[Show abstract][Hide abstract] 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.
[Show abstract][Hide abstract] 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.
[Show abstract][Hide abstract] 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;
[Show abstract][Hide abstract] 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.
[Show abstract][Hide abstract] 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
[Show abstract][Hide abstract] 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
[Show abstract][Hide abstract] 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.
[Show abstract][Hide abstract] 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
[Show abstract][Hide abstract] 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
[Show abstract][Hide abstract] 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
[Show abstract][Hide abstract] 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
[Show abstract][Hide abstract] 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.
[Show abstract][Hide abstract] ABSTRACT: Multiple theories posit that people with a history of depression are at higher risk for a depressive episode than people who have never experienced depression, which may be partly due to differences in stress-reactivity. In addition, both the dynamic model of affect and the broaden-and-build theory suggest that stress and positive affect interact to predict negative affect, but this moderation has never been tested in the context of depression history. The current study used multilevel modeling to examine these issues among 1,549 college students with or without a history of depression. Students completed a 30-day online diary study in which they reported daily their perceived stress, positive affect, and negative affect (including depression, anxiety, and hostility). On days characterized by higher than usual stress, students with a history of depression reported greater decreases in positive affect and greater increases in depressed affect than students with no history. Furthermore, the relations between daily stress and both depressed and anxious affect were moderated by daily positive affect among students with remitted depression. These results indicate that students with a history of depression show greater stress-reactivity even when in remission, which may place them at greater risk for recurrence. These individuals may also benefit more from positive affect on higher stress days despite being less likely to experience positive affect on such days. The current findings have various implications both clinically and for research on stress, mood, and depression. (PsycINFO Database Record (c) 2013 APA, all rights reserved).
[Show abstract][Hide abstract] ABSTRACT: A subset of patients with epilepsy successfully self-predicted seizures in a paper diary study. We conducted an e-diary study to ensure that prediction precedes seizures, and to characterize the prodromal features and time windows that underlie self-prediction.
Subjects 18 or older with localization-related epilepsy (LRE) and ≥3 seizures per month maintained an e-diary, reporting a.m./p.m. data daily, including mood, premonitory symptoms, and all seizures. Self-prediction was rated by, "How likely are you to experience a seizure (time frame)?" Five choices ranged from almost certain (>95% chance) to very unlikely. Relative odds of seizure (odds ratio, OR) within time frames was examined using Poisson models with log normal random effects to adjust for multiple observations.
Nineteen subjects reported 244 eligible seizures. OR for prediction choices within 6 h was as high as 9.31 (CI 1.92-45.23) for "almost certain." Prediction was most robust within 6 h of diary entry, and remained significant up to 12 h. For nine best predictors, average sensitivity was 50%. Older age contributed to successful self-prediction, and self-prediction appeared to be driven by mood and premonitory symptoms. In multivariate modeling of seizure occurrence, self-prediction (2.84; CI 1.68-4.81), favorable change in mood (0.82; CI 0.67-0.99), and number of premonitory symptoms (1.11; CI 1.00-1.24) were significant.
Some persons with epilepsy can self-predict seizures. In these individuals, the odds of a seizure following a positive prediction are high. Predictions were robust, not attributable to recall bias, and were related to self-awareness of mood and premonitory features. The 6-h prediction window is suitable for the development of preemptive therapy.
[Show abstract][Hide abstract] ABSTRACT: Alcohol misuse is one of the most serious public health problems facing adolescents and young adults in the United States. National statistics shows that nearly 90% of alcohol consumed by youth under 21 years of age involves binge drinking and 44% of college students engage in high-risk drinking activities. Conventional alcohol intervention programs, which aim at installing either an alcohol reduction norm or prohibition against underage drinking, have yielded little progress in controlling college binge drinking over the years. Existing alcohol studies are deductive where data are collected to investigate a psychological/behavioral hypothesis, and statistical analysis is applied to the data to confirm the hypothesis. Due to this confirmatory manner of analysis, the resulting statistical models are cohort-specific and typically fail to replicate on a different sample. This article presents two machine learning approaches for a secondary analysis of longitudinal data collected in college alcohol studies sponsored by the National Institute on Alcohol Abuse and Alcoholism. Our approach aims to discover knowledge, from multiwave cohort-sequential daily data, which may or may not align with the original hypothesis but quantifies predictive models with higher likelihood to generalize to new samples. We first propose a so-called temporally-correlated support vector machine to construct a classifier as a function of daily moods, stress, and drinking expectancies to distinguish days with nighttime binge drinking from days without for individual students. We then propose a combination of cluster analysis and feature selection, where cluster analysis is used to identify drinking patterns based on averaged daily drinking behavior and feature selection is used to identify risk factors associated with each pattern. We evaluate our methods on two cohorts of 530 total college students recruited during the Spring and Fall semesters, respectively. Cross validation on these two cohorts and further on 100 random partitions of the total students demonstrate that our methods improve the model generalizability in comparison with traditional multilevel logistic regression. The discovered risk factors and the interaction of these factors delineated in our models can set a potential basis and offer insights to a new design of more effective college alcohol interventions.
