R Sinha

..Thus, fMRI delineated contrasting roles of the prefrontal-caudate and striato-thalamic activities in mediating motor response inhibition...

..Finally, the significant implications of these findings for the development of novel treatment interventions that target stress processes and alcohol craving to improve alcoholism relapse outcomes are discussed...

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..The study also provides a feasible method to study brain correlates of emotional stress processing in healthy individuals and clinical samples...

..Dysregulation of the hypothalamic-pituitary-adrenal (HPA) axis, increased anxiety, and high alcohol craving have been documented during early alcohol recovery, but their influence on relapse risk has not been well studied...

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

..Finally, significant implications of these findings for clinical practice are discussed, with a specific focus on the development of novel interventions that target stress processes and drug craving to improve addiction relapse outcomes...

..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...

..Such markers may then be used to assess treatment response and develop specific treatments that will normalize these neural and biological sequelae so as to significantly improve relapse outcomes...

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..A preliminary study examined whether lofexidine decreases stress-induced and cue-induced opioid craving and improves opioid abstinence in naltrexone-treated opioid-dependent individuals...

..Efficacy of pharmacological and behavioral treatments that specifically target stress and cue-induced craving and arousal responses may also be assessed via alterations in these brain correlates...

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..The findings suggest that specialized treatment approaches that focus on enhancing treatment readiness and motivation to change substance use behaviors may be of particular benefit to substance abusing young adults...

..Participants in both conditions reported significant reductions in marijuana use and improvement in legal problems. These findings suggest that young marijuana abusers benefit from scientifically validated treatments...

..However, as this review points out, several important research questions remain regarding both the clinical manifestations of each problem in women who are comorbid for both disorders and the treatment implications...

..While several environmental situations may produce cocaine craving, there is little research on whether patterns of drug cue reactivity are similar across different environmental situations...

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..The studies also provide a promising method for examining the association between stress and drug craving in the laboratory...

..Although clinical observations suggest that exposure to stress increases drug use, and are associated with craving and relapse in addicts, human research in this area is largely correlational and at times contradictory...

..Finally, key components of a forensic substance abuse evaluation are presented...

..This study examined the response of brain stress circuits to environmental stimuli that are known to increase cocaine craving in cocaine dependent individuals...

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

..To date, gender variations in these systems have not been fully assessed in abstinent alcohol-dependent individuals who also met criteria for cocaine abuse...

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..It is hypothesized that naltrexone may reduce drinking via suppressing craving for alcohol and that this effect may be related in part to naltrexone's ability to activate the hypothalamo-pituitary-adrenocortical axis...

..Prior research has shown that cocaine dependence is associated with dysfunction of brain systems involved in emotions and motivational states...

..The results also suggest that the relationship between error-related activity and post-error behavioral adjustment may be more complicated than has been conceptualized by the conflict monitoring hypothesis...

..The aim of the current study was to examine potential difficulties in emotion regulation during early alcohol abstinence using the recently validated Difficulties of Emotion Regulation Scale (DERS)...

..These moderately significant correlations suggest that salivary measurements represent a stable, non-invasive and broad indicator of HPA axis functioning in cocaine dependent individuals...

..The results illustrate the importance of assessing and treating substance use among offenders of domestic violence, as this may be an important indicator for higher dropout rates and reoffenses among this population...

..These results suggest that diminished performance monitoring can be a critical cognitive mechanism underlying impaired response inhibition in cocaine dependent patients...

..Further studies that examine the functional relationships of these neural systems will likely provide the key to understanding the mechanisms underlying compulsive drug use behaviors in psycho-stimulant dependence...

..The absence of sleep disturbances in women suggests a need to understand the mechanisms underlying these differences, as such knowledge could lead to novel therapies in cocaine dependence...

..These results delineate the neural circuitry specifically involved in error-associated behavioral modifications...

..Finally, the significant implications of these findings for the development of novel treatment interventions that target stress processes and drug craving to improve addiction relapse outcomes are discussed...

..Overall, stress-coping interventions and harm reduction focused on reducing the amount ingested may facilitate prevention and recovery efforts...

..The findings suggest that prenatal drug exposure is associated with altered stress response in adolescence and that gender moderates this association...

..Negative emotional arousal in response to stress and drug cues is known to play a role in the development and continuation of substance use disorders. However, studies have not examined behavioral indicators of such arousal...

