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Biomedical subjects

Nancy M Petry

Publications and source records attributed to Nancy M Petry.

69 records · Page 4Linked to original sources
PubMed2002

Discounting of delayed rewards in substance abusers: relationship to antisocial personality disorder.

RATIONALE: Delay discounting is associated with impulsivity and drug abuse, and this study evaluated the relationship between discounting of delayed rewards and antisocial personality disorder (ASP). OBJECTIVES: To determine whether discounting is increased in substance abusers with ASP relative to those without; both groups were compared with non-substance-abusing controls. METHODS: Subjects ( n=166) chose between hypothetical monetary amounts available after various delays or immediately. Under one condition, a US $1000 reward was delayed at intervals ranging from 6 h to 25 years. At each delay interval, the immediately available rewards varied from US $1 to US $999 until choices reflected indifference between the smaller immediate and larger delayed rewards. Under a second condition, the delayed reward was US $100, and immediate rewards varied from US $0.10 to US $99.90. RESULTS: In all three groups, hyperbolic discounting functions provided a good fit of the data, and the smaller reward was discounted at a higher rate than the larger reward. Substance abusers discounted delayed rewards at significantly greater rates than controls, and substance abusers with ASP discounted delayed rewards at higher rates than their non-ASP substance-abusing counterparts. Discounting rates were correlated with impulsivity scores on a personality questionnaire. CONCLUSIONS: These results provide further evidence of more rapid discounting of delayed rewards in substance abusers, especially among substance abusers with a co-morbid diagnosis of ASP.

Adult↗
PubMed2002

Recent advances in the dissemination of contingency management techniques: clinical and research perspectives.

Research studies have demonstrated the efficacy of contingency management procedures in treating substance use disorders. However, these procedures have only recently been adapted to and tested within community-based clinical settings. This article reviews recent advances in the field of contingency management, with attention to dissemination issues. Counselor's reactions to the implementation of these techniques in individual and group treatment modalities are detailed. Suggestions are made for areas in which more research is needed, from both a counselor's and researcher's perspective.

Clinical Trials as Topic↗
PubMed2002

Low-cost contingency management for treating cocaine- and opioid-abusing methadone patients.

This study evaluated the efficacy of a low-cost contingency management (CM) procedure in reducing concurrent cocaine and opioid use among methadone patients. Forty-two patients were randomly assigned to 12 weeks of standard treatment or standard treatment plus CM. CM patients eamed the opportunity to draw from a bowl and win prizes ranging from $1 to $ 100 in value for submitting samples negative for cocaine and opioids. Patients in the CM condition achieved longer durations of continuous abstinence than patients in the standard treatment condition, and these effects were maintained throughout a 6-month follow-up period. On average, patients in the CM condition earned $137 of prizes. These data suggest that this prize reinforcement procedure may be suitable for community-based settings.

Adult↗
PubMed2002

Disordered gambling among university-based medical and dental patients: a focus on Internet gambling.

The authors evaluated gambling behaviors, including Internet gambling, among patients seeking free or reduced-cost dental or health care. Three hundred eighty-nine patients at university health clinics completed a questionnaire that included the South Oaks Gambling Screen (SOGS; H. R. Lesieur & S. Blume, 1987). All respondents had gambled in their lifetimes, with 70% gambling in the past 2 months. On the basis of SOGS scores, 10.6% were problem gamblers, and 15.4% were pathological gamblers. The most common forms of gambling were lottery, slot machines, and scratch tickets. Internet gambling was reported by 8.1% of participants. Compared to non-Internet gamblers, Internet gamblers were more likely to be younger, non-Caucasian, and have higher SOGS scores. This study is among the first to evaluate the prevalence of Internet gambling and suggests that people who gamble on the Internet are likely to have a gambling problem. Results also illuminate the need to screen patients seeking health care services for gambling problems.

Adult↗
PubMed2002

How treatments for pathological gambling can be informed by treatments for substance use disorders.

Substance use disorders and pathological gambling share similarities in terms of diagnostic criteria, epidemiology, and clinical course. However, relatively few studies have evaluated the efficacy of treatments for gambling disorders. As interest in pathological gambling grows, adaptation of effective treatments from the field of substance abuse may advance the study of treatment for pathological gambling. This article reviews the similarities and differences between pathological gambling and substance use disorders. It describes psychotherapeutic and pharmacological treatments for substance use disorders and their translation to pathological gambling. Future research should consider investigating the onset and course of pathological gambling within the context of other psychiatric disorders, biological abnormalities associated with gambling, and combined effects of psychotherapy and pharmacotherapy in the treatment of this disorder.

Animals↗
PubMed2002

Gender differences among pathological gamblers seeking treatment.

This study investigated gender differences among treatment-seeking pathological gamblers. During treatment intake, 115 pathological gamblers completed the Addiction Severity Index (ASI; A. T. McLellan et al., 1985), including a section on gambling severity, as well as the South Oaks Gambling Screen (H. R. Lesieur & S. B. Blume, 1987). When age and income were controlled, gender differences emerged in ASI gambling, alcohol, and legal scores. Men initiated gambling, began gambling regularly, tried to stop gambling, and first entered gambling treatment at a younger age than women. Women were more likely to be living with someone with a gambling or drinking problem but themselves had fewer alcohol and legal problems. Results suggest that gender differences exist in the initiation of gambling dysfunction and its psychosocial correlates. Understanding these differences may assist in developing treatments that address differential needs of male and female pathological gamblers.

