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ABSTRACT: BACKGROUND: Although marijuana is the most commonly used illicit substance in the US, only a small portion of users go on to develop dependence, suggesting that there are substantial individual differences in vulnerability to marijuana-related problems among users. Deficits in working memory and high trait impulsivity are two factors that may place marijuana users at increased risk for experiencing related problems. METHODS: Using baseline data from an experimental study that recruited 104 frequent marijuana users (M=71.86% of prior 60 days, SD=22%), we examined the associations of working memory and trait impulsivity with marijuana-related problems. RESULTS: Lower working memory, as measured by Trail Making Test B, but not short-term memory capacity, predicted more marijuana-related problems. Higher trait impulsivity scores were independently associated with greater number of problems. CONCLUSIONS: Results suggest that marijuana users with reduced executive cognitive ability are more susceptible to developing problems related to their use. Trait impulsivity and executive working memory appear to be independent risk factors for experiencing marijuana-related problems.
Drug and alcohol dependence 01/2013; · 3.60 Impact Factor
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ABSTRACT: American Indian (AI) youth have a high risk of smoking initiation. Sensation-seeking, defined as the tendency to seek novel and thrilling experiences, has been associated with smoking initiation in other groups but has never been examined in AI youth.
Data were from the Voices of Indian Teens Project (VOICES), a longitudinal study of AI youth from seven high schools in four AI communities in the western United States. Participants completed annual surveys in school over a three-year period. Our sample comprised 764 students who were non-smokers at baseline. Smoking initiation was defined as endorsement of daily smoking after baseline. We used binary logistic regression to evaluate the association of baseline sensation-seeking with odds of daily smoking initiation, stratified by gender.
Participants were 353 males and 411 females aged 13 to 21years at baseline. After adjusting for covariates, baseline sensation-seeking correlated with smoking initiation differently in males and females. Sensation-seeking did not predict daily smoking in males. Among females, however, higher sensation-seeking scores at baseline predicted daily smoking in both the unadjusted (odds ratio=1.4; 95% CI=1.1-1.8; p=0.005) and covariate-adjusted (odds ratio=1.3; 95% CI=1.0-1.6; p=0.04) models.
Gender-specific prevention programs may be warranted in addressing different risk-factor profiles in this high-risk population.
Addictive behaviors 12/2012; 37(12):1303-6. · 2.25 Impact Factor
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ABSTRACT: INTRODUCTION: Distress intolerance (DI) is elevated in smokers and confers increased risk for relapse following a quit attempt. Intolerance of respiratory distress and of nicotine withdrawal may be particularly relevant predictors of smoking cessation outcomes. However, no studies to date have examined the association between smoking relevant DI and smoking lapse behavior in a laboratory setting. The current study examined whether DI was associated with the risk of initiating smoking in a laboratory-based lapse analog task. METHODS: This study is a secondary data analysis from a study of the impact of alcohol administration on smoking behavior. Ninety-six cigarette smokers completed measures of DI and a smoking lapse analog task. Breath holding (BH) duration and self-reported intolerance of smoking abstinence were analyzed as predictors of smoking initiation in a survival analysis model. RESULTS: Shorter BH duration was associated with greater risk of smoking initiation, controlling for nicotine dependence, nicotine withdrawal symptoms, and demographics. Self-report measures of smoking abstinence DI were not associated with BH duration or time to smoking initiation when controlling for nicotine dependence severity.Conclusions:BH captures a domain of DI that is specifically associated with a higher risk of initiating smoking in this analog of smoking lapse. The prediction of smoking in an analog lapse task adds to the extant literature identifying an association between DI and smoking lapse and may enable further research to understand and address the mechanism through which BH affects smoking lapse risk.
Nicotine & Tobacco Research 11/2012; · 2.58 Impact Factor
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ABSTRACT: BACKGROUND: Spillane and Smith (2007, Psychol Bull 133:395-418) postulated that high levels of problem drinking in some First Nation (FN) communities resulted in part from the perception that there is low access to alternative reinforcers (e.g., jobs, friendships, family relationships, and financial security), that many alternative reinforcers are less contingent on sobriety, and that others are available regardless of drinking status for reserve-dwelling FN members. METHODS: This study examined perceptions of access to alternative reinforcers and the extent to which access varied as a function of drinking in 211 FN members living on 1 reserve in Canada, 138 middle socioeconomic status Caucasians (MCCs), and 98 low socioeconomic status Caucasians (LCCs). RESULTS: The FN group expected less access to employment, quality family and friend relationships, and financial security compared with the MCC group. After controlling for perceived access in general, gender, and age, the FN group reported that drinking would not cause a decrease in access to employment, family relationships, friendships, and finances as compared to the MCC group. The FN group did not differ from the LCC group in the degree to which they expected drinking to cost access to family relationships or finances, but the LCC group expected drinking to have less of an impact on access to jobs and friendships as compared to the FN group. CONCLUSIONS: The results provide initial support for the Spillane and Smith theory of problem drinking among this 1 FN group. The results suggest that increasing access to these reinforcers may reduce problematic drinking in this FN group.
