Journal of Consulting and Clinical Psychology, 2014
Objective: Each year, thousands of college students receive mandated intervention as a sanction f... more Objective: Each year, thousands of college students receive mandated intervention as a sanction for alcohol use or alcohol-related behavior. For these mandated students, brief motivational interventions (BMIs) are currently the most efficacious individual intervention. However, little is known about how the technical (therapist behaviors) and relational (e.g., global ratings of therapist empathy) components of BMIs influence client language as well as subsequent change in alcohol use and consequences. Method: This study used the Motivational Interviewing Skills Code (MISC 2.0; Miller, Moyers, Ernst, & Amrhein, 2003) to code BMI sessions from 2 randomized clinical trials that facilitated significant reductions in alcohol use (Study 1, n = 91) and alcohol-related consequences (Study 2, n = 158) in mandated students. Results: There were significant relationships among therapist behaviors, global scores, and client language both for and against change, yet there were no links between in-session client language and subsequent changes in alcohol use or problems. In contrast, relational aspects of motivational interviewing (MI; global ratings of therapist MI Spirit and client self-exploration) were most predictive of postsession alcohol use. Mediation models incorporating both technical and relational components revealed that higher levels of client self-exploration mediated the relationship between higher therapist ratings of MI Spirit and reduced drinking at follow-up. Conclusions: Findings highlight the importance of considering how both technical and relational components of MI may influence alcohol use in mandated college students and also suggest more exact analyses to better understand this complex relationship. (PsycINFO Database Record (c) 2014 APA, all rights reserved).
Journal of consulting and clinical psychology, 2016
Students referred to school administration for alcohol policies violations currently receive a wi... more Students referred to school administration for alcohol policies violations currently receive a wide variety of interventions. This study examined predictors of response to 2 interventions delivered to mandated college students (N = 598) using a stepped care approach incorporating a peer-delivered 15-min brief advice (BA) session (Step 1) and a 60- to 90-min brief motivational intervention (BMI) delivered by trained interventionists (Step 2). Analyses were completed in 2 stages. First, 3 types of variables (screening variables, alcohol-related cognitions, mandated student profile) were examined in a logistic regression model as putative predictors of lower risk drinking (defined as 3 or fewer heavy episodic drinking [HED] episodes and/or 4 or fewer alcohol-related consequences in the past month) 6 weeks following the BA session. Second, we used generalized estimating equations to examine putative moderators of BMI effects on HED and peak blood alcohol content compared with assessment...
Alcoholism, clinical and experimental research, 2016
Sex-related alcohol expectancies reflect the degree to which a person believes alcohol will affec... more Sex-related alcohol expectancies reflect the degree to which a person believes alcohol will affect her or his sexual behavior. Sex-related alcohol expectancies have been found to be predictors of drinking in sexual situations and engagement in risky sexual behavior after drinking. However, less is known about individual characteristics that may moderate these associations. Building upon recent evidence that steep delay discounting is associated with alcohol-related sexual risk taking, this study aimed to test the hypothesis that the associations between sex-related alcohol expectancies and alcohol-related sexual risk taking would be stronger among individuals who discount delayed rewards more steeply. The current sample comprised 126 Emergency Department patients (Mage = 27.37; 55% male) who reported high-risk alcohol use and sexual behavior during the past 3 months. Sex-related alcohol expectancies were assessed in 3 behavioral domains: increased riskiness, decreased nervousness, ...
Journal of Studies on Alcohol and Drugs, Mar 1, 2015
Although there is a clear association between early use of alcohol and short- and long-term adver... more Although there is a clear association between early use of alcohol and short- and long-term adverse outcomes, it is unclear whether consumption of minor amounts of alcohol (less than a full drink) at a young age is prognostic of risk behaviors in later adolescence. Data were taken from 561 students enrolled in an ongoing prospective web-based study on alcohol initiation and progression (55% female; 25% White non-Hispanic). Based on a combination of monthly and semiannual surveys, we coded whether participants sipped alcohol before sixth grade and examined associations between early sipping and alcohol consumption by fall of ninth grade, as well as other indices of problem behavior. Participants also reported on the context of the first sipping event. The prevalence of sipping alcohol by fall of sixth grade was 29.5%. Most participants indicated that their first sip took place at their own home, and the primary source of alcohol was an adult, usually a parent. Youth who sipped alcohol by sixth grade had significantly greater odds of consuming a full drink, getting drunk, and drinking heavily by ninth grade than nonsippers. These associations held even when we controlled for temperamental, behavioral, and environmental factors that contribute to proneness for problem behavior, which suggests that sipping is not simply a marker of underlying risk. Our findings that early sipping is associated with elevated odds of risky behaviors at high school entry dispute the idea of sipping as a protective factor. Offering even just a sip of alcohol may undermine messages about the unacceptability of alcohol consumption for youth. (J. Stud. Alcohol Drugs, 76, 212-221, 2015).