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..Analyses of variance (ANOVA) and covariance (ANCOVA), and stepwise multiple regression were conducted...

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

..Prenatal cocaine exposure (PCE) may be associated with alterations in children's developing emotional arousal and regulation systems...

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..The implications of these sex-specific variations in stress and reward system function are discussed in terms of both comorbid psychopathology and treatment outcome...

..Expectancies of global positive changes and tension reduction were hypothesized to moderate the influence of parental history of alcoholism and anxiety, respectively...

..In particular, we examined the processes of risk taking and cognitive control as the neural endophenotypes of alcohol dependence...

..The present study examines gender differences in emotional and alcohol craving responses to stress that may relate to this gender divergence in disorders...

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

..Extensive research suggests that gender may affect neuroendocrine and cardiovascular arousal mechanisms underlying biological responses to stress...

..These results highlight important sex differences in the association between antisocial personality and distress processing in cocaine-dependent individuals...

..These brain regions may represent the neural substrata of response inhibition independent of other cognitive and affective functions...

..Female and male substance abusers differ in their disease patterns and clinical outcomes. An important question in addiction neuroscience thus concerns the neural substrates underlying these sex differences...

..The results suggest an abnormal cognitive control mechanism during affective processing in association with heavy cannabis use...

..This physiological activation was a better predictor of relapse than subjective reports of craving, and may be a useful target for treatment development...

..The current study examined whether frequency of cocaine and alcohol abuse alters drug craving and associated arousal with laboratory exposure to stress and to drug related cues...

..The findings support the utility of the ETI-SF as a clinical research tool to obtain data on specific types of early trauma in drug abusing samples...

..This study examined the role of depressive symptoms in the context of specific demographic and individual treatment characteristics in predicting drug abstinence at discharge from outpatient substance abuse treatment...

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

..Both stress and an alexithymic response to stress can contribute to relapse into drug abuse, but to our knowledge the neural processing of an alexithymic response to stress in cocaine-dependent individuals has not been examined...

..Men activated the motor circuitry while women appeared to involve visual association or habit learning during stop signal performance...

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

..Relative hypoactivation of the rACC during response inhibition may represent a useful neural marker of difficulties in impulse control in abstinent cocaine-dependent men who are at risk of relapse...

..There is growing evidence of alterations in brain stress and reward circuits associated with cocaine dependence. Sex differences are also documented and sex steroid hormones have been linked to cocaine reinforcement...

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..We investigated the impact of enhancing brief cognitive-behavioral therapy with motivational interviewing techniques for cocaine abuse or dependence, using a focused intervention paradigm...

..These data suggest that recovery from chronic cocaine abuse could be hampered by a hyper-responsive stress- and drug-craving state that increases cocaine relapse susceptibility...

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

..All associations were stronger in women. Findings suggest that early intervention for childhood victims, especially females, may delay or prevent the early onset of alcohol use and reduce the risk for a more severe course of addiction...

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..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...

..Prior clinical and preclinical research has indicated that both stress and drug-cue-related arousal response is associated with craving and vulnerability to relapse in a range of drug-using populations...

..Stress and stress-coping focused interventions may be particularly indicated for cocaine dependent individuals with histories of childhood maltreatment...

..However, improved emotion regulation with DBT and associations between such improvement and behavioral outcomes such as substance use has not been previously reported...

..To identify specific genetic pathways showing altered expression in peripheral blood of depressed subjects with bipolar disorder (BPD)...

..Findings indicate that specific aspects of EI may be of clinical importance to cocaine dependent populations, impacting relapse-related factors such as stress dysregulation and impulse control. ..

..These findings have implications for understanding the impact of stress on smoking relapse and model development to assess smoking lapse behavior...

..Prior education or background in behavior therapy accounted for little variance, indicating that clinicians occupying diverse roles acquired reasonable intellectual mastery over this complex model...

..Collectively, the presentations provided convincing support for an involvement of stress in the cause of relapse and continuing alcohol abuse and suggested novel pharmacological approaches for treating relapse induced by stress...

..Better understanding of the connection between substance use disorders and psychiatric disorders could have a profound effect on prevention and treatment...

..These convergent findings are consistent with the function of NPY as an anxiolytic peptide and help to explain inter-individual variation in resiliency to stress, a risk factor for many diseases...

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..Such an understanding will have important implications for the development of gender-specific treatments for cocaine dependence that will ultimately improve the health of cocaine-addicted women and their families. ..