Gerard J Connors

Gerard J Connors
University at Buffalo, The State University of New York | SUNY Buffalo · Research Institute on Addictions

PhD

About

174
Publications
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Publications

Publications (174)
Article
This outcomes assessment was implemented to evaluate a web-based alcohol use recovery program, Tempest Sobriety School (TSS), and to provide a model for outcome evaluation. Adults (N= 541) enrolled in TSS were assessed at pre-program start and Month 2, 6, and 12. Participants reported decreased alcohol use, drug use, craving for alcohol, and alcoho...
Article
Background: As the nature of the association between Alcohol Use Disorder (AUD) and other disorders is not well understood, the ways in which psychological distress changes during the course of treatment for AUD are relatively unknown. Existing literatures posit two competing hypotheses such that treatment for AUD concurrently decreases alcohol us...
Article
Background: It is widely accepted that the therapeutic alliance (TA) is a mediator of psychotherapy effects, but evidence is sparse that the TA is an actual mechanism of behavior change. The purpose of this study was to provide the first systematic evidence regarding the TA as a mechanism of change in the treatment of alcohol use disorder (AUD)....
Article
Background: The current study aimed to contribute to the understanding of the session to session relationship between craving and drinking during the course of treatment via the incorporation into the analysis of both a) motivation to avoid alcohol and 2) pretreatment change, given that half of all individuals entering treatment change their drink...
Article
Objective: With the growing recognition that, for some, significant changes in drinking occur before the first treatment session (i.e., pretreatment change), researchers have called for the careful assessment of when change occurs and its potential impact on mechanism of behavior change (MOBC) research. Using a commonly hypothesized MOBC variable,...
Article
Full-text available
Systematic outcome assessment is central to ascertaining the impact of treatment services and to informing future treatment initiatives. This project was designed to be conducted within the clinical operations of 4 private addictions treatment centers. A structured interview was used to assess patients’ alcohol and other drug use and related variab...
Article
This study investigated the relative effects of 3 12-week secondary prevention interventions for problem drinking men and women in rural counties in New York State. The participants were 111 self-referred men and women without severe dependence on alcohol who nevertheless reported heavy drinking and a desire to reduce their alcohol consumption. The...
Article
We tested the hypothesis that indices of chronic self-regulatory stress specified by Social Action Theory (SAT; Ewart, 2011) and indices of affect specified by the Dynamic Model of Relapse (DMR; Witkiewitz & Marlatt, 2004) predict daily alcohol use by persons in outpatient treatment for alcohol use disorder (AUD). Participants (69 men, 50 women; ag...
Article
In a tightly controlled, clinical research environment, Rychtarik et al. (2000) found that individuals with an alcohol use disorder (AUD) benefited more from inpatient (IP) than outpatient care, if they presented with high alcohol problem severity and/or low cognitive functioning. This study sought to (a) validate and extend these findings within t...
Article
Motivational Interviewing (MI) is an empirically-supported approach for helping people change, but more research on its active ingredients and mechanisms of change is needed. One explanation, the conflict resolution hypothesis, states that it is MI’s specific focus on exploring and resolving ambivalence – the simultaneous presence of both wanting a...
Article
Full-text available
Objective: The therapeutic alliance is recognized as an important contributor to treatment outcomes. In this study, the session-to-session interplay of the alliance (as perceived by the patient) and alcohol involvement (drinking days and heavy drinking days between successive treatment sessions) was examined. The analyses also tested the extent to...
Article
Interpersonal stressors and reactions to them have long been considered important determinants of lapse/relapse following treatment for alcohol use disorder (AUD). We tested predictions from the Social Action Theory (SAT) of chronic stress that persons who often suffer stress related to Agonistic striving (i.e., seeking to control others) would exp...
Article
Although past research has demonstrated a positive relationship between the therapeutic alliance (TA) and improved drinking outcomes, specific aspects of the alliance have received less attention. In this study, we examined the association between alliance characteristics during treatment and 4-month follow-up drinking reports. Sixty-five treatment...
Article
Objective: Craving has been defined as intense desires or urges to consume alcohol and is considered predictive of future drinking and relapse. Despite this assumption, research on the craving-drinking relationship has been mixed, calling into question how researchers define and measure craving. The primary aim of the current study was to examine...