Cost-effectiveness of motivational intervention with significant others for patients with alcohol... more Cost-effectiveness of motivational intervention with significant others for patients with alcohol misuse AIMS: To estimate the incremental cost, cost-effectiveness, and benefit-cost ratio of incorporating a significant other (SO) into motivational intervention for alcohol misuse. We obtained economic data from the one year with the intervention in full operation for patients in a recent randomized trial. The underlying trial took place at a major urban hospital in the USA. The trial randomized 406 (68.7% male) eligible hazardous drinkers (196 during the economic study) admitted to the emergency department or trauma unit. The motivational interview condition consisted of one in-person session featuring personalized normative feedback. The significant other motivational interview condition comprised one joint session with the participant and SO in which the SO's perspective and support were elicited. We ascertained activities across 445 representative time segments through work sampling (including staff idle time), calculated the incremental cost in per patient of incorporating an SO, expressed the results in 2014 U.S. dollars, incorporated quality and mortality effects from a closely related trial, and derived the cost per quality-adjusted life year (QALY) gained. From a health system perspective, the incremental cost per patient of adding an SO was $341 [95% confidence interval (CI): $244 to $438]. The incremental cost per year per hazardous drinker averted was $3,623 (CI: $1,777 to $22,709), the cost per QALY gained $32,200 (CI: $15,800 to $201,700), and the benefit-cost ratio was 4.73 (95% CI: 0.75 to 9.66). If adding an SO into the intervention strategy were concentrated during the hours with highest risk or in the trauma unit, it would become even more cost-beneficial. Using criteria established by the World Health Organization (cost-effectiveness below the country's GDP per capita), incorporating a significant other into a patient's motivational intervention for alcohol misuse is highly cost effective.
Few prospective studies have evaluated theory-driven approaches to the implementation of evidence... more Few prospective studies have evaluated theory-driven approaches to the implementation of evidence-based opioid treatment. This study compared the effectiveness of an implementation model (Science to Service Laboratory; SSL) to training as usual (TAU) in promoting the adoption of contingency management across a multi-site opiate addiction treatment program. We also examined whether the SSL affected putative mediators of contingency management adoption (perceived innovation characteristics and organizational readiness to change). Sixty treatment providers (39 SSL, 21 TAU) from 15 geographically diverse satellite clinics (7 SSL, 8 TAU) participated in the 12-month study. Both conditions received didactic contingency management training and those in the pre-determined experimental region received 9 months of SSL-enhanced training. Contingency management adoption was monitored biweekly, while putative mediators were measured at baseline, 3-, and 12-months. Relative to providers in the TAU region, treatment providers in the SSL region had comparable likelihood of contingency management adoption in the first 20 weeks of the study, and then significantly higher likelihood of adoption (odds ratios = 2.4-13.5) for the remainder of the study. SSL providers also reported higher levels of one perceived innovation characteristic (Observability) and one aspect of organizational readiness to change (Adequacy of Training Resources), although there was no evidence that the SSL affected these putative mediators over time. Results of this study indicate that a fully powered randomized trial of the SSL is warranted. Considerations for a future evaluation are discussed.
The US HIV/AIDS epidemic is concentrated in the Deep South, yet factors contributing to HIV trans... more The US HIV/AIDS epidemic is concentrated in the Deep South, yet factors contributing to HIV transmission are not fully understood. We examined relationships between substance use, sexual partnership characteristics, and condom non-use in an African American sample of STI clinic attendees in Jackson, Mississippi. We assessed condom non-use at last intercourse with up to three recent sexual partners reported by participants between January and June 2011. Participant- and partner-level correlates of condom non-use were examined using generalized estimating equations. The 1295 participants reported 2880 intercourse events, of which 1490 (51.7 %) involved condom non-use. Older age, lower educational attainment, reporting financial or material dependence on a sex partner, sex with a primary partner, and higher frequency of sex were associated with increased odds of condomless sex. HIV prevention efforts in the South should address underlying socioeconomic disparities and structural determ...
