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Biomedical subjects

C S Martin

Publications and source records attributed to C S Martin.

At least 19 recordsLinked to original sources

Course of functioning in adolescents 1 year after alcohol and other drug treatment.

Clinical course was studied in 131 male and female adolescents with current alcohol use disorder (AUD) at baseline (BL). Participants were classified into 4 groups according to their diagnosis and drinking pattern 1 year later. The 4 groups were compared with each other and with 37 community control participants. Results showed that over half of the clinical sample no longer had a current AUD at 1 year; about 64% were and 36% were not still drinking. BL discriminators of 1-year status were alcohol dependence, other drug use, and coping. All of the clinical groups tended to show improvement at 1 year in the main dependent variables, and the abstainers' level of drug use and coping were comparable with that of the community participants. These findings suggest that many adolescents improve in functioning during the 1 year after alcohol and drug treatment and that a stress and coping model is useful for studying clinical course of AUDs in adolescents.

Adaptation, Psychological↗

Clinical features of pathological gambling in an addictions treatment cohort.

This study examined the prevalence and descriptive psychopathology of pathological gambling in a heterogeneous treatment sample of 372 substance users. About 14% of male participants and 10% of female participants were identified as presumptive pathological gamblers (PGs) on the South Oaks Gambling Screen (SOGS). The authors contrasted 49 PGs with 323 participants who were not pathological gamblers (NPGs) on a host of variables measuring premorbid risk, pathological patterns of substance use, consequences of use, and psychiatric comorbidity. PGs showed more disturbance than NPGs on some measures of premorbid risk, pathological substance use, social consequences of use, and psychiatric comorbidity. Gambling status may be an important comorbid condition in addictions treatment settings and a significant covariate in research.

Adult↗

A multi-dimensional analysis of cue-elicited craving in heavy smokers and tobacco chippers.

AIMS: This research examined the performance of a broad range of measures posited to relate to smoking craving. DESIGN: Heavy smokers and tobacco chippers, who were either deprived of smoking or not for 7 hours, were exposed to both smoking (a lit cigarette) and control cues. PARTICIPANTS: Smokers not currently interested in trying to quit smoking (n = 127) were recruited. Heavy smokers (n = 67) averaged smoking at least 21 cigarettes/day and tobacco chippers (n = 60) averaged 1-5 cigarettes on at least 2 days/week. MEASUREMENTS: Measures included urge rating scales and magnitude estimations, a rating of affective valence, a behavioral choice task that assessed perceived reinforcement value of smoking, several smoking-related judgement tasks and a measure of cognitive resource allocation. FINDINGS: Results indicated that both deprivation state and smoker type tended to affect responses across these measurement domains. CONCLUSIONS: Findings support the use of several novel measures of craving-related processes in smokers.

Adult↗

A test of the appraisal-disruption model of alcohol and stress.

OBJECTIVE: Faced with a large body of contradictory findings, investigators have begun to propose cognitive factors that moderate the effects of alcohol on stress. We tested the hypothesis, stemming from the appraisal-disruption model (ADM), that alcohol would be more likely to reduce stress when consumed prior to exposure to a stressor than when consumed following exposure. METHOD: Male and female social drinkers (N = 169, 85 men) with or without a parental history of alcoholism were recruited using separate structured clinical interviews with the participant and with a biological parent. Participants drank a moderate dose of alcohol or a placebo in one of two temporal sequences. Stress was induced by asking participants to present a self-disclosing speech about their physical appearance. Stress responses were assessed using four types of measures: self-reported anxiety, pulse rate, facial expression associated with negative affect and threat-related interference on a color-naming task. RESULTS: Alcohol was generally more likely to attenuate stress responses when initial exposure to a social stressor followed drinking than when it preceded drinking. CONCLUSIONS: Findings were consistent with predictions stemming from the ADM. Alcohol appears to be more likely to reduce stress when initial stress appraisal occurs during intoxication. In contrast, when initial appraisal occurs prior to drinking, alcohol is less effective in attenuating stress.

Adult↗

Assessment of alcohol tolerance in adolescents.

