Brian Borsari

Brian Borsari
University of California, San Francisco | UCSF · Department of Psychiatry and Behavioral Sciences

PhD, Syracuse University 2003

About

206
Publications
46,104
Reads
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9,130
Citations
Citations since 2017
90 Research Items
4227 Citations
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20172018201920202021202220230200400600800
Additional affiliations
August 2015 - present
San Francisco VA Medical Center
Position
  • Clinical Researcher/Health Behavior Coordinator
August 2015 - present
University of California, San Francisco
Position
  • Professor in Residence
August 2015 - June 2019
University of California, San Francisco
Position
  • Professor

Publications

Publications (206)
Article
Veterans with posttraumatic stress disorder (PTSD) and major depressive disorder (MDD), the 2 most prevalent mental health disorders in the Iraq and Afghanistan veterans, are at increased risk for cannabis use and problems including cannabis use disorder (CUD). The present study examined the relationship of PTSD and MDD with cannabis use frequency,...
Article
Objective: Each year, thousands of college students receive mandated intervention as a sanction for alcohol use or alcohol-related behavior. For these mandated students, brief motivational interventions (BMIs) are currently the most efficacious individual intervention. However, little is known about how the technical (therapist behaviors) and rela...
Article
Background: Pregaming, also known as frontloading or predrinking, is a common but risky drinking behavior among college students. However, little is known about the way in which a brief motivational intervention (BMI) addressing general alcohol use and consequences may impact pregaming frequency. Objectives: This study examined whether mandated...
Article
Objective: Students referred to school administration for alcohol policies violations currently receive a wide variety of interventions. This study examined predictors of response to 2 interventions delivered to mandated college students (N = 598) using a stepped care approach incorporating a peer-delivered 15-min brief advice (BA) session (Step 1...
Article
Background: Chronic pain and opioid use disorder (OUD) individually represent a risk to health and well-being. Concerningly, there is evidence that they are frequently co-morbid. While few treatments exist that simultaneously target both conditions, preliminary work has supported the feasibility of an integrated behavioral treatment targeting pain...
Article
Full-text available
This study examines hazing among a sample of young male service members in the United States (US) military. Individual semi-structured interviews were conducted with active duty service members (N = 10) aged 18 to 24 at a large Southeastern US Army post to examine their conceptualization of hazing. Thematic analysis revealed three emergent themes:...
Article
Background: Alcohol-induced blackouts have been associated concurrently and prospectively with alcohol-related harm. Although rates of heavy drinking among military samples tend to be higher or comparable to rates among their civilian counterparts, the prevalence and correlates of blackout in this population are understudied. Methods: Veterans (...
Article
Background: Craving is a distressing symptom of opioid use disorder (OUD) that can be alleviated with medications for OUD (MOUD). Buprenorphine is an effective MOUD that may suppress craving; however, treatment discontinuation and resumed opioid use is common during the early phases of treatment. More information on the craving response through th...
Article
The Veterans' Pain Care Organizational Improvement Comparative Effectiveness (VOICE) study is a 12-month pragmatic randomized comparative effectiveness trial conducted at ten United States Veterans Affairs (VA) health care sites. The overall goal was to test interventions to improve pain while reducing opioid use among VA patients with moderate-sev...
Article
The coronavirus disease 2019 (COVID-19) pandemic has created a global health crisis, with disproportionate effects on vulnerable sociodemographic groups. Although the pandemic is showing potential to increase suicide ideation (SI), we know little about which sociodemographic characteristics or COVID-19 experiences are associated with SI. Our United...
Article
Background High-risk alcohol use is a common surgical risk factor. Stopping or reducing alcohol use in the weeks before and after surgery could improve surgical health and outcomes. The purpose of this study was to evaluate the feasibility and acceptability of 2 interventions that address high-risk alcohol use in the context of surgery. Methods Pa...
Article
Motivational interviewing (MI) improves readiness for smoking cessation but can be time-intensive, require substantial expertise, and patients must still be linked with evidence-based cessation programs sensitive to local resources and patient preferences. Technology-assisted MI may provide a more efficient way to promote readiness and facilitate b...
