Carrie L. Randall's research while affiliated with Medical University of South Carolina and other places

Publications (149)

Article
Background: Drinking motives are thought to be important mediators of the relationship between social anxiety and alcohol use. This project evaluates whether specific drinking motives accurately reflect alcohol dependence. If so, brief questions about drinking motives could serve as valuable alcohol screening tools with socially anxious patients....
Article
Paroxetine alone is not sufficient to decrease alcohol use in socially anxious alcoholics seeking anxiety treatment. We tested the hypothesis that adding a brief-alcohol-intervention (BI) to paroxetine would decrease alcohol use. All subjects (N=83) had a diagnosis of social anxiety disorder, endorsed drinking to cope with anxiety, were NIAAA-defin...
Article
The co-occurrence of anxiety disorders and alcohol use disorders (AUDs) is relatively common and is associated with a complex clinical presentation. Sound diagnosis and treatment planning requires that clinicians have an integrated understanding of the developmental pathways and course of this comorbidity. Moreover, standard interventions for anxie...
Chapter
Prostaglandins (PGs) are 20-carbon chain fatty acids that functions as local hormones. There are two series of PGs. One is derived from arachidonic acid (AA, 2-series PGs), and the other is derived from related fatty acid precursors (1-series PGs). The 1-series fatty acid precursor is dependent entirely on dietary intake, whereas the 2-series precu...
Article
Relatively few studies have examined gender differences in the effectiveness of specific behavioral or pharmacologic treatment of alcohol dependence. The aim of this study is to assess whether there were gender differences in treatment outcomes for specific behavioral and medication treatments singly or in combination by conducting a secondary anal...
Article
Alcoholism treatment often encourages involvement in Alcoholics Anonymous (AA). Little provision is made for women with social phobia (SP), who have been reported to have worse outcomes in twelve-step-facilitation (TSF) relative to cognitive behavioral therapy. This study examined whether SP moderated the effects of gender for these women in TSF. 1...
Article
Data from a 6-month placebo-controlled, double-blind study of buspirone in alcohol-dependent subjects with generalized anxiety disorder were examined to determine if study completers and noncompleters differed on any identifiable characteristics. Twenty (29.9%) of 67 male veterans completed the 26-week protocol. An equal number (n = 10) of the comp...
Article
Introduction: Some anticonvulsants ameliorate signs and symptoms of alcohol withdrawal, but have an unacceptable side effect burden. Among the advantages of using anticonvulsant agents in this capacity is their purported lack of interaction with alcohol that could increase psychomotor deficits, increase cognitive impairment, or increase intoxicati...
Article
Individuals with social anxiety have difficulty participating in group settings. Although it makes intuitive sense that social anxiety could present a challenge in addiction treatment settings, which often involve small groups and encouragement to participate in self-help groups like Alcoholics Anonymous (AA) and Narcotics Anonymous (NA), to our kn...
Article
Repeated use of alcohol as a coping strategy to reduce anxiety or discomfort increases one's risk of developing alcohol dependence. Previous studies have found alcohol outcome expectancies (AOE) strongly predict drinking behavior, in general, and also are related to drinking to cope. The purpose of the current study was to examine AOE that may be r...
Article
One in five individuals seeking treatment for alcoholism also have social anxiety disorder, a comorbidity associated with more severe alcoholism and worse alcohol treatment outcomes. Social anxiety disorder has been theorized to interfere with involvement in Alcoholics Anonymous (AA), although no investigation to date has evaluated this phenomenon....
Article
Individuals with social anxiety disorder and co-occurring alcohol problems report using alcohol to cope with anxiety symptoms. Interventions that reduce both social anxiety and drinking are needed. Paroxetine, an FDA-approved medication to treat social anxiety disorder, reduces anxiety in individuals with co-occurring alcohol problems. To examine w...
Article
Patients with social anxiety disorder who are seen in clinical practice commonly have additional psychiatric comorbidity, including alcohol use disorders. The first line treatment for social anxiety disorder is selective-serotonin-reuptake-inhibitors (SSRIs), such as paroxetine. However, the efficacy of SSRIs has been determined with studies that e...
Article
Background: Alcohol abuse, especially when experienced in multiple cycles of chronic abuse and withdrawal, leads to a sensitization of central nervous system hyperexcitability that may culminate in overt expression of seizures. In spite of the growing prevalence of alcohol abuse and dependence in females shown in recent epidemiologic studies, evid...