Alcoholism Clinical and Experimental Research 07/2012; · 3.34 Impact Factor
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ABSTRACT: Problematic alcohol use is a major health concern for many Native communities in both Canada and the United States (Spillane & Smith, 2007, 2010; Spillane, Smith, & Kahler, in press). Because health disparities related to alcohol use are pronounced in this population (Beauvais, 1996; Whitesell et al., 2007), it is important to study factors that may contribute to risk for this set of problems. Alcohol expectancies represent a well known risk factor for alcohol use in non-Natives. This study sought to examine the relationship between negative urgency and negative alcohol expectancies, and to determine if this relationship is influenced by problem drinking behaviors. We hypothesized that negative urgency's effects on the development of negative alcohol expectancies would be mediated by negative urgency's influence to increase drinking behaviors in a First Nation sample (see Spillane & Smith, 2010). We also hypothesized that this relationship would be moderated by sex. We administered measures of alcohol use, negative urgency, and negative alcohol use expectancies to a total of 209 First Nation people (96 men; 113 women). Following the steps of moderated mediation outlined by Preacher, Rucker, and Hayes (2007), we found that the relationship between negative urgency and negative alcohol expectancies was significantly mediated by problem drinking for males (β=0.42, p<0.001), but not for females (β=0.13, p=0.32). The current study suggests that for males in this First Nation sample, negative urgency's effects on development of negative alcohol expectancies is mediated by problem drinking behavior.
Addictive behaviors 06/2012; 37(11):1285-8. · 2.25 Impact Factor
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ABSTRACT: Alcohol use is often implicated in initial lapses to smoking during quit smoking attempts. Mechanisms explaining this association are unknown but could include (a) learned associations between drinking and smoking or (b) direct pharmacologic effects of alcohol.
In a 2 (told alcohol vs. told placebo) × 2 (0.4 g/kg vs. 0.0 g/kg ethanol) between-subjects balanced placebo design, we examined instruction and beverage condition effects on smokers' ability to resist initiating smoking and whether these effects differed by sex.
Participants were 96 heavy alcohol drinkers, smoking 10-30 cigarettes per day. After 15 h of smoking abstinence, participants consumed either an alcoholic or a nonalcoholic beverage and 35 min later completed a smoking lapse task.
Overall, neither instructions nor beverage contents influenced behavior on the smoking lapse task. However, the instruction condition had different effects in men and women. Women, but not men, were more likely to smoke and reported expecting greater satisfaction from smoking when they were told alcohol compared to told placebo. The effects of instruction condition on smoking behavior were not mediated by self-reported expected satisfaction from smoking.
Women may be more likely to choose to smoke after drinking moderate amounts of alcohol because of their expectations rather than the pharmacological effects of the alcohol.
Psychopharmacology 01/2012; 222(1):71-80. · 4.08 Impact Factor
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ABSTRACT: The very early onset of smoking predicts numerous health problems. The authors conducted the first test of one risk model for elementary school age smoking, known as the acquired preparedness (AP) model of risk, in a cross-sectional sample of 309 5th grade children. The model posits that (a) impulsivity-related personality traits contribute to risk for a variety of risky, maladaptive behaviors; (b) smoking expectancies confer risk only for smoking; and (c) the personality traits contribute to the formation of high risk expectancies for reinforcement from smoking, which in turn increases the likelihood of early onset smoking. The model was supported: the high-risk personality traits distinguished children engaging in any risky, maladaptive behavior from other children, and the smoking expectancies differentiated smokers from all other children. The relationship between personality tendencies to act rashly when experiencing intense positive or negative emotions and smoker status was partially mediated by expectancies for reinforcement from smoking. This model should be investigated longitudinally.
Addictive behaviors 11/2011; 37(3):331-4. · 2.25 Impact Factor
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ABSTRACT: Whereas problem drinking impedes smoking cessation, less is known whether marijuana use affects smoking cessation outcomes and whether smoking cessation treatment leads to changes in marijuana smoking.
