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G Alan Marlatt

Publications and source records attributed to G Alan Marlatt.

At least 19 recordsLinked to original sources
PubMed2006

Epidemiological trends in drinking by age and gender: providing normative feedback to adults.

OBJECTIVE: The purpose of this research was to evaluate drinking rates as a function of age and gender and to disseminate current estimates of U.S. population drinking norms based on age and gender. METHODS: Participants included 42,706 men and women 18 years and older who provided information about their drinking from the National Epidemiologic Survey on Alcohol and Related Conditions [National Alcohol Survey on Alcohol and Related Conditions (NESARC, 2001) dataset collected between 2001 and 2002 from a representative, non-institutionalized sample. RESULTS: Results revealed greater frequency and typical quantity of alcohol consumption among men versus women. Age differences in drinking frequency suggests a sharp increase with legal drinking age followed by a period of reduced frequency, in turn followed by gradual increase up to retirement age. Age differences in typical drinking quantity suggest a sharp increase with legal drinking age followed by a gradual linear decline in number of drinks per occasion. Age differences in typical quantity were more pronounced among men. CONCLUSIONS: Analyses provide epidemiological trends in drinking rates by age and gender, and emphasize the importance of within group differences when examining drinking rates. Discussion focuses on explaining how to incorporate norms information in prevention and treatment.

Adolescent↗
PubMed2006

The changing influences of self-worth and peer deviance on drinking problems in urban American Indian adolescents.

This study explored the changing relations among self-worth, peer deviance, and alcohol-related problems in a sample of 224 urban-dwelling, American Indian adolescents. Data were collected annually at 7 time points to test a proposed mediational model. As expected, peer deviance mediated the relation between low self-worth and alcohol-related problems in younger adolescents; however, this relation did not hold as participants became older. In older adolescents, low self-worth and peer deviance directly and independently contributed to alcohol problems. Possible explanations for and implications of these findings are discussed in terms of developmental changes during adolescence.

Adolescent↗
PubMed2006

Family and peer interventions for adults: past approaches and future directions.

Through the use of published literature and empirical research, the authors explore the differing conceptual frameworks, techniques, and effectiveness of various family interventions for change-resistant, substance-abusing adults. The 2 dominant programs in place to help families and friends deal with the addiction of an adult loved one are the Johnson Intervention and Al-Anon. Research on these 2 programs is presented, followed by an outline of promising alternative approaches. These include A Relational Intervention Sequence for Engagement, Community Reinforcement Training, Community Reinforcement and Family Training, Unilateral Family Therapy, and Pressures to Change. The effectiveness and appropriateness of these approaches in different situations are discussed. In addition, areas in need of further study are pointed out.

Adult↗
PubMed2006

Mindfulness meditation and substance use in an incarcerated population.

Despite the availability of various substance abuse treatments, alcohol and drug misuse and related negative consequences remain prevalent. Vipassana meditation (VM), a Buddhist mindfulness-based practice, provides an alternative for individuals who do not wish to attend or have not succeeded with traditional addiction treatments. In this study, the authors evaluated the effectiveness of a VM course on substance use and psychosocial outcomes in an incarcerated population. Results indicate that after release from jail, participants in the VM course, as compared with those in a treatment-as-usual control condition, showed significant reductions in alcohol, marijuana, and crack cocaine use. VM participants showed decreases in alcohol-related problems and psychiatric symptoms as well as increases in positive psychosocial outcomes. The utility of mindfulness-based treatments for substance use is discussed.

Adult↗
PubMed2006

Adolescent tobacco-related associative memory: A cross-sectional and contextual analysis.

