Brenda Curtis

Evaluating the risk and attractiveness of romantic partners when confronted with contradictory cues.

Research shows that people engage in “risky” sex with “safe” partners and in “safer” sex with “riskier” partners. How is the determination of “risky” or “safe” status made? Factorial survey methodology was used to randomly construct descriptions of romantic partners based on attractive and/or risky characteristics. Respondents evaluated 20 descriptions for attractiveness, health risk, likelihood of going on a date, likelihood of unprotected sex, and likelihood of STD/HIV infection. Respondents were most attracted to and perceived the least risk from attractive descriptions and were least attracted to and perceived the most risk from the risky descriptions. The differences between the “conflicting information” descriptions are attributable to a primacy effect: descriptions that began with attractiveness information but end with risk information were evaluated more positively than those that began with risk and ended with attractive information.

Translating SBIRT to public school settings: an initial test of feasibility.

Public schools are not traditional locations where screening, brief motivational counseling intervention and referral to treatment (SBIRT) are provided. This translational research study aimed to test the feasibility of conducting SBIRT in two urban New York schools and to examine its economic sustainability. In Spring 2012, 248 students were screened during non-academic classes: 42% of them (n=105) reported substance use (versus 28% reported in school-wide, paper anonymous survey). All but one of the positively screened students voluntarily accepted one or more brief intervention sessions and two students were referred to treatment. This school-based SBIRT model did not interfere with academic activities, was feasible to implement, and was attractive to students, teachers and administration. The data offer clear indication that further effectiveness testing is warranted and potentially valuable, however the sustainability of this model was not supported due to our lack of obtaining insurance information, authorization and reimbursement.

Romance and risk: romantic attraction and health risks in the process of relationship formation

This paper reports on a study that identified which of 36 possible attributes of potential romantic partners were perceived as most important for selecting a romantic partner. It also quantified perceived risk and perceived attractiveness judgments for 159 partner characteristics (‘aspects’). Thus, it directly investigated the partner characteristics that reflect both risk and attractiveness as well as the correlation between these two concepts. Every one of the 36 attributes were viewed as important by at least some respondents and there was wide variance in the frequency with which they were chosen. While almost 80% of the respondents felt it was important to know something about the potential partners ‘appearance’, less than 4% felt it was important to know about ‘accessories’. In addition to ‘appearance’, only 3 other attributes were selected as one of the 15 most important by at least 60% of respondents. The gamma association across aspects between average risk and average attractiveness was − 0.61, suggesting that the more one is attracted to some aspect of a potential partner, the less likely is one to view that aspect as ‘risky’. This may help explain why it sometimes appears that risk information is ignored when it concerns a partner to whom one is attracted. Somewhat surprisingly, there were remarkable similarities between gender and among ethnicities with respect to both selecting attributes that are important in partner selection and in identifying both attractive and risky aspects.

Understanding Tailored Internet Smoking Cessation Messages A Reasoned Action Approach

Although message tailoring has been shown to produce experimental effects in previous studies, the cognitive mechanisms through which tailoring works have not been sufficiently studied. Using the integrative model to predict intentions to use the nicotine replacement patch among adult smokers, this study examines how tailoring theoretical elements of the integrative model is effective in changing the theoretical mediators. Participants were randomized into one of two conditions. In the experimental condition, participants received messages tailored to some or all of the underlying behavioral, injunctive normative, or self-efficacy beliefs with the expectation that changing the underlying beliefs would result in experimental differences in the integrative model’s direct measures. This expectation was confirmed. The integrative model also worked well in predicting intentions to perform the target behavior; attitude, perceived normative pressure, and perceived behavioral control accounted for 53 percent of the variance in intentions. Attitude and normative pressure were the strongest predictors of intention. These results provide support for tailoring messages using a reasoned action approach and provide insight into the mechanism through which message tailoring operates.

Balancing Risk and Benefit in Heavy Drinkers Treated With Topiramate: Implications for Personalized Care

BACKGROUND Despite topiramates ability to reduce heavy drinking, its adverse effects may limit its clinical utility. METHOD To evaluate the risks and benefits of topiramate, we reanalyzed data from a completed trial of the medication in 138 heavy drinkers whose goal was to reduce their drinking to safe levels. We used the number of patients who had no heavy drinking days during the last 4 weeks of treatment to calculate topiramates number needed to treat (NNT). To balance the risks and benefits of topiramate, we adjusted the NNT using 2 different levels of adverse event severity: moderate or greater (NNT-AEmod+) and severe or greater (NNT-AEsev+). This measure helps to guide the clinical use of topiramate in heavy drinkers by incorporating both its beneficial and adverse effects in a single measure. Because a polymorphism (rs2832407) in the gene encoding a kainate receptor subunit appears to moderate topiramates effects in heavy drinkers, we repeated the analyses based on rs2832407 genotype (C-homozygote vs A-allele carrier) in the European American subsample (n = 122). RESULTS Overall, the NNT for topiramate was 5.29, the NNT-AEmod+ was 7.52, and the NNT-AEsev+ was 6.12. Among European Americans with the rs2832407*CC genotype, the NNT was 2.28, the NNT-AEmod+ was 2.63, and the NNT-AEsev+ was 2.56. In contrast, for rs2832407*A-allele carriers, the NNT was 180.00, the NNT-AEmod+ was 322.16, and the NNT-AEsev+ was 217.45. CONCLUSIONS In this sample of heavy drinkers, topiramate had a clinically important treatment effect that was most evident in European Americans with the rs2832407*CC genotype. In that group, in particular, it had a robust treatment effect, even when adjusted for adverse events. TRIAL REGISTRATION ClinicalTrials.gov identifier: NCT00626925.

