PubMed Health⌕ Search

Biomedical subjects

L C Sobell

Publications and source records attributed to L C Sobell.

At least 19 recordsLinked to original sources
PubMed1996

Aftercare telephone contacts with problem drinkers can serve a clinical and research function.

Research staff typically gather treatment outcome data, whereas clinicians perform aftercare contacts. To date no alcohol treatment outcome study has examined the utility of therapists collecting outcome data through aftercare contacts. Using the Alcohol Timeline Followback (TLFB) method modified for clinical aftercare contacts, 154 problem drinkers who were part of a cognitive-behavioral intervention completed the modified TLFB with their primary therapist during aftercare telephone contacts conducted 1 and 3 months after their last treatment session. Clients reported their daily alcohol use over the past 30 days using four consumption categories (i.e. 0 drinks, 1-4 drinks, 5-9 drinks and 10+ drinks). At a 6-month follow-up research interview, a trained research assistant gathered standard TLFB data from the clients that included the time period for aftercare contacts. Correlations between the two TLFB formats showed good alternate form reliability, especially for frequency of alcohol use. Discrepancies between reports were positively associated with heavier pre-treatment and post-treatment drinking, suggesting possible memory biases among heavier drinkers. Subject reports also closely paralleled collateral reports of the subjects' drinking. These results support the utility of a brief TLFB instrument for use by therapists in assessing clients' outcomes by telephone during aftercare contacts.

Adolescent↗
PubMed1996

Recovery from alcohol problems with and without treatment: prevalence in two population surveys.

OBJECTIVES: The purpose of this study was to determine the prevalence of recovery from alcohol problems with and without treatment, including whether such recoveries involved abstinence or moderate drinking. METHODS: Data from two surveys of randomly selected adults in the general population were analyzed. Random-digit dialing was used to conduct telephone interviews with 11,634 and 1034 respondents. Respondents 20 years of age or older were categorized on the basis of drinking status and history. RESULTS: Both surveys found that most individuals (77.5% and 77.7%) who had recovered from an alcohol problem for 1 year or more did so without help or treatment. A sizable percentage (38% and 63%) also reported drinking moderately after resolving their problem. CONCLUSIONS: These two surveys are among the first to report prevalence rates for recovery from alcohol problems for treated and untreated individuals and for moderation and abstinence outcomes.

Adult↗
PubMed1995

Effect of cigarette smoking on alcohol treatment outcome.

Although smoking cigarettes and drinking alcohol are highly correlated, little research has examined the effects of smoking on alcohol abusers' posttreatment functioning. Alcohol abusers (N = 155) were classified on the basis of their pretreatment smoking status as: nonsmoker, ex-smoker, low dependent smoker (first cigarette of the day > 10 minutes after waking), and high dependent smoker (first cigarette of the day < or = 10 minutes after waking). All subjects had received brief cognitive-behavioral outpatient treatment for their alcohol problem. Subjects who were less dependent on nicotine had fewer drinking days and fewer heavy drinking days prior to entering treatment than those who were more dependent on nicotine; the two nonsmoking groups had fewer abstinent days than the low nicotine-dependent subjects and fewer heavy drinking days than the high nicotine-dependent subjects. At the 1-year follow-up, the two smoking groups did not differ from each other on the alcohol variables but reported significantly more abstinent days than the two nonsmoking groups. Treatment implications are discussed.

Adult↗
PubMed1995

Resolution from alcohol problems with and without treatment: reasons for change.

Volunteers at a local science center were asked their reasons for quitting or reducing their alcohol consumption. Of 248 respondents, 64 were classified as having had an alcohol problem from which they had successfully resolved for 1 or more years. Three quarters of all respondents resolved without treatment or self-help groups, and over half (57.8%, 37 of 64) of these respondents' resolutions involved nonabstinence (i.e., moderate drinking). The reason for resolution most often endorsed by respondents was that they had "weighed the pros and cons of drinking and not drinking." The implications of these findings for intervention programs are discussed.

Adult↗
PubMed1994

Beliefs about the causes of substance abuse: a comparison of three drugs.

Respondents were randomly assigned to one of three conditions and completed a questionnaire asking about their beliefs regarding the causes of alcohol abuse, cocaine abuse, or cigarette smoking, and about their humanitarian attitudes toward substance abusers. Three major findings emerged: (a) compared to the other substances of abuse, the disease concept was most strongly endorsed for alcohol abuse, the sin conception for cocaine abuse, and the habit conception for smoking; (b) for alcohol abuse only, endorsement of the disease concept was positively related to humanitarian attitudes; and (c) for all three substance types, the sin conception was negatively related to the expression of humanitarian attitudes. Implications of these findings are discussed.

Adult↗
PubMed1994

Clinical efficacy of the 5-HT3 antagonist ondansetron in alcohol abuse and dependence.

