Jalie A. Tucker

Validation of the sensation scale, a measure of subjective physiological responses to alcohol ☆

Abstract The Sensation Scale was originally constructed to measure the subjective experience of physiological changes following alcohol consumption. Reduction of the original scale of 31 variables on the basis of face validity resulted in six ‘factors’ comprising 26 variables and one ‘other’ factor. These sortings are shown to have good interrater reliability. Furthermore, evidence is presented from two experiments that five of the six factors discriminated between nonalcoholic male subjects who drank either a beverage containing a moderate dose of alcohol or a nonalcoholic beverage.

Help-seeking and recovery by problem drinkers: Characteristics of drinkers who attended alcoholics anonymous or formal treatment or who recovered without assistance☆

Most problem drinkers do not seek formal treatment, yet some achieve problem resolution without it. This research investigated variables related to help-seeking and to long-term drinking outcomes in a 3 x 2 factorial design, using 126 problem drinkers who varied in their help-seeking history (no assistance, A.A. only, or treatment plus A.A.) and current drinking status (abstinent more than 6 months or engaging in problem drinking). Dependent variables included alcohol-related negative consequences, dependence symptoms, drinking patterns, other drug use, and demographic characteristics. Formal treatment utilization was associated with greater psychosocial dysfunction, especially in interpersonal relationships, and with greater nonprescribed drug use. Alcohol dependence levels were not related to help-seeking, but higher levels were associated with an abstinent drinking status. Abstinent subjects also showed some evidence of greater social stability, but demographic variables, including gender, did not otherwise differentiate the groups. These findings suggest that help-seeking and attainment of abstinence are somewhat independent processes, but that both relate more to the functional consequences of problem drinking than to stable drinker characteristics.

Significance of a behavioral economic index of reward value in predicting drinking problem resolution

This study investigated whether a behavioral economic index of the value of rewards available over different time horizons improved prediction of drinking outcomes beyond established biopsychosocial predictors. Preferences for immediate drinking versus more delayed rewards made possible by saving money were determined from expenditures prior to resolution attempts by problem drinkers with different help-seeking experiences (N = 144). As hypothesized, stable resolutions over a 2-year follow-up were associated with proportionally more preresolution discretionary expenditures on savings and less on alcohol compared with unstable resolutions. The relationship held regardless of help-seeking history, and preresolution drinking practices, problems, and income were similar across outcomes. The findings extend experimental work on behavioral economics and indicate that measuring monetary allocation improves prediction of outcomes.

Resolving problems associated with alcohol and drug misuse: understanding relations between addictive behavior change and the use of services.

“Natural resolutions” highlight how influences on addictive behavior change may differ from and interact with influences on the use of substance-related services. These distinct literatures are summarized and implicate extra-therapeutic environmental variables in both processes. Whether assisted by interventions or not, stable resolutions are surrounded by environmental contexts characterized by improved circumstances across several years that bracket cessation of substance misuse. Psychosocial problems associated with substance use increase help-seeking, and interventions enhance improvements that typically follow initial resolution. Implications for promoting help-seeking and behavior change and necessary revisions in conventional views about relations between the processes are discussed. [Translations are provided in the International Abstracts section of this issue.]

Self-Report Methods

Human communication is unique among behavioral phenomena. No other type of behavior so readily serves both as a focus of study and as a measurement tool in the study of other behavior. Put simply, when we study human behavior, we have the luxury of asking our subjects what they know about it, and in many areas of psychology, this has been regarded as an offer too good to refuse. Unlike most areas of psychology, however, the experimental analysis of behavior matured primarily in the animal laboratory (Iversen & Lattal, 1991a,b; Skinner, 1996). This historical context may help to explain the trepidation with which operant researchers have faced the fact that humans regularly talk, write, and otherwise exchange information. Verbal capabilities have not been a central focus in the extension of the experimental analysis of behavior to human behavior (e.g., Oah & Dickinson, 1989), and consistent with this pattern, researchers have shown relatively little interest in data generated through verbal self-reports. In a recent 5-year survey of the Journal of the Experimental Analysis of Behavior, for example, self-report data provided a dependent measure in only about one-third of the studies conducted with human subjects.1 In about 70% of these cases, self-reports served as a collateral measure rather than the primary dependent variable.

Need and non-need factors associated with addiction treatment utilization in a cohort of homeless and housed urban poor.

