Howard Tennen

Community Health Center, Connecticut, मिडलटाउन, Connecticut, United States

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Publications (299)868.26 Total impact

  • Mark D. Litt, Ronald M. Kadden, Howard Tennen
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    ABSTRACT: Network Support treatment was intended to help alcohol dependent patients alter their close social support networks to be more supportive of sobriety and less supportive of drinking. The purpose of the present study was to examine the differential influences of Network Support treatment on men and women.
    Addictive Behaviors 06/2015; 45. DOI:10.1016/j.addbeh.2015.01.005 · 2.44 Impact Factor
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    ABSTRACT: Fibromyalgia (FM) is a chronic pain condition often resulting in functional impairments. Nonrestorative sleep is a prominent symptom of FM that is related to disability, but the day-to-day mechanisms relating the prior night's sleep quality to next-day reports of disability have not been examined. This study examined the within-day relations among early-morning reports of sleep quality last night, late-morning reports of pain and positive and negative affect, and end-of-day reports of activity interference. Specifically, we tested whether pain, positive affect, and negative affect mediated the association between sleep quality and subsequent activity interference. Data were drawn from electronic diary reports collected from 220 patients with FM for 21 consecutive days. The direct and mediated effects at the within-person level were estimated with multilevel structural equation modeling. Results showed that pain and positive affect mediated the relation between sleep quality and activity interference. Early-morning reports of poor sleep quality last night predicted elevated levels of pain and lower levels of positive affect at late-morning, which, in turn, predicted elevated end-of-day activity interference. Of note, positive affect was a stronger mediator than pain and negative affect was not a significant mediator. In summary, the findings identify 2 parallel mechanisms, pain and positive affect, through which the prior night's sleep quality predicts disability the next day in patients with FM. Furthermore, results highlight the potential utility of boosting positive affect after a poor night's sleep as one means of preserving daily function in FM.
    Pain 03/2015; 156(3):540-546. DOI:10.1097/01.j.pain.0000460324.18138.0a · 5.84 Impact Factor
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    ABSTRACT: Research consistently shows a positive association between racial discrimination and problematic alcohol use among African Americans, but little is known about the micro-processes linking this pernicious form of stress to drinking. One possibility is that the cumulative effects of discrimination increase individuals' likelihood of negative-mood-related drinking. In the current study, we examined whether individual differences in lifetime perceived racial discrimination among African American college students moderate relations between daily negative moods and evening alcohol consumption in both social and nonsocial contexts. Data came from an online daily diary study of 441 African Americans (58% female) enrolled at a historically black college/university. Lifetime discrimination was measured at baseline. For 30 days, students reported the number of drinks they consumed the night before both socially and nonsocially, as well as their daytime level of negative mood. In support of the hypotheses, only men who reported higher (vs. lower) lifetime discrimination showed a positive association between daily negative mood and that evening's level of nonsocial drinking. Contrary to expectation, women who reported higher (vs. lower) discrimination showed a negative association between daily negative mood and nonsocial drinking. Neither daily negative mood nor lifetime discrimination predicted level of social drinking. These findings provide further evidence that the cumulative impact of racial discrimination may produce a vulnerability to negative-mood-related drinking-but only for African American men. Importantly, these effects emerged only for nonsocial drinking, which may further explain the robust association between discrimination and problematic alcohol use. (J. Stud. Alcohol Drugs, 76, 229-236, 2015).
    Journal of studies on alcohol and drugs 03/2015; 76(2):229-36. · 2.27 Impact Factor
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    ABSTRACT: This study investigated relationships of income and self-reported racial discrimination to diabetes health behaviors following an acute stressor. A total of 77 diabetic women (51% Black, 49% White) completed a laboratory public speaking stressor. That evening, participants reported same-day eating, alcohol consumption, and medication adherence; physical activity was measured with actigraphy, and the next morning participants reported sleep quality. Measures were repeated on a counterbalanced control day. There was no mean level difference in health behaviors between stressor and control days. On stressor day, lower income predicted lower physical activity, sleep quality, and medication adherence, and higher racial discrimination predicted more eating and alcohol consumed, even after accounting confounders including race and control day behaviors. © The Author(s) 2015.
