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Biomedical subjects

S Shiffman

Publications and source records attributed to S Shiffman.

88 records · Page 5Linked to original sources
PubMed1986

A cluster-analytic classification of smoking relapse episodes.

Using reports of relapse crises collected through a relapse prevention hotline, this paper develops a taxonomy of relapse situations. Cluster analysis resulted in four clusters. Social situations are characterized by social drinking and exposure to smoking. Relaxation situations are marked by relaxation, usually after a meal. Work situations take place during work when the exsmoker is feeling anxious. Upset situations occur when the exsmoker is feeling anxious or depressed while home alone. These situations were significantly discriminated by their scores on the McKennel Smoking Motivation Scales, suggesting a connection between smoking patterns and relapse. Behavioral coping was less likely and relapse more likely in social and upset situations. The frequency of coping accounted for the higher relapse rates in Upset, but not in social situations. Relapse was nearly inevitable among people who failed to cope behaviorally in social situations, suggesting that they are especially tempting.

Affective Symptoms↗
PubMed1985

Smoking relapse situations: a preliminary typology.

This paper presents a preliminary attempt to develop a typology of smoking relapse episodes based on cluster analysis. Descriptions of relapse or near-relapse episodes were collected from 183 ex-smokers. Cluster analysis of 53 cases revealed five clusters in two groups distinguished by a positive (Type I) versus negative (Type II) affective tone. Type Ia situations involve drinking alcohol with others who are smoking. Type Ib situations are associated with relaxation. Type Ic episodes are associated with withdrawal symptoms. Type IIa situations involve anxiety related to work stress. Type IIb episodes occur when the ex-smoker is inactive and bored. Type Ia situations are associated with less behavioral coping and more relapse than the others.

Adaptation, Psychological↗
PubMed1984

Cigarette smoking, physiological arousal, and emotional response: Nesbitt's paradox re-examined.

Nicotine's paradoxical effects on arousal and mood are poorly understood. An experiment by Nesbitt suggested that smokers behave more relaxed as their smoking-induced physiological arousal increases. The present study attempted to replicate Nesbitt's Paradox. In smoking and sham-smoking sessions, 10 smokers were administered a series of progressively stronger electric shocks. Pain thresholds and MAACL Anxiety scores measured emotional arousal while heart rate increases served as indices of physiological arousal. All measurements were taken automatically in order to minimize experimenter-subject interaction. Smoking increased heart rate but had no effect on thresholds or MAACL scores. Emotional and physiological arousal showed a significant positive relationship (r = .65), contradicting Nesbitt's report of an inverse relationship. This suggests that Nesbitt's Paradox may not be a robust phenomenon.

Affect↗
PubMedDate not supplied

Coping with dietary relapse crises and their aftermath.

We examined dieters' attempts to cope with dietary relapse crises (Immediate coping) and their aftermath (Restorative coping). We analyzed posttreatment interviews with 57 obese subjects with Type-II diabetes, comparing coping in situations in which subjects lapsed with those in which they survived temptations to overeat. Performance of Immediate coping predicted survival but the particular type of coping made little difference. Eight types of Immediate cognitive coping were equally associated with survival: each was significantly more effective than no coping and equal to the aggregate of the other types. A similar pattern held for 5 types of Immediate behavioral coping, except that social support was no more effective than no coping and restraint was less effective than the other types. Restorative behavioral coping was elicited as a response to overeating, while Restorative cognitive coping seemed elicited by the negative thoughts and feelings that sometimes accompany lapses or temptations. Implications for treatment and future research on relapse crises and coping are discussed.

Adaptation, Psychological↗
PubMedDate not supplied

Psychosocial and personality differences in chippers and regular smokers.

