Ana M Abrantes

• Ph.D.
• Professor at Brown University

Objective: The female menstrual cycle and associated fluctuations in ovarian hormones are an important biological context that likely influences emotion-focused smoking. The present study evaluated the role of emotion regulation difficulties on daily emotional distress and cigarette craving in the context of the perimenstrum (i.e., days before and...

Introduction Estradiol (E2) and progesterone (P) and their fluctuation during the female menstrual cycle have been independently linked to both nicotine reinforcement and anxiety. The fluctuation and withdrawal of E2 and P during perimenstrum (days before and during menses) is a vulnerability window for emotional distress, thus the hormonal influen...

Purpose The Exercise Sensitivity Questionnaire (ESQ) is a self-report measure used to assess the extent to which different physical sensations of exercise elicit anxiety (ie, exercise sensitivity). The ESQ was developed for individuals with cardiovascular conditions and initially validated in a non-clinical sample. This study evaluates the factor s...

Resting‐state functional connectivity analyses have been used to examine synchrony in neural networks in substance use disorders (SUDs), with the default mode network (DMN) one of the most studied. Prior research has generally found less DMN synchrony during use and greater synchrony during cessation, although little research has utilized this meth...

In the United States (U.S.), 90% of annual health care expenditures are devoted to people with chronic physical and mental health conditions. For people with HIV (PWH), two common, chronic comorbidities are pain and depression. This report assesses the impact of a brief psychotherapy intervention for PWH and comorbid chronic pain and depression on...

Lifestyle physical activity (LPA) interventions emphasize small bouts of movement that can be flexibly integrated into one’s everyday routine. Despite research illustrating benefits for LPA on health outcomes, few LPA interventions and measurement tools have been developed and tested. The purpose of this study was to present a novel LPA self-report...

Background Exercise is beneficial for persons with schizophrenia; however, high dropout rates limit the impact of interventions. Virtual exercise programs have the potential to improve engagement; however, few intervention studies of virtual programs have been conducted in this population. Methods This study examined qualitative data from 15 adult...

Depression and substance use disorders frequently co-occur in young people, which leads to poor mood- and substance-related outcomes. This cooccurrence may be caused by depressive symptoms leading to problematic substance use, substance use leading to depressive symptoms, and/or common vulnerability factors that put individuals at risk for developm...

Objective: Strong positive links exist between mood, alcohol craving, and sweet taste preference. Research suggests a substitution effect of alcohol with sweets. During alcohol abstinence, individuals have increased craving for alcohol and sweets, in association with anxiety and depression symptoms. Thus, the present study examined the moderating...

Background: Military sexual trauma (MST) is reported by up to 74% of women veterans in the United States and is a driver of poor behavioural and physical health. Self-compassion is a transdiagnostic, protective factor linked with improved posttraumatic stress disorder (PTSD), depression, and health behaviours. Thus, Mindful Self-Compassion training...

Objective: Exercise is increasingly used as adjunct treatment for alcohol use disorder (AUD). Evidence suggests that moderate-to-high-intensity exercise can ameliorate cravings. We explored the potential mediating effects of changes in mood states in the relationship between exercise intensity and alcohol cravings. Method: Secondary analyses of a n...

Background: Rigorous data are needed on the short- and long-term effects of medical cannabis (MC) on older adults with chronic pain. In response, this prospective study combines technology-based ecological momentary assessments (EMA) and in-person visits over 12 months to obtain subjective and objective data on MC’s effects on older adults. Method:...

Consuming excessive amounts of alcohol causes impaired mobility and judgment and driving accidents, resulting in more than 800 injuries and fatalities each day. Passive methods to detect intoxicated drivers beyond the safe driving limit can facilitate Just-In-Time alerts and reduce Driving Under the Influence (DUI) incidents. Popularly-owned smartp...

Background: Cannabis use is common among young adults and is associated with many physical and mental health problems. Persons with chronic pain may be particularly susceptible to using cannabis at high rates, including for analgesic purposes, thus exposing themselves to greater risk of cannabis-related problems. However, little research has exami...