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    ABSTRACT: Past 1-month marital conflict was more frequent among female than male alcoholics.•Marital conflict over 14 days was more frequent among female than male alcoholics.•Negative and positive marital behaviors were associated with daily intoxication.
    Addictive Behaviors 02/2015; 41. DOI:10.1016/j.addbeh.2014.10.009 · 2.44 Impact Factor
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    ABSTRACT: Diabetes is the only disorder in which women's risk for heart disease exceeds men's. Elevated blood pressure (BP) increases cardiovascular risk in people with type 2 diabetes. Racial discrimination and neuroticism are both associated with BP levels but have not been examined in concert. This study investigated self-reported racial discrimination, neuroticism and ambulatory BP in women with type 2 diabetes. Thirty-nine Black and 38 White women completed a race-neutral version of the Schedule of Racist Events; BP was evaluated using ambulatory monitoring devices. Actigraphy and diaries were used to document times of sleep and wakefulness. Racial discrimination interacted with neuroticism to predict systolic and diastolic BP both while awake and during sleep, after adjustment for covariates. For each, the influence of racist events was stronger at lower levels of neuroticism. Racial discrimination is associated with higher levels of 24-h BP in diabetic women who are low in neuroticism. Copyright © 2015 John Wiley & Sons, Ltd.
    Stress and Health 01/2015; DOI:10.1002/smi.2622 · 1.34 Impact Factor
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    ABSTRACT: To document the time course of perceived stress among women through the period of a natural disaster, to determine the effect of sleep quality on this time course, and to identify risk factors that predict higher levels of perceived stress. Longitudinal study from 2006-2012. Community-based family planning clinics in southeast Texas. There were 296 women aged 18-31 y who experienced Hurricane Ike, September 2008. Cohen Perceived Stress Scale (PSS) was administered every 2 mo from 6 mo before to 12 mo after Hurricane Ike. Sleep quality was assessed 1 mo after Hurricane Ike using the Pittsburg Sleep Quality Index (PSQI). Good sleep was defined as a PSQI summary score < 5, and poor sleep as a score ≥ 5. Hurricane Ike stressors (e.g., property damage, subjective stressors) and pre-Ike lifetime major life events and emotional health (e.g., emotional dysregulation, self-control) were also assessed. Over the entire period of 18 mo (6 mo before and 12 mo after the hurricane), perceived stress was significantly higher among poor sleepers compared to good sleepers, and only good sleepers showed a significant decrease in perceived stress after Hurricane Ike. In addition, a higher level of perceived stress was positively associated with greater Ike damage among poor sleepers, whereas this correlation was not observed among good sleepers. In the final multivariate longitudinal model, Ike-related subjective stressors as well as baseline major life events and emotional dysregulation among poor sleepers predicted higher levels of perceived stress over time; among good sleepers, additional factors such as lower levels of self-control and having a history of a psychiatric disorder also predicted higher levels of perceived stress. Sleep quality after Hurricane Ike, an intense natural disaster producing substantial damage, impacted changes in perceived stress over time. Our findings suggest the possibility that providing victims of disasters with effective interventions to improve sleep quality could help to reduce their perceived stress over time. © 2014 Associated Professional Sleep Societies, LLC.
    Sleep 01/2015; · 5.06 Impact Factor
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    ABSTRACT: : This daily diary study of individuals with fibromyalgia (FM) examined whether morning increases in loneliness relate to worsened evening bodily pain through afternoon negative pain cognitions. Methods: 220 participants with FM completed electronic diaries 4 times a day for 21 days to assess loneliness, negative pain cognitions, bodily pain, and social enjoyment. Multilevel structural equation modeling was used to examine within-person relations of morning increases in loneliness, afternoon negative pain cognitions, and evening pain, controlling for morning pain. Results: On mornings when individuals experienced higher than their usual levels of loneliness, they experienced higher levels of afternoon maladaptive pain cognitions, which in turn predicted increases in evening pain above the level of morning pain. Afternoon maladaptive pain cognitions fully mediated the relations between morning loneliness and evening pain. Conclusions: Lonely episodes are associated with subsequent increases in negative patterns of thinking about pain, which in turn predict subsequent increases in bodily pain within a day. Because pain cognitions mediate the loneliness—pain link, FM interventions may benefit from addressing individuals’ vulnerability to maladaptive cognitions following lonely episodes.