Article
Full-text available
Alcohol dependence treatment may include medications, behavioral therapies, or both. It is unknown how combining these treatments may impact their effectiveness, especially in the context of primary care and other nonspecialty settings. To evaluate the efficacy of medication, behavioral therapies, and their combinations for treatment of alcohol dep...
Article
Full-text available
This article presents the proceedings of a symposium held at the meeting of the International Society for Biomedical Research on Alcoholism (ISBRA) in Mannheim, Germany, in October 2004. The organizers and chairs were Karl F. Mann, Fred Rist and Carrie L. Randall. The presentations were (1) Searching for the acamprosate and naltrexone responders, b...
Article
Basic scientists and clinicians alike are in agreement that children of alcoholic mothers are at risk for a variety of birth defects. These defects have been labeled fetal alcohol syndrome or, in a milder form, fetal alcohol effects. Prevention or therapeutic intervention of this disorder requires an understanding of the mechanism of action of alco...
Article
The purpose of the present study was to examine the effect of the prostaglandin synthetase inhibitor ibuprofen (IBU) on the teratogenic actions of alcohol. On day 10 of pregnancy, C57BL/6J mice were injected subcutaneously with 25 mg/kg IBU or vehicle control. One hour later, the mice were intubated with 5.8 g/kg alcohol or an isocaloric control so...
Article
Objectives: Frequent drinking to relieve anxiety increases the risk of alcohol problems. It is hypothesized that the high rate of comorbidity of alcohol-use disorders and anxiety disorders may be due, in part, to the practice of self-medication with alcohol. Of interest to researchers and clinicians are individual variables that predict the practic...
Article
This 6-week open-label trial of naltrexone was conducted in a preliminary fashion to determine whether naltrexone would be safe, well tolerated, and lead to a reduction in alcohol consumption in adolescents with alcohol dependence. Five outpatient treatment-seeking adolescents who met Diagnostic and Statistical Manual of Mental Disorders, 4th editi...
Article
The COMBINE Study, a federally funded multisite clinical trial, endeavored to choose drinking and related outcome variables that were scientifically sound and had both convergent validity with previously published studies and face validity for clinical meaning. This article describes these variables and the methods used to collect them. In choosing...
Article
This preliminary study examined the relationship between social anxiety and specificity of positive alcohol outcome expectancies (AOE) in a community sample of 62 drinking adults. The sample was divided into subsets of socially anxious (n = 17) and nonsocially anxious (n = 45) men and women. The Drinking Expectancy Questionnaire (DEQ) and Alcohol E...
Article
This preliminary study examined the relationship between social anxiety and specificity of positive alcohol outcome expectancies (AOE) in a community sample of 62 drinking adults. The sample was divided into subsets of socially anxious (n = 17) and nonsocially anxious (n = 45) men and women. The Drinking Expectancy Questionnaire (DEQ) and Alcohol E...
Article
Posttraumatic stress disorder (PTSD) frequently co-occurs with alcohol use disorders. This study investigated the use of sertraline, a serotonin reuptake inhibitor, in treating co-occurring symptoms of alcohol dependence and PTSD. A total of 94 individuals with current alcohol dependence and PTSD were randomly assigned to receive sertraline (150 mg...
Article
This study investigated the sensitivity of the emotional Stroop test for identifying individuals who reported drinking to cope with social fears. Community volunteers completed a modified Stroop task during which social threat, alcohol-related, and control words were presented. High scores on drinking-to-cope measures were hypothesized to be associ...
Article
This article represents the proceedings of a symposium at the 2003 annual meeting RSA in Fort Lauderdale, FL. It was organized and cochaired by Charlene E. Le Fauve and Carrie L. Randall. The presentations were (1) Introduction, by Charlene E. Le Fauve and Raye Z. Litten; (2) Treatment of co-occurring alcohol use and anxiety disorders, by Carrie L....
Article
The present studies were aimed to identify possible age- and/or sex-related differences in the effects of alcohol and nicotine. Study 1 examined age-related differences in alcohol and nicotine effects. Adolescent and adult C57BL/6J male mice were injected with alcohol or nicotine. Results indicated that alcohol and nicotine induced hypothermia and...
Article
Several hypotheses exist to account for the higher than normal rate of alcoholism in individuals with high trait anxiety (or anxiety disorders). Most of these suggest that the practice of drinking alcohol to reduce anxiety leads to an increased risk of alcoholism in vulnerable individuals. The first assumption of the hypothesis is that anxious indi...
