Biomedical subjects

T Toneatto

Publications and source records attributed to T Toneatto.

At least 19 recordsLinked to original sources

PubMed2001

Alcohol and drug abusers' perceived reasons for self-change in Canada and Switzerland: computer-assisted content analysis.

Although many people recover from substance-use associated problems on their own, little is known about this phenomenon. The paper had two objectives: to use a new research method, computer-assisted content analysis, to understand alcohol and drug abusers' perceived reasons for self-change and to undertake a comparative evaluation across substances and cultures to validate previous findings about subjective appraisal processes. Three studies of natural recoveries of alcohol and drug abusers in two countries conducted tape-recorded interviews with 216 respondents. The taped responses were coded based on a content analytic dictionary approach using a computerized content analysis program. All three studies found several processes mediating the decision to change substance use. The computer content analysis confirmed a cognitive appraisal process regardless of the cultural setting or substance. The findings suggest that several procedures might have benefit in clinical interventions.

Behavior, Addictive↗

PubMed2000

Diagnostic subgroups within a sample of comorbid substance abusers: correlates and characteristics.

Patients seeking treatment at the Addiction Research Foundation for a substance problem but who also reported psychiatric symptomatology were referred to the Mental Health Unit. Following a clinical psychiatric interview, these patients were categorized into one of six diagnostic subgroups based on the presence of DSM-III-R psychiatric disorders: mood, anxiety, psychotic, organic, Axis-II, and adjustment. A control group of patients referred to the Mental Health Unit but not diagnosed with a psychiatric disorder was also included. These groups were compared on several demographic, substance use, and psychiatric variables. Patients assigned a diagnosis of organic (substance-induced) and Axis II disorders were found to have more severe substance use histories, alcohol-related consequences and longer treatment histories. Patients with a diagnosis of adjustment disorder appeared to be functioning relatively better. Implications of studying the heterogeneity of comorbidity are discussed.

Adult↗

PubMed1999

A metacognitive analysis of craving: implications for treatment.

Cravings and urges are a common component of clinical interventions for substance use and dependence. The conceptual status of this variable remains uncertain, however. Cognitive, conditioning, pharmacological, and biological explanatory models of craving have been developed in recent years. In this article a metacognitive analysis of craving is outlined in which cravings are construed as metacognitions (i.e., statements about other cognitions). In a metacognitive analysis, craving for psychoactive substances is an indication that the individual is experiencing a cognitive event (i.e., thought, feeling, memory, image, sensation) that is aversive or unpleasant. Consumption of a psychoactive substance is a means of self-regulating such cognitive events. Identifying the cognitive experience implicit in the expression of cravings can inform the clinician of the client's deficiencies in cognitive self-regulation and other coping skills. An illustrative example of a metacognitive analysis is presented.

Adaptation, Psychological↗

PubMed1999

Implicit activation of alcohol concepts by negative affective cues distinguishes between problem drinkers with high and low psychiatric distress.

This study tested the hypothesis that negative affective (NEG) cues activate alcohol concepts more strongly in problem drinkers with high rather than low psychiatric distress (PD) and that a parallel difference applies to activation of NEG concepts by alcohol cues. A lexical decision task assessed memory activation in 36 problem drinkers with high vs. low scores on the Symptom Checklist-90. High PD drinkers displayed activation in each condition; low PD drinkers displayed inhibition. Activation of alcohol concepts by NEG cues correlated with intensity of PD, bias to drink in NEG states, and confidence to avoid drinking in these states. Results corroborate in vivo cue reactivity studies and indicate a functional difference between problem drinkers with high and low PD.

Adult↗

PubMed1999

What is the price of perfection? The hidden costs of using detailed assessment instruments to measure alcohol consumption.

OBJECTIVE: This article describes results from a study investigating the effects of using long assessment instruments on attrition rates in mailed-out surveys. METHOD: Participants were randomly assigned to receive one of two versions of a mailed-out survey; one version incorporated a detailed assessment of drinking using the Timeline Follow back method (TLFB; n = 46) and the other employed a brief graduated frequency measure of alcohol consumption (n = 49). RESULTS: 29% fewer respondents who received the TLFB returned any of their survey materials as compared to those respondents who received just the graduated frequency measure (22% vs 51%). CONCLUSIONS: In some situations, e.g., mailed-out surveys, employing detailed survey instruments may not be justified as the increased respondent burden may result in increased attrition rates.

Alcohol Drinking↗

PubMed1999

Cognitive psychopathology of problem gambling.

Drawing on the available research literature on the cognitive distortions present during gambling, a typology of gambling-relevant cognitive distortions is presented. These include the magnification of gambling skills, minimization of other gambler's skills, superstitious beliefs (including talismanic, behavioral, and cognitive superstitions), interpretive biases (including internal attributions, external attributions, gambler's fallacy, chasing, anthropomorphism, reframed losses, hindsight bias), temporal telescoping, selective memory, predictive skill, illusion of control over luck (including luck as an uncontrollable variable, luck as a controllable variable, luck as a trait variable, luck as a contagion), and illusory correlation. In addition, gambling-relevant beliefs about the self are also discussed, including entitlement, omnipotence, cognitive reasoning, and magical thinking.

