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Biomedical subjects

Jalie A Tucker

Publications and source records attributed to Jalie A Tucker.

11 recordsLinked to original sources
PubMed2006

Significance of a behavioral economic index of reward value in predicting drinking problem resolution.

This study investigated whether a behavioral economic index of the value of rewards available over different time horizons improved prediction of drinking outcomes beyond established biopsychosocial predictors. Preferences for immediate drinking versus more delayed rewards made possible by saving money were determined from expenditures prior to resolution attempts by problem drinkers with different help-seeking experiences (N = 144). As hypothesized, stable resolutions over a 2-year follow-up were associated with proportionally more preresolution discretionary expenditures on savings and less on alcohol compared with unstable resolutions. The relationship held regardless of help-seeking history, and preresolution drinking practices, problems, and income were similar across outcomes. The findings extend experimental work on behavioral economics and indicate that measuring monetary allocation improves prediction of outcomes.

Alcohol Drinking↗
PubMed2006

Need and non-need factors associated with addiction treatment utilization in a cohort of homeless and housed urban poor.

BACKGROUND: Research on addiction treatment utilization in indigent samples mainly has been retrospective, without measures of addictive consequences, social network influences, and motivation. Prospective assessment of factors influencing utilization could inform policy and clinical care. OBJECTIVE: We sought to identify factors associated with utilization of addiction treatment and mutual help groups among substance-dependent persons with high rates of homelessness. RESEARCH AND METHODS: This was a prospective cohort of patients detoxified from alcohol or drugs at baseline who were followed for 2 years in a randomized clinical trial of linkage to primary care (n = 274). Outcomes included utilization of Inpatient/Residential, Outpatient, Any Treatment, and Mutual Help Groups. Predictor variables in longitudinal regression analyses came from the literature and clinical experience, organized according to theoretical categories of Need, and non-Need (eg, Predisposing and Enabling). RESULTS: Many subjects used Inpatient/Residential (72%), Outpatient (62%), Any Treatment (88%) or Mutual Help Groups (93%) at least once. In multivariable analyses, addictive consequences (odds ratio [OR] 1.38, 95% confidence interval [CI] 1.12-1.71), motivation (OR 1.32, 95% CI 1.09-1.60), and female gender (OR 1.80, 95% CI 1.13-2.86) were associated with most treatment types (ORs are for Any Treatment). Homelessness was associated with Residential/Inpatient (for Chronically Homeless vs. Housed, OR 1.75, 95% CI 1.04-2.94). Living with one's children (OR 0.51, 95% CI 0.31-0.84) and substance-abusing social environment (OR 0.65, 95% CI 0.43-0.98) were negatively associated with Any Treatment. CONCLUSIONS: In this cohort of substance-dependent persons, addictive consequences, social network variables, and motivation were associated with treatment utilization. Non-need factors, including living with one's children and gender, also were significant.

Adult↗
PubMed2006

Extending the evidence hierarchy to enhance evidence-based practice for substance use disorders.

PURPOSE: This paper examines the evidence-based practice (EBP) movement in the context of the developmental status of theory, research and practice on substance use disorders. SCOPE: Hierarchical views that favor randomized controlled trials (RCTs) over other forms of evidence are reviewed, and the benefits and limitations of RCTs are considered as they intersect with contemporary issues in the field. FINDINGS: RCTs with lengthy follow-up intervals comprise an important piece of the relevant evidence base, especially for establishing treatment efficacy, but their continued centrality as the 'gold standard' of evidence for informing substance abuse practice is questioned. CONCLUSIONS: Given the status of knowledge, advances in science and practice will probably come from longitudinal studies of the changeable course of addictive behaviors and processes over long time frames and that investigate linkages with treatment selection factors and other surrounding contextual variables that also change through time. Benefits of evidentiary pluralism for advancing an interdisciplinary approach to research and practice are considered.

Behavior, Addictive↗
PubMed2004

Different variables are associated with help-seeking patterns and long-term outcomes among problem drinkers.

