PubMed Health⌕ Search

Biomedical subjects

D B Abrams

Publications and source records attributed to D B Abrams.

At least 73 records · Page 4Linked to original sources
PubMed1992

Exposure to environmental tobacco smoke in naturalistic settings.

BACKGROUND: Exposure to environmental tobacco smoke (ETS) has been identified as a risk factor for chronic disease among nonsmokers. Results of epidemiological surveys suggest that the majority of nonsmokers have regular ETS exposure. However, little is known about the topography of exposure. METHODS: An exposure diary was used by 186 nonsmokers to self-monitor ETS exposure over a 7-day period. Subjects also completed a questionnaire that assessed their patterns of ETS exposure. RESULTS: The primary source of ETS exposure was the workplace, except when there was a smoker in the household, in which case the household was the primary source. The presence of a smoker in the household resulted in higher levels of exposure both at work and in other locations when compared with subjects without household exposure. Subjects' assessments of exposure on the questionnaire were consistently lower than their self-monitored levels. This finding suggests that general exposure ratings underestimate exposure. CONCLUSIONS: This study provides a new understanding of the patterns of ETS exposure and may help guide the development of policies and interventions designed to reduce ETS exposure.

Adult↗
PubMed1992

Current treatment of obesity: a behavioral medicine perspective.

Obesity is a complex biopsychosocial phenomenon. It has a profound effect on patients' physical and psychological health. Due to the complexity of the problem and the recidivism following treatment, it is recommended that obese patients receive in-depth interdisciplinary evaluation to match them appropriately to comprehensive treatment. Participation in an interdisciplinary comprehensive active weight loss treatment program followed by participation in a professionally led biweekly behavioral maintenance program that included social influence and aerobic exercise has generated maintenance of 83% of initial weight loss at an 18-month follow up. This comprehensive multi-disciplinary treatment approach, best offered in a behavioral medicine center setting, represents state-of-the-art treatment at this time and can result in long-term medical and psychological benefits for the obese patient.

Behavior Therapy↗
PubMed1992

Restrictive workplace smoking policies: impact on nonsmokers' tobacco exposure.

The health consequences of exposure to environmental tobacco smoke (ETS) are well documented. Although nonsmokers are generally aware of the health risks of ETS exposure, the majority of nonsmokers are regularly exposed. The most common source of exposure is the workplace. Restrictive workplace smoking policies are being used as a primary means of reducing ETS exposure. However, few studies have focused on the relation between workplace policy and ETS exposure. We performed two studies which examined the relationship between smoking policy, self-reported ETS exposure, and salivary cotinine concentrations. Study I, a pilot study, focused on a workplace-based sample of 106 volunteers; Study 2 examined exposure among 881 nonsmokers in workplace settings. In both studies, more restrictive workplace smoking policies were associated with a lower proportion of nonsmoking volunteers with detectable salivary cotinine. In Study 2, the larger study, the only other variable found to be significantly related to cotinine detection was the presence of smokers in the home. These results suggest that restrictive workplace smoking policies may reduce employees' overall ETS exposure.

Adult↗
PubMed1991

Patient-treatment matching for alcoholic men in communication skills versus cognitive-behavioral mood management training.

It would be helpful to be able to predict which alcoholics will be more likely to benefit from specific forms of treatment in order to optimize treatment resources. Certain hypothesized patient-treatment matching predictions were investigated with 52 alcoholics who received either communication skills training or cognitive behavioral mood management training in addition to a standard Veterans Administration inpatient alcoholism treatment program. Significant interaction effects showed that alcoholics had worse treatment outcomes in mood management training if they had higher initial anxiety or urge to drink in high-risk role plays or lower had higher initial anxiety or urge to drink in high-risk role plays or lower education. No significant interaction of treatment with irrational beliefs or marital status was found. Communication skills training seemed to be equally effective for alcoholics at any educational level, irrespective of initial coping skill, anxiety, urge to drink, alcohol dependence, or marital status. Thus, although mood management training seems to be as effective as communication skills training for alcoholics with higher education, less anxiety, and less urge to drink, communication skills training benefits a broader spectrum of patients, regardless of initial level of education, alcohol dependence, skill, anxiety, or beliefs.

Adult↗
PubMed1991

Self-efficacy in weight management.

