Taste aversion therapy with alcoholics: techniques and evidence of a conditioned response.
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Biomedical subjects
Publications and source records attributed to T B Baker.
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A survey of clinical psychologists determined that both objective and projective tests were used with high frequency. The two tests clinicians most frequently recommended clinical students learn to administer were projective (the Rorschach and the TAT) and, among the 10 most frequently recommended tests, projective tests were recommended approximately 30% more often than objective tests. Clinicians who were frequent test users recommended both objective and projective tests more often than those not using tests. Clinicians doing substantial teaching and research tended to recommend projective tests less often than clinicians not engaged in those activities. Behavior therapists recommended projective tests less often than eclectic, Freudian, and neo-Freudian therapists.
Disruption of taste aversion learning following the administration of the same drug prior to and during conditioning (intra-agent disruption) was shown to be greater than disruption following the administration of one drug prior to conditioning and another during conditioning (inter-agent disruption). Comparable dosages of ethanol and lithium chloride served as unconditioned stimuli. Inter-agent disruptions are attributed to a dissociation of conditioned and unconditioned stimuli, while intra-agent disruptions are attributed to both a dissociative effect and drug-specific effects. Intra-agent disruption was correlated with an independent measure of tolerance, suggesting tolerance constitutes at least a portion of the drug-specific effects.
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Patients who volunteered for a controlled drinking training program had more severe alcohol problems and less social and family stability than those who opted for abstinence-oriented programs.
Eight halfway houses for alcoholics were surveyed and compared to other halfway houses for alcoholics, and halfway houses for the non-alcoholic mentally ill, as described in previous studies. The halfway houses for alcoholics surveyed in the present report may be separated into two principal groups: (a) a self-supporting profit-oriented type with an autonomous owner-operator, and (b) a board-controlled and supported type usually receiving group or institutional support. Regardless of group membership, however, none of the halfway houses for alcoholics in the present study matched the high standards set by halfway houses for the non-alcoholic mentally ill as described in other reports. Recent events indicate that halfway houses will be responsible for an increasing portion of persons requiring a structured, supportive or sheltered environment. This paper examines the ability of halfway houses for alcoholics to provide adequate residential care services. Additionally, disparities between alcoholism and non-alcoholism halfway houses regarding staffing, professionalised orientation, and adjunct services are scrutinised. The effectiveness of halfway houses is analysed, and suggestions for future utilisation of alcoholic halfway houses are advanced.
One taste-aversion study using male Long-Evans rats in which ethanol was the unconditioned stimulus (UCS) and six studies in which lithium chloride (LiCl) was the UCS demonstrate that (a) exposure to the UCS prior to conditioning retards subsequent acquisition of learned taste aversions; (b) a single preconditioning UCS exposure is sufficient to attenuate conditioning; (c) the preconditioning UCS exposure must occur within a limited period prior to conditioning to attenuate learning; (d) repeated conditioning trials will override the effect of prior exposure to the UCS; (e) tolerance to the UCS is not a necessary condition for the attenuation effect to occur; (f) pairing the preconditioning UCS with a novel flavor other than the CS does not remove the preexposure effect, although it may reduce its magnitude; and (g) the degree of disruption is a positive function of preconditioning UCS dosage and an inverse function of conditioning UCS dosage.
Alcoholics were exposed to behavior counseling alone (N =10), or behavior counseling with either videotape self-confrontation (N = 10) or role-modeling (N = 10), and compared to alcoholics receiving standard inpatient treatment (N =10). Immediate alternation of drinking topographies and posttreatment follow-up drinking dispositions served as dependent variables. Subjects receiving videotape self-confrontation achieved greater positive changes in posttreatment drinking analysis sessions than did other treatment groups. Follow-up probes suggested superiority of the experimental treatments in general, and particularly videotape self-confrontation. Performance in the posttreatment analysis sessions was predictive of follow-up drinking status (p less thann .05).