Article
Full-text available
Background Empirical literature indicates that the therapeutic alliance explains a modest but reliable proportion of variance in predicting alcohol-related outcomes among individuals in treatment for alcohol use disorders (AUDs). Hartzler and colleagues (2011) showed in the COMBINE data set that alcohol abstinence self-efficacy is a potentially imp...
Article
Background: Major sporting events and other festive occasions are typically associated with alcohol consumption; however, little is known about risky drinking during events such as the "Super Bowl." Objectives: We sought to determine whether drinking on Super Bowl Sunday differed from Saturdays (the heaviest drinking day of the week) surrounding...
Article
Full-text available
Objective: The current study was undertaken to better understand the craving-drinking relationship among individuals dually diagnosed with a severe mental illness (SMI) and an alcohol use disorder (AUD). Using an ambivalence conceptualization of craving (Breiner, Stritzke, & Lang, 1999), we investigated the bidirectional relationships between desi...
Article
Background: Co-occurring major depression is prevalent among alcohol-dependent women and is a risk factor for poor treatment outcomes. This uncontrolled pilot study tested the feasibility, acceptability, and initial effects of interpersonal psychotherapy (IPT) for women with co-occurring alcohol dependence and major depression (AD-MD) in an outpat...
Conference Paper
Research suggests that impulsivity is related to increased substance use and negatively associated with positive treatment outcomes. Research concerning impulsivity in alcohol treatment may be used to inform the development of prevention approaches. Impulsivity is a multi-dimensional construct and numerous impulsivity measures have been developed....
Article
Full-text available
Gaining a better understanding of the natural course of hazardous alcohol consumption could inform the development of brief interventions to encourage self-change. In the current study, hazardous drinkers (based on Alcohol Use Disorders Identification Test score) were recruited using advertisements to participate in a 2-year multiwave prospective s...
Article
Little is known about the extent to which individuals participating in drinking reduction interventions use the drinking reduction strategies presented during treatment. In consideration of this issue, we advanced hypotheses about the impact of baseline drinking patterns on strategy use and the relationship of strategy use to drinking patterns over...
Conference Paper
Full-text available
Delay discounting (DD) reflects the extent to which an individual devalues a reward based on its delay in time (i.e., preference for smaller immediate rewards relative to larger delayed rewards). DD has been consistently implicated as an important factor in the development, maintenance, and treatment of substance use disorders. Among individuals wi...
Article
This study assessed the factor structure, internal consistency, test-retest reliability, and construct validity of the Problems Assessment for Substance Using Psychiatric Patients (PASUPP; Carey, Roberts, Kivlahan, Carey, & Neal, 2004) with a sample of 278 men and women seeking outpatient dual-diagnosis treatment. All participants were diagnosed wi...
Article
Full-text available
This study examined sources of exposure to secondhand smoke (SHS) during pregnancy and misclassification of women as having no SHS exposure if partner smoking was used as the only measure of SHS exposure. We also examined changes in SHS exposure across the three trimesters of pregnancy. The sample consisted of 245 pregnant women who were in a serio...
Article
The Research Institute on Addictions (RIA) was established in 1970 as a research component of the New York State Department of Mental Hygiene. After three decades of serving as a research component of New York State agencies concerned with alcohol and substance abuse, RIA was legislatively transferred to the University at Buffalo in 1999. Today, RI...
Chapter
A number of cognitive variables have received research attention in recent years because they appear to influence decisions to drink and responses to alcohol. A cognitive factor that has received much of this research attention is expectancies regarding alcohol. Alcohol expectancies are theorized to be cognitive representations of a drinker’s past...
Article
Full-text available
Cannabis is the most frequently used illicit drug among pregnant women, but data describing the effects of prenatal cannabis exposure and concurrent nicotine and cannabis exposures on neonatal growth are inconsistent. Testing of meconium, the first neonatal feces, offers objective evidence of prenatal cannabis exposure, but the relative ability of...
Article
Full-text available
Many women continue tobacco use during pregnancy despite known adverse consequences on neonatal growth and development. Testing meconium, the first neonatal feces, for tobacco biomarkers offers objective evidence of prenatal tobacco exposure. However, relationships between the amount, frequency, and timing of cigarette smoking during gestation and...