Smoking and Cellular Telephone Use Among Pregnant Women Seeking Prenatal Care: Opportunities for Intervention.

Objectives:Although smoking during pregnancy is associated with poor pregnancy outcomes, many women continue to smoke throughout pregnancy. Behavioral interventions for smoking cessation yield modest benefits, particularly in lower socioeconomic groups. Pharmacotherapy, a first-line option for smoking cessation, has not shown clear benefits for pregnant smokers, partly due to limited adherence. We evaluated the feasibility of conducting a pharmacotherapy trial for smoking cessation in pregnant women, using text messaging to enhance medication adherence. Materials and Methods:We surveyed 724 predominantly minority pregnant women to examine the prevalence and correlates of smoking and the use of cellular telephones and text messaging. Results:Nearly 18% of the respondents were current smokers, with a majority (67.7%) expressing interest in participating in a smoking cessation trial. Only about 6% of women with a smoking history ever received nicotine dependence treatment. Smokers were significantly more likely to be depressed than nonsmokers. The vast majority of respondents (92.1%) owned cell phones, with 93.2% having an unlimited text messaging plan. Conclusions:These data support the feasibility of conducting a pharmacotherapy smoking cessation trial and using text messaging to enhance medication adherence in a predominantly minority population of pregnant smokers.

Peer-delivered harm reduction and recovery support services: initial evaluation from a hybrid recovery community drop-in center and syringe exchange program

BackgroundRecovery from substance use disorder (SUD) is often considered at odds with harm reduction strategies. More recently, harm reduction has been categorized as both a pathway to recovery and a series of services to reduce the harmful consequences of substance use. Peer recovery support services (PRSS) are effective in improving SUD outcomes, as well as improving the engagement and effectiveness of harm reduction programs.MethodsThis study provides an initial evaluation of a hybrid recovery community organization providing PRSS as well as peer-based harm reduction services via a syringe exchange program. Administrative data collected during normal operations of the Missouri Network for Opiate Reform and Recovery were analyzed using Pearson chi-square tests and Monte Carlo chi-square tests.ResultsIntravenous substance-using participants (N = 417) had an average of 2.14 engagements (SD = 2.59) with the program. Over the evaluation period, a range of 5345–8995 sterile syringes were provided, with a range of 600–1530 used syringes collected. Participant housing status, criminal justice status, and previous health diagnosis were all significantly related to whether they had multiple engagements.ConclusionsResults suggest that recovery community organizations are well situated and staffed to also provide harm reduction services, such as syringe exchange programs. Given the relationship between engagement and participant housing, criminal justice status, and previous health diagnosis, recommendations for service delivery include additional education and outreach for homeless, justice-involved, LatinX, and LGBTQ+ identifying individuals.

“Abusing Addiction”: Our Language Still Isn’t Good Enough

ABSTRACT Previous research has found initial evidence that word choice affects the perception and treatment of those with behavioral health disorders. These previous studies have relied on vignette-based methodologies, however, and a more quantifiable index of the stigma words can produce is needed. The current study uses the Go/No-Go Association Task to calculate a d-prime (sensitivity) indexed score of automatic attitudes to two terms, substance abuser and person with substance use disorder. Participants have significantly more negative automatic attitudes toward the term substance abuser, as compared to person with a substance use disorder. Consistent with previous research, implicit bias does exist for terms commonly used in the behavioral health field. Substance abuser and its derivatives should not be used in professional or lay settings.

Parental identification and response to adolescent substance use and substance use disorders

Abstract Previous research showing that parents tend to underestimate adolescent substance use is consistent with concerns that adolescent substance use may develop because parents delay in reacting to it. However, little research has examined parental decisions regarding how and when to intervene on adolescent substance use. This study examines the actions that parents report they would take after (a) discovering substance use to intoxication and (b) when they believe their child has a substance use problem. Internet surveys were conducted asking parents (N = 975) how they would respond to (a) evidence of their child’s use to intoxication and (b) their child’s significant problem with either alcohol, cannabis, prescription opioids, or illicit drugs. While parental response to alcohol and cannabis intoxication focused on talking with their children (34% and 45%, respectively) and punishment (30% and 18%, respectively), parents were significantly more likely to report help-seeking behaviors when responding to prescription opioid or illicit drug use intoxication (37% and 30%, respectively). More effective public health initiatives are needed to provide parents with practical strategies to address adolescent substance use and to increase parental engagement in the services offered by addiction specialists.