Patients treated in an urban emergency department were studied to determine if college status, ge... more Patients treated in an urban emergency department were studied to determine if college status, gender and having alcohol as a reason for medical treatment were related to alcohol use and related problem behaviors. Patients ages 18-19 years (N = 250; 55% men) who had or had not been drinking alcohol prior to the event that precipitated their medical treatment were assessed on their alcohol use, alcohol-related problems and drug use. There were high levels of alcohol use, tobacco use and other drug use in the sample, regardless of the reason for medical treatment. Analyses consistently showed that patients treated for alcohol-related reasons had more severe drinking patterns and problems than patients who were alcohol negative. Patients not enrolled in college showed similar patterns of alcohol consumption as their college-attending peers, but bad more severe alcohol-related behaviors and problems. Few gender differences were found and no interactions were found between gender, alcohol status and college status. Findings indicate that older adolescents who receive medical treatment for alcohol use are not inexperienced drinkers. Furthermore, in this convenience sample, college students did not appear to be at greater risk for substance use or problems. Findings underscore the potential usefulness of alcohol intervention programs for alcohol-involved medical patients, and the need to attend to the alcohol and drug use of nonstudent populations.
Journal of Studies on Alcohol and Drugs, Sep 1, 2008
Objective:Most colleges have sanctions or required interventions for students who receive alcohol... more Objective:Most colleges have sanctions or required interventions for students who receive alcohol violations or medical evaluation for intoxication. The aim of this study was to establish profiles of mandated students from a combined data set using exploratory and replication cluster analysis.Method:Data sets from three samples of mandated students (total participant n = 393) were combined for exploratory analyses, and a fourth sample (n = 289) was analyzed for replication. Clustering variables were past-month heavy drinking, past-year alcohol problems, incident alcohol use, responsibility for the incident, and aversiveness of the incident.Results:A three-cluster solution was produced in the exploratory analysis and confirmed in replication and cross-replication analyses. Clusters formed included a “Why Me?” cluster characterized by a pattern of relatively low heavy drinking and alcohol-related problems, very little incident drinking, and low responsibility and aversiveness. A “So What?” cluster was characterized by high heavy drinking and alcohol-related problems, moderate incident drinking and responsibility, and low aversiveness. A “Bad Incident” cluster was characterized by low scores for heavy drinking and problems and high levels of incident drinking, responsibility, and aversiveness. External variables supported the validity of the cluster solution.Conclusions:Mandated students form clinically meaningful profiles on easily measured constructs.
Http Dx Doi Org 10 1300 J029v16n02_06, Sep 21, 2008
The purpose of this study was to evaluate a brief version of the Alcohol Expectancy Questionnaire... more The purpose of this study was to evaluate a brief version of the Alcohol Expectancy Questionnaire-Adolescent (AEQ-A; Brown, Christiansen, & Goldman, 1987). The original AEQ-A was reduced to seven items (called the AEQ-AB). Principal Components Analysis (PCA) was performed and two factors emerged (General Positive Effects and Potential Negative Effects) accounting for 46% of the variance. Internal consistencies are comparable to those of the original AEQ-A (0.50). Scales correlate with criterion variables such as average drinks per week and average number of drinks per heavy drinking day (p < 0.05). It is concluded that this questionnaire may be useful to clinicians providing brief assessment and intervention. Cross-validation in other samples and other settings is recommended.