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BACKGROUND: This study was undertaken to assess the safety and efficacy of a treatment involving brief counseling and the nicotine patch among hospital inpatients and to identify variables associated with long-term smoking cessation following hospitalization. METHODS: One hundred eighty-five patients were randomly assigned to one of three smoking cessation interventions: (1) A Minimal Care (MC) condition, consisting of a brief physician-delivered motivational message to stop smoking, (2) a Counseling + Active Nicotine Patch (CAP) condition in which patients received the motivational message, a 6-week supply of nicotine patches, and extended bedside and telephone counseling, and (3) a Counseling + Placebo Patch (CPP) condition identical to the CAP condition except the supplied patches contained no nicotine. RESULTS: At 6-month follow-up, abstinence rates for the three treatments were 4.9, 6.5, and 9.7% for the MC, CPP, and CAP treatments, respectively. These differences were not statistically significant. Patients admitted for respiratory disease were more likely to quit than patients with any other diagnosis. The nicotine patch was well tolerated by hospital inpatients. CONCLUSIONS: The initiation of nicotine patch therapy during hospitalization appears to be safe when used among patients carrying a wide range of diagnoses. Our study provided no evidence of the superiority of nicotine patches versus placebo, but this does not preclude the possibility that future research using larger samples might detect differences between patch groups. Hospital interventions for smoking cessation may be most effective among patients hospitalized for a smoking-related illness such as respiratory disease.
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Intracerebroventricular administration of 20, 40 and 60 nmol of dynorphin (1-13) produced analgesia, as assessed by flinch/jump response to footshock, and hypothermia in the rat. Rats developed tolerance to both the analgesic and thermic effects of the 20 nmol dose of dynorphin. Dynorphin and beta-endorphin showed cross-tolerance with respect to their analgesic but not their thermic effects. Dynorphin and morphine also produced cross-tolerant analgesic effects. Naloxone (10 mg/kg, IP) completely blocked the barrel rolling produced by 20 nmol dynorphin but did not alter its analgesic or thermic effects.
OBJECTIVE: To estimate the overall efficacy and optimal use of the nicotine patch for treating tobacco dependence. DATA SOURCES: Nicotine patch efficacy studies published through September 1993, identified through MEDLINE, Psychological Abstracts, and Food and Drug Administration new drug applications. STUDY SELECTION: Double-blind, placebo-controlled nicotine patch studies of 4 weeks or longer with random assignment of subjects, biochemical confirmation of abstinence, and subjects not selected on the basis of specific diseases (eg, coronary artery disease). DATA EXTRACTION: Pooled abstinence rates and combined odds ratios (ORs) at end of treatment and 6-month follow-up were examined overall and in terms of patch type (16-hour vs 24-hour), patch treatment duration, dosage reduction (weaning), counseling format (individual vs group), and intensity of adjuvant behavioral counseling. DATA SYNTHESIS: Across 17 studies (n = 5098 patients) meeting inclusion criteria, overall abstinence rates for the active patch were 27% (vs 13% for placebo) at the end of treatment and 22% (vs 9% for placebo) at 6 months. The combined ORs for efficacy of active patch vs placebo patch were 2.6 at the end of treatment and 3.0 at 6 months. The active patch was superior to the placebo patch regardless of patch type (16-hour vs 24-hour), patch treatment duration, weaning, counseling format, or counseling intensity. The 16-hour and 24-hour patches appeared equally efficacious, and extending treatment beyond 8 weeks did not appear to increase efficacy. The pooled abstinence data showed that intensive behavioral counseling had a reliable but modest positive impact on quit rates. CONCLUSIONS: The nicotine patch is an effective aid to quitting smoking across different patch-use strategies. Active patch subjects were more than twice as likely to quit smoking as individuals wearing a placebo patch, and this effect was present at both high and low intensities of counseling. The nicotine patch is an effective smoking cessation aid and has the potential to improve public health significantly.