Joel D. Killen's research while affiliated with Stanford University and other places

Publications (151)

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Objective The goal of the current study was to empirically compare successive cohorts of treatment-seeking smokers who enrolled in randomised clinical trials in a region of the USA characterised by strong tobacco control policies and low smoking prevalence, over the past three decades. Design Retrospective treatment cohort comparison. Setting Data...
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Introduction: Current treatments for smoking cessation have limited efficacy. A potential pharmaceutical treatment for smoking cessation is selegiline, a selective and irreversible monoamine oxidase B inhibitor. A few clinical trials have been carried out using selegiline but the results have been mixed. We sought to determine if genetic markers i...
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To test the effects of a three-year, community-based, multi-component, multi-level, multi-setting (MMM) approach for treating overweight and obese children. Two-arm, parallel group, randomized controlled trial with measures at baseline, 12, 24, and 36months after randomization. Seven through eleven year old, overweight and obese children (BMI≥85(th...
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Introduction: Relatively few well-designed smoking cessation studies have been conducted with teen smokers. This study examined the efficacy of extended cognitive-behavioral treatment in promoting longer term smoking cessation among adolescents. Methods: Open-label smoking cessation treatment consisted of 10 weeks of school-based, cognitive-beha...
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Adolescent smoking remains a public health problem. Despite concerns regarding adolescent nicotine dependence, few well-designed smoking cessation studies have been conducted with teen smokers. This is particularly true regarding pharmacologic treatments for nicotine dependence. Currently, pharmacologic aids are not recommended for treating adolesc...
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Adolescent cigarette smokers may have more daily variability in their smoking patterns than adults. A better understanding of teen smoking patterns can inform the development of more effective adolescent smoking cessation interventions. Teen smokers seeking cessation treatment (N=366) reported the number of cigarettes smoked on each day of a typica...
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The factors that influence the initial phase of quitting smoking have been understudied. Although maintenance of change is the ultimate test of the efficacy of treatment, maintenance is a nonissue for those who fail to manage even brief periods of abstinence. We examined factors associated with smokers' ability to achieve a targeted 24-hr quit duri...
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Stopping smoking is difficult even with treatment. Many patients prescribed pharmacologic treatments for smoking cessation experience side effects or lack of efficacy. We performed a pharmacogenetic study of the efficacy and tolerability of bupropion and transdermal nicotine (TN), two treatments for smoking cessation. Samples were drawn from two st...
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To test a 2-year community- and family-based obesity prevention program for low-income African American girls: Stanford GEMS (Girls' health Enrichment Multi-site Studies). Randomized controlled trial with follow-up measures scheduled at 6, 12, 18, and 24 months. Low-income areas of Oakland, California. African American girls aged 8 to 10 years (N=2...
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To identify distinct subgroups of treatment responders and nonresponders to aid in the development of tailored smoking-cessation interventions for long-term maintenance using signal detection analysis (SDA). The secondary analyses (n = 301) are based on data obtained in our randomized clinical trial designed to assess the efficacy of extended cogni...
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To examine the effectiveness of transdermal selegiline for producing cigarette smoking abstinence. Adult smokers were randomly assigned to receive selegiline transdermal system (STS) or placebo given for 8 weeks. All participants received cognitive behavior therapy (CBT). Follow-ups were conducted at 25 and 52 weeks. Community smoking cessation cli...
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This study assessed the relationship between treatment outcome and perceived drug assignment in smokers (nicotine patch [NP] or placebo) using abstinence and relapse status. Smokers (N = 424) were randomly assigned to receive either NP or placebo as part of a study that examined the effects of combining NP with self-help programs. Beliefs about dru...
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Nine hundred thirty-nine 6th and 7th grade girls participated in the baseline phase of a prospective study designed to examine a set of potential risk factors for the development of eating disorders. Of the 939,839 girls (89%) completed the bulimia nervosa section of the Structured Clinical Interview for DSM-III-R disorders. One girl received the d...
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Nicotine dependence may be expressed differently in teens than in adults. Thus, it may not be sufficient to build diagnostic and cessation treatment strategies for teens based on adult-derived clinical and research data. This is the first study to prospectively examine the development of withdrawal symptoms by level of nicotine dependence among ado...