Article
Objective: Motivational interviewing (MI) is a promising intervention for helping patients with mental health problems reduce their substance use. Examining the cost-effectiveness of MI and associations between MI and the use of health services can inform appropriate intervention strategies for these patients. Method: Kaiser Permanente adult pat...
Article
Objective: This study aimed to provide insight into health disparities among Veterans by (a) documenting the prevalence of physical and mental health problems in a racially diverse sample of Veterans, (b) comparing Veterans' willingness to seek treatment for various physical and mental health conditions, and (c) examining the impact of discriminat...
Article
Background Veterans often use cannabis for sleep despite limited evidence of its efficacy. Moreover, how sleep disturbances impact cannabis use longitudinally is unclear. We applied a behavioral economic framework to examine whether sleep disturbances and cannabis demand (i.e., relative value) were related risk-factors for future cannabis use and p...
Article
Hispanic youth represent one of the fastest-growing minority groups. Yet, we know little about Hispanic adolescents' response to empirically-supported interventions for adolescent addiction, including motivational interviewing (MI). This randomized controlled trial (RCT) compared MI to an active educational treatment for adolescent alcohol and cann...
Article
Background: The association between behavioral economic demand and various alcohol use outcomes is well established. However, few studies have examined whether changes in demand occur following a brief alcohol intervention (BAI), and whether this change predicts alcohol outcomes over the long term. Methods: Parallel process piecewise latent grow...
Article
Introduction Veterans in general—and especially those who identify as Veterans of color—are underrepresented in health-related treatment research. This contributes to health inequity by hindering the development of evidence-based treatment recommendations for people of color. This project utilized culturally centered research procedures to identify...
Article
Full-text available
Understanding correlates of COVID-19 vaccine intentions is critical for increasing vaccine uptake. Given associations of trauma exposure and posttraumatic stress disorder (PTSD) with alterations in threat sensitivity and health behaviors, we hypothesized they could influence COVID-19 vaccine acceptance and hesitancy and be important variables to co...
Article
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Sexual assault is a significant problem within the United States military. Bystander intervention skills training is recognized as a promising strategy for sexual assault prevention within both civilian and military populations. Sexual assault prevention programs which include training in bystander intervention teach individuals to notice situation...
Article
Motivational interviewing (MI; Miller & Rollnick, 2012) has expanded from treating substance use disorders to other health concerns across a range of racial-ethnic groups and ages. The spirit of MI lends itself well to working with culturally diverse populations by eliciting the client's values and goals in a collaborative and client-centered appro...
Article
Full-text available
Objective: Psychiatric disorders increase risk for contracting coronavirus disease 2019 (COVID-19), but we know little about relationships between psychiatric symptoms and COVID-19 risky and protective behaviors. Posttraumatic stress disorder (PTSD) has been associated with increased propensity to engage in risky behaviors, but may also be associa...
Article
Objective: Brief motivational interventions (BMIs) that include personalized drinking feedback delivered in a motivational interviewing (MI) style have demonstrated reductions in drinking across numerous clinical trials with emerging adults (EAs) ages 18-25. However, effect sizes for these BMIs are generally small to moderate and drinking reductio...
Conference Paper
Background: Cannabis demand (i.e., relative value), assessed cross-sectionally via a hypothetical marijuana purchase task (MPT), has been associated with cannabis use, problems, and dependence symptoms, among others. However, neither the prospective stability of the MPT, nor the cyclical relationship between demand and use over time has been invest...
Article
Full-text available
Individual behaviors are critical for preventing the spread of coronavirus disease 2019 (COVID-19) infection. Given that both protective and risky behaviors influence risk of infection, it is critical that we understand how such behaviors cluster together and in whom. Using a data-driven approach, we identified clusters of COVID-19-related protecti...
Article
Full-text available
Background Behavioral economic theory predicts that low access to environmental reward is a risk factor for alcohol use disorder (AUD). The Substance-Free Activity Session (SFAS) is a behavioral economic supplement to standard brief alcohol interventions that attempts to increase environmental reward and may therefore have beneficial effects, parti...
Article
Full-text available
Introduction As many as 74% of veterans with alcohol use disorders (AUDS) report symptoms of insomnia. Insomnia represents a barrier to alcohol treatment because insomnia symptoms (1) may lead to relapse among those who use alcohol to help them sleep and may negatively impact (2) executive functions and (3) emotion regulation skills. Cognitive–beha...