Tobacco chippers are an anomalous group of smokers who, while having smoked regularly for years, have avoided the clutches of nicotine dependence. In an attempt to better understand the factors associated with nondependent cigarette smoking, this paper describes a study in which matched groups of regular smokers, chippers, and nonsmokers were compared on a number of personality and psychosocial variables believed relevant to drug-seeking behavior. The strongest finding indicated that sensation seeking best discriminates among the three groups, with nonsmokers clearly viewing themselves as more socially inhibited and less interested in pursuing sensations relative to both regular smokers and chippers, both of whom evidenced comparable scores. Regular smokers evidenced less self-control, or restraint, and appeared more impulsive and unable to resist temptation, compared to chippers and nonsmokers. Surprisingly, none of the groups could be differentiated on the basis of perceived stress, coping, or social support. Even among the personality variables, however, the effect sizes were relatively small, indicating that these differences in personality cannot fully account for chipper's resistance to dependence.

Adaptation, Psychological↗
PubMedDate not supplied

Smoking topography in tobacco chippers and dependent smokers.

Although most cigarette smokers exhibit signs of tobacco dependence, a subset of this population, referred to as tobacco chippers, does not show characteristic signs of dependence. Few studies have attempted to characterize differences between these groups of smokers. The purpose of the present study was to examine smoking topography in chippers (CH) and dependent smokers (DS). Topographical variables including puff number and duration, and intercigarette interval were examined in seven CH and seven DS under both laboratory and naturalistic conditions. Saliva nicotine, cotinine, and thiocyanate, as well as expired air carbon monoxide (CO) levels were also measured. The results indicate that there were no differences in smoking topography between CH and DS, except those that would be expected based on selection criteria. Although there were differences between groups on pre- and postsmoking CO and saliva cotinine levels, there were no differences in change scores from pre- to postsmoking on these measures. Additional studies will need to be done in order to completely characterize differences between CH and DS.

Adult↗
PubMedDate not supplied

Individual differences in the context of smoking lapse episodes.

Research on relapse has often focused either on the momentary context of lapses or on stable traits that predict who will relapse. We examine the relation between the two, analyzing how individual differences relate to characteristics of initial lapses, which were recorded nearly in real time by 105 smokers using hand-held computers. More nicotine-dependent smokers lapsed under more negative affect and more intense urges, but they did not smoke more in the initial lapse. Questionnaire measures of negative affect smoking did not predict negative affect lapses. Smokers who lapsed when drinking were less nicotine dependent, but they had a history of smoking while drinking, as assessed by computer monitoring. Smokers who attempted coping but lapsed nevertheless reported less active coping styles on the Ways of Coping questionnaire. The results demonstrate the interplay between individual traits and contextual influences in smoking relapse, and they particularly highlight the role of nicotine dependence in relation to contextual factors.

Adaptation, Psychological↗
PubMedDate not supplied

Addressing women's concerns about weight gain due to smoking cessation.

Specific concerns about weight gain following smoking cessation inhibit attempts to quit smoking, especially in women. However, adjunct interventions to prevent weight gain after cessation have generally been successful only in attenuating, rather than preventing, weight gain. More aggressive weight control adjuncts may be necessary to prevent cessation-induced weight gain. On the other hand, weight control programs have not been found to improve long-term smoking abstinence and, in fact, may actually impede abstinence, necessitating a search for alternative approaches to addressing weight concerns. Since the typical amount of weight gain is essentially trivial from a health standpoint, particularly when compared with the health benefits of quitting smoking, the most appropriate clinical strategy may be to combat the weight concerns themselves rather than the weight gain. A second alternative approach is to focus all treatment efforts on smoking cessation alone, to avoid placing excessive burdens on participants resulting from attempting simultaneous changes in multiple health behaviors (i.e., smoking and those related to weight). The rationales for these three clinical approaches to addressing concerns about weight gain-more effective weight control, direct reduction in weight concerns by cognitive-behavioral treatment, and smoking cessation only-are presented, followed by descriptions of the adjunct treatments based on these approaches currently being evaluated in a clinical outcome study with women trying to quit smoking.

Body Image↗
PubMedDate not supplied

A continuous-speech interface to a decision support system: I. Techniques to accommodate for misrecognized input.