In a randomized clinical trial that recruited 236 heavy drinkers seeking smoking cessation treatment, we examined whether current marijuana smokers (n=57) differed from the rest of the sample in tobacco smoking and alcohol use outcomes and whether the patterns of marijuana use changed during treatment.
Half of the marijuana users reported smoking marijuana at least weekly (an average of 42% of possible smoking days), the other half used infrequently, an average of 5% of possible days. There were no significant differences between the marijuana use groups and non-users on smoking outcomes and marijuana use did not predict smoking lapses. All participants made large reductions in weekly alcohol consumption during the trial, with weekly marijuana users reducing their drinking by 47% and at a faster rate than non-marijuana users after the 8-week follow-up. Weekly marijuana smokers also steadily decreased their marijuana use over the course of the study (at 8-, 16-, and 26-week follow-ups) by more than 24%.
These data suggest that frequent marijuana smokers may benefit from smoking cessation interventions, even when marijuana use is not explicitly discussed. These individuals do not show any more difficulty than other cigarette smokers in making efforts to reduce tobacco smoking and in fact, make meaningful changes in marijuana use and heavy drinking. Future clinical trials should examine whether smoking cessation treatment that addresses both marijuana and tobacco smoking leads to substantial reductions in marijuana use.
Drug and alcohol dependence 07/2011; 119(3):194-200. · 3.60 Impact Factor
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ABSTRACT: The question of whether abstinence during the months following a planned quit attempt exacerbates or improves depressive symptoms is an important clinical issue. Extant research has primarily modeled between-person covariation between postquit abstinence and depressive symptom trajectories. However, this approach cannot account for potential third variables between participants that may affect both smoking and depression. Accordingly, the current study examined within-person covariation between time-varying abstinence and depressive symptom in a multilevel model (MLM), which allowed for transitions between smoking statuses within a participant.
Participants were 236 heavy drinking smokers in a randomized clinical trial testing the efficacy of incorporating brief alcohol intervention into smoking cessation treatment. Depressive symptoms and biochemically verified abstinence were assessed 1 week prior to and 2, 8, 16, and 26 weeks after quit date.
MLMs indicated a slight increase in depressive symptoms over time in the sample as a whole. However, there was an inverse relation between time-varying abstinence (vs. smoking) and concurrent level of depressive symptoms, indicating that transitions from smoking to abstinence within individuals were associated with reductions in depressive symptoms.
During the first 6 months following a planned quit attempt, being abstinent in a particular week appears to be associated with lower levels of concurrent depressive symptoms. These results are not concordant with the view that intentional smoking abstinence exacerbates depressive symptoms. Efforts to promote smoking cessation should highlight that individuals are likely to feel more rather than less psychologically healthy when they successfully quit smoking.
Nicotine & Tobacco Research 02/2011; 13(2):146-50. · 2.58 Impact Factor
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ABSTRACT: Health disparities related to drinking in native communities are of concern. Although individuals living in native communities have high rates of problem drinking, there is also variability in their drinking levels. The authors conducted a test of a model of First Nation drinking risk that incorporates personality and psychosocial learning to examine its cross-cultural applicability. That model identifies a risk process thought to explain aspects of individual differences in both native problem drinking and non-native problem drinking. One implication of the theory is that positive alcohol expectancies mediate the influence of negative urgency (the tendency to act rashly when distressed) on problem drinking similarly for both cultures.
We administered questionnaires to a total of 211 First Nation people and 236 Caucasians.
A structural modeling analysis of 211 First Nation people and 236 Caucasian people found that (i) personality, alcohol expectancy, and problem drinking measures were invariant across the 2 cultures and (ii) results consistent with the hypothesis that positive alcohol expectancies mediated the influence of negative urgency on problem drinking were also invariant across culture.
The findings support the theory that personality traits and psychosocial learning are important determinants of problem drinking in First Nation people and Caucasians.
Alcoholism Clinical and Experimental Research 11/2010; 34(11):1985-92. · 3.34 Impact Factor
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ABSTRACT: This study examined alcohol use and its association with initial smoking lapses among heavy nondependent drinkers in smoking cessation treatment.
Participants were 236 heavy drinking smokers in a randomized clinical trial testing the efficacy of incorporating brief alcohol intervention into smoking cessation treatment.
Of the 178 participants who reported a smoking lapse, 41.5% lapsed when drinking alcohol. Those who had alcohol-involved lapses had significantly lower tobacco dependence severity and drank more drinks per week than those who had non-alcohol-involved lapses. The majority of alcohol-involved lapses were in a bar/restaurant, with other people, and when they were in a happy/good mood. In survival analyses with alcohol consumption as a time-varying covariate, moderate drinking days were associated with almost four times greater risk of smoking lapse than non-drinking days, and heavy drinking doubled the risk of lapsing compared with moderate drinking.