Tobacco use is prevalent in adolescents, and understanding factors that contribute to its uptake and early development remains a critical public health priority. Implicit drug-related memory associations (DMAs) are predictive of drug use in older samples, but such models have little application to adolescent tobacco use. Moreover, extant research on memory associations yields little information on contextual factors that may be instrumental in the development of DMAs. The present study examined (a) the degree to which tobacco-related memory associations (TMAs) were associated with concurrent tobacco use and (b) the extent to which TMAs mediated the association of peer and self-use. A sample of 210 Australian high school students was recruited. Participants completed TMA tasks and behavioral checklists designed to obscure the tobacco-related focus of the study. Results showed that TMAs were associated with peer use, and TMAs predicted self-use. We found no evidence that TMAs mediated the association of peer and self-use. Future research might examine the emotive valence of implicit nodes and drinking behavior. The results have implications for testing the efficacy of consciousness-raising interventions for adolescents at risk of tobacco experimentation or regular use.

Adolescent↗
PubMed2006

Relapse prevention for sexual offenders: considerations for the "abstinence violation effect".

Relapse Prevention (RP) is a cognitive-behavioral approach originally developed for treatment of addictions and has since become an effective and popular method for treating sexual offenders. The Abstinence Violation Effect (AVE) is a pivotal RP construct describing one's cognitive and affective response to re-engaging in a prohibited behavior. We review the literature on the AVE in both addiction and sexual offender applications. We summarize the original and subsequent formulations of the AVE for addictions and modifications adopted for its application to sexual offenders. We argue that these modifications have generally failed to characterize sexual offense relapse cycles accurately or comprehensively. In particular, these modifications fail to specify accurately the AVE's occurrence and influence in the offense cycle. In response to these limitations, we suggest future directions for AVE research in sexual offenders.

Behavior, Addictive↗
PubMed2005

Recent drinking consequences, motivation to change, and changes in alcohol consumption over a three month period.

Little is known about what type of drinking related consequences may enhance motivation to change or may hinder behavior change over time. In order to examine this research question, 120 adult participants abusing alcohol were administered the Drinker Inventory of Consequences-Recent (DrInC-R), the Brief Readiness to Change Questionnaire (BRTC), and the Steady Pattern Chart (SP). Subscale scores from the DrInC-R and the BRTC; and alcohol consumption as assessed by the SP at baseline and three month follow-up were retained for data analyses. Greater intrapersonal DrInC-R consequences scores significantly predicted greater contemplation stage scores (R2=.37, p<.001), and lower precontemplation stage scores (R2=.32, p<.001), and DrInC-R impulse control and interpersonal consequences scores significantly predicted alcohol consumption at three month follow-up after controlling for baseline consumption (R2=.50, p<.001). Increased awareness of intrapersonal drinking related consequences may motivate change, whereas numbers of impulse control and interpersonal consequences may predict changes in drinking behavior over the short-term.

Adolescent↗
PubMed2005

Memory, executive cognitive function, and readiness to change drinking behavior.

The transtheoretical model of Prochaska and DiClemente [Psychother. Theory Res. Prac. 19 (1982) 276] postulates that cognitive skills are critical for drinking behavior change. Memory and executive cognitive function likely influence the execution of skills that are implicated for both motivating and sustaining drinking behavior change. Participants who met criteria for alcohol abuse or dependence (N=117) were administered a battery of standardized memory and executive cognitive function tests that included the Wechsler Memory Scale-Revised (WMS-R), Controlled Oral Word Association Test (COWAT), Ruff Figural Fluency Test (RFFT), and Wisconsin Card Sort Test (WCST). Lower verbal and higher delayed recall memory score at baseline significantly predicted precontemplation, higher verbal memory scores predicted contemplation, and better attention-concentration at baseline significantly predicted reduced drinking at 3-month follow-up, after controlling for baseline alcohol consumption. The study findings indicate that explicit memory processes may have utility for predicting readiness to change drinking behavior.

Adolescent↗
PubMed2005

Spirituality, mindfulness and substance abuse.