There were two specific goals for the current study: (1) to demonstrate that adolescents display ... more There were two specific goals for the current study: (1) to demonstrate that adolescents display drug-specific cue reactivity to alcohol and cigarette visual cues that varies based on drug-use history and (2) to test the unique contribution of adolescents' avoidance reactions to alcohol and cigarette cues, independent of approach/craving reaction. Adolescents (N = 143; age 13-20 years; 58 males) with varied substance-use histories were recruited from school and community sites. Adolescents were presented with a series of alcohol, cigarette, and nondrug comparison visual cues and reported their approach/craving and avoidance reactions. They also completed individual difference measures related to their alcohol and cigarette use and experiences. When adolescents were grouped according to their current alcohol or cigarette use (no use, low use, high use), increased use of alcohol or cigarettes was associated with stronger reactions (increased approach, decreased avoidance) to cues for that substance but not to nondrug control cues. Simultaneous regression analyses demonstrated that after controlling for approach/craving reactions, avoidance cue reactions predicted unique and/or incremental variance in measures of alcohol and cigarette usage, recent change in patterns of use, alcohol expectancies, alcohol restraint and parental alcohol problems. Adolescents displayed robust alcohol and cigarette cue-specific reactions that varied systematically with their current use of these drugs. Across numerous clinically relevant individual difference variables, predictive power was greatly enhanced through the inclusion of both avoidance and approach reactions.
To identify individual therapist behaviors which elicit client change talk or sustain talk in mot... more To identify individual therapist behaviors which elicit client change talk or sustain talk in motivational interviewing sessions. Motivational interviewing sessions from a single-session alcohol intervention delivered to college students were audio-taped, transcribed, and coded using the Motivational Interviewing Skill Code (MISC), a therapy process coding system. Participants included 92 college students and eight therapists who provided their treatment. The MISC was used to code 17 therapist behaviors related to the use of motivational interviewing, and client language reflecting movement toward behavior change (change talk), away from behavior change (sustain talk), or unrelated to the target behavior (follow/neutral). Client change talk was significantly more likely to immediately follow individual therapist behaviors [affirm (p=.013), open question (p<.001), simple reflection (p<.001), and complex reflection (p<.001)], but significantly less likely to immediately follow others (giving information (p<.001) and closed question (p<.001)]. Sustain talk was significantly more likely to follow therapist use of open questions (p<.001), simple reflections (p<.001), and complex reflections (p<.001), and significantly less likely to occur following therapist use of therapist affirm (p=.012), giving information (p<.001), and closed questions (p<.001). Certain individual therapist behaviors within motivational interviewing can either elicit both client change talk and sustain talk or suppress both types of client language. Affirm was the only therapist behavior that both increased change talk and also reduced sustain talk.
Journal of Consulting and Clinical Psychology, 2014
Objective: Each year, thousands of college students receive mandated intervention as a sanction f... more Objective: Each year, thousands of college students receive mandated intervention as a sanction for alcohol use or alcohol-related behavior. For these mandated students, brief motivational interventions (BMIs) are currently the most efficacious individual intervention. However, little is known about how the technical (therapist behaviors) and relational (e.g., global ratings of therapist empathy) components of BMIs influence client language as well as subsequent change in alcohol use and consequences. Method: This study used the Motivational Interviewing Skills Code (MISC 2.0; Miller, Moyers, Ernst, & Amrhein, 2003) to code BMI sessions from 2 randomized clinical trials that facilitated significant reductions in alcohol use (Study 1, n = 91) and alcohol-related consequences (Study 2, n = 158) in mandated students. Results: There were significant relationships among therapist behaviors, global scores, and client language both for and against change, yet there were no links between in-session client language and subsequent changes in alcohol use or problems. In contrast, relational aspects of motivational interviewing (MI; global ratings of therapist MI Spirit and client self-exploration) were most predictive of postsession alcohol use. Mediation models incorporating both technical and relational components revealed that higher levels of client self-exploration mediated the relationship between higher therapist ratings of MI Spirit and reduced drinking at follow-up. Conclusions: Findings highlight the importance of considering how both technical and relational components of MI may influence alcohol use in mandated college students and also suggest more exact analyses to better understand this complex relationship. (PsycINFO Database Record (c) 2014 APA, all rights reserved).
Journal of consulting and clinical psychology, 2016
Students referred to school administration for alcohol policies violations currently receive a wi... more Students referred to school administration for alcohol policies violations currently receive a wide variety of interventions. This study examined predictors of response to 2 interventions delivered to mandated college students (N = 598) using a stepped care approach incorporating a peer-delivered 15-min brief advice (BA) session (Step 1) and a 60- to 90-min brief motivational intervention (BMI) delivered by trained interventionists (Step 2). Analyses were completed in 2 stages. First, 3 types of variables (screening variables, alcohol-related cognitions, mandated student profile) were examined in a logistic regression model as putative predictors of lower risk drinking (defined as 3 or fewer heavy episodic drinking [HED] episodes and/or 4 or fewer alcohol-related consequences in the past month) 6 weeks following the BA session. Second, we used generalized estimating equations to examine putative moderators of BMI effects on HED and peak blood alcohol content compared with assessment...
