Erich Labouvie’s research while affiliated with Rutgers, The State University of New Jersey and other places

Studies of adolescent substance use progression typically infer a sequence of initiation from self-reported ages at first use of alcohol, tobacco, marijuana, and hard drugs. This paper examines the reliability of this procedure for a sample of 892 New Jersey youths (aged 12 and 15 yrs) interviewed on two occasions separated by 3 yrs. Individual responses on the second occasion differed substantially from those provided on the first. However, the inferred sequences were consistent as long as (1) first use of alcohol and/or tobacco was considered a single stage and (2) cases in which individuals initiated the use of two substances in the same year were considered as ambiguous regarding order. The sequences reported were also consistent with the gateway theory that suggests alcohol/tobacco precedes any possible use of marijuana and hard drugs. (PsycINFO Database Record (c) 2012 APA, all rights reserved)

Many women with sexual assault histories receive care in alco-hol/other drug (AOD) treatment programs. Affected women fre-quently suffer from sexual dysfunction, leading investigators to suggest self-medication may be one path to AOD use disorders and relapse. This preliminary study examined sexual dysfunction and sexual assault in 71 women receiving treatment for addiction. Women with prior sexual assault scored higher than nonassaulted women on sexual dysfunction overall, a discrepancy accounted for by higher scores among assaulted women on sexual inhibition subscales. Sexual inhibition and sexual assault each predicted the use of alcohol or other drugs to increase sexual desire. These preliminary findings suggest sexually abused women may follow a different course into AOD-related problems than nonabused women, possibly including self-medication to relieve sexual in-hibition.

Research in religion and health has spurred new interest in measuring religiousness. Measurement efforts have focused on subjective facets of religiousness such as spirituality and beliefs, and less attention has been paid to congregate aspects, beyond the single item measuring attendance at services. We evaluate some new measures for religious experiences occurring during congregational worship services. Respondents (N=576) were religiously-diverse community-dwelling adults interviewed prior to cardiac surgery. Exploratory factor analysis of the new items with a pool of standard items yielded a readily interpretable solution, involving seven correlated but distinct factors and one index variable, with high levels of internal consistency. We describe religious affiliation and demographic differences in these measures. Attendance at religious services provides multifaceted physical, emotional, social, and spiritual experiences that may promote physical health through multiple pathways.

Distress and low perceived social support were examined as indicators of psychosocial vulnerability in patients about to undergo heart surgery. Design: A total of 550 study patients underwent heart surgeries, including bypass grafting and valve procedures. Psychosocial interviews were conducted about five days before surgery, and biomedical data were obtained from hospital records. Sociodemographic, personality, religious, and biomedical factors were evaluated as predictors of psychosocial vulnerability, and all five sets of variables were evaluated as contributors to hospital length of stay (LOS). Patients scoring higher on one or more indicator of presurgical psychosocial vulnerability were younger, more likely to be female, less likely to be married, less well educated, lower in dispositional optimism, higher in trait anger, and lower in religiousness. Older age, depression, low support, and low trait anger each showed an independent, prospective association with greater LOS, and several other predictors had prospective relationships with LOS that were statistically mediated by depression or perceived support. Evidence that multiple psychosocial factors may influence adaptation to heart surgery has implications for understanding and ameliorating presurgical distress and for improving postsurgical recovery.

The Controlled Oral Word Association (COWA) Test is a brief and sensitive measure of executive cognitive dysfunction. There are two commonly used forms of the test, one using the letters F, A, and S, and the other using C, F, and L. This study examines the relative difficulty of the two forms using a meta-analytic approach that includes multiple samples of normal individuals. The effects of age, education, gender composition, exclusion criteria, and age of study are also examined. Results indicate that the CFL form of the test is more difficult and that age, education, and the use of strict exclusion criteria influence performance. Performance is more variable for the FAS form, and age and age of study influence performance variability.