Two primary ovarian hormones that fluctuate across the female menstrual cycle—estradiol and progesterone—have been independently linked in separate literatures to nicotine reinforcement and anxiety psychopathology. We identify existing methodological limitations in these literatures, describe an example protocol that was developed to address such l...

Purpose A majority of individuals living in the United States do not meet recommended physical activity guidelines, despite the numerous physical and mental health benefits. Previous research suggests there are numerous barriers to performing physical activity, but there is less research on how these barriers cluster together; particularly in non-c...

Introduction Adults with depression have higher rates of cigarette smoking and are more likely to relapse than those without depression. Pharmacological, psychological, and combined interventions have largely yielded small improvements in smoking outcomes for adults with depression. Aerobic exercise (AE) may facilitate smoking cessation in this sub...

OBJECTIVES Mitochondrial dysfunction is implicated in the pathophysiology of psychiatric disorders. Levels of circulating cell-free mitochondrial DNA (cf-mtDNA) are observed to be altered in depression. However, the few studies that have measured cf-mtDNA in depression have reported conflicting findings. This study examined cf-mtDNA and depressive...

Behavioral economic theory of addiction proposes that substance use often takes place in environments with limited substance-free reinforcement. While increasing substance-free reinforcement is known to reduce substance use, systematic efforts to boost substance-free reinforcement is not often a focus of most alcohol treatment programs. Participant...

Chronic pain is common in people living with HIV (PLWH), causes substantial disability and is associated with limitations in daily activities. Opioids are commonly prescribed for pain treatment among PLWH, but evidence of sustained efficacy is mixed. There is little information available on how PLWH who have chronic pain use multimodal strategies i...

Depression is common during pregnancy, yet pregnant women often do not engage in standard mental health treatments, which is concerning due to negative consequences associated with untreated maternal depression. Given that exercise can help to decrease depressive symptoms, and most pregnant women are able to safely engage in mild to moderate physic...

Persons with schizophrenia have reduced cardiorespiratory fitness (CRF), a predictor of all-cause mortality. Exercise is effective for improving CRF; however, motivational challenges affecting those with schizophrenia impact exercise engagement and maintenance. Virtual Physical Activity Can Enhance Life (Virtual PACE-Life), a multicomponent walking...

In a sample of adults who reported cutting down on their alcohol use in the past 3 months, study goals were to Identify how many increased consumption of licit substances (called ‘substituters’); and analyze the psychological profiles of substituters compared to non-substituters. Participants (25.6% Latinx, 46.2% female) were recruited using Amazon...

Objective: To determine whether HIV-Pain and Sadness Support (HIV-PASS), a collaborative behavioral health intervention based on behavioral activation, is associated with decreased pain-related interference with daily activities, depression, and other outcomes in people living with HIV. Methods: We conducted a three-site clinical trial (n = 187)...

[This corrects the article DOI: 10.1016/j.bbih.2022.100519.].

Objective: To test interventions for increasing aerobic exercise in depressed individuals. Methods: We conducted a 3-arm randomized controlled trial aimed at increasing minutes of moderate-to-vigorous physical activity (MVPA) in depressed adults (N = 242). Each successive arm included an added component that might serve to increase and maintain...

Most U.S. adults, even more so those with psychiatric conditions like obsessive-compulsive disorder (OCD), do not engage in the recommended amount of physical activity (PA), despite the wide array of physical and mental health benefits associated with exercise. Therefore, it is essential to identify mechanistic factors that drive long-term exercise...

Major medical organizations have issued statements discouraging cannabis use in the perinatal period to minimize the risk of potential adverse outcomes. However, many pregnant individuals may decide to continue to use cannabis, or they may wish to quit, but have trouble discontinuing, potentially because they use cannabis to alleviate symptoms such...