Alcoholism, clinical and experimental research, 2016
Sex-related alcohol expectancies reflect the degree to which a person believes alcohol will affec... more Sex-related alcohol expectancies reflect the degree to which a person believes alcohol will affect her or his sexual behavior. Sex-related alcohol expectancies have been found to be predictors of drinking in sexual situations and engagement in risky sexual behavior after drinking. However, less is known about individual characteristics that may moderate these associations. Building upon recent evidence that steep delay discounting is associated with alcohol-related sexual risk taking, this study aimed to test the hypothesis that the associations between sex-related alcohol expectancies and alcohol-related sexual risk taking would be stronger among individuals who discount delayed rewards more steeply. The current sample comprised 126 Emergency Department patients (Mage = 27.37; 55% male) who reported high-risk alcohol use and sexual behavior during the past 3 months. Sex-related alcohol expectancies were assessed in 3 behavioral domains: increased riskiness, decreased nervousness, ...
Journal of Studies on Alcohol and Drugs, Mar 1, 2015
Although there is a clear association between early use of alcohol and short- and long-term adver... more Although there is a clear association between early use of alcohol and short- and long-term adverse outcomes, it is unclear whether consumption of minor amounts of alcohol (less than a full drink) at a young age is prognostic of risk behaviors in later adolescence. Data were taken from 561 students enrolled in an ongoing prospective web-based study on alcohol initiation and progression (55% female; 25% White non-Hispanic). Based on a combination of monthly and semiannual surveys, we coded whether participants sipped alcohol before sixth grade and examined associations between early sipping and alcohol consumption by fall of ninth grade, as well as other indices of problem behavior. Participants also reported on the context of the first sipping event. The prevalence of sipping alcohol by fall of sixth grade was 29.5%. Most participants indicated that their first sip took place at their own home, and the primary source of alcohol was an adult, usually a parent. Youth who sipped alcohol by sixth grade had significantly greater odds of consuming a full drink, getting drunk, and drinking heavily by ninth grade than nonsippers. These associations held even when we controlled for temperamental, behavioral, and environmental factors that contribute to proneness for problem behavior, which suggests that sipping is not simply a marker of underlying risk. Our findings that early sipping is associated with elevated odds of risky behaviors at high school entry dispute the idea of sipping as a protective factor. Offering even just a sip of alcohol may undermine messages about the unacceptability of alcohol consumption for youth. (J. Stud. Alcohol Drugs, 76, 212-221, 2015).
Cost-effectiveness of motivational intervention with significant others for patients with alcohol... more Cost-effectiveness of motivational intervention with significant others for patients with alcohol misuse AIMS: To estimate the incremental cost, cost-effectiveness, and benefit-cost ratio of incorporating a significant other (SO) into motivational intervention for alcohol misuse. We obtained economic data from the one year with the intervention in full operation for patients in a recent randomized trial. The underlying trial took place at a major urban hospital in the USA. The trial randomized 406 (68.7% male) eligible hazardous drinkers (196 during the economic study) admitted to the emergency department or trauma unit. The motivational interview condition consisted of one in-person session featuring personalized normative feedback. The significant other motivational interview condition comprised one joint session with the participant and SO in which the SO's perspective and support were elicited. We ascertained activities across 445 representative time segments through work sampling (including staff idle time), calculated the incremental cost in per patient of incorporating an SO, expressed the results in 2014 U.S. dollars, incorporated quality and mortality effects from a closely related trial, and derived the cost per quality-adjusted life year (QALY) gained. From a health system perspective, the incremental cost per patient of adding an SO was $341 [95% confidence interval (CI): $244 to $438]. The incremental cost per year per hazardous drinker averted was $3,623 (CI: $1,777 to $22,709), the cost per QALY gained $32,200 (CI: $15,800 to $201,700), and the benefit-cost ratio was 4.73 (95% CI: 0.75 to 9.66). If adding an SO into the intervention strategy were concentrated during the hours with highest risk or in the trauma unit, it would become even more cost-beneficial. Using criteria established by the World Health Organization (cost-effectiveness below the country's GDP per capita), incorporating a significant other into a patient's motivational intervention for alcohol misuse is highly cost effective.
