Dialectical behavior therapy (DBT) was developed for treatment of borderline personality disorder... more Dialectical behavior therapy (DBT) was developed for treatment of borderline personality disorder (BPD), and adapted forms of DBT are currently used to treat bipolar disorder, eating disorders, anxiety, and depression. This study was designed to validate the Dialectical Behavior Therapy Ways of Coping Checklist (DBT-WCCL) DBT Skills subscale (DSS) for use in a diagnostically heterogeneous sample. We used naturalistic data from 228 patients receiving treatment at a partial hospital program to assess psychometric properties of the DBT-WCCL DSS. We assessed interitem correlations, internal consistency, factor structure, construct validity and sensitivity to change. Internal consistency, construct validity, and sensitivity to change were good. The measure displayed good convergent and discriminant validity. Factor analysis results were consistent with previous research indicating a 1-factor solution for this subscale. Psychometric properties were similar to the original BPD sample, indi...
Individuals with psychotic disorders are at increased risk for suicidality. Demographic and clini... more Individuals with psychotic disorders are at increased risk for suicidality. Demographic and clinical characteristics were compared in individuals with psychotic disorders reporting either high or low suicidality. Among this sample of 259 partial hospital patients, 116 (44.8%) were classified as high risk on the suicidality section of the Mini Neuropsychiatric Interview, and 143 (55.2%) were considered low risk. Bivariate analyses revealed that patients classified as high risk demonstrated greater depression severity, more relationship difficulties, greater emotional lability, and more substance use problems. A logistic regression model indicated that substance use was the most powerful predictor of higher levels of suicidality. Monitoring and intervention for substance use should be targeted as a particularly important aspect of treatment for acutely ill patients diagnosed with psychotic disorders.
Abstract Treatment outcome studies for social anxiety disorder have provided consistent evidence ... more Abstract Treatment outcome studies for social anxiety disorder have provided consistent evidence for the efficacy of two modalities of treatment: cognitive behavioral therapy (CBT) and pharmacotherapy. Comparison-treatment studies, as well as a meta-analytic review of the treatment outcome literature suggest that, on average, these treatment modalities provide equivalent outcome.
Background and ObjectivesEarly dropout is common in substance abuse treatment settings and may le... more Background and ObjectivesEarly dropout is common in substance abuse treatment settings and may lead to poorer outcomes relative to those completing a full course of treatment. Attempts to identify predictors of dropout have yielded mixed results, highlighting the need for additional research in this area to clarify risk and protective factors to guide intervention and retention efforts. This study evaluated predictors of dropout from psychosocial treatment among opioid‐dependent patients on methadone maintenance therapy.MethodsParticipants included 78 patients who had failed to respond to at least 4 months of methadone maintenance plus group counseling with clinic substance abuse counselors, and were enrolled in a study of randomized psychosocial treatment in addition to treatment‐as‐usual. Several factors that have been implicated in previous studies as well as two affective variables (distress intolerance and coping motives for drug use) were examined.ResultsResults indicated that...
Individuals with elevated levels of anxiety sensitivity (AS) may be motivated to avoid aversive e... more Individuals with elevated levels of anxiety sensitivity (AS) may be motivated to avoid aversive emotional or physical states, and therefore may have greater difficulty achieving healthy behavioral change. This may be particularly true for exercise, which produces many of the somatic sensations within the domain of AS concerns. Cross-sectional studies show a negative association between AS and exercise. However, little is known about how AS may prospectively affect attempts at behavior change in individuals who are motivated to increase their exercise. We recruited 145 young adults who self-identified as having a desire to increase their exercise behavior. Participants completed a web survey assessing AS and additional variables identified as important for behavior change-impulsivity, grit, perceived behavioral control, and action planning-and set a specific goal for exercising in the next week. One week later, a second survey assessed participants' success in meeting their exerc...
The American Journal of Drug and Alcohol Abuse, 2015
Abstract Background: Co-occurring drug use disorders are under-detected in psychiatrically ill po... more Abstract Background: Co-occurring drug use disorders are under-detected in psychiatrically ill populations highlighting the need for more efficient screening tools. This study compares a single-item screening tool, previously validated in a primary care setting, to the 10-item Drug Abuse Screening Test (DAST-10) for identifying co-occurring drug use disorders among patients with severe psychiatric illness. A total of 395 patients attending a psychiatric partial hospital program completed both the single-item screen and DAST-10. A subsample of consecutive patients (n = 67) was also administered the Structure Clinical Interview for DSM-IV (SCID-IV) as a diagnostic reference standard. Concordance between screening measures was moderate (κ = 0.4, p < 0.01). Sensitivity and specificity of the single-item screen and DAST-10 as compared to the SCID-IV were comparable, while area under the receiver operating curve showed better discriminatory power for the identification of drug use disorders with the single-item screen. In comparison to the DAST-10, the single-item screen appears to be a more efficient tool to identify co-occurring drug use disorders in a psychiatric treatment setting among patients with a range of psychiatric diagnoses.