The COVID-19 pandemic resulted in global monumental upheaval. Many people were displaced from their jobs and sources of income. COVID-19 was also linked to increased mental health difficulties and increased alcohol consumption and problems. The current study aims to identify the indirect effect of depression, stress, and anxiety on the relations be...

Background: mHealth technology can be used as a potential intervention for alcohol-related consequences. Applications designed to monitor alcohol use and relay information to the user may help to reduce risky behavior. Acceptability of such applications needs to be assessed. Methods: Survey data from 139 participants (29.8 years on average, 58%...

Background Depression is strongly implicated in drinking to cope and the development of alcohol use disorders (AUD) in women, particularly among women with a history of sexual assault victimization (SAV). Alcohol use in women is heavily stigmatized, and substance use stigma is associated with depression. This study examined the link between interna...

Physical and mental health symptoms can reduce participation in physical activity. The current study assessed the impact of a bout of exercise on mood state in depressed participants with and without current physical pain. We enrolled a community sample of 147 participants (Mage = 45.5; SD = 11.98; 87.1% female) with elevated depressive symptoms. I...

Background Alcohol use disorder (AUD) is a significant public health concern worldwide. Alcohol consumption is a leading cause of death in the United States and has a significant negative impact on individuals and society. Relapse following treatment is common, and adjunct intervention approaches to improve alcohol outcomes during early recovery co...

Chronic pain, depression, and substance use are common among people living with HIV (PLWH). Physical activity can improve pain and mental health. Some substances such as cannabis may alleviate pain, which may allow PLWH to participate in more physical activity. However, risks of substance use include poorer mental health and HIV clinical outcomes....

Background Engaging in regular physical activity (PA) is particularly important among individuals with depression, who are at heightened risk for a host of negative health outcomes. However, people with depression are 50% less likely to meet national guidelines for PA and face unique barriers to PA adherence, including lower distress tolerance and...

Background Ecological momentary assessment (EMA) studies have provided conflicting evidence for the mood regulation tenet that people drink in response to positive and negative moods. The current study examined mood‐to‐alcohol relationships idiographically to quantify the prevalence and intensity of relationships between positive and negative moods...

Background and aims Cell-free DNA (cfDNA) is elevated in several disease states. Metabolic syndrome is a constellation of factors associated with poor cardiometabolic outcomes. This study examined associations of cfDNA from the nucleus (cf-nDNA) and mitochondria (cf-mtDNA), C-reactive protein (CRP), and metabolic syndrome risk, in low-active smoker...

Background: Alcohol use disorder (AUD) is associated with severe chronic medical conditions and premature mortality. Expanding the reach or access to effective evidence-based treatments to help persons with AUD is a public health objective. Mobile phone or smartphone technology has the potential to increase the dissemination of clinical and behavi...

Regular exercise protects against overweight/obesity as well as numerous chronic diseases. Yet, less than half of Americans exercise sufficiently. Elevated levels of depressive symptoms have been identified as an important correlate of physical inactivity as well as poor adherence to exercise programs. Individuals with depression are less sensitive...

Chronic pain increases the risk of substance use in people living with HIV (PLWH). Depression and anxiety have also been identified as risk factors for substance use among PLWH. Relatedly, other negative mood states, such as anger, may influence chronic pain among PLWH. The current cross-sectional study examined whether the distinct negative mood s...

Background: Internalized weight stigma (Internalized-WS) is prevalent among individuals with severe obesity, particularly women, and is associated with shame, disordered eating, and weight gain. Effective, accessible interventions that address both severe (Class-III) obesity and Internalized-WS are needed. This randomized pilot trial evaluated the...

Objective Persons living with HIV (PWH) experience a disproportionate level of comorbid chronic pain and depression compared to individuals who do not have a diagnosis of HIV. Many PWH report pain that impairs daily function, is severe, and requires medical management. Depression alone is associated with HIV disease progression, medication non-adhe...

Aerobic exercise is frequently used as an intervention for depression and smoking cessation because of its antidepressant and anxiolytic effects. Distress intolerance (DI) is a proposed individual difference factor that, coupled with a higher rating of perceived exertion during exercise, may significantly impact the acute mood and anxiolytic effect...