Self-efficacy is an important mediating mechanism in advancing understanding of the treatment of obesity. This study developed and validated the Weight Efficacy Life-Style Questionnaire (WEL), improving on previous studies by the use of clinical populations, cross-validation of the initial factor analysis, exploration of the best fitting theoretical model of self-efficacy, and examination of change in treatment. The resulting 20-item WEL consists of five situational factors: Negative Emotions, Availability, Social Pressure, Physical Discomfort, and Positive Activities. A hierarchical model was found to provide the best fit to the data. Results from two separate clinical treatment studies (total N = 382) show that the WEL is sensitive to changes in global scores as well as to a subset of the five situational factor scores. Treatment programs may be incomplete if they change only a subset of the situational dimensions of self-efficacy. Theoretical and clinical implications are discussed.

Adult↗
PubMed1991

The Contemplation Ladder: validation of a measure of readiness to consider smoking cessation.

Presents evidence for the validity of the Contemplation Ladder, a measure of readiness to consider smoking cessation. Analyses of data collected from more than 400 smokers at two worksites before and during a 10-month intervention indicate that Ladder scores were significantly associated with reported intention to quit, number of previous quit attempts, perceived co-worker encouragement to quit, and socioeconomic status. Ladder scores predicted subsequent participation in programs designed to educate workers about their smoking habit and its contingent risks. The Ladder did not predict biochemically validated abstinence of 24 hr or more. To assess its ability to distinguish between groups known a priori to differ in readiness, we administered the Ladder to 36 participants in a clinic-based smoking cessation program. As predicted, clinic patients scored significantly higher than the workers on the Ladder. The importance of distinguishing between smokers at the lowest stages of readiness to quit is discussed.

Adult↗
PubMed1991

Alcohol abusers' and social drinkers' responses to alcohol-relevant and general situations.

Responses of alcohol abusers and social drinkers were compared on general and alcohol-specific problem situations using role-play methodology. Multiple responses were assessed including behavioral observational ratings, self-reports and psychophysiologic measures. There were few differences between groups in responses to the general situations. Alcohol abusers had higher urges to drink than did the social drinkers in both the general and the alcohol-specific situations. However, in response to the alcohol-specific situations, the alcohol abusers, compared to the social drinkers, were rated by judges as significantly less skillful, and they displayed more self-reported anxiety, had a higher frequency of occurrence of problem situations in the natural environment and reported greater perceived realism of the alcohol-specific situations. Psychophysiologic measures did not differentiate between the groups. Results are discussed with respect to the importance of situation specificity in understanding the precipitants of drinking and their treatment implications.

Adaptation, Psychological↗
PubMed1990

Communication skills training, communication skills training with family and cognitive behavioral mood management training for alcoholics.

To evaluate three promising social learning approaches to the treatment of alcoholism, 69 male alcoholics in standard inpatient treatment participated in either a communication skills training group (CST), a communication skills training group with family participation (CSTF) or a cognitive behavioral mood management training group (CBMMT). Alcoholics who received CST or CSTF drank significantly less alcohol per drinking day during 6-month follow-up than those in CBMMT. The groups did not differ in abstinence rates or latency to relapse. All groups improved in skill and anxiety on the extensive battery of process measures, including role-play tests of general and alcohol-specific coping skills, but those in CST improved most in skill in alcohol-specific high-risk role plays and in ability to relax after the role plays. Alcoholics' skill, response latency, anxiety and urge to drink during alcohol-specific role plays were highly correlated with treatment outcome, demonstrating the importance of including comprehensive process measures in treatment outcome research. Implications for patient-treatment matching and future research are discussed.

Adaptation, Psychological↗
PubMed1989

Reasons for smoking and severity of residual nicotine withdrawal symptoms when using nicotine chewing gum.

Prior to smoking cessation treatment using nicotine chewing gum, 65 smokers completed the Horn Reasons for Smoking Test, the Fagerstrom Tolerance Questionnaire and were assessed on measures of smoking history including saliva cotinine concentration. These measures were used to predict severity of residual nicotine withdrawal symptoms and urges to smoke assessed on a daily basis during the first 2 weeks of attempted abstinence. Univariate analyses indicated that smoking for reasons of handling, craving and to cope with negative affect correlated positively with both residual withdrawal symptoms and urges during the first week. Smoking for reasons of stimulation and habit were also correlated positively with residual withdrawal, and smoking for pleasure correlated with urges to smoke. After controlling for concurrent level of nicotine gum use, analyses suggested that only smoking for reasons of stimulation predicted residual withdrawal. Urges to smoke were positively related to level of smoking during treatment and also to smoking for reasons of craving and handling. Thus, it appears that individual differences in reasons for smoking influence severity of residual nicotine withdrawal symptoms and urges to smoke while chewing nicotine gum. The findings for stimulation smoking and withdrawal are discussed in terms of the reinforcing properties of nicotine with different routes of administration.

