Craig R. Colder’s research while affiliated with University at Buffalo, State University of New York and other places

Introduction Relative to other pharmacotherapies for smoking cessation, varenicline has significantly greater efficacy in females; however, sex-specific mechanisms have not yet been investigated. We conducted a secondary analysis of ecological momentary assessment (EMA) data to assess whether reductions in craving, negative affect, and smoking satisfaction/reward/aversion mediate effects of varenicline on next-day smoking to a greater degree in females (n=179) relative to males (n=141). Methods Data were from a 3-week medication manipulation period during the pre-quit phase of a double-blind randomized placebo-controlled trial investigating extended preloading (4 weeks) vs. standard preloading varenicline (1 week, preceded by 3 weeks of placebo, NCT03262662). Time-invariant multilevel moderated mediation models and time-varying mediation models were utilized. Results A significant time-varying indirect effect through craving that increased in magnitude over the pre-quit period was identified only in females. Exploratory analysis found that decreases in psychological reward and smoking satisfaction mediated the relationship between varenicline and reductions in craving only in females. Time-invariant multi-level models did not evidence a significant indirect effect through candidate mediators in males or females; the index of moderated mediation was not significant in any of the models. Conclusions Our findings suggest that the efficacy of varenicline on reductions in pre-quit smoking in females operates through reductions in craving. Furthermore, reductions in craving may be due to decreases in positive subjective experiences of smoking. Augmenting craving coping strategies as well as reducing smoking reward and satisfaction may be a beneficial approach in females. Implications This is the first study to investigate sex-specific mediation of varenicline on reductions in pre-quit smoking. Further investigation into varenicline-induced changes in smoking reinforcement and craving is warranted, particularly in females. For example, experimentally manipulating these mediators may inform them as mechanisms for smoking reduction.

Psychopathology assessed across the lifespan often can be summarized with a few broad dimensions: internalizing, externalizing, and psychosis/thought disorder. Extensive overlap between internalizing and externalizing symptoms has garnered interest in bifactor models comprised of a general co-occurring factor and specific internalizing and externalizing factors. We focus on internalizing and externalizing symptoms and compare a bifactor model to a correlated two-factor model of psychopathology at three timepoints in a large adolescent community sample ( N = 387; 55 % female; 83% Caucasian; M age = 12.1 at wave 1) using self- and parent-reports. Each model was tested within each time-point with 25–28 validators. The bifactor models demonstrated better fit to the data. Child report had stronger invariance across time. Parent report had stronger reliability over time. Cross-informant correlations between the factors at each wave indicated that the bifactor model had slightly poorer convergent validity but stronger discriminant validity than the two-factor model. With notable exceptions, this pattern of results replicated across informants and waves. The overlap between internalizing and externalizing pathology is systematically and, sometimes, non-linearly related to risk factors and maladaptive outcomes. Strengths and weaknesses to modeling psychopathology as two or three factors and clinical and developmental design implications are discussed.

Background and aims Mechanisms of varenicline preloading in promoting smoking abstinence have not been evaluated. Based on an extinction of reinforcement framework, we tested the hypothesis that pre‐quit reductions in smoking rate mediate the effect of extended preloading on abstinence. We also tested alternative indicators of change in smoking reinforcement, as well as smoking aversion, nausea and abstinence self‐efficacy as candidate mediators. Design, participants and intervention Randomized, double‐blind, placebo‐controlled trial (NCT03262662) comparing extended (4‐week varenicline) to standard (3 weeks of placebo, 1‐week varenicline) preloading, preceding 11 weeks of open‐label varenicline, in 320 adults (56% female). The primary outcome was self‐reported continuous smoking abstinence during the last 4 weeks of treatment, with cotinine bio‐verification at end of treatment (EOT). Setting University at Buffalo, State University of New York, USA (part of the trial was conducted at participants' homes due to the COVID‐19 pandemic). Measurements Candidate mediators, including smoking rate and subjective effects of smoking (reward, satisfaction, aversion), self‐reported craving, withdrawal, nausea and abstinence self‐efficacy, were assessed daily during the pre‐quit period with ecological momentary assessment. At two laboratory visits participants completed a choice task to assess smoking reinforcement. Findings There was a statistically significant indirect effect of extended preloading on greater EOT abstinence rates through pre‐quit declines in smoking rate [ a*b = 0.284, 95% confidence interval (0.072,0.616)] and percent reduction in smoking across the pre‐quit period [ a*b = 0.225, (0.080,0.437)]. There were also statistically significant indirect effects through reductions in pre‐quit craving [ a*b = 0.150, (0.01,0.420)] and increases in pre‐quit self‐efficacy [ a*b = 0.157, (0.038,0.375)]. Sex‐specific analyses suggested these mediated effects were consistently limited to females. No other candidate mediators yielded statistically significant indirect effects. Conclusions Extended varenicline preloading mediated smoking abstinence through reduced pre‐quit smoking and craving among female smokers seeking to quit; increased pre‐quit abstinence self‐efficacy was also a significant mediator.