ACM Transactions on Intelligent Systems and Technology (TIST). 09/2013; 4(4).
[Show abstract][Hide abstract] ABSTRACT: The current study used a person-centered approach (i.e. latent profile analysis) to identify distinct types of college student drinkers based on the predictions of motivational, social learning, and stress and coping theories of maladaptive drinking. A large sample (N=844; 53% female) of first-year undergraduates from two institutions, public and private, who reported consuming one or more drinks in the last three months completed measures of depressive and anxiety symptoms, positive alcohol-outcome expectancies, negative life events, social support, drinking motives, drinking level and drinking-related problems. Latent profile analysis revealed a small subgroup of individuals (n=81, 9%) who conformed to the anticipated high-risk profile; specifically, this group demonstrated high levels of negative affect, coping motives, drinks per week, and drinking-related problems. However, additional groups emerged that showed patterns inconsistent with the proposed vulnerability profile (e.g., high negative affect, positive expectancies, and negative life events, but relatively low drinking levels). Findings from our person-centered approach showing the presence of groups both consistent and inconsistent with the predictions of motivational, social learning, and stress and coping theories highlight the need to identify and target certain college students for prevention and intervention of negative affect-related drinking.
[Show abstract][Hide abstract] ABSTRACT: Eighteen- to twenty-five-year-olds show the highest rates of alcohol use disorders (AUD) and heavy drinking, which may have critical neurocognitive implications. Regions subserving memory may be particularly susceptible to alcohol-related impairments.
We used blood oxygen level-dependent (BOLD) functional magnetic resonance imaging (fMRI) to examine the neural correlates of visual encoding and recognition among heavy-drinking college students. We predicted that heavy drinkers would show worse memory performance, increased frontal/parietal activation, and decreased hippocampal response during encoding.
Participants were 23 heavy drinkers and 33 demographically matched light drinkers, aged 18-20, characterized using quantity/frequency of drinking and AUD diagnosis. Participants performed a figural encoding and recognition task during fMRI. BOLD response during encoding was modeled based on whether each stimulus was subsequently recognized or forgotten (i.e., correct vs. incorrect encoding).
There were no group differences in behavioral performance. Compared to light drinkers, heavy drinkers showed (1) greater BOLD response during correct encoding in the right hippocampus/medial temporal, right dorsolateral prefrontal, left inferior frontal, and bilateral posterior parietal cortices; (2) less left inferior frontal activation and greater bilateral precuneus deactivation during incorrect encoding; and (3) less bilateral insula response during correct recognition (clusters >10,233 μl, p < 0.05 whole brain).
This is the first investigation of the neural substrates of figural memory among heavy-drinking older adolescents. Heavy drinkers demonstrated compensatory hyperactivation of memory-related areas during correct encoding, greater deactivation of default mode regions during incorrect encoding, and reduced recognition-related response. Results could suggest use of different encoding and recognition strategies among heavy drinkers.
[Show abstract][Hide abstract] ABSTRACT: Impaired inhibition of prepotent motor responding may represent an important risk factor for alcoholism. Alcohol use also may increase impulsive behaviors, including impaired response inhibition. Little is known about brain function underlying response inhibition among college-age drinkers based on their drinking patterns, despite college-age drinkers demonstrating high rates of alcohol use disorders. Our major objective was to compare behavior and associated brain activity measured with fMRI during a response-inhibition task in matched heavy- and light-alcohol-drinking college students. Participants were light (N=36) and heavy (N=56) drinkers, aged 18-20 years. We characterized blood oxygen level-dependent (BOLD) responses while participants performed an fMRI Go/No-Go task to quantify inhibitory behavior and brain activity. Behaviorally, group performance differences were observed for Go correct-hit and No-Go false-alarm reaction times with increased reaction times in heavy compared to light drinkers. During fMRI No-Go correct rejections, light drinkers exhibited greater BOLD response than did heavy drinkers in left supplementary motor area, bilateral parietal lobule, right hippocampus, bilateral middle frontal gyrus, left superior temporal gyrus and cingulate gyrus/ACC (BA24). Group differences in Go/No-Go-related regional activations correlated with alcohol-and impulsivity-related measures. These findings suggest that heavy alcohol drinkers may have dysfunction in brain regions underlying attention and response inhibition, leading to diminished abilities to suppress prepotent responding. The extent to which these tendencies relate to impulsive decision-making and behaviors in real-life settings and may guide intervention development warrants additional investigation.Neuropsychopharmacology accepted article preview online, 14 May 2013; doi:10.1038/npp.2013.119.
Neuropsychopharmacology: official publication of the American College of Neuropsychopharmacology 05/2013; · 8.68 Impact Factor