Erin Rotheram-Fuller

Social Networks and Friendships at School: Comparing Children With and Without ASD

Self, peer and teacher reports of social relationships were examined for 60 high-functioning children with ASD. Compared to a matched sample of typical children in the same classroom, children with ASD were more often on the periphery of their social networks, reported poorer quality friendships and had fewer reciprocal friendships. On the playground, children with ASD were mostly unengaged but playground engagement was not associated with peer, self, or teacher reports of social behavior. Twenty percent of children with ASD had a reciprocated friendship and also high social network status. Thus, while the majority of high functioning children with ASD struggle with peer relationships in general education classrooms, a small percentage of them appear to have social success.

Making the Connection: Randomized Controlled Trial of Social Skills at School for Children with Autism Spectrum Disorders

BACKGROUND   This study compared two interventions for improving the social skills of high functioning children with autism spectrum disorders in general education classrooms. One intervention involved a peer-mediated approach (PEER) and the other involved a child-assisted approach (CHILD). METHOD   The two interventions were crossed in a 2 × 2 factorial design yielding control, PEER, CHILD, and both PEER and CHILD conditions. Sixty children participated from 56 classrooms in 30 schools. Interventions involved 12 sessions over 6 weeks, with a 3-month follow-up. Outcome measures included self, peer and teacher reports of social skills and independent weekly observations of children on their school playground over the course of the intervention. RESULTS   Significant improvements were found in social network salience, number of friendship nominations, teacher report of social skills in the classroom, and decreased isolation on the playground for children who received PEER interventions. Changes obtained at the end of the treatment persisted to the 3-month follow-up. CONCLUSIONS   These data suggest that significant improvements can be made in peer social connections for children with autism spectrum disorders in general education classrooms with a brief intervention, and that these gains persist over time.

Randomized, placebo-controlled trial of bupropion for the treatment of methamphetamine dependence

OBJECTIVE To compare bupropion to placebo for reducing methamphetamine (MA) use, increasing retention, and reducing the severity of depressive symptoms and MA-cravings. A secondary objective compared bupropion to placebo for reducing cigarette smoking among MA dependent participants. METHODS Following a 2-week, non-medication baseline screening period, 73 treatment-seeking MA dependent participants were randomly assigned to bupropion sustained release (150 mg twice daily; N=36) or placebo (twice daily; N=37) for 12-weeks under double-blind conditions. Participants attended clinic thrice weekly to provide urine samples analyzed for MA-metabolite, to complete research measures and assessments, and to receive contingency management and weekly cognitive behavioral therapy sessions. RESULTS There were no statistically significant effects for bupropion relative to placebo on MA use verified by urine drug screens, for reducing the severity of depressive symptoms or MA-cravings, or on study retention. In a post hoc analysis, there was a statistically significant effect of bupropion treatment on MA use among participants with lighter (0-2 MA-positive urines), but not heavier (3-6 MA-positive urines) MA use during baseline (OR=2.81, 95% CI=1.61-4.93, p<0.001 for MA-free week with bupropion among light users). Bupropion treatment was also associated with significantly reduced cigarette smoking, by almost five cigarettes per day (p=0.0002). CONCLUSION Bupropion was no more effective than placebo in reducing MA use in planned analyses, though bupropion did reduce cigarette smoking. Post hoc findings of an effect for bupropion among baseline light, but not heavy, MA users suggests further evaluation of bupropion for light-MA users is warranted.

Sustained reductions in drug use and depression symptoms from treatment for drug abuse in methamphetamine-dependent gay and bisexual men.

Methamphetamine abusers often complain of feelings of depression that can complicate accurately diagnosing these individuals during treatments for methamphetamine abuse. This article presents an examination of temporal associations between documented methamphetamine use and reported ratings of depression among 162 gay and bisexual male methamphetamine abusers who participated in a 16-week randomized clinical trial of four behavioral therapies for methamphetamine abuse. Methamphetamine use was measured using thrice-weekly urine samples analyzed for drug metabolite. Self-reported depressive symptoms were collected weekly using the Beck Depression Inventory (BDI). At treatment entry, 73.2% of participants rated their depressive symptoms as mild or higher in severity (BDI≥10), with 28.5% reporting BDI scores in the moderate to severe range (BDI≥19). All participants reported significant decreases in depressive symptoms from baseline through the end of treatment, regardless of treatment condition, HIV status, or mood disorder diagnosis. A mixed regression model showed methamphetamine use for up to 5 days prior to the BDI score strongly predicted depressive symptoms (F1,968=18.6, P<.0001), while BDI scores had no significant association with subsequent methamphetamine use. Findings show that behavioral methamphetamine abuse treatment yields reductions in methamphetamine use and concomitant depressive symptom ratings that are sustained to 1 year after treatment entry.

Outcomes using two tailored behavioral treatments for substance abuse in urban gay and bisexual men

This project evaluated two behavioral therapies for substance abuse and concomitant sexual risk behaviors applied to primarily stimulant-abusing gay and bisexual men in Los Angeles. One hundred twenty-eight participants were randomly assigned to 16 weeks of a gay-specific cognitive-behavioral therapy (GCBT, n = 64) or to a gay-specific social support therapy (GSST; n = 64), with follow-up evaluations at 17, 26, and 52 weeks after randomization. No overall statistically significant differences were observed between conditions along retention, substance use, or HIV-related sexual risk behaviors. All participants showed a minimum of twofold reductions in substance use and concomitant sexual risk behaviors from baseline to 52-week evaluations. Among methamphetamine-using participants, the GCBT condition showed significant effects over GSST for reducing and sustaining reductions of methamphetamine. Findings replicate prior work and indicate that GCBT produces reliable, significant, and sustained reductions in stimulant use and sexual risk behaviors, particularly in methamphetamine-abusing gay and bisexual men.