This study investigated variables associated with help-seeking for drinking problems and with long-term drinking outcomes. In a 3 x 2 design, problem drinkers (N=167) were selected according to their help-seeking history [no assistance (NA), Alcoholics Anonymous (AA) only, or treatment plus AA (TxAA)] and current drinking status [resolved abstinent (RA) for >2 years or non-resolved (NR) active drinkers]. Drinking practices and problems, influences on help-seeking, and life events were assessed retrospectively during structured interviews. Participant reports were verified through collateral or reliability interviews. Stable resolution was associated with heavier drinking and greater negative life events before resolution. Seeking help, especially from treatment, was associated with greater psychosocial problems and higher dependence levels. The results indicate that different dimensions of drinking problems are associated with help-seeking and drinking outcomes, and suggest ways to increase help-seeking.

Adult↗
PubMed2004

A factor analytic study of influences on patterns of help-seeking among treated and untreated alcohol dependent persons.

Influences on seeking help from professional alcohol treatment and from Alcoholics Anonymous (AA) were investigated using problem drinkers (N = 167) with different help-seeking experiences (no assistance, AA only, or treatment plus AA) and current drinking statuses (sustained abstinence for > 2 years or active problem drinking). Depending on their help-seeking experiences, participants rated barriers to or reasons for seeking help from treatment and AA, which were factor analyzed. Common impediments to help-seeking included privacy concerns and participants' beliefs that they could solve their problem on their own and that it was not serious enough to seek help. Common reasons for help-seeking included social and other functional problems related to drinking. There were also influences unique to treatment (e.g., cost) and to AA (e.g., group format). Help-seeking factors did not vary by drinking status. The implications for increasing help-seeking among problem drinkers are discussed.

Alcoholics Anonymous↗
PubMed2002

Predicting natural resolution of alcohol-related problems: a prospective behavioral economic analysis.

This study investigated whether the relative allocation of discretionary monetary expenditures to alcoholic beverages versus savings (presumed to reflect relative preferences for immediate vs. delayed rewards) before quitting abusive drinking predicted natural resolution among untreated problem drinkers. Drinking, life events, income, and expenditures were assessed for the year before resolution and again 1 and 2 years later (N = 50). Compared with those who relapsed, participants who remained resolved at 2 years reported proportionally more pre-resolution discretionary expenditures on savings and less on alcohol. Income and expenditures were similar across groups. The findings support the predictive utility of this functional index of relative reward preferences that operate over variable time horizons and suggest that temporal discounting is an important process in addictive behavior change.

Adult↗
PubMed2002

Environmental contexts surrounding resolution of drinking problems among problem drinkers with different help-seeking experiences.

OBJECTIVE: This study investigated whether similar environmental contexts surround abstinent resolutions associated with different intervention experiences, including no assistance. METHOD: Participants were selected in a 3 x 2 design (25-30 per group, N = 167) according to their help-seeking experiences (no assistance, Alcoholics Anonymous [AA] only, treatment plus AA) and current drinking status (resolved abstinent [RA] for >2 years or nonresolved [NR] controls). Life events were assessed retrospectively over a 4-year period that spanned the 2 years before and 2 years after the initiation of stable abstinence by RA participants or over a matched interval for NR participants. Collateral or reliability interviews were conducted for 84% of the sample as checks on participant reports. RESULTS: Across help-seeking groups, RA participants reported decreased negative events and increased positive events from the pre- through the post-resolution period. Interventions, especially treatment, enhanced the postresolution improvements in RA participants' life circumstances. This pattern was absent among NR participants. CONCLUSIONS: The findings suggest that a similar molar environmental context surrounds resolutions achieved with and without interventions and that interventions are associated with enhanced improvements during maintenance.

Adult↗
PubMedDate not supplied

Temporal sequencing of alcohol-related problems, problem recognition, and help-seeking episodes.

Little is known about temporal relations between the development of alcohol-related problems, self-recognition of problems, and help seeking from professional and lay sources. The sequencing of these events was investigated retrospectively using a community sample of male and female problem drinkers (N= 101) who varied in their help-seeking histories [no assistance, Alcoholics Anonymous (AA)-only, or treatment-plus-AA] and current drinking status (resolved abstinent or nonresolved). The rank-order of events was similar across groups and gender. Problem recognition typically occurred early with the onset of pathological drinking and related psychosocial problems. Health problems and help seeking were late developments, if they occurred at all. Although the sequence order was similar across groups, the latency to help seeking varied; help seeking was more rapid among women, resolved participants, and participants who had sought help from both treatment and AA. The findings question conventional views that denial deters help seeking and suggest opportunities for screening and early intervention.

Alcoholism↗