Results suggest that alcohol-related lapses are qualitatively different from lapses that do not involve alcohol. Furthermore, among heavy drinkers in cessation treatment, even moderate alcohol use is associated with increased risk of smoking, with heavy drinking further increasing the risk. Smoking cessation treatments for heavy alcohol drinkers should highlight the lapse risk associated with any alcohol consumption and with heavy drinking during a quit smoking attempt.
Nicotine & Tobacco Research 07/2010; 12(7):781-5. · 2.58 Impact Factor
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ABSTRACT: Recent research has deconstructed the concept of impulsivity by identifying five different traits that influence engagement in impulsive behaviors: positive urgency (tendency to act rashly in response to a positive mood), negative urgency (tendency to act rashly in response to a negative mood), sensation seeking, lack of planning, and lack of perseverance. The traits are only moderately related to each other. The aim of this study was to apply this advance to the study of smoking. We tested a two-stage hypothesis: Higher sensation seeking was hypothesized to differentiate current smokers from non-smokers, and negative and positive urgencies were expected to predict concurrent level of nicotine dependence among smokers. As anticipated, greater sensation seeking was associated with a higher odds of being a current smoker (odds ratio=1.51). Greater positive urgency, but not other impulsivity-related traits, was associated with significantly higher levels of nicotine dependence, explaining 29% of the variance in level of nicotine dependence.
Addictive behaviors 03/2010; 35(7):700-5. · 2.25 Impact Factor
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ABSTRACT: The personality trait of sensation seeking has been positively associated with risk of smoking initiation and level of tobacco use. However, its role in smoking cessation is much less established. This study examined the association between sensation seeking and smoking cessation among 236 heavy social drinkers participating in a clinical trial testing the efficacy of incorporating brief alcohol intervention into smoking cessation treatment. As hypothesized, higher sensation seeking predicted reduced odds of abstinence from smoking as well as greater alcohol use over 26 weeks of follow-up. Sensation seeking also significantly interacted with age, having a protective influence on smoking outcomes among the youngest participants and an increasingly negative effect on smoking outcomes with greater age. Compliance with nicotine replacement therapy and use of smoking cessation strategies (e.g., planning for high risk situations, thinking about the benefits of quitting, avoiding smoking situations) were negatively associated with sensation seeking and accounted for most of the main effect of sensation seeking on smoking outcomes. Findings suggest (a) that smokers high in sensation seeking may require a specific emphasis on treatment compliance and behavioral rehearsal of cessation strategies, and (b) that the significance of sensation seeking for smoking cessation may change with increasing age.
Pharmacology Biochemistry and Behavior 10/2009; 93(3):285-90. · 2.53 Impact Factor
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ABSTRACT: Hostility is a multifaceted construct encompassing affective, behavioral, and cognitive aspects. There is preliminary evidence linking hostility to poorer outcomes in smoking cessation treatment; however, it is unclear which components of hostility are most important in cessation. In this study, the authors examined multiple aspects of trait hostility in 92 heavy social drinkers who were seeking smoking cessation treatment. Consistent with their hypothesis, the authors found that the cognitive component of hostility was most relevant to smoking cessation outcome. Specifically, those who expressed bitterness about their lives and tended to believe that they had poor luck and had gotten a raw deal out of life had poor smoking cessation outcomes. Cognitive measures of hostility also predicted greater nicotine withdrawal symptoms 1 week after quitting smoking. Other components of hostility including anger and both physical and verbal aggression did not significantly predict smoking outcome or nicotine withdrawal. Further examination of how a hostile worldview contributes to smoking cessation failure is warranted, as this facet of hostility may prove a valuable target for smoking cessation interventions. (PsycINFO Database Record (c) 2009 APA, all rights reserved).
Psychology of Addictive Behaviors 04/2009; 23(1):67-76. · 2.09 Impact Factor
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ABSTRACT: We argue that ongoing criticism of existing theories, the development of alternative theories, and empirical theory tests offer the best chance for advancing American Indian research. We, therefore note our appreciation for Beals et al.'s comments. We nevertheless did disagree with many of Beals et al.'s specific claims, noting that (a) our characterization of the existing literature on reservation-dwelling American Indian drinking was accurate; (b) no argument made by Beals et al. undermines their theoretical contention that there is a relative lack of contingency between access to basic life reinforcers and sobriety on many reservations; (c) our theory was developed in a responsible manner: a reservation-tied American Indian developed the theory, which was reviewed by a reservation leadership team, a cultural consultant, and reviewers for this journal, at least one of whom consulted leaders of other reservations; and (d) our theory was based on previous interdisciplinary theory development. We encourage the development and testing of new, alternative theories.
