Michael Hufford

Publications (28) View all

• Article: Ecological Momentary Assessment: Real-world, real-time measurement of patient experience.

  Michael R. Hufford, Saul Shiffman, Jean Paty, Arthur A. Stone
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  ABSTRACT: Describes the rationale for moving away from retrospective measurement of clinical phenomena by reviewing the inaccuracies and biases associated with many types of retrospective reports. The use of diaries, experience sampling methods, and self-monitoring is reviewed as steps in the progression from retrospective to momentary data collection. Next, the authors describe a unifying framework for collection of real-time data in the real world, by a variety of methodologies, under the rubric of Ecological Momentary Assessment (A. A. Stone & S. Shiffman,1994). Finally, the importance of S compliance is reviewed as one critical component to the successful execution of real world data collection methods. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
  10/2012;
• Article: Alcohol and suicidal behavior.

  M R Hufford
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  ABSTRACT: Alcohol dependence and alcohol intoxication are important risk factors for suicidal behavior. However, the mechanism for the relationship remains unclear. This review presents a conceptual framework relating alcohol to suicidal behavior. Distal risk factors create a statistical potential for suicide. Alcohol dependence, as well as associated comorbid psychopathology and negative life events, act as distal risk factors for suicidal behavior. Proximal risk factors determine the timing of suicidal behavior by translating the statistical potential of distal risk factors into action. The acute effects of alcohol intoxication act as important proximal risk factors for suicidal behavior among the alcoholic and nonalcoholic alike. Mechanisms responsible for alcohol's ability to increase the proximal risk for suicidal behavior include alcohol's ability to: (1) increase psychological distress, (2) increase aggressiveness, (3) propel suicidal ideation into action through suicide-specific alcohol expectancies, and (4) constrict cognition which impairs the generation and implementation of alternative coping strategies. Moreover, the proximal risk factors associated with acute intoxication are consistent with Baumeister's (1990) escape theory of suicide. Suggestions for additional research are discussed, including the possibility that a nonlinear cusp catastrophe model characterizes the relationship between alcohol intoxication and suicidal behavior.
  Clinical Psychology Review 08/2001; 21(5):797-811. · 7.07 Impact Factor
• Article: The relationship of self-efficacy expectancies to relapse among alcohol dependent men and women: a prospective study.

  S F Greenfield, M R Hufford, L M Vagge, L R Muenz, M E Costello, R D Weiss
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  ABSTRACT: We studied the relationship of self-efficacy expectancies measured during inpatient alcohol treatment and time to first drink and time to relapse following hospitalization. We also examined whether the relationship of in-hospital self-efficacy and posttreatment drinking outcome differed by gender. We measured self-efficacy expectancies using the Situational Confidence Questionnaire (SCQ) in 100 subjects (59 men) during inpatient treatment for alcohol dependence. We followed subjects monthly for 1 year and examined the relationship of their in-hospital SCQ scores to posttreatment drinking behavior, as measured by time to first drink, time to relapse and percent abstinent days. Self-efficacy during hospitalization was related to relapse during the 12 months following hospitalization. Survival analysis demonstrated that in-hospital SCQ scores greater than 45 were predictive of better drinking outcomes. The median number of days to relapse after treatment were 30 and 135, respectively, in those with in-hospital SCQ scores less than or equal to 45 compared with those with SCQ scores greater than 45. There were no gender differences in self-efficacy measured during hospitalization, nor were there gender differences in the relationship of self-efficacy to time to relapse. However, men with SCQ scores less than or equal to 45 had fewer abstinent days during follow-up. Among both men and women being treated for alcohol dependence, a cut-off score of 45 on the SCQ may be especially important in helping clinicians assess patients who are at high risk for more rapid return to drinking after hospitalization.
  Journal of studies on alcohol 04/2000; 61(2):345-51.
• Article: Empirically supported treatments and comorbid psychopathology: Spelunking Plato's cave.

  Michael R. Hufford
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  ABSTRACT: Presents two case examples of diagnostic ambiguity and examines the empirical literature to identify appropriate empirically supported treatments (ESTs). The author contends that the examples outlined show the discontinuity between clients with comorbid psychopathology and ESTs. He suggests two agendas for future research and practice: (1) the inevitable limitations of efficacy studies do not excuse clinicians from ignoring scientific evidence. The expensive tradeoff of client heterogeneity for experimental control and statistical power is the cost of keeping the discipline grounded in science and (2) to practice maximally affect practice, researchers need to incorporate more comorbid psychopathology. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
  Professional Psychology Research and Practice 01/2000; 31(1):96-99. · 1.34 Impact Factor
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  Available from: Michael Hufford

  Article: Remember that? A comparison of real-time versus retrospective recall of smoking lapses.

  S Shiffman, M Hufford, M Hickcox, J A Paty, M Gnys, J D Kassel
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  ABSTRACT: Research and treatment assessments often rely on retrospective recall of events. The accuracy of recall was tested using accounts of smoking lapse episodes from 127 participants who had quit smoking, and lapses and temptations were recorded in near-real time using a hand-held computer. These computer records were compared with retrospective accounts elicited 12 weeks later, with a focus on recall of lapses in 4 content domains: mood, activity, episode Triggers, and abstinence violation effects. Recall of lapses was quite poor: Average kappas for items ranged from 0.18 to 0.27. Mean profile rs assessing recall for the overall pattern of behavior were .36, .30, .33, and .44 for these domains, respectively. In recall, participants overestimated their negative affect and the number of cigarettes they had smoked during the lapse, and their recall was influenced by current smoking status. The findings suggest caution in the use of recall in research and intervention.
  Journal of Consulting and Clinical Psychology 05/1997; 65(2):292-300. · 4.85 Impact Factor