A growing body of research suggests that mindfulness-based therapies may be effective in treating a variety of disorders including stress, chronic pain, depression and anxiety. However, there are few valid and reliable measures of mindfulness. Furthermore, mindfulness is often thought to be related to spirituality, given its roots in Buddhist tradition, but empirical studies on this relationship are difficult to find. The present study: (1) tested the reliability and validity of a new mindfulness measure, the Freiburg Mindfulness Inventory (FMI), (2) explored the relationship between mindfulness and spirituality, and (3) investigated the relationship between mindfulness and/or spirituality and alcohol and tobacco use in an undergraduate college population (N=196). Results support the reliability of the FMI and suggest that spirituality and mindfulness may be separate constructs. In addition, smoking and frequent binge-drinking were negatively correlated with spirituality scores; as spirituality scores increased the use of alcohol and tobacco decreased. Thus, spirituality may be related to decreased substance use. In contrast, a positive relationship between mindfulness and smoking/frequent binge-drinking behavior was uncovered, and warrants further investigation.

Adolescent↗
PubMed2005

Relapse in alcohol- and drug-disordered adolescents with comorbid psychopathology: changes in psychiatric symptoms.

This study examined reciprocal relationships between posttreatment substance use and psychiatric symptoms in adolescents with both a substance use disorder and an Axis I mental health disorder. Participants (13-18 years old) were recruited from inpatient treatment centers and interviewed during treatment and monthly for 6 months. Participants who relapsed (N=103; 48% female) reported the incidence and severity of psychiatric symptoms experienced before and after their 1st posttreatment substance use. The number of symptoms and depression symptoms experienced were related to use of stimulants and other drugs during relapse. There was evidence for both self-medication (symptom reduction) and rebound (symptom exacerbation) effects of substance use on symptom severity. These results demonstrate that, for adolescents with both substance use and mental health disorders, psychiatric symptoms are 1 factor influencing posttreatment substance use.

Adolescent↗
PubMed2005

Alcohol-related associative strength and drinking behaviours: concurrent and prospective relationships.

The first part of this research assessed the longitudinal relationships between alcohol-related associative strength and alcohol use measured at two time-points, 6 months apart. Cross-lagged results support the utility of alcohol-related associative strength to predict drinking behaviours prospectively and vice versa. These results remained after competing explanations of previous use, autocorrelations between memory measures, sensation seeking and background variables of age and gender were accounted for. Findings offer further evidence for an implicit cognitions approach to drinking processes. In the second part of our study, cross-sectional analysis investigated potential mediating mechanisms in the relation of associative strength to quantity and frequency dimensions of drinking. Mediational models provide preliminary evidence that implicit memory processes may have differential effects on quantity and frequency dimensions of drinking behaviours. The results point to the possibility that increasing awareness of implicit alcohol-related associations may have utility in interventions for young adults.

Adolescent↗
PubMed2004

Treating addictive behaviors in the employee assistance program: implications for brief interventions.

Employee assistance programs (EAPs) are widely available to assist employees with a variety of problems. This research examined factors related to utilization and outcome by individuals with addictive behaviors (ABs) versus other problem areas. The specific aims of this study were to evaluate referral source and treatment outcome by gender and presenting problem. The sample included 3890 men and women who attended the EAP for a variety of concerns. Men were less likely than women to self-refer and more likely to be mandated to the EAP. Men were also much more likely to present with ABs. Relative to clients presenting with other issues, individuals with ABs were less likely to self-refer, have their problems resolved in the EAP, and were seen for fewer sessions. These results suggest that EAPs may be well suited for implementation of brief interventions (BIs) that have been empirically supported in other contexts.

Adult↗
PubMed2004

Indicated prevention of problem gambling among college students.

This research provides a brief qualitative description of the development of an indicated prevention intervention for college student gamblers. The proposed intervention integrates alcohol prevention strategies with elements of gambling treatment. The intervention combines cognitive-behavioral skills-training and motivational interviewing and includes personalized normative feedback, cognitive correction, discussion of gambling consequences, and relapse prevention techniques. Examples detailing all phases of the intervention are provided from interviews conducted in a pilot of the intervention. Preliminary pilot data suggests the intervention shows promise in reducing high risk gambling among college students.

Adult↗
PubMed2004

Preventing substance abuse in American Indian and Alaska native youth: promising strategies for healthier communities.

