Howard Tennen

Community Health Center, Connecticut, Middletown, Connecticut, United States

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Publications (282)785.33 Total impact

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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.
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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; · 5.91 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.
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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 : a publication of the Society of Behavioral Medicine. 11/2014;
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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; · 4.85 Impact Factor
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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 : official journal of the Division of Health Psychology, American Psychological Association. 09/2014; 33(9):968-976.
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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).
    Journal of studies on alcohol and drugs. 09/2014; 75(5):766-774.
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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 : journal of the Society of Psychologists in Addictive Behaviors. 08/2014;
  • 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).
    Journal of studies on alcohol and drugs. 07/2014; 75(4):606-14.
  • Ross E O'Hara, Stephen Armeli, Howard Tennen
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    ABSTRACT: 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.
    Drug and Alcohol Review 06/2014; · 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; · 1.04 Impact Factor
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    ABSTRACT: We (Kranzler et al., 2014) reported that topiramate 200 mg/day reduced heavy drinking days and increased abstinent days in 138 heavy drinkers whose treatment goal was to reduce drinking to safe levels. In that 12-week, placebo-controlled study, we measured drinking using the Timeline Follow-back method at each treatment visit. In addition to the intent-to-treat effects of topiramate, we found that a single nucleotide polymorphism (rs2832407) in GRIK1, encoding the GluK1 subunit of the kainate receptor, moderated the treatment effect in European Americans (EAs; n = 122). Topiramate reduced heavy drinking only in rs2832407*C allele homozygotes. Here, we augment those analyses by using patients' daily reports obtained using interactive voice response technology; (a) to validate the interactive effects of GRIK1 and topiramate as predictors of drinking level; and, (b) to examine changes in expected positive effects of drinking (i.e. positive outcome expectancies) and desire to drink. We found that rs2832407*C allele homozygotes treated with topiramate drank less overall during treatment than those receiving placebo, validating our earlier findings for heavy drinking days (Kranzler et al., 2014). There was also a study day × medication group × genotype group interaction that predicted both positive alcohol expectancies and desire to drink, with rs2832407*C-allele homozygotes treated with topiramate showing the largest decreases in these outcomes during the study period. Changes in positive alcohol expectancies or desire to drink did not mediate the effects on drinking. These findings validate and extend our previous pharmacogenetic findings with topiramate.
    The International Journal of Neuropsychopharmacology 04/2014; · 5.64 Impact Factor
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    ABSTRACT: To test whether level of perceived stress and reductions in levels of perceived stress (i.e., "let-down") are associated with the onset of migraine attacks in persons with migraine. Patients with migraine from a tertiary headache center were invited to participate in a 3-month electronic diary study. Participants entered data daily regarding migraine attack experience, subjective stress ratings, and other data. Stress was assessed using 2 measures: the Perceived Stress Scale and the Self-Reported Stress Scale. Logit-normal, random-effects models were used to estimate the odds ratio for migraine occurrence as a function of level of stress over several time frames. Of 22 enrolled participants, 17 (median age 43.8 years) completed >30 days of diaries, yielding 2,011 diary entries including 110 eligible migraine attacks (median 5 attacks per person). Level of stress was not generally associated with migraine occurrence. However, decline in stress from one evening diary to the next was associated with increased migraine onset over the subsequent 6, 12, and 18 hours, with odds ratios ranging from 1.5 to 1.9 (all p values < 0.05) for the Perceived Stress Scale. Decline in stress was associated with migraine onset after controlling for level of stress for all time points. Findings were similar using the Self-Reported Stress Scale. Reduction in stress from one day to the next is associated with migraine onset the next day. Decline in stress may be a marker for an impending migraine attack and may create opportunities for preemptive pharmacologic or behavioral interventions.
    Neurology 03/2014; · 8.30 Impact Factor
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    ABSTRACT: Objective: Racial discrimination has been identified as an important predictor of alcohol-related outcomes for African Americans. The goal of the current study was to extend previously found links between lifetime discrimination, alcohol use, and alcohol problems as well as to elucidate the affective mechanisms underlying these associations, as moderated by gender. Method: A multiple-groups structural equation model was computed using survey data collected from 619 students from a historically Black college/university. Results: The final model provided excellent fit to the data, explaining 6% of the variance in alcohol consumption and 37% of the variance in alcohol problems. Discrimination was a significant predictor of alcohol-related problems but not, by and large, level of use. For men, anger-but not discrimination-specific anger-was a significant partial mediator of the link between discrimination and both alcohol use and alcohol problems. Depression partially mediated the link between discrimination and alcohol problems for both men and women. Conclusions: The results suggest that, for African Americans whose drinking leads to drinking-related problems, discrimination and poor affective self-regulation are highly relevant and predictive factors, especially for men. (J. Stud. Alcohol Drugs, 75, 228-234, 2014).
    Journal of studies on alcohol and drugs 03/2014; 75(2):228-34. · 1.68 Impact Factor
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    ABSTRACT: We examined among college students the interactive effects of drinking to cope motivation, anxiety and depression symptoms, and drinking level in predicting drinking-related problems. Using an Internet-based survey, participants (N = 844, 53% women) first reported on their drinking motives and monthly for up to 3 months, they reported on their drinking level, anxiety, depression and DRPs. We found a 3-way interaction between drinking to cope motivation and average levels of drinking and anxiety (but not depression) in predicting drinking-related problems. Specifically, among individuals with stronger drinking to cope motives, higher mean levels of anxiety were associated with a stronger positive association between mean drinking levels and drinking-related problems. We did not find 3-way interactions in the models examining monthly changes in anxiety, depression and drinking in predicting monthly drinking-related problems. However, individuals high in drinking to cope motivation showed a stronger positive association between changes in drinking level and drinking-related problems. The results are discussed in terms of mechanisms related to attention-allocation and self-control resource depletion.