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PRIMARY AIM: Examine the effectiveness of extended cognitive behavior therapy (CBT) in promoting longer-term smoking abstinence. Open-label treatment phase followed by extended treatment phase. Randomization conducted prior to entry into open-label treatment phase; analysis based on intention-to-treat to avoid threat of selection bias. Community sm...
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To evaluate a developmental psychopathology approach for understanding adolescent social anxiety, parent-reported predictors of social anxiety were examined in a nonclinical sample of adolescents. Structured diagnostic interviews were obtained from biological parents of 770 participants. Potential risk factors assessed included child characteristic...
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African-American girls and women are at high risk of obesity and its associated morbidities. Few studies have tested obesity prevention strategies specifically designed for African-American girls. This report describes the design and baseline findings of the Stanford GEMS (Girls health Enrichment Multi-site Studies) trial to test the effect of a tw...
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Objective: To test the efficacy of a 2-year, community- & family-based intervention to reduce weight gain in low-income, preadolescent African-American girls Design: 2 arm, parallel group, randomized controlled trial Setting: Low-income areas of Oakland, CA Participants: 8 –10 year old African-American girls Interventions: Girls were randomized to...
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Sleepers were studied in their homes to obtain measures of relationships between (a) discrepancies between reported and recorded sleep, (b) degree of sleep difficulty, and (e) reported cognitive activity. Twelve good sleepers and 12 insomniacs were questioned immediately after lights out, at the occurrence of the first sleep spindle or K-complex, 1...
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Food-related parenting attitudes are thought to influence children's dietary intake and weight. The objective of this study was to examine the associations between mothers' reports of food-related parenting and children's dietary intake and body mass index (BMI). A sample of 108 Mexican-American fifth-grade children and their mothers were surveyed....
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The authors present results of a randomized clinical trial of the efficacy of extended treatment with bupropion SR in producing longer term cigarette smoking cessation. Adult smokers (N = 362) received open-label treatment (11 weeks) that combined relapse prevention training, bupropion SR, and nicotine patch followed by extended treatment (14 weeks...
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Thirty-one adolescents were assigned to either a parent participation or a no-parent participation group. All adolescents attended weekly classes to learn weight loss and self-management skills via videotape, role play, and group discussion. Monetary deposits were returned to adolescents when they achieved weight loss goals. Parents of adolescents...
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This is the first study to examine the prevalence and effects of major depression (MDD) in a sample of adolescent smokers (N = 211) undergoing treatment for nicotine dependence. We assessed MDD at baseline and end of treatment with the mood disorders portion of the Structured Clinical Interview for the Diagnostic and Statistical Manual of Mental Di...
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Adolescent smokers (N = 211) were randomized to 1 of 2 groups: (a) nicotine patch plus bupropion SR (sustained release; 150 mg per day) or (b) nicotine patch plus placebo. Group skills training sessions were conducted each week by research staff. Abstinence rates at Weeks 10 and 26 were as follows: (a) patch plus bupropion, 23% and 8%, (b) patch pl...
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Television viewing is associated with childhood obesity. Eating during viewing and eating highly advertised foods are 2 of the hypothesized mechanisms through which television is thought to affect children's weight. Our objectives were to describe the amounts and types of foods that children consume while watching television, compare those types wi...
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To identify parent-reported risk factors for adolescent panic attacks. Structured diagnostic interviews were obtained from 770 parents of participants in a school-based risk factor study for adolescent panic. Parent-reported risk factors assessed included characteristics of the child (negative affect, separation anxiety disorder [SAD], childhood ch...
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Reliability and validity were established for weight concern measures completed by 8-10-year-old African-American girls participating in a pilot obesity prevention program. Two hundred ten girls and parents participated in the program. Girls completed subscales of the McKnight Risk Factor Survey (MRFS) and body silhouette ratings, had height, weigh...
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Latino families who express a higher degree of familism are characterized by positive interpersonal familial relationships, high family unity, social support, interdependence in the completion of daily activities, and close proximity with extended family members. Retention of cultural values, such as familism, may be linked to positive health outco...
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To test whether high school students' participation in advocacy activities related to the advertising, availability, and use of tobacco in their communities would prevent or reduce their own tobacco use. Ten continuation high schools in northern California, randomly assigned to a semester-long program in which students either carried out advocacy a...
