that of alcoholics detoxified with chlordiazepoxide (n = 15), and to that of alcoholics in their fourth week after drinking (n = 28). Cue reactivity assessment investigated salivation and urge to drink after 3 minutes of water cue exposure and then after 3 minutes of alcohol cue exposure. Urges to drink were assessed during an additional 15 minutes of alcohol exposure to explore latency to maximum reactivity and habituation. Reactivity did not differ as a function of group membership, although salivation was elevated to both beverages during the first week of detoxification. Of the sample, 70% reacted to alcohol with increased urge and 65% with increased salivation, with no difference between groups in proportions of reactors. The maximum urge to drink occurred in the first 6 minutes of alcohol exposure, followed by a gradual and significant decrease. There were no differences on these measures between alcoholics in their first or fourth week after their last drink. Implications for theory and clinical applications are discussed.

Adaptation, Psychological↗
PubMed1985

Smoking cessation in chronically ill medical patients.

Eight male smokers with chronic pulmonary and/or cardiac disease participated in a 9-week treatment program that consisted of gradual nicotine withdrawal, self-management techniques, and relapse prevention strategies. At 1-year follow-up, 50% remained abstinent, while those who relapsed were smoking substantially less than prior to treatment. Reductions in CO and thiocyanate levels were both statistically significant and clinically meaningful. Nonspecific factors of group influence and support, as well as weekly feedback of CO levels, were judged as particularly important components of treatment. The availability of non-aversive strategies for smoking cessation in persons with chronic illness is important. These promising though preliminary findings indicate the need for additional applications of multi-component behavioral approaches with this population.

Behavior Therapy↗