Biomedical subjects

Ronald Kadden

Publications and source records attributed to Ronald Kadden.

4 recordsLinked to original sources

PubMed2006

Cognitive-behavioral therapy for pathological gamblers.

Few studies have evaluated efficacy of psychotherapies for pathological gambling. Pathological gamblers (N = 231) were randomly assigned to (a) referral to Gamblers Anonymous (GA), (b) GA referral plus a cognitive- behavioral (CB) workbook, or (c) GA referral plus 8 sessions of individual CB therapy. Gambling and related problems were assessed at baseline, 1 month later, posttreatment, and at 6- and 12-month follow-ups. CB treatment reduced gambling relative to GA referral alone during the treatment period and resulted in clinically significant improvements, with some effects maintained throughout follow-up ( ps = .05). Individual CB therapy improved some outcomes compared with the CB workbook. Attendance at GA and number of CB therapy sessions or workbook exercises completed were associated with gambling abstinence. These data suggest the efficacy of this CB therapy approach.

Adolescent↗

PubMed2002

Cognitive functioning of long-term heavy cannabis users seeking treatment.

CONTEXT: Cognitive impairments are associated with long-term cannabis use, but the parameters of use that contribute to impairments and the nature and endurance of cognitive dysfunction remain uncertain. OBJECTIVE: To examine the effects of duration of cannabis use on specific areas of cognitive functioning among users seeking treatment for cannabis dependence. DESIGN, SETTING, AND PARTICIPANTS: Multisite retrospective cross-sectional neuropsychological study conducted in the United States (Seattle, Wash; Farmington, Conn; and Miami, Fla) between 1997 and 2000 among 102 near-daily cannabis users (51 long-term users: mean, 23.9 years of use; 51 shorter-term users: mean, 10.2 years of use) compared with 33 nonuser controls. MAIN OUTCOME MEASURES: Measures from 9 standard neuropsychological tests that assessed attention, memory, and executive functioning, and were administered prior to entry to a treatment program and following a median 17-hour abstinence. RESULTS: Long-term cannabis users performed significantly less well than shorter-term users and controls on tests of memory and attention. On the Rey Auditory Verbal Learning Test, long-term users recalled significantly fewer words than either shorter-term users (P =.001) or controls (P =.005); there was no difference between shorter-term users and controls. Long-term users showed impaired learning (P =.007), retention (P =.003), and retrieval (P =.002) compared with controls. Both user groups performed poorly on a time estimation task (P<.001 vs controls). Performance measures often correlated significantly with the duration of cannabis use, being worse with increasing years of use, but were unrelated to withdrawal symptoms and persisted after controlling for recent cannabis use and other drug use. CONCLUSIONS: These results confirm that long-term heavy cannabis users show impairments in memory and attention that endure beyond the period of intoxication and worsen with increasing years of regular cannabis use.

Adult↗

PubMed2002

Tailoring cannabis dependence treatment for a diverse population.

Accumulating evidence suggests that psychosocial treatment for cannabis dependence is effective. Earlier investigations were well designed and sought to evaluate efficacy of manual-guided therapies with particular attention to protecting the independent variable. The Marijuana Treatment Project (MTP) represents an effort to build upon previous knowledge about cannabis dependence treatment through an evaluation of an integrative therapy, which was meant to allow for greater therapist latitude in its delivery, and to be more responsive to a potentially more diverse population of clients. The treatment intervention developed for delivery in the Marijuana Treatment Project (MTP) reflects an effort to find a true compromise between the needs of the scientific community to have clearly specified and measurable treatments, and the realities of the treatment community, which demand flexibility, appreciation of the multi-determined nature of most problems, and individualized approaches. This paper will describe the clinical interventions used with the MTP participants, the theoretical rationale guiding their design and practical aspects related to implementation and treatment response.

Decision Making↗

PubMed2002

The Marijuana Treatment Project: rationale, design and participant characteristics.

AIMS: Recent findings regarding the prevalence of marijuana dependence and associated consequences indicate the need for empirically validated treatments for this population. The Marijuana Treatment Project (MTP) was a multi-site study of two treatments for adults with marijuana dependence. DESIGN: Participants (N= 450) were randomly assigned to one of three conditions at each of three sites: 1) a 9-session cognitive behavioral treatment (CBT) with motivational enhancement therapy (MET) and case management (CM) components; 2) a 2-session MET intervention; or 3) a delayed treatment control (DTC). SETTING: The study was conducted in outpatient drug treatment clinics in three U.S. cities. PARTICIPANTS: Participants were individuals aged 18 or over who met diagnostic criteria for cannabis dependence and who voluntarily presented for treatment. MEASUREMENT: Study variables included DSM-IV dependence criteria, timeline follow-back assessment of drug use, Addiction Severity Index composite scores, and problems related to marijuana use. FINDINGS: Participants were daily users, who smoked marijuana multiple times per day, and had been doing so for more than 15 years. They reported multiple dependence symptoms and negative consequences related to marijuana use. Approximately 32% of the sample was female, and 30% of the sample was either Hispanic (17%), African American (12%), or of mixed racial backgrounds (1%). CONCLUSIONS: The multi-site nature of the MTP allowed for the recruitment of a more ethnically and gender diverse sample than had been studied previously but there were few differences in the clinical characteristics of participants at the geographically and sociodemographically diverse study sites.

Adolescent↗