Women with alcohol use disorder (AUD) often present to treatment with heightened negative emotionality, including negative affect, anxiety, stress, and depression. Negative emotionality might impact women’s alcohol abstinence self-efficacy (AASE), or confidence in their ability to remain sober, which is an important predictor of treatment outcomes....

Background Preliminary studies show that structured physical activity (PA) interventions can reduce negative affect and alcohol use in patients recovering from alcohol use disorder (AUD). The current study tested whether the association between PA, affect, and alcohol cravings can be observed in patients’ natural environments (i.e., without a struc...

Internalized weight stigma (IWS) is independently associated with less intuitive eating (i.e., eating based on endogenous hunger/satiety cues) and higher Body Mass Index (BMI), and intuitive eating training is commonly conceptualized as protective against the effects of IWS on poor behavioral health. The 3-way relationship between IWS, intuitive ea...

Cigarette smoking is associated with multiple adverse health outcomes. When smokers attempt to quit smoking, one of the leading predictors of relapse are cravings. Recent research shows a relationship between positive and negative affect, exercise, and cravings, but the exact nature of this relationship has yet to be understood. This study explored...

Background Research on perinatal mental health during the COVID-19 pandemic has largely focused on data from community samples. This study sought to understand the experiences of pregnant and postpartum women with histories of clinically elevated symptoms of depression. Methods Participants included 60 perinatal women who participated in wellness...

Chronic pain is highly prevalent among persons with HIV (PWH), as is depression. Both comorbidities might contribute to, as well as be maintained by, avoidance-based coping. A promising alternative to avoidance-based coping is acceptance. Acceptance of pain is associated with improved functioning and quality of life in chronic pain patients, but th...

Aims Exercise is increasingly being studied as treatment for alcohol use disorder (AUD). We examined the effects of an acute bout of exercise on alcohol craving, heterogeneity of response, and factors associated with reductions in craving. Methods Within the context of a randomized controlled trial, we conducted an exploratory, single-arm study. I...

Purpose While methadone maintenance treatment (MMT) has been effective in improving opioid use outcomes, most patients continue to engage in unhealthy lifestyles that lead to significant mental and physical health consequences. Interventions targeting increases in physical activity (PA) in MMT patients could have a significant impact on reducing th...

Introduction Alcohol cravings can predict relapse in persons with alcohol use disorders (AUD). Research commonly recommends consuming sweets as a strategy to quell alcohol cravings in early recovery from AUD, yet research is equivocal on whether consuming sweets mitigates alcohol cravings or relapse risk. The current study used ecological momentary...

Women with Alcohol use disorder (AUD) are more likely than men to have co-occurring depression, drink to cope with negative affect (NA), and cite negative affect as a contributor to relapse. Among AUD treatment seekers, low behavioral activation, NA, and reduced self-efficacy in abstaining from alcohol (e.g., in tempting situations) are relapse ris...

Smoking-related diseases (e.g., lung cancer) are the leading cause of mortality in HIV-infected patients. While many PLWH who smoke report a desire to quit, a majority of them have low readiness to quit. This study used logistic and linear regression to examine the relations among two (continuous vs. binary) measures of readiness to quit, smoking c...

Objectives Up to 70% of women service members in the United States report military sexual trauma (MST); many develop post-traumatic stress disorder (PTSD) and co-occurring disorders. Trauma-informed yoga (TIY) is suggested to improve psychiatric symptoms and shown feasible and acceptable in emerging research, yet no work has evaluated TIY in MST su...

Background Emotional eating in bariatric surgery patients is inconsistently linked with poor post-operative weight loss and eating behaviors, and much research to date is atheoretical. To examine theory-informed correlates of pre-operative emotional eating, the present cross-sectional analysis examined paths through which experienced weight bias an...