    Journal of Psychosomatic Research 01/2015; DOI:10.1016/j.jpsychores.2014.12.018 · 2.84 Impact Factor
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    ABSTRACT: Previous studies indicate that topiramate reduces alcohol use among problem drinkers, with one study showing that the effect was moderated by a polymorphism (rs2832407) in GRIK1, the gene encoding the GluK1 kainate subunit. We examined whether the interactive effect of medication and genotype (1) altered the association between daily self-efficacy and later-day drinking; and (2) had an indirect effect on drinking via self-efficacy. In a 12-week, placebo-controlled trial of topiramate, we used daily interactive voice response technology to measure self-efficacy (i.e. confidence in avoiding heavy drinking later in the day) and drinking behavior in 122 European-American heavy drinkers. Topiramate's effects on both self-efficacy and drinking level were moderated by rs2832407. C-allele homozygotes treated with topiramate showed higher levels of self-efficacy and lower levels of nighttime drinking across the 12-week trial. Further, the interactive effect of topiramate and genotype on mean nighttime drinking levels was mediated by mean levels of self-efficacy. By modeling topiramate's effects on nighttime drinking across multiple levels of analysis, we found that self-efficacy, a key psychologic construct, mediated the effect of topiramate, which was moderated by rs2832407 genotype. Thus, it may be possible to use an individualized assessment (i.e. genotype) to select treatment to optimize the reduction in heavy drinking and thereby provide a personalized treatment approach.
    Addiction Biology 01/2015; DOI:10.1111/adb.12207 · 5.93 Impact Factor
  • Ross E O'Hara, Stephen Armeli, Howard Tennen
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    ABSTRACT: Prior investigations have established between-person associations between drinking motives and both levels of alcohol use and social-contextual factors surrounding that use, but these relations have yet to be examined at the within-person level of analysis. Moreover, exploring previously posited subtypes of coping motives (i.e., coping with depression, anxiety, and anger) may shed light on the within-person processes underlying drinking to cope. In this daily diary study of college student drinking (N = 722; 54% female), students reported each day how many drinks they consumed the previous evening in both social and nonsocial settings along with their motives for each drinking episode. Additionally, they reported whether they attended a party the evening before, the number of people they were with, the gender makeup of that group, and their perceptions of their companions' drinking prevalence and quantity. External reasons for drinking-social and conformity motives-showed patterns largely consistent across levels of analysis and in agreement with motivational models. However, internal reasons for drinking-enhancement and coping motives-demonstrated divergent associations that suggest different processes across levels of analysis. Finally, coping subtypes showed differing associations with drinking levels and social-contextual factors dependent on the predisposing emotion and the level of analysis. These results suggest that internal drinking motives have unique state and trait components, which could have important implications for the application of motivational models to prevention and treatment efforts. We recommend including drinking motives (including coping subtypes) as within-person measures in future microlongitudinal studies. (PsycINFO Database Record (c) 2014 APA, all rights reserved).
    Psychology of Addictive Behaviors 12/2014; DOI:10.1037/adb0000046 · 2.09 Impact Factor
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    ABSTRACT: Using retrospective reports obtained during treatment visits in 138 heavy drinkers, we found that topiramate's reduction of heavy drinking was moderated by a polymorphism (rs2832407) in GRIK1, which encodes the GluK1 kainate subunit (Kranzler et al., 2014a). A subsequent analysis of that 12-week topiramate treatment trial showed similar effects of medication and genotype on daily drinking reports obtained via interactive voice response technology (IVR; Kranzler et al., 2014b). Specifically, rs2832407*C-allele homozygotes treated with topiramate reported lower levels of drinking than those receiving placebo. This group also had the largest decreases in the expected positive effects of drinking (i.e., expectancies) and desire to drink. To extend that analysis, which focused on how mean levels of desire and expectancies changed over time with treatment, we used a within-person approach to examine whether daily variation in expectancies and desire to drink interact with topiramate treatment and genotype to predict nighttime drinking levels. In contrast to the previous analysis (Kranzler et al., 2014b), here we focus on whether alcohol expectancies and desire to drink moderate the effects of topiramate on drinking. Results showed a 3-way interaction of daily expectancies with genotype and medication, such that the protective effect of topiramate on nighttime drinking among rs2832407*C-allele homozygotes was decreased on days characterized by relatively high levels of anticipated positive effects of alcohol. There was no moderating effect of desire to drink or negative alcohol expectancies. Thus, there is specific moderation of the effects of topiramate by both genotype and cognitive process. (PsycINFO Database Record (c) 2014 APA, all rights reserved).