Article
This study investigated gender differences in a sample of outpatient, treatment-seeking individuals (N = 84) with comorbid alcohol dependence and post-traumatic stress disorder (PTSD). Assessments included substance use severity, trauma history, PTSD symptomatology, and comorbid psychiatric disorders. Men reported an earlier age of onset of alcohol...
Article
This study investigated gender differences in a sample of outpatient, treatment-seeking individuals (N=84) with comorbid alcohol dependence and post-traumatic stress disorder (PTSD). Assessments included substance use severity, trauma history, PTSD symptomatology, and comorbid psychiatric disorders. Men reported an earlier age of onset of alcohol d...
Article
Increasing knowledge about effective therapies for alcohol dependence calls for new research designs to examine treatment interactions between pharmacotherapies and behavioral interventions. In 1997, the National Institute on Alcohol Abuse and Alcoholism recruited 11 sites and a coordinating center for a large-scale (1,375 subjects), randomized pla...
Article
It is well documented that many individuals endorse the belief that alcohol reduces social anxiety. Individuals with social phobia, therefore, might be expected to use alcohol as a coping strategy in an attempt at self-medication. The purpose of the present paper was to review the published literature on the relationship between alcohol use and soc...
Article
It is well documented that many individuals endorse the belief that alcohol reduces social anxiety. Individuals with social phobia, therefore, might be expected to use alcohol as a coping strategy in an attempt at self-medication. The purpose of the present paper was to review the published literature on the relationship between alcohol use and soc...
Article
Full-text available
This chapter describes the results for the Aftercare arm of Project MATCH, which investigated treatment matching in clients who had just completed a program of conventional inpatient or day-hospital treatment. As with the Outpatient arm, there was no evidence for the superiority of any one treatment over another on the primary drinking outcome meas...
Article
The A-OCDS was modeled after the Obsessive Compulsive Drinking Scale (OCDS) to establish an instrument appropriate for use in adolescent/young adult populations. Initial exploratory analysis of the A-OCDS revealed two factors, namely "irresistibility" and "interference," which were specific and sensitive to identifying problematic drinking. The stu...
Article
Studies investigating carbamazepine (CBZ) in the treatment of cocaine dependence have been inconsistent. In this study, cocaine-dependent individuals with (n = 57) and without (n = 82) affective disorder were compared in a 12-week, double-blind, placebo-controlled trial. Urine drug screens (UDS) and self-report of drug use were collected weekly. Af...
Article
Studies investigating carbamazepine (CBZ) in the treatment of cocaine dependence have been inconsistent. In this study, cocaine-dependent individuals with (n = 57) and without (n = 82) affective disorder were compared in a 12-week, double-blind, placebo-controlled trial. Urine drug screens (UDS) and self-report of drug use were collected weekly. Af...
Article
The detrimental effects of alcohol on offspring have been alluded to for centuries, although only in the past few decades has the relationship between alcohol and birth defects been shown conclusively. This review article begins with a historical overview of the understanding of alcohol's effects on the offspring, followed by a description of the f...
Article
Objective: This study investigated whether different alcoholism treatment approaches differentially impact social support scores in individuals with concurrent alcohol dependence and social phobia. Method: Individuals (N = 397) were selected retrospectively from a larger pool of participants enrolled in a multisite randomized clinical trial on trea...
Article
The present experiment was designed to evaluate the development of tolerance to alcohol and cross-tolerance to nicotine in adolescent mice. C57BL/6J mice (30-40 days old) were injected IP with alcohol (2.5 g/kg) for 4 consecutive days. A control group received four saline injections. On the test day, all subjects received an alcohol injection. Tole...
Article
Alcoholism has been studied in adults and found to share obsessive-compulsive characteristics. The Yale-Brown Obsessive Compulsive Scale (YBOC) was used to quantify the measurements of this disorder. This study adapted the YBOC for use with adolescents/young adults in an attempt to measure the "craving" expressed as obsessive and compulsive phenome...
Article
Background: Social anxiety disorder (also called social phobia) is an anxiety disorder in which affected individuals fear the scrutiny of others. Clinical reports suggest that individuals with social anxiety disorder often use alcohol to alleviate anxiety symptoms, a practice that leads to alcohol abuse and/or dependence in approximately 20% of af...