Conference Paper
Analysis of client and therapist behavior in counseling sessions can provide helpful insights for assessing the quality of the session and consequently, the client's behavioral outcome. In this paper, we study the automatic classification of standardized behavior codes (i.e. annotations) used for assessment of psychotherapy sessions in Motivational...
Article
Purpose: College students who identify as a sexual minority consume alcohol at rates that are equal to, or greater than, their heterosexual peers and sexual minority stress factors (e.g. discrimination, sexual orientation-based violence) are predictors of their alcohol use. Despite research supporting the use of brief motivational interventions (BM...
Article
Full-text available
Purpose To determine the effectiveness of telephone motivational coaching delivered by veteran peers to improve mental health (MH) treatment engagement among veterans. Methods Veterans receiving primary care from primarily rural VA community‐based outpatient clinics were enrolled. Veterans not engaged in MH treatment screening positive for ≥1 MH p...
Article
Objectives There is limited research examining the relationship between alcohol use and eating pathology in men or factors that may moderate this association. The current study investigated the relationship between alcohol use and eating pathology, and examined emotion dysregulation as a moderator of this association, among heavy‐drinking college m...
Article
Objective: Several studies suggest that alcohol and cannabis co-users are heavier drinkers and experience more alcohol-related consequences. However, day-level associations between co-use and drinking levels are mixed. One reason may be that individual characteristics moderate the daily impact of using alcohol alone or in conjunction with cannabis....
Article
Full-text available
Objectives: Elective surgical patients with unhealthy alcohol use have unique pain management needs and addiction risk factors that are relevant to surgical preparation and recovery. This descriptive qualitative study sought to better understand patients' beliefs and behaviors related to opioid use, alcohol use, and pain management in the perioper...
Article
Background Patients in methadone maintenance treatment (MMT) with problem gambling (PG) experience worse psychosocial outcomes than their non-PG counterparts. Interventions targeting PG in MMT may enhance psychosocial functioning beyond gambling reduction and abstinence. The present study was a secondary data analysis that examined the trajectories...
Article
Background and aims Opioid use and chronic pain are prevalent in the veteran population. Collaborative Care enhances coordination between patients and their care teams and Motivational Interviewing (MI) is a communication style designed to facilitate behavior change. This study evaluated the use of Collaborative Care with MI (CCMI) with patients wi...
Article
The present study utilizes data from a Couple and Family Therapy Program in the Veterans Affairs Health Care System (VAHCS) seeks to understand veterans’ and their family members’ treatment engagement and dropout from initial referral for therapy to the active phase of treatment. Veterans (N = 177) referred to couple or family therapy were included...
Article
Background The Whole Health model of the U.S. Department of Veterans Affairs (VA) emphasizes holistic self-care and multimodal approaches to improve pain, functioning, and quality of life. wHOPE (Whole Health Options and Pain Education) seeks to be the first multisite pragmatic trial to establish evidence for the VA Whole Health model for chronic p...
Conference Paper
Motivational Interviewing (MI) is defined as a collaborative conversation style that evokes the client's own intrinsic reasons for behavioral change. In MI research, the clients' attitude (willingness or resistance) toward change as expressed through language, has been identified as an important indicator of their subsequent behavior change. Automa...
Article
Full-text available
The current study sought to examine how heavy-drinking college men describe communication of sexual interest and sexual consent. Thematic analysis of semi-structured interviews with 12 heavy-drinking college men identified three themes. Themes included: (a) expectations about parties and sexual activity, (b) observing and communicating sexual inter...
Article
Objective: Attention-deficit/hyperactivity disorder (ADHD) is linked prospectively to cannabis; however, no study has examined mechanisms underlying this comorbidity. We examined 5 cannabis motives (i.e., coping with negative affect, sleep, social anxiety, perceived low risk of cannabis, and altered perception) as mediators of the prospective ADHD-...
Article
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Objectives: Risky alcohol use before surgery is associated with an increased risk of postoperative complications and longer hospital stays. Preoperative alcohol interventions can improve surgical outcomes but are not commonly integrated into routine care. This study sought to better understand patient's and provider's perceptions of alcohol-relate...