Depression Ratings, Reported Sexual Risk Behaviors, and Methamphetamine Use: Latent Growth Curve Models of Positive Change Among Gay and Bisexual Men in an Outpatient Treatment Program

Although the cessation of substance use is the principal concern of drug treatment programs, many individuals in treatment experience co-occurring problems such as mood disruptions and sexual risk behaviors that may complicate their recovery process. This study assessed relationships among dynamic changes tracked over time in methamphetamine use, depression symptoms, and sexual risk behaviors (unprotected anal intercourse) in a sample of 145 methamphetamine-dependent gay and bisexual males enrolled in a 16-week outpatient drug treatment research program. Participants were randomly assigned into 1 of 4 conditions: contingency management (CM), cognitive behavioral therapy (CBT; the control condition), combined CM and CBT, and a tailored gay-specific version of the CBT condition. Using latent growth curve models, the authors assessed the relationship of means (intercepts) and the slopes of the 3 measures of interest over time to test whether changes in methamphetamine use predicted declining rates of depression and risky sexual behavior in tandem. Participants with the greatest downward trajectory in methamphetamine use (urine verified) reported the greatest and quickest decreases in reported depressive symptoms and sexual risk behaviors. The control group reported the most methamphetamine use over the 16 weeks; the tailored gay-specific group reported a more rapidly decreasing slope in methamphetamine use than the other participants. Findings indicate that lowering methamphetamine use itself has a concurrent and synergistic effect on depressive symptoms and risky sexual behavior patterns. This suggests that some users who respond well to treatment may show improvement in these co-occurring problems without a need for more intensive targeted interventions.

Exploring the Social Impact of Being a Typical Peer Model for Included Children with Autism Spectrum Disorder

This study examined the social impact of being a typical peer model as part of a social skills intervention for children with autism spectrum disorder (ASD). Participants were drawn from a randomized-controlled-treatment trial that examined the effects of targeted interventions on the social networks of 60 elementary-aged children with ASD. Results demonstrated that typical peer models had higher social network centrality, received friendships, friendship quality, and less loneliness than non-peer models. Peer models were also more likely to be connected with children with ASD than non-peer models at baseline and exit. These results suggest that typical peers can be socially connected to children with ASD, as well as other classmates, and maintain a strong and positive role within the classroom.

HIV-Associated Medical, Behavioral, and Psychiatric Characteristics of Treatment-Seeking, Methamphetamine-Dependent Men Who Have Sex with Men

Abstract This paper examines medical and psychiatric symptoms and disorders associated with reported HIV serostatus among methamphetamine-dependent, treatment-seeking men who have sex with men (MSM) in Los Angeles. Baseline data from a NIDA-funded, randomized clinical trial of behavioral drug abuse therapies included medical examinations and behavioral interviews of the 162 randomized participants. Variables identified as significantly associated with HIV infection were entered into a multivariate, hierarchical logistic regression analysis to optimally predict HIV serostatus. The disturbingly high 61% of the sample with reported HIV-seropositive status represents 3-4 times the prevalence for all MSM in Los Angeles County. HIV infection status strongly associated with prior treatment for methamphetamine dependence; unprotected receptive anal intercourse; history of sexually transmitted infections; and health insurance status. Findings demonstrate the powerful connection between methamphetamine dependence and HIV infection, and strongly suggest a need for development of interventions that function as both substance abuse treatment and HIV prevention for this population.

Bupropion Hydrochloride versus Placebo, in Combination with Cognitive Behavioral Therapy, for the Treatment of Cocaine Abuse/Dependence

Abstract Bupropion hydrochloride is a dopamine and norepinephrine reuptake inhibitor which may be an effective treatment for cocaine dependence due to its ability to reverse deficits in dopaminergic functioning that occur in chronic cocaine users. We performed a randomized, double-blind, placebo controlled trial comparing outpatient treatment with bupropion (N = 37) and placebo (N = 33) in combination with standard cognitive behavioral therapy. There were no statistically significant differences between bupropion and placebo in treatment outcomes, including aggregate measures of urine drug screen results (Joint Probability Index at 16 weeks: 0.43 for bupropion and 0.38 for placebo), treatment retention, cocaine craving ratings, and assessments of depressive symptoms. The failure to find an effect for bupropion relative to placebo, when combined with standard cognitive behavioral therapy, dampens enthusiasm for future development of bupropion as a cocaine pharmacotherapy.

Current trends in psychological research on children with high-functioning autism and Asperger disorder

Purpose of review This review explores current trends in the literature during 2004 on psychological studies of children with high-functioning autism and Asperger syndrome. Studies are reviewed that examine diagnostic dilemmas and methodological concerns, cognitive and social deficits, and interventions. Recent findings There is considerable debate over the distinction between high-functioning autism and Asperger syndrome, but few studies find support for separate disorders. Most studies reviewed combine high-functioning autism and Asperger syndrome into an autism spectrum disorder group or study only one diagnostic group, either high-functioning autism or Asperger syndrome. Research into cognitive processes (specifically mentalizing) and social understanding (nonliteral language) continue to dominate research efforts. Current studies suggest specific weaknesses in many areas of nonliteral language, such as humor, irony, and teasing. Studies rely heavily on current theoretical explanations for deficits, namely the central coherence, social inference, and executive function theories, and varying levels of support were found for all three theories. Intervention and outcome studies lag behind experimental and theoretical studies, but two studies employed scientifically rigorous intervention designs with promising results. Summary Children with high-functioning autism and Asperger syndrome have a great deal of potential with respect to long-term developmental outcomes, and yet they continue to be understudied and under-served in current intervention programs. Future studies are needed in developmental processes and outcomes in this population, and in the development of effective treatment strategies that have undergone scientifically rigorous testing.