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This study explores whether asking minors about risky weight control behaviors and attitudes increases the frequency of those behaviors and attitudes. Participants were 115 sixth-grade girls who responded to questions on risky weight control behaviors and attitudes at baseline and at 12-month follow-up. An additional 107 girls, who had not been par...
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The purpose of this study was to evaluate the clinical correlates of agoraphobic fear and avoidance and panic disorder in a non-clinical sample of adolescents. In a sample of 2365 high school students, combined data from a questionnaire and a structured clinical interview were used to classify subjects with agoraphobic fear and avoidance. Panic sym...
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We monitored the emergence of major depression (MDD) during treatment for nicotine dependence among 224 smokers. MDD was assessed on three occasions during the course of treatment with the mood disorders portion of the Structured Clinical Interview for the Diagnostic and Statistical Manual of Mental Disorders (SCID), fourth edition (DSM-IV). Out of...
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Objective: This study examined the importance of potential risk factors for eating disorder onset in a large multiethnic sample followed for up to 3 years, with assessment instruments validated for the target population and a structured clinical interview used to make diagnoses. Method: Participants were 1,103 girls initially assessed in grades 6-9...
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To test the feasibility, acceptability, and potential efficacy of after-school dance classes and a family-based intervention to reduce television viewing, thereby reducing weight gain, among African-American girls. Twelve-week, 2-arm parallel group, randomized controlled trial. Low-income neighborhoods. Sixty-one 8-10-year-old African-American girl...
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This investigation sought to expand existing knowledge of anxiety sensitivity in a sample of high school students (N = 2,365) assessed over 4 years. The stability of anxiety sensitivity levels across assessment periods was examined, and cluster analyses were used to identify different developmental pathways in levels of anxiety sensitivity. Groups...
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Using data from 4 smoking cessation trials conducted from 1988 to 2000, the authors investigated whether men are more successful than women in quitting smoking. Odds ratios indicated that the abstinence rates were not significantly different for men and women. Thus, there may be little value to diverting research funds from efforts to develop more...
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Food insecurity is a critical variable for understanding the nutritional status of low-income populations. However, limited research is available on the relation between household food insecurity and children's nutritional status. Our objective was to examine the relations among household food insecurity, household food supplies, and school-age chi...
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Using data from 4 smoking cessation trials conducted from 1988 to 2000, the authors investigated whether men are more successful than women in quitting smoking. Odds ratios indicated that the abstinence rates were not significantly different for men and women. Thus, there may be little value to diverting research funds from efforts to develop more...
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Adding exercise to a comprehensive weight-loss program might not only attenuate any psychological distress associated with weight-loss attempts but also may provide psychological benefits. This study examined whether a diet-plus-exercise weight-loss program improved psychological outcomes more than a diet-only weight-loss program or an assessment-o...
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This study examined selection bias by comparing characteristics of a general population sample of tobacco chewers, participants in a chewing tobacco cessation trial, and non-participants in the trial. A population-based sample of chewers (n = 155) was surveyed by telephone to assess demographics, tobacco-use patterns, and quitting history. Six mont...
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We hypothesized that children's perceptions of more neighborhood hazards would be associated with less physical activity, less aerobic fitness, and a higher body mass index. To examine the association between a hazardous neighborhood context and physical activity in children. Fourth-grade students (n = 796) of diverse ethnic and economic background...
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This is the first controlled prospective study of the effects of nicotine deprivation in adolescent smokers. Heart rate and subjective withdrawal symptoms were measured over an 8-hr period while participants smoked normally. Seven days later, participants were randomized to wear a 15-mg (16-hr) nicotine patch or a placebo patch for 8 hr, and they r...
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To examine the prevalence of overweight concerns and body dissatisfaction among third-grade girls and boys and the influences of ethnicity and socioeconomic status (SES). Nine hundred sixty-nine children (mean age, 8.5 years) attending 13 northern California public elementary schools completed assessments of overweight concerns, body dissatisfactio...
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Smokers (N = 224) were randomized to 1 of 3 groups: (a) transdermal system (TNS) + placebo; (b) TNS + paroxetine (20 mg); (c) TNS + paroxetine (40 mg). Assignment to treatment was double-blind. Nicotine patch (TNS) treatment was provided for 8 weeks; paroxetine or placebo was provided for 9 weeks. Abstinence rates at Weeks 4, 10, and 26 were as fol...
