1995 — 1999 |
Sterling, Robert C |
R29Activity Code Description: Undocumented code - click on the grant title for more information. |
Cocaine Relapse--Helplessness and Cue Exposure Mastery @ Thomas Jefferson University
Feelings of low personal control and meaninglessness in life have ben implicated in both the onset and maintenance of substance abuse. If we were able to help cocaine dependent individuals develop an internal sense of the control over relapse generating stimuli, the ability of these stimuli to produce renewed substance use might be lessened, and feelings of helplessness might give way to a sense of personal efficacy, and the clinical course could be altered. Recent de-conditioning studies with substance dependent patients indicate that not only does the pairing of substance use triggering stimuli with the absence of substance use extinguish physiologic and subjective craving responses, but evidence also suggests that a sense of personal control and efficacy develops during these extinction trials. However, these grains have failed to generalize to the natural environment. The primary aim of this proposed five ear research project is to determine whether a Cocaine Stimulus Control Training (CSCT) program which, unlike the extinction studies, features immediate feedback regarding physiological control in the presence of cocaine use related stimuli, impacts on feelings of helplessness, abstinence efficacy, retention nd outcome. Volunteers (N=120) will be recruited from individuals who have relapsed to cocaine use and are seeking readmission to our inner city, publicly funded, intensive group treatment program. Of the 120 volunteers, 60 will be randomly assigned to twelve weeks of intensive group therapy plus the CSCT add on module and 60 will be assigned to twelve weeks of intensive group therapy;plus educational programming about cocaine triggers and the risks and the risks and consequences of continued cocaine use. Hypotheses to be tested are as follow: a) patients assigned to CSCT will show greater gains in psychological functioning (i.e., efficacy to remain abstinent) than those in the comparison group, and b) individuals in the CSCT procedures will remain in treatment longer and be functioning better at nine month follow-up.
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2002 — 2004 |
Sterling, Robert C |
R21Activity Code Description: To encourage the development of new research activities in categorical program areas. (Support generally is restricted in level of support and in time.) |
Levels of Spirituality and Treatment Outcome @ Thomas Jefferson University
DESCRIPTION (provided by applicant): The economic and social consequences of alcohol abuse are immense. Job loss, family disruptions, and traffic fatalities are just some of the sequelae that contribute to alcohol abuse costing the United States over $165 billion per year. When individuals acknowledge the need for help, treatment planning is all too often a subjective process determined by what a patient believes and is willing to accept. For example, for some individuals a spiritually oriented 12-step treatment program with its attendant discussions of powerlessness and spirituality may be congruent with their personal histories and beliefs; for others, however, such a treatment experience might be discomfiting, potentially serving a negative function. Therefore, it seems reasonable to consider the spiritual orientations of the patient and treatment facility components of an interaction that influences outcome. The primary aim of this proposed two-year project is to examine whether admission differences in levels of spirituality predispose participants to favorable or unfavorable outcomes following admission to facilities that differ in the degree to which spirituality is emphasized. All participants will meet DSM-IV criteria for alcohol abuse or dependence. Since some persons are likely to be amenable to a treatment experience that emphasizes spiritual principles, while others are not, the proposed research will allow us to test the hypothesis that persons whose admission level of spirituality is congruent with the treatment program's orientation, and who as such are considered optimally placed (i.e., "matched") for treatment, evince better outcomes. Specifically, it is hypothesized that these patients will, relative to a group whose beliefs are not congruent with program philosophy, a) be less likely to terminate treatment prematurely, b) show greater gains in psychological functioning (i.e., abstinence efficacy), and c) be less likely to have renewed alcohol use at follow-up. Serial administration of measures of spirituality, learned helplessness, and abstinence efficacy will allow for an assessment of changes that accompany involvement in both treatment and the recovery process. Secondary analyses will examine the relationship of spirituality, helplessness and treatment outcome.
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