B J Rounsaville

..Nevertheless, more research is needed particularly to examine the comparative reliability and validity of abuse and harmful use diagnoses...

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..However, experimental rigor can be maintained while allowing subjects to use ancillary medications if steps are taken to monitor and minimize the variability in treatment delivery...

..Although many treatment efficacy questions can best be answered by single focus studies, we recommend that such designs be adopted only after less restrictive designs are first considered...

..Ambulatory opioid detoxification can give internists a larger role in initiating drug treatment for IDUs who are addicted to opioids...

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..Strategies for using the YACS in both psychotherapy and pharmacotherapy research in the addictions are described...

..The results of the present study highlight the importance of the identification and treatment of individuals with gambling problems with respect to legal issues...

..Nonspecific aspects of treatment such as therapist skillfulness and level of the therapeutic alliance were comparable across treatment conditions...

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..To evaluate outcomes 1 year after cessation of treatment for cocaine- and alcohol-dependent individuals...

..In addition, significantly more participants in the CBT group completed treatment. These preliminary results suggest that when combined with CM, the standard weekly format of CBT is more acceptable to adolescent smokers...

..These subtype differences remained after controlling for the effects of antisocial personality and psychiatric symptoms...

..The characteristics of male and female gamblers utilizing a gambling helpline were examined to identify gender-related differences...

..We evaluated the efficacy of disulfiram for cocaine dependence, both with and without co-morbid alcohol abuse, in a group of methadone-maintained opioid addicts...

..The authors did not find that the five factors were more reliable than the Axis II symptoms. Issues related to the reliability of personality assessment in multiply diagnosed patients are discussed...

..e., "telescoping") of alcohol-related complications. This phenomenon also appears to be evident in drug-dependent women, though the data available to support telescoping in drug dependence is less abundant...

..0001). Of 45 patients who ultimately completed AOD, 78% (35/45) remained in treatment for at least one month...

..Contingency management (CM) and significant other involvement (SO) were evaluated as strategies to enhance treatment retention, medication compliance, and outcome for naltrexone treatment of opioid dependence...

..Although Type A/B may be an important theoretical model for guiding alcoholism research, it usefulness and efficiency for treatment matching, planning, or placement purposes is questioned...

..This study investigated the safety and efficacy of naltrexone in combination with Cognitive Behavioral Coping Skills Therapy (CBCST) in a sample of alcohol-dependent women, some with comorbid eating pathology...

..Results suggest that the interview is sensitive in detecting money mismanagement and raises questions concerning the validity of clinicians' judgments...

..This study evaluated the efficacy of a computer-based version of cognitive-behavioral therapy (CBT) for substance dependence...

..Because very little is known about the parenting of drug-abusing men, this study was designed to document ways that drug abuse contributes to compromise of responsible fathering...

..Participants assigned to MET/CBT continued to reduce the frequency of their marijuana use through a 6-month follow-up...

..Comprehensive assessments of childhood trauma and specialized treatments that address trauma-related pathophysiology could be of benefit in improving cocaine treatment outcomes in women...

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..Given the strong association between SUDs and psychotic disorders, research on the neurobiology of psychotic disorders could fruitfully include subjects with comorbid SUDs to shed light on shared etiology and pathophysiology...

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..The findings suggest that alcohol dependent men who continue to use illicit drugs may require additional interventions to effectively control their drug use and, their anger management styles...

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..Previous studies have found that driving while intoxicated (DWI) offenders report high rates of substance dependence and other psychiatric disorders...

..No prior studies have systematically examined the neural correlates of cognitive control as related to treatment outcomes for cocaine dependence...

..To evaluate the durability of effects of a computer-assisted version of cognitive behavioral therapy (CBT) as treatment for substance dependence through a 6-month follow-up...

..The effectiveness of expert-led (EX) and train-the-trainer (TT) strategies was compared to a self-study approach (SS) for teaching clinicians motivational interviewing (MI)...

..To report on the development of a questionnaire to screen for hazardous substance use in pregnant women and to compare the performance of the questionnaire with other drug and alcohol measures...

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..These findings are likely to have implications for resource and program planning in MMT programs.?..

..Altered ventromedial prefrontal activation and increased blood pressure may represent useful CNS and peripheral biomarkers in individualized treatment with methylphenidate for patients with cocaine dependence...

..This randomized clinical trial was conducted to determine the effect of a money management-based therapy, advisor-teller money manager (ATM), on substance abuse or dependence...

..These findings support the hypothesis that heightened thalamic reactivity to salient stimuli co-occur with cocaine craving and loss of self control...

..Results suggest that campus alcohol and sexual assault prevention efforts should include information on alcohol expectancies and use of protective strategies...

..We then propose new directions for treatment development and targets that are informed by recent evidence regarding the heterogeneity of addictions and the neurobiological contributions to these disorders...

..It was hypothesized that different treatments may affect different trajectories of drinking...