Few prospective studies have evaluated theory-driven approaches to the implementation of evidence... more Few prospective studies have evaluated theory-driven approaches to the implementation of evidence-based opioid treatment. This study compared the effectiveness of an implementation model (Science to Service Laboratory; SSL) to training as usual (TAU) in promoting the adoption of contingency management across a multi-site opiate addiction treatment program. We also examined whether the SSL affected putative mediators of contingency management adoption (perceived innovation characteristics and organizational readiness to change). Sixty treatment providers (39 SSL, 21 TAU) from 15 geographically diverse satellite clinics (7 SSL, 8 TAU) participated in the 12-month study. Both conditions received didactic contingency management training and those in the pre-determined experimental region received 9 months of SSL-enhanced training. Contingency management adoption was monitored biweekly, while putative mediators were measured at baseline, 3-, and 12-months. Relative to providers in the TAU region, treatment providers in the SSL region had comparable likelihood of contingency management adoption in the first 20 weeks of the study, and then significantly higher likelihood of adoption (odds ratios = 2.4-13.5) for the remainder of the study. SSL providers also reported higher levels of one perceived innovation characteristic (Observability) and one aspect of organizational readiness to change (Adequacy of Training Resources), although there was no evidence that the SSL affected these putative mediators over time. Results of this study indicate that a fully powered randomized trial of the SSL is warranted. Considerations for a future evaluation are discussed.
The US HIV/AIDS epidemic is concentrated in the Deep South, yet factors contributing to HIV trans... more The US HIV/AIDS epidemic is concentrated in the Deep South, yet factors contributing to HIV transmission are not fully understood. We examined relationships between substance use, sexual partnership characteristics, and condom non-use in an African American sample of STI clinic attendees in Jackson, Mississippi. We assessed condom non-use at last intercourse with up to three recent sexual partners reported by participants between January and June 2011. Participant- and partner-level correlates of condom non-use were examined using generalized estimating equations. The 1295 participants reported 2880 intercourse events, of which 1490 (51.7 %) involved condom non-use. Older age, lower educational attainment, reporting financial or material dependence on a sex partner, sex with a primary partner, and higher frequency of sex were associated with increased odds of condomless sex. HIV prevention efforts in the South should address underlying socioeconomic disparities and structural determ...
Patients treated in an urban emergency department were studied to determine if college status, ge... more Patients treated in an urban emergency department were studied to determine if college status, gender and having alcohol as a reason for medical treatment were related to alcohol use and related problem behaviors. Patients ages 18-19 years (N = 250; 55% men) who had or had not been drinking alcohol prior to the event that precipitated their medical treatment were assessed on their alcohol use, alcohol-related problems and drug use. There were high levels of alcohol use, tobacco use and other drug use in the sample, regardless of the reason for medical treatment. Analyses consistently showed that patients treated for alcohol-related reasons had more severe drinking patterns and problems than patients who were alcohol negative. Patients not enrolled in college showed similar patterns of alcohol consumption as their college-attending peers, but bad more severe alcohol-related behaviors and problems. Few gender differences were found and no interactions were found between gender, alcohol status and college status. Findings indicate that older adolescents who receive medical treatment for alcohol use are not inexperienced drinkers. Furthermore, in this convenience sample, college students did not appear to be at greater risk for substance use or problems. Findings underscore the potential usefulness of alcohol intervention programs for alcohol-involved medical patients, and the need to attend to the alcohol and drug use of nonstudent populations.
Journal of Studies on Alcohol and Drugs, Sep 1, 2008
Objective:Most colleges have sanctions or required interventions for students who receive alcohol... more Objective:Most colleges have sanctions or required interventions for students who receive alcohol violations or medical evaluation for intoxication. The aim of this study was to establish profiles of mandated students from a combined data set using exploratory and replication cluster analysis.Method:Data sets from three samples of mandated students (total participant n = 393) were combined for exploratory analyses, and a fourth sample (n = 289) was analyzed for replication. Clustering variables were past-month heavy drinking, past-year alcohol problems, incident alcohol use, responsibility for the incident, and aversiveness of the incident.Results:A three-cluster solution was produced in the exploratory analysis and confirmed in replication and cross-replication analyses. Clusters formed included a “Why Me?” cluster characterized by a pattern of relatively low heavy drinking and alcohol-related problems, very little incident drinking, and low responsibility and aversiveness. A “So What?” cluster was characterized by high heavy drinking and alcohol-related problems, moderate incident drinking and responsibility, and low aversiveness. A “Bad Incident” cluster was characterized by low scores for heavy drinking and problems and high levels of incident drinking, responsibility, and aversiveness. External variables supported the validity of the cluster solution.Conclusions:Mandated students form clinically meaningful profiles on easily measured constructs.