Poor health and low cardiorespiratory fitness (CRF) contribute substantially to the shortened lifespan of individuals with schizophrenia spectrum disorders (SSDs). Increasing physical activity has demonstrated value; however, there are limited interventions that are accessible and adequately address motivational challenges. This paper reports on an...

Smoking prevalence among individuals in substance use treatment remains higher than in the general population. Given that many smokers in substance use treatment are reluctant to quit smoking, it is important to understand the factors that impede smokers’ readiness to quit. The current study used baseline data from a randomized controlled trial inv...

Purpose: This efficacy trial tests the hypothesis that exercise training favorably affects hedonic eating (i.e., overeating, stress-induced overeating, disinhibited eating, eating when tempted), in a sample of women who are overweight or obese. Methods: Participants were inactive at baseline, self-identified as "stress eaters," and were randomiz...

Driving is a dynamic activity, which requires quick reflexes and decision making in order to respond to sudden changes in traffic conditions. Alcohol consumption impairs motor and cognitive skills, and causes many driving-related accidents annually. Passive methods of proactively detecting drivers who are too drunk to drive in order to notify them...

Sweet liking (heightened preference for highly sweet solutions) is linked to Alcohol Use Disorder (AUD) and relapse, as well as attitudes toward sweet foods – use of sugar to cope with negative affect (sweet-cope), and impaired control over sweet consumption (sweet-control). This prospective analysis of individuals with AUD (N= 26) participating in...

Purpose Internalized weight stigma (IWS) is common in the United States of America across body weight categories, and is implicated in the development of distress and unhealthy eating behaviors (e.g. overeating, disordered eating) that can foster poor cardiometabolic health. While emerging intervention research shows early promise in reducing IWS,...

Lifestyle physical activity (LPA) interventions are a promising alternative to structured exercise interventions for addressing mental health problems. The authors conducted a systematic review of the literature on LPA interventions in any population in order to determine (a) the extent to which mental health outcomes were examined and (b) whether...

Introduction Measures of motives for alcohol use provide an important avenue for understanding underlying psychological reasons that drive use and predict distinct patterns of use. The Modified Drinking Motives Questionnaire–Revised (MDMQ-R; Grant, Stewart, O'Connor, Blackwell, Conrod, 2007) measures five drinking motives: social, enhancement, conf...

Background: Emerging adulthood (18-25 years) represents a risky time for mental health and substance use. Emerging adults are particularly susceptible to problematic patterns of substance use, especially if they experience anxiety and/or depression and use substances as a way to cope with such issues. However, many mental health treatments do not...

Background Emerging adulthood is a critical period for the onset of both mental health disorders and problematic alcohol use. Coping strategies can play an important role in mitigating the onset and progression of these conditions in emerging adulthood. The current study examined daily mood, coping strategy use, and alcohol use during an individual...

Background Aerobic exercise is essential for the primary and secondary prevention of cardiovascular disease and is a critical component of cardiac rehabilitation (CR). However, anxiety and avoidance of aerobic exercise is common in those with cardiac risk and disease due to heightened sensitivity to exercise sensations due to deconditioning or simi...

Background: Exercise may be a potentially helpful strategy to improve mood during the perinatal period. However, little is known about the exercise behaviors and preferences of perinatal women seeking psychiatric care. This study was designed to shed light on the acceptability of exercise-based interventions for this population, and to examine the...

Introduction Regular engagement in physical activity (PA) decreases risks for many chronic conditions, and there is growing evidence showing a positive impact of this behavior on the reduction of depression symptoms. However, rates of PA as well as adherence to exercise interventions remain low among depressed individuals relative to non-depressed...

Introduction: The majority of women who smoke cigarettes report that concern about weight gain is a barrier to quitting. We developed an intervention incorporating distress tolerance, appetite awareness, and mindful eating skills to target concerns about post-cessation weight gain and emotional eating (DT-W). In the current study, we conducted a p...

