Tony Cellucci

Cognitive impairment in substance abuse

Conventional wisdom, and even well-reasoned theoretical mechanisms, suggests that the chronic use of psychoactive substances would impair cognitive functioning of individuals. This article summarizes the research literature with regard to specific drugs of abuse. Undoubtedly, acute intoxication and immediate and protracted withdrawal produce transient alterations of cognitions that can persist for weeks to months. Some subtle residual effects remain for up to 1 year for certain drugs. Evidence of irreversible effects is less clear. Even subtle lingering effects can impact treatment efforts, yet they often go undetected or unaddressed.

Help seeking for alcohol problems in a college population

Despite the availability of effective treatments for problem drinkers, only a minority seek professional assistance. The authors investigated the influences on help seeking for alcohol-related difficulties in two separate studies. In Study 1, 59 men and 74 women completed questionnaires regarding their alcohol use, related problems, readiness to change, and help-seeking interest. The authors also developed a measure of stigma related to alcohol help seeking. Problem recognition, anxiety symptoms, and stigma predicted a global rating of help-seeking. Students (22 men and 60 women) participated in Study 2, which incorporated a multi-item measure of help-seeking intentions as well as attitude and personality measures. Positive attitudes, less perceived stigma, and greater self-efficacy increased help seeking. The findings highlight the importance of both approach and avoidance factors that affect help-seeking decisions, and the authors suggest directions for further research.

Schemas and Borderline Personality Disorder symptoms in incarcerated women.

There is increasing interest regarding the role of maladaptive cognition in Borderline Personality Disorder (BPD). The current study examined the relationship between early maladaptive schema (EMS) domains and BPD symptoms as well as whether schema domains account for the relationship between childhood maltreatment and BPD severity. Incarcerated women (N=105) were assessed for BPD symptoms via semi-structured diagnostic interview. Disconnection/Rejection and Impaired Limits were associated with BPD pathology although these domains shared variance with depression and antisocial personality disorder pathology, respectively. In addition, the relationship between childhood abuse and BPD severity was non-significant after controlling for schema domains. Related findings and the implications for cognitive treatment of BPD are discussed.

Personality characteristics of cocaine and alcohol abusers: More alike than different☆

Although there is extensive literature describing the characteristics of individuals entering treatment for alcoholism, few research reports are available describing the personality characteristics of individuals addicted to cocaine. Forty-four matched patient pairs, one member of each pair who abused cocaine and the other alcohol, were compared on the basis of their Minnesota Multiphasic Personality Inventory (MMPI) profiles. The subjects were matched on the basis of age, sex, and race from a larger population entering an inpatient addiction treatment center. Statistical analysis revealed more similarities than differences between the two groups, with the average profile type for both cocaine and alcohol abusers being 4-2. These results are discussed in the context of previous reports of psychopathology among cocaine abusers and personality theories of drug choice. The number of different code types within each substance abuse group is also reported and the concept of profile heterogeneity supported. Profile subtypes among cocaine patients are described clinically along with their implications for treatment.

Childhood sexual abuse and substance abuse treatment utilization among substance-dependent incarcerated women

Incarcerated women have high rates of substance abuse problems and trauma. A variety of variables may influence whether these women seek help or are referred for substance abuse problems. This study reports an exploratory project on service utilization among incarcerated substance-dependent women (N = 40) in southeastern Idaho. Using self-report and interview tools, most participants reported some substance abuse treatment history, although extent and types of treatment varied. Most of the women also reported some type of childhood abuse. Age, income, and consequences of alcohol and other drug use related positively to substance abuse treatment. However, severity of childhood sexual abuse and current trauma symptoms were negatively correlated with substance abuse treatment episodes. These women may use substances to cope with childhood trauma or may not perceive the substance abuse system as responsive to their co-occurring trauma symptoms.