Attitude↗

PubMed1999

Clinical use of benzodiazepines and decreased memory activation in anxious problem drinkers.

Clinical use of benzodiazepines (BZDs) may improve treatment outcome in anxious problem drinkers. Decreased activation of alcohol-related memories by negative affective cues may partly explain the beneficial effects of BZDs. To explore this possibility, the present study assessed semantic priming of alcohol words by negative affective words in anxious problem drinkers who received their standard dose of BZD and in unmedicated controls. Two groups of nine subjects each were matched on levels of anxiety, alcohol use, and alcohol dependence before performing a lexical decision task. Medicated subjects displayed significantly less activation than did unmedicated subjects on trials containing negative affective primes and alcohol-related targets, but displayed equivalent activation on control trials with neutral, categorized words. Degree of activation also correlated with a drug's affinity for the BZD receptor. These preliminary results suggest that BZD-induced amnesia may contribute to the therapeutic effects of these drugs in anxious problem drinkers.

Adult↗

PubMed1998

The SCL-90 factor structure in comorbid substance abusers.

Previous research has shown that the SCL-90 predicts response to treatment by substance abusers. However, the construct validity of the subscales has been questioned. The present study assessed the factor structure of the SCL-90 in 740 outpatients with coexisting substance use and nonsubstance use psychiatric disorders. The congruency coefficient and salient similarity index tested factorial invariance across gender. Exploratory factor analyses assessed the scale's empirical factor structure. The pattern of loadings for the first three factors was congruent in each gender. The factor analysis yielded three inter-correlated factors that together accounted for 38% of the variance in ratings from the entire sample. A single higher-order factor was identified that explained 60% of the variance in factor scores. These findings are consistent with previous studies that obtained a single predominant factor, and suggest that the SCL-90 primarily taps general psychiatric distress in comorbid substance abusers.

Adult↗

PubMed1997

Cognitive distortions in heavy gambling.

A sample of 38 regular and heavy gamblers, recruited through advertisements and not seeking treatment, were asked to describe special strategies, techniques or rituals that they used to increase their chances of winning at gambling in an open-ended interview. The mean South Oaks Gambling Screen Score for the sample was 7.7 with 64% of the sample scoring higher than 4. Their responses reflected multiple means by which the individual believed they were able to control (i.e., active illusory control, passive illusory control), reframe (i.e., interpretive control), or predict (i.e., probability control, predictive control) gambling outcomes. A larger number of cognitive distortions was associated with playing games in which skill was potentially a component (e.g., cards, sports) than in non-skill games (e.g., lotteries) as well as a positive family history of gambling. There were no sex differences. Implications of these findings for the cognitive psychopathology of gambling are discussed.

Journal Article↗

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

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

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↗

PubMed1991

Opportunities for treatment of psychoactive substance use disorders with serotonergic medications.

The authors review both the preclinical and the clinical evidence for a role of serotonin (5-HT) systems in the regulation of drug-taking behavior. Animal studies show that pharmacologic treatments that enhance 5-HT function, notably selective reuptake inhibitors, reduce the self-administration of a variety of substances of abuse, including ethanol and cocaine. These treatments also tend to suppress consummatory behavior in general. In contrast to the broad spectrum of suppression following 5-HT enhancement, selective antagonists at the 5-HT3 receptor subtype have been reported to reduce ethanol but not cocaine or food intake. Although essentially limited to alcohol abusers, clinical studies seem to support the preclinical findings that a number of 5-HT reuptake inhibitors decrease interest in and intake of alcohol in mild-moderate ethanol-dependent individuals. Furthermore, other serotonergic drugs may show utility in the treatment of alcohol abuse. Another way in which serotonergic medications can be used in treating substance abuse is by the treatment of comorbid psychoactive illness for which such drugs are already known to be effective, e.g., depression and anxiety disorders.

Alcoholism↗

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↗

PubMedDate not supplied

Alcohol abusers' perceptions of the accuracy of their self-reports of drinking: implications for treatment.

Several major literature reviews have concluded that alcohol abusers generally give valid self-reports when interviewed under certain conditions. Nevertheless, across all studies a small proportion of alcohol abusers' self-reports continue to be suspect. Sources of invalidity may relate to subject factors or to circumstances under which data are collected. One novel way of gaining information about conditions possibly affecting the accuracy of alcohol abusers' self-reports is to ask the subjects themselves. In the present study, 208 alcohol abusers were asked about (a) how accurately different people they knew or lived with would report their (i.e., the subjects') drinking at different levels (e.g., abstinent, 1-4 drinks) compared to the subjects' own reports; (b) how accurate their own reports would be at different levels of ethanol consumption; and (c) how accurate their own reports would be when interviewed under different conditions (e.g., by phone, their therapist, a researcher, their employer). The results are largely consistent with studies that have empirically examined the validity of alcohol abusers' self-reports. Suggestions for future research and evaluation are offered.

Adult↗