..This pilot study provides evidence of the feasibility of MT in treating SUDs and suggests that MT may be efficacious in targeting stress...

..These findings may have implications for resource and program planning in MMTPs...

..These findings provide promising support for DCS combined with cue exposure therapy in attenuating conditioned reactivity to smoking cues...

..Treatment fidelity was assessed using the Yale Adherence and Competence System. Behavioral treatment delivery in this setting is feasible and is being evaluated in a randomized, controlled, clinical trial...

..Those with higher levels of risk taking completed fewer sessions and homework assignments and had poorer substance use outcomes...

..This pilot study examined the efficacy of a two-session motivational interview adapted for dually diagnosed psychotic and drug-related disordered patients (DDMI) in comparison to a two-session standard psychiatric interview (SI)...

..An improved understanding of the neural correlates of gambling urges in PG would advance our understanding of the brain mechanisms underlying PG and would help direct research into effective treatments...

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..Available manualized behavioral treatments are reviewed, noting their strengths and limitations as behavioral therapy platforms for pharmacotherapy trials and as potential concomitant therapies in clinical practice...

..Reasons for this apparent sex-based response are not clear, but possible mechanisms worthy of greater study include differences in alcohol use by sex as well as differences in dopamine-mediated responses to cocaine and disulfiram...

..These findings suggest that targeted behavioral therapies can play a substantial role in broadening the utility of available pharmacotherapies...

..Disulfiram has emerged as a promising treatment for cocaine dependence, but it has not yet been evaluated in general populations of cocaine users...

..The second goal is to make recommendations for future research in the area of gender-specific aspects of comorbid depression and substance abuse...

..This study tests naltrexone and primary care management (PCM) vs naltrexone and cognitive behavior therapy (CBT) and tests naltrexone maintenance among patients who respond to an initial course of naltrexone combined with PCM vs CBT...

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..Such issues include diversity in settings, clinicians, and patients; cost-effectiveness of treatment; training issues; and patient and clinician satisfaction...

..Predictive validity analyses indicated less symptom improvement for the higher problem subtypes, and patient treatment matching analyses indicated that some subtypes had better outcomes in the no-incentive voucher conditions...

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..Stress and drug cue exposure are known to increase cocaine craving and stress arousal, but the association between these responses and cocaine relapse has not been previously studied...

..These data suggest the promise of the SADV group therapy approach for alcohol-dependent males with a history of IPV who present for substance abuse treatment...

..The high proportion of callers reporting daily tobacco smoking highlights the need for enhanced smoking cessation efforts in problem gamblers...

..There were no significant gender differences in the number of children or the average age of children. The results suggested that fathering may be an important, but largely neglected, treatment issue for drug-abusing men...

..Results from this preliminary evaluation will guide the development of an instrument and intervention focused on dropout risk factors and treatment reengagement...

..Identifying neural activity associated with stress and stress-induced cocaine craving is important in understanding the neurobiology of cocaine craving and relapse...

..Poor rates of diagnostic agreement were obtained for the histrionic and dependent diagnostic categories. No single diagnostic change appears to be responsible for the prevalence rate differences between the two systems...

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..To assess the feasibility and efficacy of two interventions for improving adherence to antiretroviral therapy regimens in HIV-infected subjects compared with a control intervention...

..Identification of brain activity associated with craving is important for understanding the neurobiology of addiction...

..Progress in the field of drug abuse treatment has been significantly hampered by the failure to adopt, across research and clinical settings, a common set of assessments...

..To perform a controlled family study of probands with several different predominant drugs of abuse, including opioids, cocaine, cannabis, and/or alcohol...

..The findings of an association between better WM integrity at treatment onset and longer abstinence suggest that strategies for improving WM integrity warrant consideration in developing new interventions for cocaine dependence...

..Statistically significant differences favoring the seminar plus supervision over the manual only condition were found for adherence and skill ratings for 2 of the 3 role plays, with intermediate scores for the Web condition...

..CONCLUSIONS: These findings argue for caution in characterizing the personality correlates of substance use disorders as representing familial or heritable risk factors...

..This pilot trial suggests that application of low-cost CM procedures is feasible within this novel setting and may decrease substance use...

..The SCI-PG demonstrated excellent reliability and validity in diagnosing PG in subjects presenting with gambling problems. These findings require replication in other groups to examine their generalizability...

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..This study evaluated the efficacy of a low-cost, prize reinforcement contingency management (CM) intervention for reducing cocaine use...

..Findings implicate an association between behavioral disinhibition and a continuum of addiction defined primarily in terms of polysubstance involvement...

..To arrive at recommendations for addressing co-occurring psychiatric and substance use disorders in the development of the Diagnostic and Statistical Manual of Mental Disorders fifth edition (DSM-V) criteria...

..Secondary outcomes will include reductions in illicit opioid use and alcohol use, as well as improvements in psychosocial functioning. ..

..Since the onset of the program we have provided training for 22 Clinician Scientists, many of whom are among the leaders of their generation of drug abuse investigators. ..