    Anxiety, stress, and coping 02/2014; · 1.55 Impact Factor
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    ABSTRACT: OBJECTIVE Topiramate has been shown to reduce drinking and heavy drinking in individuals with alcohol dependence whose goal was to stop drinking. The authors evaluated the efficacy and tolerability of topiramate in heavy drinkers whose treatment goal was to reduce drinking to safe levels. METHOD A total of 138 individuals (62.3% men) were randomly assigned to receive 12 weeks of treatment with topiramate (N=67), at a maximal daily dose of 200 mg, or matching placebo (N=71). Both groups received brief counseling to reduce drinking and increase abstinent days. It was hypothesized that topiramate-treated patients would be better able to achieve these goals, and it was predicted that based on prior research, the effects would be moderated by a single nucleotide polymorphism (rs2832407) in GRIK1, encoding the kainate GluK1 receptor subunit. RESULTS The rate of treatment completion was 84.9% and equal by treatment group. Topiramate treatment significantly reduced heavy drinking days and increased abstinent days relative to placebo. Patients receiving topiramate also had lower concentrations of the liver enzyme γ-glutamyl transpeptidase and lower scores on a measure of alcohol-related problems than the placebo group. In a European American subsample (N=122), topiramate's effect on heavy drinking days was significantly greater than that for placebo only in rs2832407 C-allele homozygotes. CONCLUSIONS These findings support the use of topiramate at a daily dose of 200 mg to reduce heavy drinking in problem drinkers. The moderator effect of rs2832407, if validated, would facilitate the identification of heavy drinkers who are likely to respond well to topiramate treatment and provide an important personalized treatment option. The pharmacogenetic findings also implicate the kainate receptor in the mechanism of topiramate's effects on heavy drinking.
    American Journal of Psychiatry 02/2014; · 14.72 Impact Factor
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    ABSTRACT: We investigated whether self-reported racial discrimination was associated with continuous glucose levels and variability in individuals with diabetes, and whether diabetes distress mediated these associations. Seventy-four Black and White women with type 2 diabetes completed the Experience of Discrimination scale, a measure of lifetime racial discrimination, and the Problem Areas in Diabetes, a measure of diabetes distress. Participants wore a continuous glucose monitor for 24 h after 8 h of fasting, a standard meal, and a 4-h run in period. Higher discrimination predicted higher continuous mean glucose and higher standard deviation of glucose. For both mean and standard deviation of glucose, a race × discrimination interaction indicated a stronger relationship between discrimination and glucose for Whites than for Blacks. Diabetes distress mediated the discrimination-mean glucose relationship. Whites who report discrimination may be uniquely sensitive to distress. These preliminary findings suggest that racial discrimination adversely affects glucose control in women with diabetes, and does so indirectly through diabetes distress. Diabetes distress may be an important therapeutic target to reduce the ill effects of racial discrimination in persons with diabetes.
    Journal of Immigrant and Minority Health 01/2014; · 1.16 Impact Factor
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    ABSTRACT: Although both Black and White individuals report racial discrimination, self-report measures of exposure to racial discrimination that can be used across races/ethnicities are rare. The primary aim of our study was to determine if the Schedule of Racist Events (SRE), which was designed for use in Black samples, should also be used in White samples, and if so, what modifications to the scale are necessary. In a sample of 302 adults, approximately equally divided by race, we investigated whether item endorsement differed between Black and White respondents. Results of confirmatory factor analysis and differential item functioning (DIF) analysis suggest that changing the item stem (from 'because you are Black' to 'because of your race/ethnicity') and removing four items that show differential item functioning and/or do not load on the first factor, results in a psychometrically sound scale with no evidence of measurement bias. Researchers interested in measuring racial discrimination in samples that include both Black and White respondents may consider using this version of the SRE. Future studies should investigate other forms of validity in Black and White samples.
    Ethnicity & disease 01/2014; 24(4):406-12. · 1.12 Impact Factor
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    ABSTRACT: Young adults show the highest rates of escalating drinking, yet the neural risk mechanisms remain unclear. Heavy drinkers show variant functional magnetic resonance imaging (fMRI) blood oxygen level-dependent (BOLD) response to alcohol cues, which may presage increasing drinking. In this longitudinal study, we ascertained whether BOLD response to alcohol pictures predicted subsequent heavy drinking among college students. Participants were forty-three 18- to 21-year-olds in the United States who underwent BOLD scanning and completed monthly substance use surveys over the following year. Participants were categorized according to baseline and follow-up drinking into 13 continuously moderate drinkers, 16 continuously heavy drinkers, and 14 transitioners who drank moderately at baseline but heavily by follow-up. During fMRI scanning at baseline, participants viewed alcohol and matched non-alcohol beverage images. We observed group differences in alcohol cue-elicited BOLD response in bilateral caudate, orbitofrontal cortex, medial frontal cortex/anterior cingulate and left insula (clusters>2619ml, voxel-wise F(2,40)>3.23, p<.05, whole-brain corrected p<.05), where transitioners hyperactivated compared with moderate and heavy drinkers (all Tukey p<.05). Exploratory factor analysis revealed a single brain network differentiating those who subsequently increased drinking. Exploratory regressions showed that, compared with other risk factors (e.g., alcoholism family history, impulsivity), BOLD response best predicted escalating drinking amount and alcohol-related problems. Neural response to pictures of alcohol is substantially enhanced among United States college students who subsequently escalate drinking. Greater cue-reactivity is associated with larger increases in drinking and alcohol-related problems, regardless of other baseline factors. Thus, neural cue-reactivity could uniquely facilitate identifying individuals at greatest risk for future problematic drinking.
    Addiction 12/2013; · 4.58 Impact Factor