Article
Full-text available
This study examined the associations of pretreatment and posttreatment depressive symptoms with drinking outcomes in the year following treatment in Project MATCH (Matching Alcoholism Treatments to Client Heterogeneity), a multisite clinical trial of behavioral treatments for alcohol-use disorders. Data from 1,726 participants were modeled using ge...
Article
This work explored the association between quality of life and drinking intensity in the Project MATCH sample. Tobit regression models were evaluated to assess the relationship between quality of life indicators (eg, measures of depression, adverse consequences, and others) and drinks per drinking day (DDD), and to assess modification or confoundin...
Article
Full-text available
Few investigators studying alcohol abuse among individuals with a severe mental illness (SMI) have examined predictors of posttreatment alcohol outcomes. In the present study, a multivariate approach based on a theoretical model was used to study the relationship between psychosocial factors and post-treatment-initiation alcohol use. Predictors of...
Article
This study was designed to investigate the effects of instructions regarding beverage content and alcohol beverage consumption on preference for alcohol. The subjects were 32 male undergraduate nonalcoholic drinkers. Subjects were told they would receive either an alcoholic or a nonalcoholic beverage and did or did not receive an alcoholic priming...
Article
Interpersonal stress is a significant determinant of relapse following treatment for Alcohol Use Disorders (AUDs), but there remains little specific information about the mechanisms underlying the relationship between interpersonal stress and AUD relapse. Application of Social Action Theory provides one new approach to advancing knowledge about the...
Article
While a number of discrete person and environment factors have been studied in the context of alcohol use, more recently attention has been focused on the study of these variables in tandem. In this paper, we describe historically how an appreciation of the person-environment interaction has evolved. We also delineate the host of person and environ...
Article
Alcoholics Anonymous (AA) is the most popular mutual-help program for individuals with alcohol-related problems, and most treatment programs encourage AA attendance during and after treatment. As part of a larger study (Project MATCH, 1997; 1998), this study examined aftercare (n = 621) and outpatient (n = 415) client subjective impressions about A...
Article
Full-text available
This study examined subject-collateral reports of alcohol use among a sample of 167 dually diagnosed individuals seeking outpatient treatment at a community mental health clinic. All subjects met Diagnostic and Statistical Manual of Mental Disorders (4th ed.; American Psychiatric Association, 1994) criteria for a schizophrenia-spectrum or bipolar d...
Article
In this chapter, we focus broadly on spiritual change in recovery, particularly in relation to involvement in AA. We open with a discussion on defining spirituality and provide an operationalization of spirituality for present purposes. We next provide a conceptualization of alcoholism as a spiritual disease. This is followed by a review of topics...
Article
Alcohol dependence is prevalent among medically hospitalized patients, and acute illness has the potential to increase motivation to change and provide a therapeutic window for treatment of alcohol dependence. This study evaluated the correlations of readiness to change drinking behavior with perceived physical and mental health status and specific...
Article
This study examined the durability of a group-based drinking moderation training for heavily drinking women reporting low physical dependence on alcohol. A 30-month follow-up of participants was conducted based on a previous study of 144 women randomly assigned to treatment conditions (G. J. Connors & K. S. Walitzer, 2001). Thirty-month follow-up r...
Article
Liver cirrhosis mortality differs by ethnicity in the United States. Some studies suggest alcohol sensitivity may contribute to this finding. This analysis evaluated if alcohol-associated changes in aspartate aminotransferase (AST) and alanine transaminase (ALT) differed by ethnicity among heavy drinkers. Subjects included 1691 subjects from Projec...
Article
This study assessed medically hospitalized alcoholics attitudes about pharmacotherapy and interest in primary care-based treatment. The survey included 50 medical inpatients with current alcohol dependence. Participants were asked to indicate their agreement with the following statements: (1) I need to stop drinking, (2) Some medications can help p...
Article
Previously, items on the relapse-onset section of the Relapse Questionnaire have been grouped together based on face validity. In the present article, an empirical scoring method for this measure is derived through a factor analysis of Project MATCH data. Three factors replicate the factor solutions of other measures of alcohol relapse onset and re...
Article
Full-text available
This study evaluated the associations of gender and ethnicity with GGT in a large sample of patients with DSM-IV alcohol abuse or dependence, as well as modification of alcohol's effects on GGT by gender and ethnicity. Subjects included 1691 African American, Mexican American, and non-Hispanic white individuals with DSM-IV alcohol dependence or abu...