Article
Full-text available
Minority stress theory posits that unique stressors create an invalidating environment, which places sexual minority individuals at increased risk for psychiatric morbidity. Sexual minority veterans' experience of minority stressors results in elevated levels of emotion dysregulation, anxiety, depression, and suicidality. Clinical interventions des...
Article
Full-text available
High levels of 3 behavioral economic indices (delay discounting, alcohol demand, and proportionate substance-related reinforcement) are consistently associated with greater alcohol misuse and alcohol-related problems. However, it is unclear whether and how these variables jointly increase the risk for alcohol-related outcomes among college students...
Article
Full-text available
Background Posttraumatic stress disorder (PTSD) is the most highly co-occurring psychiatric disorder among veterans with cannabis use disorder (CUD). Despite some evidence that cannabis use prospectively exacerbates the course of PTSD, which in turn increases the risk for CUD, the causal nature of the relationship between cannabis and psychiatric c...
Article
Full-text available
Background Methamphetamine (METH) use is a public health crisis that disproportionately affects men who have sex with men (MSM). There are currently no FDA-approved pharmacological interventions to treat methamphetamine use disorder (MUD). MUD is associated with social impairments and extremely high treatment attrition rates. Administration of oxyt...
Article
Minority stress theory posits that unique stressors create an invalidating environment, which places sexual minority individuals at increased risk for psychiatric morbidity. Sexual minority veterans’ experience of minority stressors results in elevated levels of emotion dysregulation, anxiety, depression, and suicidality. Clinical interventions des...
Article
Background: College students are among the most vulnerable groups to problems associated with high-risk drinking consequences such as illness, injury, sexual abuse, and death. Promising mobile health (mHealth) approaches, such as smartphone (SP) apps, can be used in interventions to address or prevent excessive drinking. Method: The aim of the inve...
Article
Motivational interviewing (MI) is a widely disseminated evidence-based therapeutic approach for engaging clients and motivating health behavior change, especially risky substance use. Refinement of MI theory over the past few decades has provided empirical evidence that the technical component of MI (in-session client language) is a promising mecha...
Article
There is a high comorbidity between symptoms of depression and cannabis and alcohol use in civilian and veteran populations. Prospective studies attempting to clarify the directionality of these comorbidities have yielded mixed results. Further, the relations between these constructs and impulsive personality, particularly negative urgency (NU, the...
Article
Full-text available
Heavy episodic drinking (HED) and depressive symptoms often co-occur among college students and are associated with significant impairment. However, evidence-based treatments for these common co-occurring conditions are not available for college students. The current study compared the effectiveness of a treatment combining Cognitive-Behavioral The...
Article
To respond to the rapidly increasing awareness of the many serious issues related to the opioid crisis that are being encountered by our broad clinical-scientist and practitioner audience, we assembled a special issue on opioid use in all areas of clinical and clinical-health psychology. Together, the papers that comprise this collection shed light...
Article
Objective: Due to a combination of unique circumstances, opioid use and misuse in the United States have escalated dramatically over the past 15 years, resulting in a national crisis. Method: To bring together work that addresses the role that psychologists can play in responding to this crisis, we assembled this special issue. Results: The pa...
Article
Background: Prompted by the ongoing debate regarding whether cannabis serves as a complement to or substitute for alcohol, this study uses prospective data to examine daily associations between medicinal versus recreational cannabis and alcohol use in veterans. Methods: Three semi-annual waves of Timeline Followback Interview data were collected...
Article
Introduction: Behavioral economic theory views addiction as a reinforcer pathology characterized by excessive demand for drugs relative to alternatives. Complementary to this theory, Lamb and Ginsburg (Pharmacology Biochemistry and Behavior, 164, 2018, 62) describe addiction as a behavioral allocation disorder and predict that decisions to drink u...
Article
Background: Research suggests bidirectional associations between symptoms of posttraumatic stress disorder (PTSD) and sleep disturbance, both of which have been associated with alcohol problems. However, few studies have examined the interplay of these conditions in predicting alcohol problems over time. This study tested 2 competing models: (i) s...