OBJECTIVE: To improve assessment of the DSM-IV alcohol tolerance criterion in adolescents, this study tested the performance of a minimum percentage increase in drinking quantity, and a proxy measure of tolerance (i.e., average heavy-drinking quantity per occasion) in identifying adolescents with alcohol dependence. METHOD: Two adolescent samples were examined. In one sample (N = 415, 58% male, 79% white, 57% clinical), a modified version of the SCID was used to determine DSM-IV alcohol diagnoses, and lifetime drinking history data were collected by interview. In the second sample (N = 470, 60% male, 76% white, 100% clinical), the Adolescent Diagnostic Interview was used to determine DSM-IV alcohol diagnoses and to collect data on initial- and current-drinking quantities needed to become intoxicated. The performance of a percentage increase and average heavy-drinking quantity in identifying those with dependence was evaluated using receiver operating characteristic analysis. RESULTS: The utility of a percentage increase definition was limited by the high degree of variability in initial-drinking quantities. Percentage increase may underassign the tolerance symptom when initial-drinking quantities are high and overassign the symptom when initial-drinking quantities are low. Average heavy-drinking quantity per occasion, combined with a minimum frequency of drinking, demonstrated better performance than any percentage increase definition. CONCLUSIONS: Alternatives to a change-based (e.g., percentage increase) definition of tolerance warrant study due to limits of change-based definitions when initial-drinking quantity shows a high degree of variability. The variability in initial-drinking quantity may reflect individual differences in initial sensitivity that need to be considered in tolerance assessment.

Adolescent↗

Effects of assessment frequency on subjective intoxication ratings after alcohol consumption.

BACKGROUND: It is common for subjective intoxication measures to be administered frequently throughout an experimental session. It is unclear, however, whether repeated assessments affect the experience of intoxication. This study examined the effect of assessing subjective intoxication levels during alcohol consumption on subsequent perceptions of intoxication after drinking. METHODS: Forty-two participants consumed a moderate dose of alcohol (men, 82 g/kg; women, 0.74 g/kg) during a 30-min period. Participants either reported or did not report subjective intoxication levels at 10-min intervals during the drinking period. After the drink, all participants rated their level of subjective intoxication on several occasions. RESULTS: Individuals who reported their intoxication during the drinking period reported higher levels after consumption than did those who did not rate their intoxication during drinking. CONCLUSIONS: These data suggest the potential for reactivity effects when conducting repeated assessments of perceived subjective intoxication.

Adult↗

Constructive thinking in adolescents with substance use disorders.

This study examined the concurrent validity and clinical correlates of the Constructive Thinking Inventory (CTI), a measure of experiential coping, in 551 adolescents aged 14-18 years with and without Diagnostic and Statistical Manual of Mental Disorders (4th ed.; American Psychiatric Association, 1994) substance use disorders (SUDs). The CTI was correlated with depression, anxiety, and conduct problems. After controlling for demographics and comorbid lifetime psychiatric disorders, the CTI scales of Behavioral Coping and Categorical Thinking distinguished adolescents with and without SUDs. Implications of these findings for assessment and treatment are discussed.

Adaptation, Psychological↗

Parental alcoholism and the effects of alcohol on mediated semantic priming.

In this study, researchers tested the effects of a moderate dose of alcohol on the spread of activation of associated information in memory using a mediated semantic priming task in which target words are preceded by primes that are either unrelated or indirectly related to the target. Male and female participants with or without a parental history (PH+ and PH-, respectively) of alcoholism were administered the priming task after consuming alcohol or a placebo beverage. Among PH- individuals, alcohol constrained the spread of activation of associated information, as manifested by a reduced priming effect. In contrast, alcohol enhanced priming effects among PH+ participants, though this latter effect appears to be due to a particularly slow response among these individuals to unprimed words. Results are discussed with regard to theories of alcohol's effects on cognitive processes.

Adult↗

Classification and course of alcohol problems among adolescents in addictions treatment programs.