Compensatory eating in response to exercise may be an obstacle to achieving weight-loss and fitne... more Compensatory eating in response to exercise may be an obstacle to achieving weight-loss and fitness goals. In this study we develop and conduct a preliminary examination of the psychometric properties of the Compensatory Eating Motives Questionnaire (CEMQ), a self-report questionnaire of motives for compensatory eating. Development and testing of the CEMQ was conducted in two student samples. Of respondents, 75% reported engaging in compensatory eating. Factor analysis yielded factors representing three domains of motives for compensatory eating: Eating for Reward, Eating for Recovery, and Eating for Relief. Internal consistency of the factors was adequate, and the factor structure was replicated. Correlations between the CEMQ subscales and trait questionnaires supported hypotheses for convergent and divergent validity. These results encourage further investigation of compensatory eating as a potential obstacle to weight loss, and support the continued assessment of the CEMQ as a tool to measure three conceptually distinct motives for compensatory eating.
Investigations in both alcohol and smoking have provided preliminary evidence for the use of atte... more Investigations in both alcohol and smoking have provided preliminary evidence for the use of attentional training interventions to reduce vigilance toward salient drug cues. The current study evaluated the efficacy of an attentional training intervention for reducing attentional bias toward smoking cues and craving among cigarette smokers. Participants were randomized to receive an attentional training intervention or a control training. Sixty-four regular cigarette smokers (individuals smoking at least 10 cigarettes/day for at least 1 year) provided informed consent and were enrolled in the study. The dot probe paradigm was used both to measure attentional bias and for the training intervention. Attentional bias and craving were measured prior to and following training. Results indicated that the randomized groups did not differ significantly in attentional bias as measured by novel stimuli and, correspondingly, in craving response to relevant cues following the training intervention. These results for a single-session training suggest that this "dose" is insufficient for reducing attentional bias. Given the success of this intervention in other applications, research on the efficacy of multiple-session trainings is an important area for further study.
Dialectical behavior therapy (DBT) was developed for treatment of borderline personality disorder... more Dialectical behavior therapy (DBT) was developed for treatment of borderline personality disorder (BPD), and adapted forms of DBT are currently used to treat bipolar disorder, eating disorders, anxiety, and depression. This study was designed to validate the Dialectical Behavior Therapy Ways of Coping Checklist (DBT-WCCL) DBT Skills subscale (DSS) for use in a diagnostically heterogeneous sample. We used naturalistic data from 228 patients receiving treatment at a partial hospital program to assess psychometric properties of the DBT-WCCL DSS. We assessed interitem correlations, internal consistency, factor structure, construct validity and sensitivity to change. Internal consistency, construct validity, and sensitivity to change were good. The measure displayed good convergent and discriminant validity. Factor analysis results were consistent with previous research indicating a 1-factor solution for this subscale. Psychometric properties were similar to the original BPD sample, indi...
Individuals with psychotic disorders are at increased risk for suicidality. Demographic and clini... more Individuals with psychotic disorders are at increased risk for suicidality. Demographic and clinical characteristics were compared in individuals with psychotic disorders reporting either high or low suicidality. Among this sample of 259 partial hospital patients, 116 (44.8%) were classified as high risk on the suicidality section of the Mini Neuropsychiatric Interview, and 143 (55.2%) were considered low risk. Bivariate analyses revealed that patients classified as high risk demonstrated greater depression severity, more relationship difficulties, greater emotional lability, and more substance use problems. A logistic regression model indicated that substance use was the most powerful predictor of higher levels of suicidality. Monitoring and intervention for substance use should be targeted as a particularly important aspect of treatment for acutely ill patients diagnosed with psychotic disorders.
Abstract Treatment outcome studies for social anxiety disorder have provided consistent evidence ... more Abstract Treatment outcome studies for social anxiety disorder have provided consistent evidence for the efficacy of two modalities of treatment: cognitive behavioral therapy (CBT) and pharmacotherapy. Comparison-treatment studies, as well as a meta-analytic review of the treatment outcome literature suggest that, on average, these treatment modalities provide equivalent outcome.