Adult↗
PubMed2002

Cigarette smoking is associated with increased severity of gambling problems in treatment-seeking gamblers.

AIMS: Cigarette smoking and gambling often co-occur, but very little is known about smoking or its correlates in disordered gamblers. This study compared gambling and psychosocial problems in treatment-seeking gamblers who smoke versus those who do not. METHODS: At intake to gambling treatment programs, gamblers completed the addiction severity index (ASI) and gambling questionnaires. Subjects were categorized into non-daily smokers (n=107) and daily smokers (n=210). Differences in demographics, gambling variables and ASI composite scores were compared between the groups. RESULTS: The daily smokers were more likely to have a history of treatment for a substance use disorder than the non-daily smokers. After controlling for substance abuse treatment histories, gender and age, the daily smokers demonstrated more severe gambling, family/social and psychiatric problems. Compared to non-daily smokers, the daily smokers gambled on more days and spent more money gambling; they also 'craved' gambling more and had lower perceived control over their gambling. The daily smokers were more likely to be taking psychiatric medications, and they experienced psychiatric symptoms, especially anxiety symptoms, on a greater number of days than non-daily smokers. IMPLICATIONS: Results from this study suggest that about two-thirds of treatment-seeking gamblers are current daily cigarette smokers, and smoking status is associated with more severe gambling and psychiatric symptoms. These results warrant further investigation of smoking in gamblers and whether smoking adversely affects the course of treatment or outcomes among gamblers.

Adult↗
PubMed2002

A comparison of young, middle-aged, and older adult treatment-seeking pathological gamblers.

PURPOSE: Pathological gambling is an increasing public health concern, but very little is known about this disorder in older adults. This study evaluated gambling and psychosocial problems across age groups in treatment-seeking gamblers. DESIGN AND METHODS: At intake to gambling treatment programs, 343 pathological gamblers completed the Addiction Severity Index (ASI) and gambling questionnaires. Participants were categorized by age into young adults (ages 18-35 years; n = 97), middle-aged adults (ages 36-55 years, n = 197), and older adults (aged older than 55 years, n = 49). Differences in demographics, gambling variables, and ASI composite scores were compared across the groups. RESULTS: The middle- and older age gamblers were more likely to be female (45%-55%) than were the younger gamblers (23%), but the groups were similar with respect to most other demographic variables. When controlled for gender, older age was associated with increased employment problems, but fewer social, legal, and substance-abuse difficulties. Compared with middle-aged gamblers, older gamblers wagered on fewer days. Age x Gender effects emerged in onset of gambling problems and amount spent gambling. Older women did not begin gambling regularly until an average age of 55 years, whereas older male gamblers generally reported a lifelong history of gambling. The older female gamblers also wagered the greatest amounts in the month prior to treatment entry. IMPLICATIONS: These data suggest that older adults compose a minority of treatment-seeking gamblers, but differences in psychosocial problems across the age groups may suggest the need for interventions tailored to particular issues encountered by older pathological gamblers. Specifically, treatments focusing on later life development of problems may be indicated for older female gamblers.

Adult↗
PubMed2002

Suicidal ideation and suicide attempts in treatment-seeking pathological gamblers.

This study assessed rates and correlates of suicidal ideation and suicide attempts in individuals seeking treatment for pathological gambling. At intake to gambling treatment programs, 342 pathological gamblers completed the Addiction Severity Index and the South Oaks Gambling Screen. Participants were categorized into three groups: no suicidal ideation (N = 175, 51%), suicidal ideation alone (N = 109, 32%), and suicide attempters (N = 58, 17%). After controlling for gender, age, treatment site, and substance abuse treatment histories, differences among the groups emerged in terms of severity of psychiatric, social/family, and gambling problems. Compared with nonsuicidal gamblers, those with suicidal ideation suffered from more psychiatric symptoms, were less satisfied with their living situations, and experienced more days of conflict in the month before entering gambling treatment. Compared with pathological gamblers with no history of suicidal ideation, those with suicidal ideation spent more money gambling in the month before entering treatment, reported greater cravings for gambling, and had higher South Oaks Gambling Screen scores. These data confirm other reports of high rates of suicidality in pathological gamblers and may suggest the need for more intensive and focused treatments in pathological gamblers with suicidality.

Adult↗
PubMed2002

Effects of gender and family history of alcohol dependence on a behavioral task of impulsivity in healthy subjects.