Http Dx Doi Org 10 1300 J029v16n02_06, Sep 21, 2008
The purpose of this study was to evaluate a brief version of the Alcohol Expectancy Questionnaire... more The purpose of this study was to evaluate a brief version of the Alcohol Expectancy Questionnaire-Adolescent (AEQ-A; Brown, Christiansen, & Goldman, 1987). The original AEQ-A was reduced to seven items (called the AEQ-AB). Principal Components Analysis (PCA) was performed and two factors emerged (General Positive Effects and Potential Negative Effects) accounting for 46% of the variance. Internal consistencies are comparable to those of the original AEQ-A (0.50). Scales correlate with criterion variables such as average drinks per week and average number of drinks per heavy drinking day (p < 0.05). It is concluded that this questionnaire may be useful to clinicians providing brief assessment and intervention. Cross-validation in other samples and other settings is recommended.
There were two specific goals for the current study: (1) to demonstrate that adolescents display ... more There were two specific goals for the current study: (1) to demonstrate that adolescents display drug-specific cue reactivity to alcohol and cigarette visual cues that varies based on drug-use history and (2) to test the unique contribution of adolescents' avoidance reactions to alcohol and cigarette cues, independent of approach/craving reaction. Adolescents (N = 143; age 13-20 years; 58 males) with varied substance-use histories were recruited from school and community sites. Adolescents were presented with a series of alcohol, cigarette, and nondrug comparison visual cues and reported their approach/craving and avoidance reactions. They also completed individual difference measures related to their alcohol and cigarette use and experiences. When adolescents were grouped according to their current alcohol or cigarette use (no use, low use, high use), increased use of alcohol or cigarettes was associated with stronger reactions (increased approach, decreased avoidance) to cues for that substance but not to nondrug control cues. Simultaneous regression analyses demonstrated that after controlling for approach/craving reactions, avoidance cue reactions predicted unique and/or incremental variance in measures of alcohol and cigarette usage, recent change in patterns of use, alcohol expectancies, alcohol restraint and parental alcohol problems. Adolescents displayed robust alcohol and cigarette cue-specific reactions that varied systematically with their current use of these drugs. Across numerous clinically relevant individual difference variables, predictive power was greatly enhanced through the inclusion of both avoidance and approach reactions.
To identify individual therapist behaviors which elicit client change talk or sustain talk in mot... more To identify individual therapist behaviors which elicit client change talk or sustain talk in motivational interviewing sessions. Motivational interviewing sessions from a single-session alcohol intervention delivered to college students were audio-taped, transcribed, and coded using the Motivational Interviewing Skill Code (MISC), a therapy process coding system. Participants included 92 college students and eight therapists who provided their treatment. The MISC was used to code 17 therapist behaviors related to the use of motivational interviewing, and client language reflecting movement toward behavior change (change talk), away from behavior change (sustain talk), or unrelated to the target behavior (follow/neutral). Client change talk was significantly more likely to immediately follow individual therapist behaviors [affirm (p=.013), open question (p<.001), simple reflection (p<.001), and complex reflection (p<.001)], but significantly less likely to immediately follow others (giving information (p<.001) and closed question (p<.001)]. Sustain talk was significantly more likely to follow therapist use of open questions (p<.001), simple reflections (p<.001), and complex reflections (p<.001), and significantly less likely to occur following therapist use of therapist affirm (p=.012), giving information (p<.001), and closed questions (p<.001). Certain individual therapist behaviors within motivational interviewing can either elicit both client change talk and sustain talk or suppress both types of client language. Affirm was the only therapist behavior that both increased change talk and also reduced sustain talk.
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Papers by Nancy Barnett