Adult↗
PubMed1989

Effects of behavioral skills training and schedule of nicotine gum administration on smoking cessation.

Eighty-nine smokers were randomly assigned to four nicotine gum treatments for smoking cessation: behavioral treatment plus a fixed schedule of nicotine gum, behavioral treatment plus an ad lib schedule, education plus a fixed schedule, and education plus an ad lib schedule. The four treatment conditions produced similar rates of abstinence (40.9% to 58.3%) at the end of 11 weeks of treatment. However, at 6-month follow-up, the subjects who had received behavioral treatment had a significantly better abstinence rate (36.7%) than those receiving education (17.5%). Nicotine gum schedule had no effect on treatment outcome.

Behavior Therapy↗
PubMed1989

Irrational beliefs, urges to drink and drinking among alcoholics.

The relationship of various irrational beliefs to alcohol dependence, urges to drink, anxiety and drinking after treatment was investigated for 63 male alcoholics, using Jones' Irrational Beliefs Test (IBT). Alcohol dependence was most strongly associated with problem avoidance. Urges to drink, anxiety and difficulty during alcohol-related role-plays were strongly correlated with problem avoidance and dwelling on negative events. The IBT was unrelated to pretreatment drinking measures but did predict 6-month posttreatment drinking (n = 48) which suggests these beliefs can mediate treatment response. Feeling doomed by the past was the best predictor of both frequency of drinking and average quantity consumed during follow-up. Treatment implications include targeting specific beliefs for intervention.

Adaptation, Psychological↗
PubMed1989

A comparative evaluation of a restrictive smoking policy in a general hospital.

The impact of a restrictive smoking policy on the behavior and attitudes of smokers and non-smokers was assessed by surveying random cross-sectional samples of hospital employees before, six months after and 12 months after the policy was implemented, and comparing responses with those of employees of a hospital with no restrictive policy. Effectiveness of policy implementation was also evaluated. Results indicated that the policy was well-publicized and was approved by virtually all the non-smokers and the majority of the smokers. Following implementation, employees in the smoking policy hospital were less likely to report being bothered by smoke at their work stations than were employees of the comparison hospital. Six months and one year after the policy change, smokers reported lower smoking rates while at work, although quit smoking rates and home smoking rates were similar in both hospitals.

Adult↗
PubMed1989

Reactivity to high risk situations and smoking cessation outcome.

Smokers' reactions to a laboratory assessment that simulated high-risk-for-smoking-relapse situations were monitored prior to and at the end of treatment for smoking cessation. Measures included self-reported urges to smoke, efficacy, anxiety, behaviorally rated coping effectiveness, and heart rate. Observed pretreatment responses were unrelated to smoking outcome at the end of treatment. Univariate analyses indicated that decreased efficacy and coping effectiveness and increased urges at the end of treatment were related to relapse during 6-month follow-up. However, multivariate analysis demonstrated that these relationships were a function of the end-of-treatment smoking level. When end-of-treatment smoking rate was controlled for statistically, only increased heart rate response during the assessment predicted smoking status at 6 months. The theoretical significance of the findings is discussed.

Adaptation, Psychological↗
PubMed1989

Evaluating worksite smoking policies. Methodologic issues.

This paper discusses the methodologic issues one confronts when studying the impact of worksite smoking policies, using one such study as an example. Topics covered include defining the research questions, deciding on timing of measurements in relation to policy implementation, advantages and disadvantages of cohort versus cross-sectional research designs, and alternative measurement techniques. The sample study examined changes over one year in the smoking-related behaviors and attitudes of employees of a hospital that initiated a restrictive smoking policy, in relation to employees of a comparable hospital without a restrictive policy. The short term impact on ambient carbon monoxide was also examined. A case is made for studying the impact of smoking policy in the context of other strategies for reducing smoking prevalence at the worksite, such as individual treatment and organizational initiatives to motivate smoking cessation.

Carbon Monoxide↗
PubMed1988

Properties of saliva cotinine in young adult light smokers.

The half-life of saliva cotinine and its accuracy at detecting light or intermittent smoking were examined. Five subjects provided daily saliva samples for 23 days and quit smoking on day 4. An average of 2.8 days was required for saliva continue to drop below the cutoff for classification as a smoker. All smokers smoked intermittently at various times after day 9. In most cases the smoking of one or two cigarettes was detected in the saliva sample on subsequent days. Saliva cotinine was sensitive to low rates of smoking and to intermittent smoking.

Adolescent↗