Background:Research on addiction treatment utilization in indigent samples mainly has been retrospective, without measures of addictive consequences, social network influences, and motivation. Prospective assessment of factors influencing utilization could inform policy and clinical care. Objective:We sought to identify factors associated with utilization of addiction treatment and mutual help groups among substance-dependent persons with high rates of homelessness. Research and Methods:This was a prospective cohort of patients detoxified from alcohol or drugs at baseline who were followed for 2 years in a randomized clinical trial of linkage to primary care (n = 274). Outcomes included utilization of Inpatient/Residential, Outpatient, Any Treatment, and Mutual Help Groups. Predictor variables in longitudinal regression analyses came from the literature and clinical experience, organized according to theoretical categories of Need, and non-Need (eg, Predisposing and Enabling). Results:Many subjects used Inpatient/Residential (72%), Outpatient (62%), Any Treatment (88%) or Mutual Help Groups (93%) at least once. In multivariable analyses, addictive consequences (odds ratio [OR] 1.38, 95% confidence interval [CI] 1.12–1.71), motivation (OR 1.32, 95% CI 1.09–1.60), and female gender (OR 1.80, 95% CI 1.13–2.86) were associated with most treatment types (ORs are for Any Treatment). Homelessness was associated with Residential/Inpatient (for Chronically Homeless vs. Housed, OR 1.75, 95% CI 1.04–2.94). Living with ones children (OR 0.51, 95% CI 0.31–0.84) and substance-abusing social environment (OR 0.65, 95% CI 0.43–0.98) were negatively associated with Any Treatment. Conclusions:In this cohort of substance-dependent persons, addictive consequences, social network variables, and motivation were associated with treatment utilization. Non-need factors, including living with ones children and gender, also were significant.

Temporal sequencing of alcohol-related problems, problem recognition, and help-seeking episodes

Little is known about temporal relations between the development of alcohol-related problems, self-recognition of problems, and help seeking from professional and lay sources. The sequencing of these events was investigated retrospectively using a community sample of male and female problem drinkers (N= 101) who varied in their help-seeking histories [no assistance, Alcoholics Anonymous (AA)-only, or treatment-plus-AA] and current drinking status (resolved abstinent or nonresolved). The rank-order of events was similar across groups and gender. Problem recognition typically occurred early with the onset of pathological drinking and related psychosocial problems. Health problems and help seeking were late developments, if they occurred at all. Although the sequence order was similar across groups, the latency to help seeking varied; help seeking was more rapid among women, resolved participants, and participants who had sought help from both treatment and AA. The findings question conventional views that denial deters help seeking and suggest opportunities for screening and early intervention.

Environmental Influences on Relapse in Substance Use Disorders

Characteristics of the posttreatment environment have been implicated in relapse and recovery in substance use disorders. We summarize these findings and describe how different models of relapse interpret the data and diverge in their representations and measurement operations of environmental variables. The advantages and limitations of common measures of the posttreatment environment are discussed using research on life events and relapse as an example. An alternative approach to representing covariation over time between environmental characteristics and substance use that is derived from an application of behavioral theories of choice to relapse is presented.

Alcohol's Effects on Human Emotions: A Review of the Stimulation/Depression Hypothesis

Recent hypotheses hold that acute alcohol consumption sequentially stimulates and then depresses (stimulation/depression) the drinkers emotional state as well as other physiological and non-mood-related behavioral functions. This paper traces the development of the stimulation/depression hypothesis as applied to human emotions and critically evaluates investigations of alcohols acute emotional effects in order to assess its validity. Although some evidence suggests and elatant (i.e., stimulant) effect of alcohol at moderate intoxication levels, particularly on the rising limb of the blood alcohol curve, it is concluded that because of methodological inadequacies in the relevant experimental literature, the stimulation/depression hypothesis as applied to emotions remains largely untested. Conceptual and methodological refinements necessary for testing the hypothesis are discussed, and potentially important nonpharmacological factors that may also influence postconsumption mood changes are identified.

Determinants of Substance Abuse Relapse

Research on the short-term effectiveness of treatments for alcohol, cigarette, and drug abuse suggests that most individuals may expect immediate amelioration of their problem upon entering a formal treatment program (e.g., Dole & Joseph, 1978; Lichtenstein, 1982; Miller & Hester, 1980). The prognosis over the long run, however, is not so optimistic. Approximately two-thirds of individuals who successfully complete treatment programs for various substance abuse disorders relapse within 3 months after treatment. At 12 months, relapse rates often exceed 75% or more (e.g., Hunt, Barrett, & Branch, 1971; Marlatt, 1978; Schachter, 1982). These high relapse rates appear to be relatively independent of the particular addictive disorder, the type of treatment intervention, or its guiding conceptual framework. Such findings force consideration of the determinants of relapse as a core problem in substance abuse research and treatment.