The purpose of this study was to examine the dimensionality, stability, and course of depressive symptoms over the 12-month period beginning approximately 1 week before heart surgery. The Center for Epidemiological Studies Depression Scale (CES-D) was administered to 570 patients before heart surgery and 1, 3.5, 6.5, and 12.5 months later. Confirmatory factor analysis rejected a four-factor model as a result of small variances for two interpersonal items. With their elimination, a three-factor solution (negative affect, low positive affect, somatic/vegetative symptoms) showed good psychometric properties. Except for the somatic/vegetative factor at the 1-month follow up, there was a high degree of stability in the factor pattern over a 12-month period beginning approximately 1 week before heart surgery. Latent mean structure analysis indicated that, apart from elevations in several somatic/vegetative symptoms during the month after surgery, means for all three depressive symptoms declined over time. The recovery of positive affect showed a steeper trajectory toward the end of the follow-up period by comparison with the rates of decline for depressed affect and somatic/vegetative symptoms. These findings support using 18 CES-D items to measure three depressive symptom dimensions in heart patients and may reflect a normative pattern of adjustment to heart surgery.

While heavy drinking among men who have sex with men (MSM) has been shown to be associated with an increase in sexual risk taking, a temporal relationship between drinking and an increase in subsequent HIV risk behaviors among adult samples has been less obvious. This study used an event level analysis to examine this relationship among HIV negative problem drinking MSM. Within subjects analyses show a higher probability of unprotected anal intercourse after drinking. Post-hoc analyses of within subjects data indicate that drinking increases risk taking when engaging in receptive anal intercourse but not for insertive anal intercourse. Findings from this study support evidence that drinking is a factor that increases risk taking among HIV negative problem drinking MSM, particularly for receptive anal intercourse.

This study evaluated two brief personal feedback substance-use interventions for students mandated to the Rutgers University Alcohol and Other Drug Assistance Program for Students (ADAPS): (1) a brief motivational interview (BMI) intervention and (2) a written feedback-only (WF) intervention. A key question addressed by this study was whether there is a need for face-to-face feedback in the context of motivational interviewing to affect changes in substance-use behaviors or whether a written personal feedback profile is enough of an intervention to motivate students to change their substance use. The sample consisted of 222 students who were mandated to ADAPS, were eligible for the study, and completed the 3-month follow-up assessment. Eligible students completed a baseline assessment from which a personal feedback profile was created. They were then randomly assigned to the BMI or WF condition. Students were followed 3 months later. Students in both interventions reduced their alcohol consumption, prevalence of cigarette and marijuana use, and problems related to alcohol and drug use between baseline and follow-up. There were no differences between the two intervention conditions in terms of any substance-use outcomes. The results suggest that, under these circumstances and with these students, assessment and WF students changed similarly to those who had an assessment and WF within the context of a BMI. Given the fact that the former is less costly in terms of time and personnel, written profiles may be found to be a cost-effective means of reducing alcohol and drug use and related problems among low- to moderate-risk mandated college students. More research is needed with mandated students to determine the efficacy of feedback interventions and to isolate the effects of interventions from the effects of being caught and being reprimanded to treatment.

The relationship between therapeutic alliance, therapist adherence to treatment protocol, and outcome was analyzed in a randomized trial of cognitive-behavioral therapy (CBT) and interpersonal psychotherapy for bulimia nervosa. Independent observers rated audiotapes of full-length therapy sessions. Purging frequency was the primary outcome variable. There were no significant therapist or Therapist x Treatment effects on outcome. Although results showed high levels of alliance and adherence across treatments, CBT was associated with greater adherence. Across treatments and time points, better adherence was associated with enhanced alliance. Treatment condition and baseline purging frequency, but not adherence, predicted outcome. Early alliance predicted posttreatment purging frequency. In temporal analyses, prior symptom change assessed early in treatment was significantly related to subsequent adherence at midtreatment.