B Rounsaville’s research while affiliated with Yale University and other places

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Publications (7)


Unitary versus multidimensional models of alcoholism treatment outcome: An empirical study
  • Article

April 1988

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12 Reads

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80 Citations

Journal of Studies on Alcohol

T F Babor

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Z Dolinsky

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B Rounsaville

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This study examined two issues related to the distinction between unitary and multidimensional models of alcoholism treatment outcome. First, does treatment outcome vary along a variety of relatively independent dimensions? Second, how important is abstinence to improved health and psychosocial adjustment? A sample of 266 alcoholics were evaluated at intake and 1 year following inpatient treatment using an extensive battery of assessments. Correlational analysis and factor analysis provided limited support for both the unidimensional and multidimensional approaches. A synthetic measure of posttreatment drinking showed a clear linear relationship between level of consumption and lack of improvement in medical status, biological function, life stress and psychopathology. The findings are discussed in terms of the methodological difficulties in treatment evaluation and the need for more systematic research on the effect of posttreatment drinking on multiple dimensions of outcome status.



A 2.5 year follow-up of abstinence and relapse to cocaine abuse in opioid addicts
  • Article
  • Full-text available

February 1988

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1,148 Reads

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9 Citations

NIDA research monograph

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A field trial of DSM-III-R psychoactive substance dependence disorders

April 1987

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7 Reads

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48 Citations

American Journal of Psychiatry

The authors field-tested proposed criteria for diagnoses of psychoactive substance use disorders in the revision of DSM-III (DSM-III-R) and compared them with DSM-III criteria in a treated group of 83 patients. They found a high level of agreement between the diagnostic systems in rates of diagnosis and in the individuals receiving the diagnosis. The greatest cross-system agreement occurred when the minimum number of symptoms required to make the DSM-III-R diagnosis was set at three. Discrepant diagnoses between systems related to removal of social consequences as a requirement for the DSM-III-R diagnoses, less emphasis on physiological tolerance in DSM-III-R, and disagreement in subjects with mild symptoms.


Clonidine in outpatient detoxification from methadone maintenance

May 1985

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11 Reads

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121 Citations

Archives of General Psychiatry

Inpatient narcotic detoxification with clonidine hydrochloride has been used since 1978. Outpatient withdrawal, potentially more useful, has not been adequately studied. This report describes a double-blind random assignment of 49 methadone hydrochloride-maintained patients whose dose had been lowered to 20 mg. Twenty-five were detoxified using methadone at 1-mg decrements, 24 by abrupt substitution with clonidine. Approximately 40% of both groups achieved successful detoxification, with one third maintaining abstinence over the subsequent six months. The groups were also largely equivalent on withdrawal symptoms, but the clonidine group experienced symptoms in the first half of the study and the methadone group in the second half. Clonidine appears to be a safe and efficacious outpatient treatment for opiate withdrawal, although the results were less favorable than those obtained in open or inpatient studies.


Citations (4)


... This result was in the predicted direction and approached statistical significance. Regarding the frequency of crime, the result that the greater number of days used cocaine was significantly associated with the greater number of crime days was consistent with previous research on heroindependent (Ball, Rosen, Flueck, & Nurco, 1981;Kosten, Rounsaville, & Kleber, 1988) and cocaine-dependent (Inciardi, 2008) individuals. However, the current finding regarding the relationship between frequency of heroin use and frequency of crime days, found in previous studies (Anglin & Hser, 1987;Ball et al., 1981;Kinlock et al., 2003) although in the predicted direction, was not observed in the present study. ...

Reference:

The Severity, Frequency, and Variety of Crime in Heroin-Dependent Prisoners Enrolled in a Buprenorphine Clinical Trial
A 2.5 year follow-up of abstinence and relapse to cocaine abuse in opioid addicts

NIDA research monograph

... Au-delà des travaux de la lignée de Jellinek, d'autres typologies ont été développées intégrant parfois des critères psychocomportementaux (voir Slater et al., 1999), des dimensions de psychiatrie, de psychopathologie ou de psychologie comportementale (Jenicek et Cleroux, 1985), et parfois aussi de phénoménologie, de sociologie ou d'anthropologie (pour une recension des écrits sur le sujet voir Babor et al., 1988 ;Babor, 1992 ;SFA, 2001 ;Paille, 2000Paille, , 2002Lesch et al., 2011). Généralement, les typologies pathologiques sont développées à partir d'indicateurs de comportements de consommation d'alcool, de types de dépendance, de vulnérabilité génétique, de traits de personnalité ou de dysfonctionnements psychopathologiques face à l'alcool (Babor, 1992 ;Moss 2 Type Alpha : represents a purely psychological continual dependence or reliance upon the effect of alcohol to relieve bodily or emotional pain. ...

Unitary versus multidimensional models of alcoholism treatment outcome: An empirical study
  • Citing Article
  • April 1988

Journal of Studies on Alcohol

... The third edition, DSM-III (APA, 1980), was the first version to create an abuse/dependence classification using specific diagnostic criteria . Published in 1987, the DSM-III-R (revised) further modified the AUD criteria for substance abuse and substance dependence based on empirical research and World Health Organization recommendations (APA, 1987;Edwards et al., 1981;Kosten et al., 1987;Rounsaville et al., 1987), referring to dependence as a syndrome as first described in the 1980s (Edwards, 1986;Kosten et al., 1987). DSM-IV, published in 1994, maintained the AUD differentiation between abuse and dependence (Hasin & Grant, 1994;, but no longer referred to dependence as a syndrome but rather as a "cluster," and removed the overlap between abuse and dependence criteria that had existed in DSM-III-R (Hasin & Grant, 1994). ...

A field trial of DSM-III-R psychoactive substance dependence disorders
  • Citing Article
  • April 1987

American Journal of Psychiatry

... 23−25 Traditional methods of detoxification from opioids, including tapering off the opioid agonist methadone or buprenorphine and supportive treatment of symptomatology with the α2-adrenergic receptor agonists clonidine or lofexidine, as well as subsequent treatment with the injectable formulation of the opioid antagonist naltrexone (Vivitrol TM ) for relapse prevention, are limited not only by high relapse rates but also lack of efficacy in relieving subjective symptoms of cravings and withdrawals. [26][27][28][29][30][31][32][33][34][35][36][37] Thus, exploring other detoxification strategies involving opioids is of great importance, not only for opioid-dependent pain patients and prescription opioid abusers, but also for providing a smooth transition from opioid agonists to naltrexone therapy or a drug-free state. ...

Clonidine in outpatient detoxification from methadone maintenance
  • Citing Article
  • May 1985

Archives of General Psychiatry