Substance abuse has had profoundly devastating effects on the health and well-being of American Indians and Alaska Natives. A wide variety of intervention methods has been used to prevent or stem the development of alcohol and drug problems in Indian youth, but there is little empirical research evaluating these efforts. This article is an overview of the published literature on substance use prevention among Indian adolescents, providing background epidemiological information, a review of programs developed specifically for Indian adolescents, and recommendations for the most promising prevention strategies currently in practice.

Adolescent↗
PubMed2003

Journeys of the Circle: a culturally congruent life skills intervention for adolescent Indian drinking.

There has been an increasing call for and development of culturally appropriate substance prevention/intervention for ethnic minorities in schools and communities, especially among reservation and in urban American Indian and Alaska Native (AIAN) communities. Past attempts to intervene in and reduce misuse of alcohol and other drugs have not had great success. The Journeys of the Circle Project utilized innovative programs with a strong emphasis on historic cultural traditions.

Adaptation, Psychological↗
PubMed2003

New constructs and assessments for relapse and continued use potential in the ASAM Patient Placement Criteria.

One area of intensive study in recent years in addiction research is the characterization and prediction of relapse risk. Given the growing list of findings and assessment tools in this area, in preparation for the second edition, revised volume of the Patient Placement Criteria (PPC) of the American Society of Addiction Medicine (ASAM), a workgroup of the Coalition for National Criteria was assigned the task of creating a revised conceptual organization for Dimension 5: Relapse/Continued Use Potential. The workgroup conducted a review of the previous Dimension 5 constructs and criteria, including a decision analysis of the previous Dimension 5 decision rules. Following that analysis, field data from the ASAM Criteria Validity Study at Massachusetts General Hospital and Harvard Medical School were analyzed from a large cohort of public and indigent patients in eastern Massachusetts. After determining the concurrent validity of the Dimension 5 decision rules and their limitations, the decision rules were rewritten to gain improved validity. This exercise revealed techniques that can and should be used to improve the discrimination of levels of care among all Dimensions. Finally, the workgroup expanded and refined the constructs that should comprise a revised Dimension 5. This revised list of constructs is sequential and hierarchical. It offers face validity on several levels of current basic and clinical research knowledge: behavioral pharmacology, behavioral psychology, learning theory and psychopathology. While the Second Edition-Revised volume of the ASAM PPC (PPC-2R) does not go so far as to propose final decision rules for Dimension 5 based on these new constructs, it does recommend pilot adoption of several new assessment tools for this dimension and provides the framework incorporating those constructs and assessments in the next complete PPC edition.

Adaptation, Psychological↗
PubMed2003

Validity of the CRAFFT in American-Indian and Alaska-Native adolescents: screening for drug and alcohol risk.

OBJECTIVE: Native-American adolescents are reported to be at high risk for drug and alcohol use and related negative consequences. A brief screening instrument that is culturally and developmentally appropriate can aid clinicians who work with Native youth in determining whether more extensive assessment of substance use is necessary. The CRAFFT has been shown to be a valid and reliable screen among general adolescent outpatient clinic samples. METHOD: Data were collected as part of the Journeys of the Circle project, a collaborative effort between the Seattle Indian Health Board (SIHB) and the University of Washington's Addictive Behaviors Research Center. Psychometric properties of the CRAFFT were examined in 70 American-Indian and Alaska-Native youths ages 13 to 19 recruited from public schools and SIHBs outpatient clinics. RESULTS: The CRAFFT demonstrated good internal consistency (alpha = 0.81). A score of 2 or higher on the CRAFFT was found to be optimal for capturing youths with high alcohol-related problems (sensitivity, 0.95; specificity, 0.86), frequent alcohol use (sensitivity, 1.00; specificity, 0.72) and frequent marijuana use (sensitivity, 1.00; specificity, 0.75). A cut-point of 3 was appropriate for identifying adolescents with frequent other drug use (sensitivity, 0.86; specificity, 0.76). CONCLUSIONS: The CRAFFT may be a valid instrument for identifying Native youths at risk for alcohol and other drug problems. This brief screen can be effective in helping providers determine the need for further assessment and treatment or prevention services for Native-American adolescents.

Adolescent↗