Medications that act on the serotonergic system have been found to be of benefit in the treatment of alcohol-dependent individuals. In a randomized, placebo-controlled study, the efficacy of 6 weeks of ondansetron, a 5-HT3 antagonist (0.25 mg bid or 2.0 mg bid), in the treatment of 71 nonseverely alcohol-dependent males was tested. The results showed reduction of drinking differences were steadily increasing toward the end of the treatment period approached significance at week 7 in the 0.25 mg group (p = 0.06). Twice as many patients in this group showed > or = 2 standard deviations decrease in drinking compared with the other groups. When patients drinking > 10 drinks/drinking day at baseline (n = 11) were excluded from the analysis, significant group differences were found at both treatment and follow-up, with the lower ondansetron dose producing the greatest reduction from baseline (i.e., 2.8 standard drinks; -35% compared with baseline and -21% compared with placebo; p < 0.02-0.001). Within this group, there was an almost 4-fold greater number of patients showing a clinically meaningful decrease in drinking. Lower baseline drinking and higher level of education were significant and strong predictors of drinking reduction during treatment. Ondansetron was very well tolerated; hence, further long-term studies with 5-HT3 antagonists alone or in combination with other treatment components may offer promise for treatment of alcoholism.

Adult↗
PubMed1993

What triggers the resolution of alcohol problems without treatment.

This study investigated natural recoveries (self-change) from alcohol problems, and overcame several methodological problems that affected the few previous studies of this phenomenon. Three groups of individuals who had resolved an alcohol problem without treatment were interviewed about their drinking history, life events that occurred during the year prior to their resolution, and factors that helped maintain their resolution. As a control for prevalence of life events, a control group of nonresolved, nontreated alcohol abusers were interviewed about events in a randomly selected year. Collaterals were interviewed for all subjects. No life event or constellation of events was differentially associated with the resolutions across the three resolved groups or differentiated the resolved and nonresolved groups. Interviews with resolved subjects were qualitatively analyzed-the majority (57%) of recoveries were characterized as involving a "cognitive evaluation" or appraisal of the pros and cons of drinking. Spousal support was reported by the greatest number of resolved subjects as having helped them maintain their resolution. Findings from this study may provide direction for developing new treatment strategies and for accelerating self-change among problem drinkers in the community. The study also demonstrates the importance of using a control group, without which very different conclusions might have been drawn.

Adult↗
PubMed1993

What's in a label? The effects of substance types and labels on treatment considerations and stigma.

Visitors (N = 579) to a science center read selected scenarios and evaluated the most likely outcome for a hypothetical substance abuser. Respondents were randomly assigned to one of six scenario conditions: a person with one of three different substance abuse problems (alcohol, tobacco, or cocaine) was crossed with two labels reflecting high or low substance dependence. Results indicated that: (1) cigarettes were viewed as a less serious substance abuse problem than were alcohol or cocaine (a person who smoked cigarettes was rated as more likely to recover from his problem, self-change was regarded as more appropriate and less stigma was associated with smoking than with the other two drugs); (2) non-abstinent recoveries of all types were greeted with skepticism; and (3) recovery was rated as more likely to occur from treatment than from self-change.

Adaptation, Psychological↗
PubMed1993

Severely dependent alcohol abusers may be vulnerable to alcohol cues in television programs.

The self-reported ability of 96 alcohol abusers to resist the urge to drink heavily was assessed after they viewed a videotape of a popular prime time television program complete with advertisements. Different versions of the videotape were used to evaluate the effects of a television program with and without alcohol scenes as crossed with the effects of three different types of commercials (i.e., beer, nonalcoholic beverages, food). Before and after viewing the videotape, subjects, who were led to believe that they were participating in two separate and unrelated sets of experimental procedures, completed several drinking questionnaires. Responses to one of the questionnaires provided an unobtrusive measure of self-reported ability to resist the urge to drink heavily. Results indicated that alcohol cues in a television program affected some alcohol abusers' perceived ability to resist the urge to drink heavily. In particular, those with higher alcohol dependence scores showed a decrease in confidence after viewing a television program with alcohol cues compared to subjects who watched the same program but without the alcohol scenes. The clinical implications of these findings are discussed. Until further research is forthcoming, given the artificial nature of the study setting, the results of this study must be viewed with some caution.

Adult↗
PubMed1992

Gender issues in the treatment of abusers of alcohol, nicotine, and other drugs.

This review considers gender issues in the recent literature for alcohol, nicotine, and other psychoactive drug abuse and for each of the three drug types reports: (1) the ratio of men to women treated; (2) gender differences in treatment outcome; (3) whether the senior author's gender is related to the gender ratio of subjects in studies; and (4) the percentage of studies reporting methodological variables by gender (e.g., dropouts, outcome). No evidence for sex differences was obtained for any drug class. However, despite the recognized importance of gender as a treatment variable, the majority (72%) of studies failed to address gender differences in treatment outcome.

Adult↗
PubMed1992

Predictors of alcohol abusers' inconsistent self-reports of their drinking and life events.