    Experimental and Clinical Psychopharmacology 12/2014; 22(6):494-501. DOI:10.1037/a0038350 · 2.63 Impact Factor
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    ABSTRACT: Fatigue is a debilitating symptom of fibromyalgia (FM) that has limited treatment options. Some evidence, however, has linked positive social engagement with reduced within-day fatigue.
    Annals of Behavioral Medicine 11/2014; DOI:10.1007/s12160-014-9666-z · 4.20 Impact Factor
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    ABSTRACT: Objective: This study compared the impact of cognitive-behavioral therapy for pain (CBT-P), mindful awareness and acceptance treatment (M), and arthritis education (E) on day-to-day pain- and stress-related changes in cognitions, symptoms, and affect among adults with rheumatoid arthritis (RA). Method: One hundred forty-three RA patients were randomized to 1 of the 3 treatment conditions. CBT-P targeted pain-coping skills; M targeted awareness and acceptance of current experience to enhance coping with a range of aversive experiences; E provided information regarding RA pain and its management. At pre- and posttreatment, participants completed 30 consecutive evening diaries assessing that day's pain, fatigue, pain-related catastrophizing and perceived control, morning disability, and serene and anxious affects. Results: Multilevel models compared groups in the magnitude of within-person change in daily pain and stress reactivity from pre- to posttreatment. M yielded greater reductions than did CBT-P and E in daily pain-related catastrophizing, morning disability, and fatigue and greater reductions in daily stress-related anxious affect. CBT-P yielded less pronounced declines in daily pain-related perceived control than did M and E. Conclusions: For individuals with RA, M produces the broadest improvements in daily pain and stress reactivity relative to CBT-P and E. These findings also highlight the utility of a diary-based approach to evaluating the treatment-related changes in responses to daily life. (PsycINFO Database Record (c) 2014 APA, all rights reserved).
    Journal of Consulting and Clinical Psychology 11/2014; 83(1). DOI:10.1037/a0038200 · 4.85 Impact Factor
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    ABSTRACT: Objective: The goal of the present study was to examine whether within-person, episode-specific changes in drinking-to-cope (DTC) motivation from the previous evening were associated with concurrent daily mood and fatigue-related symptoms among college student drinkers (N = 1,421; 54% female). Method: We conducted an Internet-based daily diary study in which students reported over 30 days on their previous night's drinking level and motivation and their current mood (i.e., sadness, anxiety, anger/hostility, and positive mood) and fatigue-related symptoms. Hypotheses were tested using hierarchical linear models in which the current day's outcome was predicted by last night's levels of DTC motivation and drinking, controlling for drinking to enhance motivation, sex, current day's physical symptoms and drinking, and yesterday's level of the outcome. Subsequent models also predicted outcomes 2 days following the drinking event. Results: Relative increases in previous night's DTC motivation were associated with higher levels of current day negative mood and fatigue-related symptoms and lower levels of positive mood. Also, the association between episode-specific DTC motivation and negative mood was stronger in the positive direction when individuals reported higher levels of nonsocial drinking from the previous night. Last, episode-specific DTC showed similar associations with sadness and anger/hostility 2 days after the drinking event. Conclusions: The results are generally consistent with the posited attention allocation and ego-depletion mechanisms. Findings suggest that the deleterious effects of repeated episodes of DTC, over time, could help to explain the increased likelihood of alcohol-related problems seen in prior studies. (J. Stud. Alcohol Drugs, 75, 766-774, 2014).