Article
Earlier exploratory work on a scoring algorithm for the Reasons for Drinking Questionnaire. Exploratory findings from the Reasons for Drinking Questionnaire presented a number of interesting findings, but were limited by a fairly low consistency in type of relapse between the first relapse and the second relapse (63%). This scoring algorithm object...
Article
This paper identifies the major consistencies in substantive and methodological findings across the review papers in this special issue on relapse in the addictive behaviors. The papers were consistent in suggesting that there have been major methodological advances which have helped to move the field forward. Furthermore, the papers show the need...
Article
Understanding and preventing relapse are among the greatest challenges facing those working in the field of addictions. In response, this special issue was conceived and developed (1) to provide comprehensive reviews of the literature on important topics relevant to relapse to addictive behaviors and (2) to identify issues of central importance to...
Article
Research on alcohol treatment outcomes has the potential to advance knowledge about how treatment combines with other variables to influence post treatment course of functioning. The purpose of this study was to replicate and extend [Connors, G. J., Maisto, S. A., & Zywiak, W. H. (1996). Understanding relapse in the broader context of post-treatmen...
Article
Individuals undergoing treatment for alcohol use disorders exhibit increased risk for impaired oral health. We conducted a study to assess oral health and demographic characteristics of inpatients under treatment for alcohol use disorders. Thirty-four inpatients, 24 male and 10 female, with diverse ethnicity, were recruited in a rehabilitation cent...
Article
Screening tests are useful in a variety of settings and contexts, but not all disorders are amenable to screening. Alcohol use disorders (AUDs) and other drinking problems are a major cause of morbidity and mortality and are prevalent in the population; effective treatments are available, and patient outcome can be improved by early detection and i...
Article
Screening tests are useful in a variety of settings and contexts, but not all disorders are amenable to screening. Alcohol use disorders (AUDs) and other drinking problems are a major cause of morbidity and mortality and are prevalent in the population; effective treatments are available, and patient outcome can be improved by early detection and i...
Article
Background and aims Subject self-reports are the primary source of research and clinical data on drinking behavior. In this report, we review and summarize the current literature on the reliability and accuracy of alcohol abusers’ self-reports of alcohol consumption and related behaviors in relation to similar reports provided by collateral informa...
Article
Marlatt and Gordon's (1985) relapse prevention therapy has received widespread interest and application. The categorization of relapse precipitants was one of the original central features of this model. In more recent iterations of this therapy, increasing emphasis has been placed on coping strategies. In the present article, exploratory findings...
Article
Although the number of alcohol treatment efficacy trials has mushroomed, there is no consensus on how best to measure outcomes. To advance the goal of establishing cross-trial consistency in measuring outcomes in clinical efficacy studies, the National Institute on Alcohol Abuse and Alcoholism convened a panel of experts and charged them with explo...
Article
In this study, 126 clients (87 men, 39 women) entering outpatient alcoholism treatment were assigned randomly to 1 of 3 preparatory conditions: a role induction (RI) session, a motivational interview (MI) session, or a no-preparatory session control group (CG). Clients assigned to the MI preparatory condition attended more treatment sessions and ha...
Article
In this study, 126 clients (87 men, 39 women) entering outpatient alcoholism treatment were assigned randomly to 1 of 3 preparatory conditions: a role induction (RI) session, a motivational interview (MI) session, or a no-preparatory session control group (CG). Clients assigned to the MI preparatory condition attended more treatment sessions and ha...
Article
While substance use disorders have long been recognized as chronic relapsing conditions, it has mainly been in the last two decades that clinical researchers have been systematically attending to the nature and processes of relapse. These efforts have led to the development of a variety of psychological and psychobiological models of relapse. These...
Article
Although older adults are sometimes believed to have the lowest rates of alcohol abuse as an age cohort, the prevalence of alcohol use and abuse in this group is clearly underestimated. The under-diagnosis of alcohol abuse is due, in part, to the facts that the effects of alcohol use among older adults tend to be less clearly visible than among oth...
Article
The present study used data gathered in Project MATCH to longitudinally assess intake symptomatology, Alcoholics Anonymous (AA) participation, and outcome. Three primary constructs were considered: intake symptomatology, engagement in prescribed AA-related activities and functioning after engagement in AA-related behaviors. The participants were 48...