Article
Smoking during pregnancy is associated with a number of maternal and fetal complications. The mechanisms underlying the effects of nicotine on fetal growth and development are not known, but may involve decreases in umbilical–placental blood flow. Prostaglandins are vasoactive mediators that regulate umbilical–placental blood flow and there is evid...
Article
The objective of this study was to compare the efficacy and tolerability of paroxetine to matched placebo in adults with co-occurring social anxiety disorder and alcohol use disorder. Outcome measures included standardized indices of social anxiety and alcohol use. Fifteen individuals meeting DSM-IV criteria for both social anxiety disorder and alc...
Article
HIV/AIDS infection has become a serious threat to many adolescents, as reflected by the increase in the number of AIDS cases among adolescents and young adults. Substance abusing adolescents, in particular, tend to engage in high risk HIV behaviors despite their knowledge of HIV/AIDS. To determine the effectiveness of a brief educational motivation...
Article
In order to preliminarily evaluate the efficacy, safety and tolerability of the serotonin reuptake inhibitor, sertraline, in the treatment of adolescents with a primary depressive disorder and a comorbid alcohol use disorder, a 12-week double-blind, placebo-controlled trial of sertraline plus cognitive behavior group therapy was conducted. Subjects...
Article
The present study compares male and female alcoholics with concurrent social phobia (N = 110) enrolled in an alcohol treatment study. Groups were compared using demographics, social phobia symptoms and severity, and psychiatric variables. Results showed that females reported higher fear ratings than males on some social phobia measures, although fo...
Article
The present study was conducted to test the hypothesis that socially phobic alcoholics treated with Cognitive Behavioral therapy (CBT) will have better drinking outcomes than those treated with Twelve-Step Facilitation therapy (TSF). Three hundred ninety-seven treatment-seeking alcoholics with concurrent social phobia were compared retrospectively...
Article
Recently, an association between alcohol consumption during pregnancy and shortened gestational length has been reported, but the underlying mechanisms remain unknown. Progesterone (P4) and prostaglandins have been shown to play important roles in parturition in both human and animal models. Recently, it has been suggested that prostaglandin H synt...
Article
A C57BL/6J mouse model was used to examine the coteratology of alcohol and cocaine. Plugged female mice were assigned to one of four treatment groups: control, cocaine only, alcohol only, or alcohol-cocaine. Experimental animals were treated from gestation day (GD) 6-18 and were killed the morning of GD 19. Alcohol was administered in a liquid diet...
Article
: Recently, an association between alcohol consumption during pregnancy and shortened gestational length has been reported, but the underlying mechanisms remain unknown. Progesterone (P4) and prostaglandins have been shown to play important roles in parturition in both human and animal models. Recently, it has been suggested that prostaglandin H sy...
Article
While alcoholics with social phobia comprise a substantial portion of the alcoholic population, little is known about how they differ from alcoholics without social phobia in their substance use and psychiatric health. The present study was conducted to examine baseline differences between alcoholics with and without social phobia on substance use...
Article
Despite the fact that the rate of substance abuse and dependence is higher among men than it is among women, the prevalence rates, especially the more recent ones, indicate that a diagnosis of substance abuse is not gender specific. From the emerging literature on gender differences over the past 25 years, male and female substance abusers are clea...
Article
Differences on demographics and seven measures of social support between matched, treatment-seeking alcoholics with and without social phobia (SP and NSP groups, respectively) were examined. The groups did not differ on most demographic variables, although the SP group (n = 397) had a lower occupational status and had fewer years of education (both...
Article
Differences on demographics and seven measures of social support between matched, treatment-seeking alcoholics with and without social phobia (SP and NSP groups, respectively) were examined. The groups did not differ on most demographic variables, although the SP group (n = 397) had a lower occupational status and had fewer years of education (both...
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
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
Objective: This article examines client drinking and related psychosocial functioning during the course of alcoholism treatment. It focuses on (1) the main effects of the three Project MATCH treatments, (2) the prognostic value of client attributes employed in the matching hypotheses, and (3) the attribute by treatment interaction effects. Method...
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
A common pattern of birth defects was reported in children born to alcoholic women over 20 years ago. Shortly thereafter the constellation of defects became known as the Fetal Alcohol Syndrome, and reports from around the world served to acknowledge the pervasiveness of the disorder. Simultaneously with the clinical reports, animal models were deve...