Although considerable research supports the veridicality of alcohol abusers' self-reports, all studies find that some proportion of self-reports are inaccurate. Recently, a few studies have examined variables predictive of inaccurate self-reports and found considerable intersubject variability. The present study examined predictors of alcohol abusers' inconsistent reports of life events and drinking using test-retest reliability data from two questionnaires. Results indicated that inconsistent self-reports were associated with the type (i.e., objective versus subjective) and amount (i.e., more drinking involvement at the first interview was associated with greater discrepant reports at the second interview) of information to be recalled. It appears that the nature of the questions asked may be as much or more of a contributing factor to inaccurate self-reports as subject or setting factors, especially for individuals who report high levels of alcohol use, for whom special efforts may be necessary to gather valid self-report data.

Adult↗
PubMed1992

Characteristics of long-term alprazolam users in the community.

The widespread use of benzodiazepines remains a source of concern to the medical profession and the general public, especially as newer compounds come on the market. Our goal was to characterize long-term alprazolam users in the community and to determine whether such use represented abuse or behavioural dependence. We conducted three community surveys to learn about the natural history of long-term alprazolam use. Current long-term alprazolam users (those using the drug for 3 months or longer) were recruited on three separate occasions 1 year apart by identical newspaper advertisements in the metropolitan Toronto area. All respondents were mailed a questionnaire with a stamped, addressed return envelope. Our data from 312 respondents show that: (1) the majority of patients have a substantial history of prior medication use for symptom control (65%), (2) dose escalation is not a characteristic of long-term use, (3) patients change their initial pattern of regular use to one of symptom control only when required, (4) most physicians do not discuss discontinuation of the drug with their patients, (5) patients frequently try to stop their drug use (with a median of 2 attempts) and often report symptoms upon discontinuation, and (6) patients perceive a need for medication use and indicate that alprazolam is effective (75%). We conclude that some patients persistently use alprazolam but that this use does not represent abuse or behavioral dependence.

Alprazolam↗
PubMed1991

Long-term alprazolam use: abuse, dependence or treatment?

Concern about persistent benzodiazepine use should be informed by data about reasons for such use. Consecutive long term alprazolam users (n = 25) admitted to an advertised outpatient program for discontinuation were characterized with respect to alprazolam use patterns and lifetime and current Axis I and II disorders. Patient characteristics were: females 50 percent; mean age, 46 +/- 12 yrs; prior medication use--benzodiazepines, 47 percent, antidepressants, 23 percent; median duration of use 104 +/- 96 wks; median daily dose, 0.5 mg; continued effectiveness of alprazolam 50 percent. Over the duration of use patients shifted their initial pattern of use from as prescribed to a self-controlled "as required" basis (p less than .05). Interviews using the Structured Clinical Interview for DSM-III-R (SCID) yielded diagnoses of DSM-III-R alprazolam dependence in all patients plus at least one additional psychiatric diagnosis in 65 percent (Axis I 65%; Axis II 39%). Most persistent alprazolam use does not represent abuse or addiction as usually understood. These data are most consistent with the interpretation that alprazolam is the most recent benzodiazepine used by patients to help control clinically important psychopathology and that most users make efforts to control or stop use.

Adult↗
PubMed1990

A procedure for reducing errors in reports of life events.

Despite the widespread use of life event inventories, relatively little research has been conducted evaluating whether recall techniques can reduce reporting errors. This study evaluated whether memory aids would reduce errors in reports of life events and explored subjects' explanations for why they had given inconsistent answers to life event questions over the course of two interviews. Seventy-one college students were randomly assigned to two groups: memory aids (MA: n = 36) and no memory aids (NMA: n = 35). Memory aids, as used in this study, reduced errors in reports of life events as reflected in the following results: (1) significantly fewer subjects in the MA group reported dating events incorrectly; (2) subjects in the MA group consistently gave more reliable responses between the two interviews as measured by intraclass correlations; (3) there was a significantly higher test-retest reliability correlation for life events reported by MA subjects; and, (4) MA subjects recalled more life events and had fewer inconsistent responses. A further probe revealed that memory aids differentially aided recall of subjective as compared to objective life events. Overall, the findings of this study suggest that memory aid procedures can differentially reduce errors in reporting life events.

Adult↗
PubMed1990

Pathological gambling treated with cognitive behavior therapy: a case report.

A novel approach to the cognitive behavioral treatment of pathological gambling is described. The approach is based on the hypothesis that biased information may form the basis of the rules governing gambling behavior. The treatment focused on modifying assumptions and beliefs underlying the gambling behavior of a 47-year-old male with a 26-year gambling history. Based on a 6-month follow-up, the intervention successfully reduced the frequency of the client's gambling behavior from 10 times per month in the 3 years prior to treatment to three total times in the 6-month follow-up period.

Alcoholism↗
PubMed1990

Alcohol or tobacco research versus alcohol and tobacco research.

Despite the frequent co-occurrence of tobacco and alcohol use, little is known about relationships between alcohol and nicotine. This paper reviews similarities and differences between tobacco and alcohol use, offers speculation about why a marriage of the two fields has been so long in coming, and discusses the multiple scientific and therapeutic benefits that could derive from the study of individuals who use both drugs.

Alcoholism↗