BACKGROUND: This study tested whether adolescents in addictions treatment programs could be reliably classified into milder and more severe alcohol problem categories using latent class analysis, and examined the relation of latent class structure to DSM-IV alcohol diagnoses. Transition probabilities among the latent classes at 1-year follow-up and their predictors were used to characterize the short-term course of alcohol problems. METHODS: Adolescents recruited from addictions treatment were administered a modified section of the Structured Clinical Interview for the DSM (SCID) alcohol use disorders (AUD) during or shortly after addictions treatment and at 1-year follow-up. DSM-IV lifetime conduct disorder diagnosis was assessed at baseline using a modified version of the Schedule for Affective Disorders and Schizophrenia for School-Age Children (K-SADS). RESULTS: A 3-class solution that represented increasing severity of alcohol problems (i.e., asymptomatic, mild, and severe) provided the best fit to the alcohol symptom data, and was consistent across gender, ethnicity, and presence of conduct disorder. Cross-classification of latent class membership with DSM-IV alcohol diagnosis indicated only a fair level of agreement. There was an overall decrease in alcohol problem severity from baseline to follow-up. Conditional transition probabilities indicated that males and those with conduct disorder, particularly for those in the severe class at baseline, had a lower likelihood of transitioning to the asymptomatic class at 1-year follow-up. CONCLUSIONS: The latent class structure of alcohol problems in an adolescent clinical sample was best represented by a 3-class severity-based model. Cross-classification of latent class membership with DSM-IV alcohol diagnosis suggests the potential utility of re-organizing diagnostic criteria to better distinguish the relative severity of abuse and dependence diagnoses. Transitions between latent classes were fairly common at 1-year follow-up, and characterized by a general reduction in alcohol symptoms.

Adolescent↗

Anti-restenotic effect of copper-62 liquid-filled balloon in porcine coronary arteries: novel use of a short half-life positron emitter.

PURPOSE: To determine the efficacy of the use of copper-62, a positron emitter with a half-life of 9.7 minutes, as an intracoronary brachytherapy (IRBT) source in the prevention of neointima formation (NF) following overstretch balloon injury (BI) in the porcine model. METHODS AND MATERIALS: Sixteen swine were treated after BI to their left anterior descending (LAD), left circumflex (LCX), and/or right coronary artery (RCA). Twelve of the injured arteries received placebo and 10 received 25 Gy, delivered to 0.5 mm from the surface of the treatment balloon filled with liquid (62)Cu. Dosimetry was based on Monte Carlo calculations. Two weeks after treatment, the animals were sacrificed, and the treated coronaries were perfusion-fixed and stained. Intimal area (IA) and medial fracture length (FL) were analyzed by computer-aided histomorphometry. RESULTS: The ((62)Zn/(62)Cu) generator, together with a rapid concentration process, was successful in delivering the short-lived (62)Cu at the high concentration required for intravascular brachytherapy (IVBT). The fracture length in the two groups was similar (2.10 +/- 0.57; 2.02 +/- 0.77; p = NS). Arteries studied showed significant reduction in NF (IA: 0.23 +/- 0.47 mm(2) vs. 1.08 +/- 0.57 mm(2); p < 0.01. IA/FL = 0.09 +/- 0.17 mm vs. 0.51 +/- 0.21 mm; p < 0.01). CONCLUSIONS: This study demonstrated that use of liquid (62)Cu as an IVBT source is safe and feasible. All 16 swine tolerated the treatment well with no radiation-induced side effects or symptoms throughout the 2-week period. The isotope delivered the dose necessary to inhibit NF in the porcine coronary BI model.

Animals↗

Inter-rater reliability of the SCID alcohol and substance use disorders section among adolescents.

Diagnostic interviews for substance use disorders tend to have high reliability among adults. We examined the inter-rater reliability of the substance use disorders section of the Structured Clinical Interview for the DSM, using 46 male and 25 female adolescent drinkers recruited from community and treatment sources. Inter-rater reliability was high for individual DSM-IV alcohol symptoms (kappa=0.84-1.0) and diagnoses (kappa=0.94), and for other substance use disorder diagnoses (kappa=0.82-1.0).

Adolescent↗

Chemiluminescent reporter gene assays with 1,2-dioxetane enzyme substrates.