Article
Aims. (1) To assess the benefits of matching alcohol dependent clients to three treatments, based upon a priori hypotheses involving 11 client attributes; (2) to discuss the implications of these findings and of matching hypotheses previously reported from Project MATCH. Setting and participants. (1) Clients receiving outpatient therapy (N = 952; 7...
Article
These studies were designed to determine the effect of acute alcohol treatment on gestational length and to probe for a mechanism underlying alcohol-induced early onset of parturition (EOP) in mice. Experiment 1: alcohol increases the incidence of EOP. Pregnant C57BL/6J mice were given alcohol (0, 4, 5 or 6 g kg(-1), i.g.) on Gestational Day (GD) 1...
Article
Objective: To assess the benefits of matching alcohol dependent clients to three different treatments with reference to a variety of client attributes. Method: Two parallel but independent randomized clinical trials were conducted, one with alcohol dependent clients receiving outpatient therapy (N = 952; 72% male) and one with clients receiving aft...
Article
The deleterious effects of prenatal ethanol exposure have been extensively documented in clinical and experimental studies. This paper provides an overview of work conducted with mice to examine the myriad of adverse consequences that result from embryonic/fetal exposure to ethanol. All of the hallmark features of the clinical fetal alcohol syndrom...
Article
Studies from our laboratory indicate that prostaglandins may be mediators of at least some of the teratogenic actions of ethanol in both mouse and human tissue model systems. The present studies were designed to evaluate the relationship between ethanol and prostaglandin E (PGE) production in isolated human placental cotyledons. Placentas were obta...
Article
Studies from our laboratory indicate that prostaglandins may be mediators of at least some of the teratogenic actions of ethanol in both mouse and human tissue model systems. The present studies were designed to evaluate the relationship between ethanol and prostaglandin E (PGE) production in isolated human placental cotyledons. Placentas were obta...
Article
The teratogenic effects of the coadministration of alcohol and cocaine on gestation days 14-17 were investigated using an acute exposure model. Pregnant C57BL/6J mice were assigned randomly to treatment groups generated from a 2 (0 or 6 g/kg alcohol) x 2 (0 or 60 mg/kg cocaine) x 4 (day of treatment) factorial design. An untreated control group was...
Article
Vasoactive prostaglandins have been reported to mediate umbilical/placental blood flow in humans. Since it has been suggested that cocaine exerts its teratogenic action via vasoconstriction and a corresponding reduction in blood flow, it is reasonable to hypothesize that cocaine influences the vasoactive prostaglandins such that blood flow would be...
Article
Traditional methods of data analysis in alcohol studies focus only on alcohol consumption as dependent variables rather than considering a global, person-in-environment perspective. The purpose of this study was to evaluate treatment outcome in a clinical trial using dimensions of life functioning in addition to quantity-frequency measures of alcoh...
Article
The teratogenic effects of cocaine and ethanol were investigated using an acute treatment model of C57BL/6J mice treated on gestation day 15 (GD15) with evaluation on GD17. Females were intubated once with a subteratogenic dose of ethanol (0 or 4 g/kg) and injected subcutaneously twice, 1 h apart, with equal doses of cocaine HCl (0 or 60 mg/kg), fo...
Article
In order to assess differences between cocaine dependence alone and cocaine dependence complicated by alcohol abuse, 34 subjects who met DSM-III-R criteria for alcohol abuse and cocaine dependence (COC-ETOH group) were compared with 39 subjects who met criteria for cocaine dependence only (COC-only group) with regard to demographics, substance use,...
Article
The purpose of this study was to determine the effects of ethanol on prostacyclin (PGE, prostaglandin E (PGE), and thromboxane (TXA2 production in perfused human umbilical veins. PGI2, PGE, and TXA2 levels were measured from human umbilical veins perfused with either 25, 50, or 100 mM ethanol by radioimmunoassay of their stable metabolites. Alcohol...
Article
This article reviews methodological and conceptual issues regarding the choice of drinking outcome measures in alcoholism treatment research. The following issues are discussed: Should drinking outcomes be conceptualized in terms of an underlying unitary disorder, or should provision be made for independent outcomes that cover a wide variety of dim...
Article
Multisite clinical trials have two major advantages over single-site studies: the large sample size of multisite studies allows for adequate statistical power and better representativeness of the population being studied. However, they are more complex to implement than single-site studies. This article reviews previous multisite clinical trials of...