Background and ObjectivesEarly dropout is common in substance abuse treatment settings and may le... more Background and ObjectivesEarly dropout is common in substance abuse treatment settings and may lead to poorer outcomes relative to those completing a full course of treatment. Attempts to identify predictors of dropout have yielded mixed results, highlighting the need for additional research in this area to clarify risk and protective factors to guide intervention and retention efforts. This study evaluated predictors of dropout from psychosocial treatment among opioid‐dependent patients on methadone maintenance therapy.MethodsParticipants included 78 patients who had failed to respond to at least 4 months of methadone maintenance plus group counseling with clinic substance abuse counselors, and were enrolled in a study of randomized psychosocial treatment in addition to treatment‐as‐usual. Several factors that have been implicated in previous studies as well as two affective variables (distress intolerance and coping motives for drug use) were examined.ResultsResults indicated that...
Individuals with elevated levels of anxiety sensitivity (AS) may be motivated to avoid aversive e... more Individuals with elevated levels of anxiety sensitivity (AS) may be motivated to avoid aversive emotional or physical states, and therefore may have greater difficulty achieving healthy behavioral change. This may be particularly true for exercise, which produces many of the somatic sensations within the domain of AS concerns. Cross-sectional studies show a negative association between AS and exercise. However, little is known about how AS may prospectively affect attempts at behavior change in individuals who are motivated to increase their exercise. We recruited 145 young adults who self-identified as having a desire to increase their exercise behavior. Participants completed a web survey assessing AS and additional variables identified as important for behavior change-impulsivity, grit, perceived behavioral control, and action planning-and set a specific goal for exercising in the next week. One week later, a second survey assessed participants' success in meeting their exerc...
The American Journal of Drug and Alcohol Abuse, 2015
Abstract Background: Co-occurring drug use disorders are under-detected in psychiatrically ill po... more Abstract Background: Co-occurring drug use disorders are under-detected in psychiatrically ill populations highlighting the need for more efficient screening tools. This study compares a single-item screening tool, previously validated in a primary care setting, to the 10-item Drug Abuse Screening Test (DAST-10) for identifying co-occurring drug use disorders among patients with severe psychiatric illness. A total of 395 patients attending a psychiatric partial hospital program completed both the single-item screen and DAST-10. A subsample of consecutive patients (n = 67) was also administered the Structure Clinical Interview for DSM-IV (SCID-IV) as a diagnostic reference standard. Concordance between screening measures was moderate (κ = 0.4, p < 0.01). Sensitivity and specificity of the single-item screen and DAST-10 as compared to the SCID-IV were comparable, while area under the receiver operating curve showed better discriminatory power for the identification of drug use disorders with the single-item screen. In comparison to the DAST-10, the single-item screen appears to be a more efficient tool to identify co-occurring drug use disorders in a psychiatric treatment setting among patients with a range of psychiatric diagnoses.
Compensatory eating in response to exercise may be an obstacle to achieving weight-loss and fitne... more Compensatory eating in response to exercise may be an obstacle to achieving weight-loss and fitness goals. In this study we develop and conduct a preliminary examination of the psychometric properties of the Compensatory Eating Motives Questionnaire (CEMQ), a self-report questionnaire of motives for compensatory eating. Development and testing of the CEMQ was conducted in two student samples. Of respondents, 75% reported engaging in compensatory eating. Factor analysis yielded factors representing three domains of motives for compensatory eating: Eating for Reward, Eating for Recovery, and Eating for Relief. Internal consistency of the factors was adequate, and the factor structure was replicated. Correlations between the CEMQ subscales and trait questionnaires supported hypotheses for convergent and divergent validity. These results encourage further investigation of compensatory eating as a potential obstacle to weight loss, and support the continued assessment of the CEMQ as a tool to measure three conceptually distinct motives for compensatory eating.
Investigations in both alcohol and smoking have provided preliminary evidence for the use of atte... more Investigations in both alcohol and smoking have provided preliminary evidence for the use of attentional training interventions to reduce vigilance toward salient drug cues. The current study evaluated the efficacy of an attentional training intervention for reducing attentional bias toward smoking cues and craving among cigarette smokers. Participants were randomized to receive an attentional training intervention or a control training. Sixty-four regular cigarette smokers (individuals smoking at least 10 cigarettes/day for at least 1 year) provided informed consent and were enrolled in the study. The dot probe paradigm was used both to measure attentional bias and for the training intervention. Attentional bias and craving were measured prior to and following training. Results indicated that the randomized groups did not differ significantly in attentional bias as measured by novel stimuli and, correspondingly, in craving response to relevant cues following the training intervention. These results for a single-session training suggest that this "dose" is insufficient for reducing attentional bias. Given the success of this intervention in other applications, research on the efficacy of multiple-session trainings is an important area for further study.
Uploads
Papers by Bridget Hearon