Article
Alcohol use is highly comorbid with depression, especially among college students whose rates of both phenomena are higher than in the general population. The self-medication hypothesis (i.e., alcohol use is negatively reinforced via the alleviation of negative affect) has dominated explanatory models of comorbidity. However, self-regulation has al...
Article
Brief motivational interventions (BMIs) are widely used and efficacious interventions that address alcohol misuse in mandated college students. Consistent with motivational interviewing (MI; Miller & Rollnick, 2013) theory, within-therapist improvements in MI-consistent (MICO) skills over time-that is, as a therapist gains skill through repeated pr...
Article
Full-text available
Objective: Behavioral economic theory suggests that a reduction in alcohol use is most likely when there is an increase in rewarding substance-free activities. Anxiety has also been linked to heavy drinking, and strategies to reduce anxiety may enhance alcohol interventions. The goal of this 2-site randomized controlled clinical trial was to evalu...
Article
Background Alcohol‐induced blackouts, a form of anterograde amnesia that restricts the encoding of short‐term memories into long‐term ones, are among the most severe alcohol‐related consequences. College students are at high risk of experiencing alcohol‐induced blackouts, and there is a need to determine whether alcohol interventions can effectivel...
Article
Full-text available
Background The prevalence of methamphetamine use disorder (MUD) in the United States has risen dramatically in the past four decades and is concentrated in populations such as men who have sex with men (MSM). Despite the public health consequences of MUD, there are no FDA-approved psychopharmacological treatments. Psychosocial treatment alone has b...
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Full-text available
Frequency of cannabis use and cognitive vulnerabilities such as anxiety sensitivity (i.e., the fear of bodily sensations), have been independently linked with poor physical health, however the interplay between these health-mental health processes may compound poor physical health and functioning in cannabis users. Thus, the current study evaluated...
Article
Full-text available
Veterans seeking care in VA medical facilities have high rates of chronic pain, which often co-occur with mental health and substance use disorders, including prescription opioid misuse. The overall goal of the Optimizing Pain Treatment Interventions (OPTI) study was to pilot a 12-week Collaborative Care intervention to improve opioid safety, chron...
Article
Heavy alcohol use is a serious health issue in the United States with consequences such as illness, injury, and death. College students are among the most vulnerable to problems associated with risky drinking. This demographic is known as the Net Generation because members have grown up with digital technologies such as smartphones and apps. Thus,...
Conference Paper
Full-text available
Motivational Interviewing (MI) is a widely disseminated and effective therapeutic approach for behavioral disorder treatment. Over the past decade, MI research has identified client language as a central mediator between therapist skills and subsequent behavior change. Specifically, in-session client language referred to as change talk (CT; persona...
Article
Full-text available
Despite the prevalence of sexual assault on college campuses, few interventions aimed at decreasing college men’s proclivity to perpetrate sexual aggression have been developed and tested. This article details the theoretical framework, content, and piloting of a sexual assault prevention program for college men who engage in heavy drinking, a high...
Article
Full-text available
The present study examined the ways alcohol use and risk factors for sexual assault perpetration vary by relationship status. Participants included 242 college men (age = 18-22 years) from a northeastern university who identified as being single or in a casual or committed dating relationship with a female partner. ANCOVAs and paired t tests compar...
Article
Behavioral economic theory suggests that increased engagement in constructive, substance-free activities that are in the service of long-term goals (e.g., college graduation, career development, health) can decrease alcohol use and related problems. However, engaging in activities such as these in the high-risk college environment requires the abil...
Article
Objective: This meta-analysis examines the predictive validity of client change language subtypes in motivational interviewing (MI) sessions addressing addictive behavior change. Method: A systematic review identified k = 13 primary studies, contributing 16 MI conditions (N = 1556). The pooled correlation coefficient was used to assess the signi...
Article
Background Pregaming is a common, high‐risk drinking activity among college students that has been largely unchangeable despite targeted intervention approaches. Therefore, identifying profiles of pregamers could enhance understanding of the risks associated with this practice and inform intervention development. Methods This study identified subt...
Article
Full-text available
Background To goal of this study was to better understand mechanisms underlying associations between Major Depressive Disorder (MDD) and marijuana use and problems. Specifically, it was hypothesized that negative urgency (NU), the tendency to act rashly while experiencing negative mood states, would uniquely (compared to other impulsivity traits: p...