Publication Stats

7k Citations
785.33 Total Impact Points

Institutions

  • 2001–2014
    • Community Health Center, Connecticut
      Middletown, Connecticut, United States
  • 1994–2014
    • University of Connecticut
      • • Department of Community Medicine and Health Care
      • • Department of Psychology
      • • Department of Psychiatry
      Storrs, Connecticut, United States
  • 2001–2013
    • Yale University
      • • Department of Psychiatry
      • • School of Medicine
      New Haven, CT, United States
  • 1985–2013
    • Trinity College
      • Psychology
      Hartford, Connecticut, United States
  • 2012
    • University of Pennsylvania
      • Department of Psychiatry
      Philadelphia, PA, United States
  • 2010–2011
    • Hospital of the University of Pennsylvania
      • Department of Psychiatry
      Philadelphia, Pennsylvania, United States
    • Albert Einstein College of Medicine
      • Department of Epidemiology & Population Health
      New York City, NY, United States
  • 2008–2011
    • Fairleigh Dickinson University
      Philadelphia, Pennsylvania, United States
    • Portland State University
      Portland, Oregon, United States
  • 2001–2011
    • Arizona State University
      • Department of Psychology
      Mesa, AZ, United States
  • 1997–2011
    • UConn Health Center
      • • Division of Behavioral Sciences and Community Health
      • • Department of Community Medicine and Health Care
      • • Department of Psychiatry
      Farmington, CT, United States
  • 2009
    • University of Minnesota Twin Cities
      • Department of Psychology
      Minneapolis, MN, United States
    • University of Otago
      • Department of Psychology
      Dunedin, Otago, New Zealand
    • Rhode Island Hospital
      Providence, Rhode Island, United States
  • 2005–2009
    • Pacific Institute for Research and Evaluation
      • Prevention Research Center PRC
      Calverton, MD, United States
  • 2003–2008
    • University of Maine at Farmington
      Farmington, Maine, United States
  • 2007
    • University of California, Los Angeles
      • Department of Psychology
      Los Angeles, CA, United States
    • American Military University
      Charles Town, West Virginia, United States
  • 2006
    • The University of Memphis
      Memphis, Tennessee, United States
    • State University of New York
      New York City, New York, United States
    • Pace University
      • Department of Psychology
      New York City, NY, United States
  • 2000
    • University of Amsterdam
      • Amsterdam School of Economics Research Institute
      Amsterdam, North Holland, Netherlands
    • The Netherlands Institute for Addiction Healthcare
      Arnheim, Gelderland, Netherlands
  • 1997–2000
    • Duke University Medical Center
      • Department of Pediatrics
      Durham, NC, United States
  • 1999
    • Ohio University
      • Department of Psychology
      Athens, OH, United States
    • Fordham University
      • Department of Psychology
      New York City, NY, United States