Psychological Bulletin 03/2009; 135(2):344-346. · 14.46 Impact Factor
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ABSTRACT: The ability to make precise distinctions among related personality constructs helps clarify theory and increases the utility of clinical assessment. In three studies, the authors evaluated the validity of distinctions among four impulsivity-like traits: sensation seeking, lack of planning, lack of persistence, and urgency (acting rashly when distressed). Factor analyses indicated that lack of planning and lack of persistence are two distinct facets of one broader trait, whereas urgency and sensation seeking are both very modestly related to each other and to the planning/persistence measures. The authors developed interview assessments of each, and multitrait, multimethod matrix results indicated clear convergent and discriminant validity among the constructs. The distinctions among them were useful: The traits accounted for different aspects of risky behaviors. Sensation seeking appeared to relate to the frequency of engaging in risky behaviors, and urgency appeared to relate to problem levels of involvement in those behaviors.
Assessment 07/2007; 14(2):155-70. · 2.01 Impact Factor
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ABSTRACT: The authors present a theory for understanding risk for problem drinking among reservation-dwelling American Indians. The theory offers an overall framework for understanding the risk process for this group. It considers the distinction between factors that influence mean levels of American Indian problem drinking and factors that influence individual differences in American Indian drinking. It proposes important contextual differences between reservation-dwelling American Indians and Caucasians that may help explain the higher mean levels of American Indian problem drinking. The theory further holds that, within the high mean level of problem drinking characteristic of many American Indian reservations, individual differences in problem drinking can be explained by very similar personality and learning factors as those that influence problem-drinking levels for other ethnic groups.
Psychological Bulletin 06/2007; 133(3):395-418. · 14.46 Impact Factor
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ABSTRACT: In 3 studies, the authors developed and began to validate a measure of the propensity to act rashly in response to positive affective states (positive urgency). In Study 1, they developed a content-valid 14-item scale, showed that the measure was unidimensional, and showed that positive urgency was distinct from impulsivity-like constructs identified in 2 models of impulsive behavior. In Study 2, they showed that positive urgency explained variance in risky behavior not explained by measures of other impulsivity-like constructs, differentially explained positive mood-based risky behavior, differentiated individuals at risk for problem gambling from those not at risk, and interacted with drinking motives and expectancies as predicted to explain problem drinking behavior. In Study 3, they confirmed the hypothesis that positive urgency differentiated alcoholics from both eating-disordered and control individuals.
Psychological Assessment 04/2007; 19(1):107-18. · 2.99 Impact Factor
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ABSTRACT: Researchers studying eating disorders in men often use eating disorder risk and symptom measures that have been validated only on women. Using a sample of 215 college women and 214 college men, we report on the validity of doing so with a set of measures chosen to reflect a wide range of risk factors and symptoms. The Bulimia Test-revised (BULIT-R), the restraint scale (RS), the three-factor eating questionnaire (TFEQ), the Eating Expectancy Inventory, and the eating attitudes test (EAT) all had the same factor structures for both genders, and tests of invariance showed that factor loadings, factor variances, and intercorrelations among factors were equivalent across gender. A modified Structured Clinical Interview for DSM-IV anorexic symptoms questionnaire did not perform adequately for either gender. Men produced slightly less reliable scores on virtually all measures, with the result that Pearson-based estimates of correlations among the measures were slightly lower for men. Men had lower scores on symptom and risk measures, but not on other eating measures.
Eating Behaviors 08/2004; 5(3):209-22. · 1.58 Impact Factor
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ABSTRACT: Researchers studying eating disorders in men often use eating-disorder risk and symptom measures that have been validated only on women. Using a sample of 215 college women and 214 college men, this article reports on the validity the Eating Disorder Inventory-2 (EDI-2), one of the best-validated among women and the most widely used risk and symptom measure for women. The EDI-2 had the same, standard eight-factor structure for both genders, and tests of invariance showed that factor loadings, factor variances, and factor intercorrelations were equivalent across gender. The EDI-2 scales correlated with questionnaire measures of bulimic and anorexic symptomatology equivalently across gender. However the EDI-2 scales were generally less reliable for men, leading to slightly lower Pearson-based estimates of correlations among the measures for men.
Assessment 04/2004; 11(1):85-93. · 2.01 Impact Factor