Background: Emerging adulthood is a common and problematic time for alcohol and cannabis use. Emerging adulthood also represents a vulnerable time period for anxiety and depression. Substance use and mental health issues are highly comorbid, yet substance use is commonly neglected in psychiatric care. Objective: The goal of this study was to cat...

The use of marijuana is now legal for medical purposes in 39 of the 50 United States. Eleven of these 39 states have also legalized marijuana for non-medical usage. Marijuana impairs users' motor skills, making Driving Under the Influence of Marijuana (DUIM) a growing public health concern. There are currently few accessible and accurate methods to...

Introduction Avoidance of physical activity is a common migraine management strategy. Anxiety sensitivity (i.e. fear of anxiety and bodily sensations due to physical, cognitive, or social consequences) is a potential correlate of physical activity avoidance and may strengthen beliefs about physical activity's detrimental effect on migraine. Method...

The purpose of this project was to assess the feasibility and acceptability of a hatha yoga program designed to target chronic pain in people receiving opioid agonist therapy for opioid use disorder. We conducted a pilot randomized trial in which people with chronic pain who were receiving either methadone maintenance therapy (n = 20) or buprenorph...

Intoxicated driving causes 10,000 deaths annually. Smartphone sensing of user gait (walk) to identify intoxicated users in order to prevent drunk driving, have recently emerged. Such systems gather motion sensor (accelerometer and gyroscope) data from the users' smartphone as they walk and classify them using machine or deep learning. Standard Fiel...

Introduction: Experiences of childhood sexual abuse (CSA) and childhood physical abuse (CPA) are associated with poor mental health outcomes including substance use in subsequent years. Marijuana use motives (i.e., coping with negative affect, enhancing positive affect, or improving social interactions) may influence problematic substance use amon...

Objective: The primary aim of this exploratory study was to assess the relationship between anxiety sensitivity and emotional disorders, migraine characteristics, and migraine-related fear and avoidance behaviors in women with probable migraine. Background: Anxiety and depressive disorders are the most frequent comorbid psychiatric conditions in...

A sample of 42 generally physically inactive AA women (mean age =35, SD=10.25) completed the Mobile Phone Affinity Scale (MPAS), which consists of six subscales that represent both positive (Connectedness, Productivity, Empowerment) and negative (Continuous Use, Anxious Attachment, Addiction) cognitions and behaviors that are associated with mobile...

Background and Objectives Despite the benefits of maintenance buprenorphine treatment for opioid use disorder (OUD), many individuals report an interest in discontinuing the medication, while also expressing worries about tapering. The purpose of this study was to develop a measure of worries about buprenorphine discontinuation (“Off Bupe”) and det...

Although the association between anxiety and sleep disturbance is well-documented, the underlying mechanisms are less clear. Anxiety sensitivity (AS), the fear of physiological arousal and bodily sensations, is a risk factor for anxiety and poor sleep. Smoking also contributes to poor sleep and may compound the effects of AS on sleep quality. This...

Substance Use Disorders (SUD)continue to be a significant public health concern. Exercise has been examined as an adjunctive approach to addiction treatment in an effort to improve mental health, physical health, and substance use outcomes. This review will present the existing evidence for the efficacy of exercise in the context of SUD treatment....

Purpose: One unexplored mechanism for poor outcomes in cardiovascular and pulmonary rehabilitation (CVPR) is fear about aerobic exercise. Patients in CVPR may tend to avoid aerobic exercise because of the fear of physical sensations associated with exertion. This study examined fear about exercise in patients enrolled in outpatient CVPR and practi...

Background: The subjective affective response to, and enjoyment of, physical activity are strong predictors of engagement in physical activity. Anxiety sensitivity, the fear of bodily sensations, is a cognitive factor that may inhibit the pleasurable affective experience of physical activity, possibly contributing to low levels of physical activit...

Exercise is an efficacious treatment approach for the prevention and management of depression. In this article, we review the efficacy of aerobic exercise and resistance training in the treatment of depression, including comparative efficacy to pharmacotherapy and psychotherapy. We describe existing exercise interventions for depression and provide...