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It is commonly believed that overweight children are unhappy with their weight. However, population-based data addressing this association are lacking. To evaluate the association between obesity and depressive symptoms in a diverse, school-based sample of preadolescent children, and to examine whether overweight concerns play a role in this associ...
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Background It is commonly believed that overweight children are unhappy with their weight. However, population-based data addressing this association are lacking.Objectives To evaluate the association between obesity and depressive symptoms in a diverse, school-based sample of preadolescent children, and to examine whether overweight concerns pla...
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This study examined data from a 4-year school-based longitudinal study (n = 1,124), to test whether the increase in major depression that occurs among girls during adolescence may be partially explained by the body-image and eating disturbances that emerge after puberty. Elevated body dissatisfaction, dietary restraint, and bulimic symptoms at stud...
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To identify risk factors for onset of panic attacks in adolescents, a prospective cohort design was used to evaluate the following risk factors: negative affectivity, female sex, anxiety sensitivity, and childhood separation anxiety disorder. These risk factors were also evaluated for predicting onset of major depression to test their specificity....
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To examine the relationship between use of electronic media and perceived importance of appearance and weight concerns among adolescent girls. Physical measures and self-report surveys were obtained from 837 ninth-grade girls attending pubs lic high schools in San Jose, California (mean age = 14.9 +/- 0.47 years; 36% Latino, 24% White, 22% Asian, 8...
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This study examined the prospective relations of naturalistic weight-reduction efforts to growth in relative weight and onset of obesity with data from a community study of female adolescents (N = 692). Initial self-labeled dieting, appetite suppressant/laxative use, incidental exercise, vomiting for weight-control purposes, and binge eating predic...
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The authors examined the efficacy of transdermal nicotine replacement for cessation in 410 adult nonsmoking chewing tobacco users. Participants were randomly assigned to 6 weeks of 15-mg nicotine patch plus behavioral treatment or placebo patch plus behavioral treatment. All participants received the same behavioral treatment of 2 pharmacy visits,...
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Heavy smokers (N = 408, smoking more than 25 cigarettes/day) were randomized to receive high-dose (25 mg) or standard-dose (15 mg) nicotine patch therapy delivered during the daytime only (16 hr) for a period of 6 weeks. Treatment effects of each dose were similar. The percentages of participants not smoking at 2-, 6-, and 12-month follow-ups were...
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To describe the development, test-retest reliability, internal consistency, and convergent validity of the McKnight Risk Factor Survey-III (MRFS-III). The MRFS-III was designed to assess a number of potential risk and protective factors for the development of disordered eating in preadolescent and adolescent girls. Several versions of the MRFS were...
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Objective To describe the development, test-retest reliability, internal consistency, and convergent validity of the McKnight Risk Factor Survey-III (MRFS-III). The MRFS-III was designed to assess a number of potential risk and protective factors for the development of disordered eating in preadolescent and adolescent girls.Method Several versions...
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This study was undertaken to evaluate the long-term smoking cessation efficacy of varying doses of transdermal nicotine delivery systems 4 to 5 years post-quit day. A follow-up study was conducted 48 to 62 months after quit day among patients who were enrolled in the Transdermal Nicotine Study Group investigation. The latter study included group sm...
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We examine the relation between acculturation and eating disorder symptoms in a normative sample of 920 adolescent girls of high school age. Results indicate that acculturation is positively associated with structured-interview defined partial syndrome eating disorders in Hispanic girls (13.6% vs. 0% prevalence rate in more acculturated vs. less ac...
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Behavioral inhibition in children has been hypothesized to be a risk factor for the later development of social phobia. However, this hypothesis has yet to be demonstrated in a prospective study. The purpose of the study presented here is to test whether behavioral inhibition in childhood constitutes a risk factor for social phobia during adolescen...
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Alcohol use is frequently portrayed in television programming and advertising. Exposure to media portrayals of alcohol use may lead to increased drinking. To address this issue, we examined prospectively the associations between media exposure and alcohol use in adolescents. Prospective cohort study. Setting. Six public high schools in San Jose, Ca...