Article
Problem-drinking women (N = 144) without histories of severe physical dependence on alcohol received drinking-reduction training and were assigned to receive (or not receive) 2 treatment enhancements: life-skills training and booster sessions. The design resulted in 4 treatment conditions: drinking-reduction treatment (DRT) plus life-skills trainin...
Article
The relationships among alcohol treatment, coping skills, and self-efficacy in predicting alcohol use and related consequences following treatment initiation were investigated. The participants were 77 men and 65 women who were entering either inpatient or outpatient alcohol treatment. The analyses confirmed predictions that treatment, coping skill...
Article
This study compared inpatient, intensive outpatient, and standard outpatient treatment settings for persons with alcoholism and tested a priori hypotheses about the interaction of setting with client alcohol involvement and social network support for drinking. Participants (N = 192) were assigned randomly in cohorts to 1 of the 3 settings. The sett...
Article
This study compared inpatient, intensive outpatient, and standard outpatient treatment settings for persons with alcoholism and tested a priori hypotheses about the interaction of setting with client alcohol involvement and social network support for drinking. Participants (N = 192) were assigned randomly in cohorts to 1 of the 3 settings. The sett...
Article
The purpose of this study was to systematically assess the attitudes of Alcoholics Anonymous (AA) members toward the newer medications used to prevent relapse (e.g., naltrexone) and to assess their experiences with medication use, of any type, in AA. Using media solicitations and snowball sampling techniques, 277 AA members were surveyed anonymousl...
Article
Prediction of the therapeutic alliance in alcoholism treatment (as rated by the client and by the therapist) was examined in light of a range of potentially relevant factors, including client demographics, drinking history, current drinking, current psychosocial functioning and therapist demographics. The data were gathered in Project MATCH. The pr...
Article
The literature suggests that women exhibit "telescoped" development of (i.e., faster progression to) alcoholism, with fewer years drinking than men. The purpose of this study was to use data gathered in the course of a large clinical trial to further examine this issue. Subjects in this retrospective study were from a pool of 1,307 men and 419 wome...
Article
Recent data suggest that most people experiencing alcohol problems have problems of mild to moderate severity. Relative to alcoholics, these drinkers have a shorter problem-drinking history, greater social and economic stability, and greater personal resources. This article describes a cognitive-behavioral treatment approach designed specifically f...
Article
Substantial numbers of mental health clients do not return following their initial therapy visits or drop out of treatment prematurely. Two general classes of strategies designed to reduce premature attrition and enhance treatment participation are reviewed. Research on psychotherapy preparatory techniques (role induction, vicarious therapy pretrai...
Article
Full-text available
Prior research indicates that therapist effects can be sizeable in substance-abuse treatment. Therapist differences were examined within a multisite (N = 1726) randomized trial of three psychosocial treatments for alcohol problems: twelve-step facilitation (TSF), cognitive-behavioral skills training (CBT), and motivational enhancement therapy (MET)...
Article
Eligible participants and decliners in a randomized study of inpatient, intense outpatient, and standard outpatient treatments for alcoholics were compared and contrasted on a series of demographic, social stability, psychological, legal, drug use, problem severity, and treatment history variables. Among 302 individuals meeting eligibility requirem...
Article
This study reports 3-year outcomes for clients who had been treated in the five outpatient sites of Project MATCH, a multisite clinical trial designed to test a priori client treatment matching hypotheses. The main purpose of this study was to characterize the status of the matching hypotheses at the 3-year follow-up. This entailed investigating wh...
Article
Full-text available
Project MATCH (Matching Alcoholism Treatments to Client Heterogeneity) is a multisite collaborative project designed to evaluate patient-treatment interactions in alcoholism treatment. To evaluate whether major threats to the internal validity of the independent (treatment) variable in Project MATCH could be ruled out, we investigated several aspec...
Article
This study was designed to examine male and female alcoholics' attributions of factors associated with the onset and termination of specific relapse events. In addition, data were gathered on factors associated with the achievement and maintenance of abstinent periods. The participants were 77 men and 65 women alcoholics entering alcoholism treatme...
Article
Restraint is a construct of potential use forunderstanding addictive behaviors. In terms of alcoholand other drug use, restrained individuals arecognitively and behaviorally preoccupied withcontrolling their substance use. Previous work in thecontext of alcohol consumption suggests that whenregulation fails, a