EFFECTS OF A SCHOOL-BASED ALCOHOL EDUCATION PROGRAM WITH A MEDIA PREVENTION COMPONENT

The effects of an alcohol education presentation with a media component of public service announcements were evaluated. The presentation was conducted over three (consecutive) days with 10th and 11th grade students in a rural area of South Carolina. The professionally produced announcements focused on drinking and driving. 52 subjects were assigned by classroom to either of two treatment groups or a control condition. Both treatment groups received the educational presentation but differed in that Group 2 was also exposed to the videotaped announcements. Effects of exposure were evaluated in separate measures of knowledge, attitudes, and alcohol involvement, using a pre-posttest design, with a 1-mo. follow-up. Analysis showed an effect of over-all program on knowledge at follow-up, but none on attitudes or alcohol involvement. These findings and their implications are discussed in the context of previous evaluations of alcohol education programs and media efforts.

The Prevention of Alcohol Problems

Although concern over the prevention of alcohol problems has a long history, evaluative research regarding such effects is of more recent vintage. In effect, the post-prohibition era shifted the focus of social concern from alcohol per se to the individual with alcohol problems, individuals said to be predisposed and afflicted with the disease of alcoholism. Consequently, the major emphasis in the alcohol field became treatment. The formation and subsequent reports of the Cooperative Commission on the Study of Alcoholism (Plaut, 1967; Wilkinson, 1970) emerged later as a major prevention landmark. The members of this commission, who represented various professions and disciplines, examined the many social and developmental influences on alcohol problems from a broad perspective. The commission’s observation and resultant recommendations essentially constituted a programmatic social plan for reducing the country’s drinking problems. It is no small tribute that many of their specific proposals for prevention found their way into the early activities of the then newly formed National Institute on Alcohol Abuse and Alcoholism (NIAAA). The overriding them of a need for change in alcohol-related attitudes and social norms, with a particular emphasis on the preventive value of education, characterizes the literature of the late 1960s and early 1970s. Changes in distribution and licensing were seen as important ways of modifying key social attitudes.

Case formulation and behavioral treatment of chronic cough.

The present report describes the case formulation and successful treatment of a 13 year-old boy with a severe habitual cough persisting 2 months after hospitalization, despite negative physical findings. At initial assessment, he literally coughed at every breath and was on housebound instruction. The case formulation highlighted the etiological importance of classical conditioning to breathing in air and the subsequent development of a nervous habit. Treatment was conducted over six sessions and initially involved desensitization to increasing amounts of air flow. A second phase involved strengthening awareness and control over coughing at home using self-management and positive practice procedures. The case formulation, treatment procedures and changes in coughing behavior (2-year follow-up) are described.

Rumination, anxiety sensitivity, and negative reinforcement drinking

Objective: Prior research has established anxiety sensitivity (AS, essentially fear of anxiety) as an individual difference variable conveying risk for alcohol abuse and specifically negative reinforcement drinking (NRD). This study sought to replicate and extend that finding, examining the role of rumination (related to the cognitive dyscontrol aspect of anxiety sensitivity) in mediating this association. Method: Seventy-three women and 40 men collegiate drinkers completed several questionnaire measures assessing anxiety sensitivity and negative reinforcement drinking, including an adapted measure of anxiety rumination. Results: Findings indicated a moderate relationship (R2 = 0.21) between anxiety sensitivity components and NRD with regression analyses showing that cognitive dyscontrol and anxiety rumination were most strongly associated with NRD. As predicted, anxiety rumination fully statistically mediated (ß = 0.50) the relationship between AS and NRD. Conclusions: Rumination, conceptualized as a maladaptive coping response for emotional regulation, warrants further study in relation to NRD and in developing treatment interventions for high anxiety, at-risk drinkers.

Psycho-Educational Evaluations for University Students in One Clinic

The number of university students requesting services based on the Americans with Disabilities Act for learning disabilities and ADHD-related difficulties has increased, although there are limited reports in the literature describing these evaluations. The current study describes a sample of 140 individuals (59% women) who presented for psycho-educational evaluation at the university psychology clinic. The students were individually administered self-report, cognitive, academic, and attention measures as indicated, and diagnosed according to the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV). Difficulties with mathematics, attention, and reading concerns were the most frequent presenting complaints. 46 students met criteria for one or more learning disorders and 20 students met criteria for a diagnosis of ADHD. Test scores are summarized and findings compared with the literature.