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This prospective study examined age of onset for binge eating and purging among girls during late adolescence and tested whether dieting and negative affectivity predicted these outcomes. Of initially asymptomatic adolescents, 5% reported onset of objective binge eating, 4% reported onset of subjective binge eating, and 4% reported onset of purging...
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This prospective study examined age of onset for binge eating and purging among girls during late adolescence and tested whether dieting and negative affectivity predicted these outcomes. Of initially asymptomatic adolescents, 5% reported onset of objective binge eating, 4% reported onset of subjective binge eating, and 4% reported onset of purging...
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There has been debate as to whether bulimia represents the endpoint of an eating disorder continuum (the continuity hypothesis) or is categorically different from subthreshold bulimia or an absence of eating disorders (the discontinuity hypothesis). The present study tested whether differences among bulimic, subthreshold bulimic, and control women...
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This study examined factors that influence youth participation in heart disease prevention activities among 2,609 ninth graders in six inner-city public high schools. Constructs derived from social cognitive, empowerment, and community development theories informed the conceptual framework employed. Study participants were diverse with respect to g...
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This study examined the association of weight concerns with potential risk factors for the development of eating disorders. A self-report survey was given to 103 elementary (Grades 4 and 5) and 420 middle (Grades 6-8) school students in Arizona and California. Of these, 78 elementary and 333 middle school students provided complete data and were us...
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Signal detection methods were used to identify predictors of successful weight loss in 177 mildly to moderately overweight women and men assigned to one of two weight-loss programs. Predictors included initial demographic, physiological, behavioral, and psychosocial characteristics, and program type (e.g. diet-only and diet-plus-exercise). Successf...
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The purpose of this study was to assess the association between attachment style and weight concerns, a major risk factor for eating disorders, in preadolescent and adolescent girls. Three hundred and five female elementary and middle school students completed measures of attachment style and weight concerns. Insecurely attached subjects reported h...
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To assess nicotine dependence among adolescents to determine whether quitting smoking is associated with the emergence of nicotine withdrawal symptoms and craving, and to identify the factors associated with these symptoms. Cross-sectional survey. We studied 2197 10th-grade students in 6 San Jose, Calif, high schools. Smoking status; history of qui...
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Objective The purpose of this study was to assess the association between attachment style and weight concerns, a major risk factor for eating disorders, in preadolescent and adolescent girls. Method: Three hundred and five female elementary and middle school students completed measures of attachment style and weight concerns. Results: Insecurely a...
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Risk factors for the initiation of cigarette smoking were examined in 2 consecutive cohorts of teenagers (N = 1,901). Students in Cohort 1 were followed over 4 years from 9th to 12th grade; those in Cohort 2 were followed over 3 years from 9th to 11th grade. Among girls with no history of smoking at baseline, those with more friends who smoked at b...
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A total of 424 smokers were randomized in a 2 x 2 factorial experiment. A pharmacologic factor contained 2 levels: transdermal nicotine path (TNP; 21 mg) and placebo. A self-help behavioral treatment factor contained 2 levels: video-enhanced self-help treatment manual and self-help treatment manual only. At 2 months, TNP produced a higher level of...
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In a combined sample of more than 2600 smokers, immediate postcessation craving is shown to be prospectively associated with smokers' ability to maintain abstinence. Relapse is strikingly rapid among those reporting high levels of craving following cessation. More than 32% of those with high craving scores relapsed within 1 week of cessation. In co...
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To examine the association between adolescents knowledge of cigarette warning labels and actual smoking behavior. Cohort analytic study. Four public high schools in northern California. Seventeen hundred forty-seven ninth graders (mean age, 14.9 years). Students from 2 of the schools (n = 803) were observed for approximately 3 months. Self-reported...
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Recent reviews of studies concerning panic attacks in adolescents have emphasized research limitations, noting problems of validity, reliability, and lack of normative data. To address some of these limitations we evaluated two methods of panic ascertainment (questionnaire versus interview), reliability of interview-determined panic, and clinical c...
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This study prospectively evaluated the relationship between early puberty and the onset of internalizing symptoms and disorders in adolescent girls. The sample was drawn from 1,463 sixth-, seventh-, and eighth-grade girls who participated in a longitudinal school-based study of growth and development. Pubertal stage was determined by self-assessmen...