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    ABSTRACT: Objective: Although the adverse effects of chronic pain on work productivity and daily life pursuits are clear, the within-person dynamics of pain, goal cognition, and engagement in work-related and lifestyle goals remain uncharted. This study investigated the impact of pain intensity (assessed on 3 occasions each day) and goal-related schematic thinking (ratings of importance, planning, and goal pursuit opportunities, assessed only in the morning) on afternoon and evening work and lifestyle goal pursuit. Methods: A community sample of working adults with chronic pain (N = 131) were screened and interviewed about their work and lifestyle goals and completed a 21-day telephonic diary. Hierarchical linear modeling was used to estimate within-person and between-person effects. Results: At the within-person level, morning pain intensity was inversely related to schematic cognition concerning work and lifestyle goals, whereas, at the between-person level, morning pain intensity varied positively with schematic thinking about work goals as well with afternoon lifestyle goal pursuit. At both the between- and within- analytic levels, morning goal schemas were positively associated with the pursuit of each type of goal in the afternoon and again in the evening. Moreover, positive carry-over effects of morning goal schemas on next day afternoon goal pursuit were observed. Conclusions: Whereas morning pain intensity exhibited inconsistent effects across analytic levels, morning goal-related schematic thinking consistently predicted goal pursuit across analytic levels, type of goal, and time of day. These findings have implications for treatment and prevention of pain's potentially deleterious effects on workplace and lifestyle goals. (PsycINFO Database Record (c) 2014 APA, all rights reserved).
    Health Psychology 09/2014; 33(9):968-976. DOI:10.1037/hea0000093 · 3.95 Impact Factor
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    ABSTRACT: Despite evidence that African Americans are disproportionately affected by drinking to cope relative to European Americans, African American college students' drinking motives remain understudied. Additionally, most research has only examined between-person differences in drinking to cope as a predictor of alcohol use, ignoring within-person variability. In the current daily diary study of 462 African American undergraduates from a historically Black university, associations between episode-specific drinking to cope motives and alcohol use were tested, an approach more consistent with motivational theories of drinking. At baseline, students completed traditional global drinking motive measures; then for 30 days they reported the number of standard drinks they consumed the previous night, and, if they drank, their coping, enhancement, and social reasons for doing so. Students who reported higher mean levels of episode-specific coping motives, on average, consumed more alcohol on drinking evenings. Furthermore, mean episode-specific coping motives, but not global coping motives, predicted average levels of alcohol use. Additionally, coping motives were particularly important for predicting nonsocial (vs. social) drinking. Finally, during evenings for which students reported higher than usual episode-specific coping motives, men consumed more alcohol in both social and nonsocial contexts; in contrast, women reporting higher than usual drinking-to-cope motives only consumed more nonsocial drinks. In conclusion, drinking among African American college students was related to coping motives, particularly among men and in the context of nonsocial alcohol consumption. Moreover, motivational theories of alcohol use may be refined by measuring episode-specific drinking motives that more accurately capture the drinking-to-cope process. (PsycINFO Database Record (c) 2014 APA, all rights reserved).
    Psychology of Addictive Behaviors 08/2014; 28(3). DOI:10.1037/a0036303 · 2.09 Impact Factor
  • Ross E O'Hara, Stephen Armeli, Howard Tennen
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    ABSTRACT: Objective: This study examined whether global drinking-to-cope (DTC) motivation moderates negative mood-drinking contingencies and negative mood-motivation contingencies at the daily level of analysis. Method: Data came from a daily diary study of college student drinking (N = 1,636; 53% female; Mage = 19.2 years). Fixed-interval models tested whether global DTC motivation moderated relations between daily negative mood and that evening's drinking and episodic DTC. Time-to-drink models examined whether global DTC motivation moderated the effects of weekly negative mood on the immediacy of drinking and DTC in the weekly cycle. Results: More evening drinking occurred on days characterized by relatively higher anxiety or anger, and students were more likely to report DTC on days when they experienced greater sadness. However, only the daily Anxiety × Global DTC Motivation interaction for number of drinks consumed was consistent with hypotheses. Moreover, students reported drinking, heavy drinking, and DTC earlier in weeks characterized by relatively higher anxiety or anger, but no hypothesized interactions with global DTC motivation were found. Conclusions: Results indicate that negative mood is associated with increased levels of drinking and drinking for coping reasons among college students but that the strength of these relations does not differ by global levels of DTC motivation. These findings raise the possibility that global DTC measures are insufficient for examining within-person DTC processes. Further implications of these results are discussed, including future directions that may determine the circumstances under which, and for whom, DTC occurs. (J. Stud. Alcohol Drugs, 75, 606-614, 2014).