Posttraumatic stress disorder (PTSD) confers considerable risk for alcohol-related harms. Trauma-exposed individuals may turn to alcohol in response to intrusive trauma-related symptoms (e.g., memories, flashbacks, and nightmares) or distressing trauma-related emotions, with such desires to drink shifting dynamically in the moment in response to PTSD symptoms. However, the in-the-moment reasons for drinking that may underlie these dynamic processes remain largely unknown. The present qualitative study aimed to identify key in-the-moment PTSD-related reasons for drinking. Focus groups of frequent drinkers with a provisional diagnosis of past-month PTSD recruited from the community (n = 39; 44% female adults) provided in-depth information on their reasons for drinking during several recent drinking episodes. Focus group data were subjected to directed content analysis. The findings revealed several novel insights regarding in-the-moment reasons for PTSD-related drinking. Participants endorsed perceptions that alcohol could numb trauma-related thoughts and emotions or distract from intrusive symptoms (i.e., negative reinforcement). Participants also described perceptions that alcohol could enhance positive emotions amid persistent negative mood and help process complex trauma-related memories as well as facilitate interpersonal connection. The results identify specific, in-the-moment reasons for drinking in response to emergent PTSD symptoms, which appear at times unique from more general drinking motivations. The findings shed light on potential risk pathways for problem drinking in response to PTSD symptoms as they occur across daily life. These specific in-the-moment reasons for drinking could represent important clinical targets for real-time, adaptive interventions for comorbid PTSD and problem alcohol use.

Objective Posttraumatic stress disorder (PTSD) and alcohol use disorder (AUD) commonly co-occur. Momentary alcohol cognitions may represent in-the-moment, modifiable risk factors to target in interventions for comorbid PTSD and AUD. However, the role of such cognitions in risk for problematic drinking as it emerges in response to individuals’ fluctuating PTSD symptoms across their daily lives remains unknown. The present study aimed to test whether state-level PTSD-alcohol expectancies and/or drinking motives modulate in-the-moment associations between PTSD symptoms and alcohol outcomes. Method Frequent drinking adults with current PTSD ( n = 54) reported on their posttraumatic symptoms and alcohol cognitions, craving, and consumption during four momentary surveys each day for 14 days (3,024 observations) in an ecological momentary assessment design. Multilevel moderation analyses tested whether in-the-moment PTSD-alcohol expectancies and/or drinking motives moderated relations of PTSD symptoms with alcohol craving and consumption. Results Findings demonstrated a significant interaction between PTSD symptoms and coping drinking motives on in-the-moment alcohol craving. Specifically, greater experience of PTSD symptoms related more strongly to craving for alcohol during events in which drinkers endorsed higher levels of coping drinking motives. There were no additional interaction effects for drinking motives or PTSD-alcohol expectancies on either alcohol craving or consumption. Conclusions Coping drinking motives appear to convey strong in-the-moment risk for PTSD-related alcohol craving yet not subsequent alcohol consumption. Future research should delineate concurrent alcohol risk and possible protective processes active in the presence of PTSD symptoms to help identify targets for interventions tailored to the unique risk processes maintaining comorbid PTSD and AUD.

Objective: Sexual assault (SA) is unfortunately common in U.S. college campuses. Friends are central to the social context of college women, and thus to the context of SA, and thus may play a key role in SA prevention. The objective of the present study was to provide a preliminary test of a novel friend-based motivational intervention (FMI) that encourages and prepares friends to work together to reduce SA risk. Method: In a pilot trial, 51 friend dyads (N = 102) were randomized to either FMI or waitlist control (WLC) conditions and then followed over 3 months. Participant perceptions of the intervention and intervention-associated outcomes (engagement in friend-based assault protective behaviors [FAPB], readiness to change, barriers, sexual assault occurrences) were examined. Results: Those in the FMI reported greater readiness to engage in efforts to protect their friend against SA and reported higher rates of FAPB across time points relative to the WLC. Though not statistically significant, women in the FMI also reported half as many incidences of SA at the 3-month follow-up. We did not observe decreases in perceived barriers to intervening that were targeted with the FMI. Participant feedback on their experiences with the FMI was positive; women reported that FMI was empowering, personally relevant, and useful. Conclusions: Findings point to the promise of this dyad-based motivational intervention that capitalizes on the natural resource of women’s friendships to decrease risk for sexual assault.

Children's temperament is a central individual characteristic that has significant implications, directly and indirectly, for their social, emotional, behavioral, cognitive, and health outcomes, through its evocative and moderating effects on other social and contextual influences. Accounting for these contextual influences is critical to articulating the role of temperament in children's development. This Element defines temperament and describes its roots in neurobiological systems as well as its relevance to children's developmental outcomes, with a focus on understanding the influence of temperament in children's social and environmental contexts. It covers key developmental periods, situating the contribution of temperament to children's development in complex and changing processes and contexts from infancy through adolescence. The Element concludes by underscoring the value of integrating contextual, relational, and dynamic systems approaches and pointing to future directions in temperament research and application.

Introduction: Hazardous drinking by fathers poses a significant risk for negative family interactions and child outcomes. The transition to parenthood may be a time when expectant parents are potentially motivated for health behavior change, suggesting that implementing preventive interventions during this period may be particularly effective. This article provides an overview of the rationale for an innovative prevention strategy incorporating alcohol-use intervention with a family-focused program. Method: We describe the process of integration and adaptation of two evidence-based interventions beginning in pregnancy: (a) Family Foundations, a universal transition-to-parenthood intervention for couples to enhance coparenting and couple dyadic functioning, and (b) brief intervention to address alcohol use delivered using a couples-focused motivational interviewing style. Results: Lessons learned from pilot testing (conducted October 2020–March 2021) included the importance of softened framing of the discussions and language used around alcohol use given that parents were not specifically seeking treatment for alcohol use and the program was described as a parenting program that included discussion of health behaviors, including drinking. In addition, we found that evoking discussion and communication within dyads and supporting autonomy in decision making regarding alcohol use also facilitated engagement. Conclusion: Pilot testing demonstrated the acceptability and feasibility of an adapted, integrated intervention program designed to strengthen coparenting skills and dyadic functioning and promote lower risk levels of alcohol use among couples during the transition to parenthood.