OBJECTIVE: Substance misusers are often considered impulsive, but it is unclear whether impulsivity precedes substance misuse or develops as a consequence of it. Because alcohol dependence has a clear familial component, a study comparing impulsivity in nonaffected individuals who differ with respect to paternal history of alcohol dependence may provide evidence of familial vulnerability to impulsivity. METHOD: 122 healthy individuals participated, none of whom misused alcohol or drugs; 58 were paternal history positive (PHP) and 64 were paternal history negative (PHN) for alcohol dependence. The paternal-history groups were balanced on gender, and the four paternal-history-by-gender groups were comparable with respect to demographic features. Participants were offered choices between monetary rewards (e.g., $34) available immediately and larger rewards (e.g., $50) available after delays ranging from 1 week to 6 months. This task measures a construct of impulsivity by assessing the rates at which individuals discount rewards delayed in time. RESULTS: Although discount rates in PHP men did not differ reliably from those in PHN men, PHP women had higher discount rates than PHN women. Post hoc contrasts revealed that PHN women had lower discount rates than the other three groups. Similar results were obtained when age, education, socioeconomic status, and scores on a measure of sociopathy were used as covariates. CONCLUSIONS: Paternal history of alcohol dependence is associated with greater discount rates among women. The lack of an effect for men may suggest different mechanisms by which risk is transmitted from alcohol-dependent fathers to daughters compared with sons. Further research examining these relations and the implications that delay discounting has for drinking and related behaviors is warranted.

Adult↗
PubMedDate not supplied

Severity of gambling is associated with physical and emotional health in urban primary care patients.

OBJECTIVE: The purpose of this study is to assess the prevalence of recreational and disordered gambling, and to identify its association with health functioning, in urban primary care patients. MATERIALS AND METHODS: Data were collected from 574 adults presenting to an urban primary care medical clinic. Participants completed the South Oaks Gambling Screen, Short Form-12 Health Survey, Second Edition and questions assessing demographic characteristics and frequency and intensity of current gambling behaviors. RESULTS: Overall, 10.6% of participants met lifetime criteria for pathological gambling, and an additional 5.1% were classified as problem gamblers. Pathological gamblers and problem gamblers reported more health-related concerns than recreational gamblers and nongamblers on indices of physical and emotional functioning. Contrary to prior research, recreational gambling was not associated with better health. CONCLUSION: These data suggest that disordered gambling is relatively common in primary care settings, and gambling severity is associated with decreased health functioning.

Adult↗
PubMedDate not supplied

Relationship between custodial status and psychosocial problems among cocaine-abusing parents initiating substance abuse treatment.

Using the Addiction Severity Index and Brief Symptom Inventory, drug use and psychosocial problems are compared between 93 custodial and 125 non-custodial mothers and fathers initiating outpatient treatment for cocaine dependence. Compared to non-custodial parents, custodial parents experienced more severe current cocaine and alcohol problems, including spending more money on cocaine and alcohol, as well as using more cocaine and being intoxicated on more days. Non-custodial parents demonstrated more psychological distress, more prior history of alcohol problems, and greater current employment and legal problems than custodial parents. Suggestions are made for differential treatment plans based on these findings.

Adult↗
PubMedDate not supplied

Prevalence and health correlates of gambling problems in substance abuse counselors.

This study examined the prevalence of disordered gambling in substance abuse counselors. Participants (N = 328) completed an anonymous self-report survey assessing lifetime disordered gambling, past two-month gambling behavior, and current mental and physical health. The lifetime prevalence rates of pathological and problem gambling in this sample (11.9% and 6.4%, respectively) were higher than rates reported in general population surveys. Poorer physical health was associated with pathological gambling, but mental health was not. These results suggest that substance abuse counselors may benefit from education, prevention, and intervention efforts for disordered gambling.

Adult↗
PubMedDate not supplied

Health problems and medical utilization associated with gambling disorders: results from the National Epidemiologic Survey on Alcohol and Related Conditions.

OBJECTIVE: Pathologic gambling is believed to be associated with adverse health consequences, but no prior studies have rigorously evaluated these relationships. We sought to examine medical disorders and health service utilization associated with problem and pathologic gambling. METHOD: A total of 43,093 adults aged 18 years and older were evaluated in the 2001 to 2002 National Epidemiologic Survey on Alcohol and Related Conditions. Self-reported medical diagnoses and past-year medical services used were assessed. RESULTS: Pathologic gamblers were more likely than low-risk individuals to have been diagnosed with tachycardia (odds ratio [OR] = 1.77; 95% confidence interval [CI] = 1.05-2.97), angina (OR = 2.35; 95% CI = 1.33-4.15), cirrhosis (OR = 3.90; 95% CI = 1.11-13.72), and other liver disease (OR = 2.98; 95% CI = 1.07-8.26). Gambling severity was also associated with higher rates of medical utilization with pathologic gamblers more likely than low-risk individuals to have been treated in the emergency room in the year before the survey (OR = 1.98; 95% CI = 1.27-3.09). Significant effects of gambling severity remained even after controlling for demographic characteristics (age, gender, ethnicity, marital status, education, income, and region of the country) and behavioral risk factors such as body mass index, alcohol abuse and dependence, nicotine dependence, and mood and anxiety disorders. CONCLUSIONS: A lifetime diagnosis of pathologic gambling is associated with several medical disorders and increased medical utilization, perhaps leading to a burden on healthcare costs in the United States.

Adolescent↗