OBJECTIVE: Develop a continuous-speech interface that allows flexible input of clinical findings into a medical diagnostic application. DESIGN: The authors' program allows users to enter clinical findings using their own vernacular. It displays from the diagnostic program's controlled vocabulary a list of terms that most closely matches the input, and allows the user to select the single best term. The interface program includes two components: a speech-recognition component that converts utterances into text strings, and a language-processing component that matches recognized text strings with controlled-vocabulary terms. The speech-recognition component is composed of commercially available speech-recognition hardware and software, and developer-created grammars, which specify the language to be recognized. The language-processing component is composed of a translator, which extracts a canonical form from both recognized text strings and controlled-vocabulary terms, and a matcher, which measures the similarity between the two canonical forms. RESULTS: The authors discovered that grammars constructed by a physician, who could anticipate how users might speak findings, supported speech recognition better than did grammars constructed programmatically from the controlled vocabulary. However, this programmatic method of grammar construction was more time efficient and better supported long-term maintenance of the grammars. The authors also found that language-processing techniques recovered some of the information lost due to speech misrecognition, but were dependent on the completeness of supporting synonym dictionaries. CONCLUSIONS: The authors' program demonstrated the feasibility of using continuous speech to enter findings into a medical application. However, improvements in speech-recognition technology and language-processing techniques are needed before natural continuous speech becomes an acceptable input modality for clinical applications.

Diagnosis, Computer-Assisted↗
PubMedDate not supplied

A continuous-speech interface to a decision support system: II. An evaluation using a Wizard-of-Oz experimental paradigm.

OBJECTIVE: Evaluate the performance of a continuous-speech interface to a decision support system. DESIGN: The authors performed a prospective evaluation of a speech interface that matches unconstrained utterances of physicians with controlled-vocabulary terms from Quick Medical Reference (QMR). The performance of the speech interface was assessed in two stages: in the real-time experiment, physician subjects viewed audiovisual stimuli intended to evoke clinical findings, spoke a description of each finding into the speech interface, and then chose from a list generated by the interface the QMR term that most closely matched the finding. Subjects believed that the speech recognizer decoded their utterances; in reality, a hidden experimenter typed utterances into the interface (Wizard-of-Oz experimental design). Later, the authors replayed the same utterances through the speech recognizer and measured how accurately utterances matched with appropriate QMR terms using the results of the real-time experiment as the "gold standard." MEASUREMENTS: The authors measured how accurately the speech-recognition system converted input utterances to text strings (recognition accuracy) and how accurately the speech interface matched input utterances to appropriate QMR terms (semantic accuracy). RESULTS: Overall recognition accuracy was less than 50%. However, using language-processing techniques that match keywords in recognized utterances to keywords in QMR terms, the semantic accuracy of the system was 81%. CONCLUSIONS: Reasonable semantic accuracy was attained when language-processing techniques were used to accommodate for speech misrecognition. In addition, the Wizard-of-Oz experimental design offered many advantages for this evaluation. The authors believe that this technique may be useful to future evaluators of speech-input systems.

Adolescent↗
PubMedDate not supplied

BrainImageJ: a Java-based framework for interoperability in neuroscience, with specific application to neuroimaging.

The Human Brain Project consortium continues to struggle with effective sharing of tools. To facilitate reuse of its tools, the Stanford Psychiatry Neuroimaging Laboratory (SPNL) has developed BrainImageJ, a new software framework in Java. The framework consists of two components-a set of four programming interfaces and an application front end. The four interfaces define extension pathways for new data models, file loaders and savers, algorithms, and visualization tools. Any Java class that implements one of these interfaces qualifies as a BrainImageJ plug-in-a self-contained tool. After automatically detecting and incorporating new plug-ins, the application front end transparently generates graphical user interfaces that provide access to plug-in functionality. New plug-ins interoperate with existing ones immediately through the front end. BrainImageJ is used at the Stanford Psychiatry Neuroimaging Laboratory to develop image-analysis algorithms and three-dimensional visualization tools. It is the goal of our development group that, once the framework is placed in the public domain, it will serve as an interlaboratory platform for designing, distributing, and using interoperable tools.

Algorithms↗