1,2-Dioxetane chemiluminescent substrates provide highly sensitive, quantitative detection with simple, rapid assay formats for the detection of reporter enzymes that are widely used in gene expression studies. Chemiluminescent detection methodologies typically provide up to 100-1000x higher sensitivities than can be achieved with the corresponding fluorescent or colorimetric enzyme substrates. The varieties of 1,2-dioxetane substrates available provides assay versatility, allowing optimization of assay formats with the available instrumentation, and are ideal for use in gene expression assays performed in both biomedical and pharmaceutical research. These assays are amenable to automation with a broad range of instrumentation for high throughput compound screening.

Alkaline Phosphatase↗

Quantitative polymerase chain reaction and solid-phase capture nucleic acid detection.

The combination of PCR amplification and chemiluminescent detection of PCR products provides a highly sensitive system for the quantitation of DNA and RNA. The broad dynamic range of the chemiluminescent detection assay simplifies the selection of cycling and concentration parameters critical to harnessing the quantitative aspects of PCR amplification. Detection of 200 amol of PCR product is attained using the described procedures. The tube or microplate format of the assay avoids many of the limitations associated with other methods of PCR quantitation involving gel electrophoresis. This detection methodology can be applied to a variety of quantitative nucleic acid assays, including viral load and gene expression analysis.

DNA↗

DSM-IV learning disorders in 10- to 12-year-old boys with and without a parental history of substance use disorders.

This research examined whether learning disorders (LDs) among 10- to 12-year-old boys are related to a parental history of alcohol and other substance use disorders (SUDs). Subjects were boys with (SA+; n = 179) and without (SA-; n = 203) a parental history of SUDs. LD diagnoses were made according to DSM-IV criteria using several standardized intelligence tests, and mother and teacher reports of academic and cognitive difficulties. The results indicated a higher rate of DSM-IV LDs in SA+ compared to SA- boys. This association remained significant after accounting for the effects of socioeconomic status and ethnicity. SA+ boys with a lower socioeconomic status had particularly high rates of LDs (15.3%). The results suggest that LDs are associated with a parental history of SUDs. SA+ children with lower SES may be at particularly high risk for cognitive and academic difficulties.

Black or African American↗

Gender differences and similarities in the personality correlates of adolescent alcohol problems.

The personality traits of behavioral under-control (BU) and negative emotionality (NE) are associated with alcohol problems. The authors examined gender differences in the associations of BU and NE with alcohol problems in 710 adolescents recruited from community and treatment sources. Multiple measures were used to characterize each construct, and the specified 2-factor model provided a reasonably good fit to the data. ANCOVAs were used to examine each construct by gender across four groups: never-regular drinkers, regular drinkers, and those with DSM-IV alcohol abuse and alcohol dependence. Males had significantly higher BU and lower NE than did females. BU and NE both increased with degree of alcohol problems. However, there was not a significant Gender x Alcohol Group interaction for BU or NE. Although there are gender differences in levels of BU and NE, mechanisms of alcohol involvement related to these 2 personality traits may operate similarly in adolescent males and females.

Adolescent↗

The measurement of drug craving.

This paper reviews theoretical and methodological issues in the measurement of drug craving, with an emphasis on self-report assessment. Despite the important role that craving plays in many research and clinical settings, the way in which the construct is conceptualized and measured rarely receives sufficient attention. Issues pertinent to conceptualizing craving are identified. Because there is no single perfect measure of craving, it is essential that researchers understand the limitations of each measure. Measurement performance concerns that affect the validity of different measures are reviewed. Non-verbal assessment methods are also reviewed. Research factors that may help determine the optimal measures for a given study are highlighted. It is concluded that advances in assessment will proceed only when combined with additional research and a better theoretical understanding of craving.

Behavior, Addictive↗

Diagnostic concordance of DSM-III, DSM-III-R, DSM-IV and ICD-10 alcohol diagnoses in adolescents.