  • Ross E O'Hara, Stephen Armeli, Howard Tennen
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    ABSTRACT: Introduction and Aims. Motivational models of alcohol use posit opposing approach and avoidance motives related to drinking, yet no micro-longitudinal study of college students has examined avoidance motives [i.e. reasons for not drinking (RND)]. This exploratory study examined daily-and person-level correlates of students' RNDs to identify factors that may inhibit alcohol use. Design and Methods. College students (n = 1631; 54% female) participated in a 30-day daily diary study in which they reported RNDs for non-drinking evenings, as well as daily moods, global drinking motives and alcohol expectancies. Results. Daily sadness was positively associated with not drinking due to having nobody with whom to drink but negatively associated with not drinking due to school work. Daily anxiety was negatively associated with not drinking due to lack of desire and positively associated with not drinking due to habit or having school or job responsibilities. At the person level, multiple RNDs were associated with both coping and conformity motives (but not social or enhancement motives), as well as positive (but not negative) alcohol expectancies. Discussion and Conclusions. Results demonstrate the complexity of modelling mood-drinking contingencies proposed by motivational theories of alcohol use. Distinct moods may promote or inhibit drinking through various pathways, which could help explain the weak associations between daily mood and drinking level observed in previous studies. Measuring reasons both for and against drinking in micro-longitudinal studies (e. g. daily diaries) is recommended to better understand the processes underlying alcohol use and to inform future prevention efforts.
    Drug and Alcohol Review 06/2014; 33(4). DOI:10.1111/dar.12162 · 1.55 Impact Factor
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    ABSTRACT: This study examined the role of stress as a mediator of the relationship between prior drug addiction and current high-risk sexual behaviour. Eight hundred twenty women aged 18 to 30 years, who received care at community-based family planning clinics, were interviewed using the Composite International Diagnostic Interview and the Sexual Risk Behavior Assessment Schedule. They also completed the brief version of the Self-Control Scale as a measure of problem-solving strategies and measures of recent stressful events, daily hassles and ongoing chronic stress. Regardless of addiction history, stress exposure during the previous 12 months was associated with risky sexual behaviour during the previous 12 months. Structural equation modelling revealed that 12-month stress levels mediated the relationship between past drug addiction and 12-month high-risk sexual behaviours, as well as the negative relationship between problem-solving strategies and high-risk sexual behaviours. Problem-solving strategies did not moderate the relationship between drug addiction and high-risk sexual behaviours. These findings suggest that stress management training may help reduce risky behaviour among young, low-income women Copyright © 2014 John Wiley & Sons, Ltd.
    Stress and Health 06/2014; DOI:10.1002/smi.2587 · 1.34 Impact Factor

Publication Stats

10k Citations
868.26 Total Impact Points


  • 2000–2015
    • Community Health Center, Connecticut
      मिडलटाउन, Connecticut, United States
    • University of Bordeaux
      Burdeos, Aquitaine, France
    • The Netherlands Institute for Addiction Healthcare
      Arnheim, Gelderland, Netherlands
    • Duke University Medical Center
      • Department of Pediatrics
      Durham, NC, United States
  • 1987–2015
    • University of Connecticut
      • • Department of Community Medicine and Health Care
      • • Department of Psychology
      • • Department of Medicine
      • • Department of Psychiatry
      Storrs, Connecticut, United States
  • 2000–2012
    • Yale University
      • Department of Psychiatry
      New Haven, Connecticut, United States
  • 2008–2011
    • Fairleigh Dickinson University
      Philadelphia, Pennsylvania, United States
    • Portland State University
      • Department of Psychology
      Portland, Oregon, United States
  • 2009
    • University of Michigan
      • Addiction Research Center
      Ann Arbor, Michigan, United States
  • 2004–2007
    • UConn Health Center
      • • Division of Behavioral Sciences and Community Health
      • • Department of Community Medicine and Health Care
      • • Department of Psychiatry
      Farmington, CT, United States
  • 2006
    • The University of Memphis
      Memphis, Tennessee, United States
  • 2004–2006
    • Pace University
      • Department of Psychology
      New York City, NY, United States
  • 2001–2006
    • Arizona State University
      • Department of Psychology
      Phoenix, Arizona, United States
  • 2005
    • Pacific Institute for Research and Evaluation
      • Prevention Research Center PRC
      Calverton, MD, United States
  • 2003
    • University of Maine at Farmington
      Farmington, Maine, United States
  • 1999
    • Fordham University
      • Department of Psychology
      New York City, NY, United States