OBJECTIVE: Little is known about the validity of diagnostic criteria for alcohol use disorders (AUDs) when applied to adolescents. This study examined the diagnostic concordance of DSM-III, DSM-III-R, DSM-IV and ICD-10 AUDs in a sample of adolescents with a broad range of alcohol problem severity. METHOD: Participants were 413 adolescents (250 male), ages 13 to 19, drawn from clinical and community sources. AUDs were assessed using the Structured Clinical Interview for the DSM (SCID), modified to make diagnoses in the four nosological systems. Diagnostic agreement for lifetime diagnoses was quantified with the kappa statistic. RESULTS: Agreement was fair to high across the three categories of alcohol dependence, alcohol abuse and no alcohol diagnosis (kappa = 0.51 to 0.76); for alcohol dependence (kappa = 0.51 to 0.83); and for the categories of any AUD versus no AUD (kappa = 0.55 to 0.96). Concordance was very low for alcohol abuse diagnoses (kappa = 0.10 to 0.23), with the exception of DSM-III-R and DSM-IV (kappa = 0.62). Dependence was superior to abuse in the degree of temporal overlap in diagnostic agreements. CONCLUSIONS: Similar to findings with adults, diagnostic concordance among adolescents tended to be fair to high for alcohol dependence and very low for alcohol abuse. The data highlight the inconsistency across nosological systems in the conceptual framework and definition of the alcohol abuse category.

Adolescent↗

Performance of a 62Zn/62Cu generator in clinical trials of PET perfusion agent 62Cu-PTSM.

UNLABELLED: The 62Zn/62Cu PET generator can be inexpensively produced and distributed from a single production site operating under typical good manufacturing practice guidelines. It therefore has the potential to greatly facilitate development of clinically practical PET. We report generator performance in a study in which 62Cu-pyruvaldehyde-bis(n4-methylthiosemicarbazone (PTSM) myocardial perfusion imaging is compared with 99mTc-sestamibi in the diagnosis of coronary artery disease. The 62Zn/62Cu generator is an improved version of a previously reported system that employs automated synthesis of 62Cu-PTSM. With this approach, the cumbersome step of 18C purification has been eliminated. METHODS: The 62Zn (9.3 h half-life) parent isotope is prepared by proton bombardment of natural copper at 33 MeV. A typical target irradiated with 37.5 microA/h is delivered by 12:00 PM on the day it is to be processed. Purified 62Zn obtained from the target is loaded onto the generator column in 2 mol/L HCl. The generator is eluted using an internal three-channel peristaltic pump, which delivers 2.25 mL eluant (1.8 mol/L NaCl, 0.2 mol/L HCl) through the generator column to elute the 62Cu in 40 s. The same pump simultaneously pumps an equal volume of buffer (0.4 mol/L NaOAc) and 1 mL ligand solution (2 ppm PTSM, 2% EtOH) passing it through a septum into a 35-cc syringe preloaded with 28 mL sterile water. This solution is thoroughly mixed by agitation of the syringe and injected as a bolus through a 0.2 microm filter. The generator is eluted twice before shipping, providing quality assurance samples, and shipped to the clinical site by overnight delivery. Complete quality assurance testing is performed the evening before the generator reaches the clinical site. RESULTS: A total of 34 generators have been produced and shipped to 2 clinical sites for a phase III Food and Drug Administration study. The load activity on the generators at 8:00 AM the day of clinical use was 1.7+/-0.2 GBq (46.7+/-5.6 mCi), and yield was 72%+/-16%. Breakthrough of 62Zn was undetectable by high-purity germanium spectroscopy for all units. Radiochemical purity was 95.4%+/-2.4%. Volume delivered, pH, sterility, and bacterial endotoxin tests yielded passing results on all generators. The entire process of generator production, from target receipt to generator shipment, took less than 6 h and cost approximately $1000, including shipping charges and cyclotron cost. A total of 68 patients were injected with 2 62Cu-PTSM doses, with a mean injected activity of 0.8+/-0.2 GBq (20.5+/-5.3 mCi) with no adverse side effects. CONCLUSION: Results of this work confirm that the 62Zn/62Cu generator is an easily produced, transportable, and inexpensive source of PET radiopharmaceuticals, which can expand the field of clinical PET imaging by providing radiopharmaceuticals to sites not associated with cyclotrons.

Clinical Trials, Phase III as Topic↗