Journal of Addictive Behaviors Therapy & Rehabilitation
Editor-in-chief: Peter R. Martin, MD
Vanderbilt University, USA
The Journal of Addictive Behaviors, Therapy & Rehabilitation (JABTR) promotes rigorous research that makes a significant contribution in advancing knowledge for Addiction Therapy. The journal includes all major themes pertaining to Substance dependence and Behavioral addiction.
JABTR is lead by scientists throughout the world and provides the editors with expert refereeing, ensuring the high quality of articles published in the Journal. It invites the reports of theoretically informed and empirically grounded research which focuses on important issues related to the fields of Addictive behaviors and Substance abuse. Articles submitted by authors are evaluated by a group of peer review experts in the field, and ensures that the published articles are of high quality, reflect solid scholarship in their fields, and that the information they contain is accurate and reliable.
Mirtazapine In Comorbid Major Depression And Alcohol Use Disorder: A Long-Term Follow-Up Study
Background/Objective: To date, pharmacotherapy trials of depressed alcoholics (MDD/AUD) have focused on SSRI medications, with disappointing results, so effective treatments for that comorbid population are lacking. Mirtazapine is an FDAapproved medication for treating MDD with a unique pharmacological profile whose efficacy may exceed that of SSRIs. Results from our recent open label study suggest robust acute phase efficacy for mirtazapine for decreasing both the depression and the drinking of that population. However, to date, no studies have evaluated the longer-term efficacy of mirtazapine in that population. We now report findings from a first long-term (two-year) naturalistic followup evaluation involving subjects from the acute phase trial. We hypothesized that the improvements would persist at follow-up.
Consistency and Recanting of Ever-Smoking Status Reported by Self and Proxy Respondents One Year Apart
The study examined consistency of reports concerning current and prior smoking behaviors. Data came from the 2002-2003 Tobacco Use Supplement to the Current Population Survey, where the current smoking behaviors and smoking history were reported by self- and proxy-respondents on two occasions, one year apart. The eversmoking status is reported consistently, overall: Kappa coefficient is 0.78 with the corresponding 95% confidence interval given by (0.77, 0.78). One specific type of inconsistency of prior reports was assessed for respondents who were identified as never smokers at the latter assessment and former or current smokers at the earlier assessment. Based on the survey logistic regression that controls for multiple respondent characteristics and survey administration method, the estimated prevalence of such inconsistent self-reports is 9.0%, and prevalence of inconsistent proxy-reports is 5.4%. In addition, prevalence of recanting, i.e., future reporting never smoking for respondents who previously claimed to be a former or a current smoker was assessed. The recanting was shown to be most prevalent with respect to proxy-reports and former smokers: overall prevalence of recanting was estimated to be in the range 13% - 19% for current smokers, and 27% - 46% for former smokers. Our findings indicate that while, unexpectedly, proxy-respondents are more likely to report the ever-smoking status consistently than do self-respondents, the proxies are also more likely to incorrectly report never smoking in the future for smokers especially regarding adolescents and young adults. Therefore, the observed higher level of consistency for proxy-respondents may be due to proxies’ incorrect knowledge which leads to consistent yet ambiguous responses.
Stigma among Individuals with Substance Use Disorders: Does it Predict Substance Use, and Does it Diminish with Treatment?
Aims: Drug and alcohol use-related stigma affects employment, physical and mental health, and has been shown to be a barrier to seeking treatment. Thus, the need to address stigma in substance use disorders treatment has been noted in the clinical literature. We aimed to examine whether stigma is related to alcohol/substance use as well as whether treatment as usual for substance use disorders affects stigma, depressive symptoms, and quality of life. Methods: Participants were individuals attending intensive outpatient treatment for substance use disorders. Baseline sample consisted of 17 Caucasian, predominantly male (i.e. 65%) participants, averaging 34.06 years of age. At post-treatment and one month follow-up assessments there were 12 and 7 participants respectively. Results: Higher post-treatment stigma was significantly related to a greater number of drug use days at follow-up. We did not find significant differences between baseline, post-treatment and followup assessment on self-stigma. However, participants reported a significant decrease in symptoms of depression from baseline to post-treatment and a significant increase in these symptoms between post-treatment and follow-up. Conclusions: Our results suggest that stigma may have a detrimental impact on substance use. Also, while depressive symptoms may improve as a result of treatment as usual for substance use disorders, symptoms of depression may worsen shortly after treatment. These results highlight the need for more work on these relationships due to the very preliminary nature of these findings.
Sex addiction has been a topic of debate. With the new DSM-V (2013) category of Substance-Related and Addictive Disorders that now includes gambling disorder, other excessive behaviors including sex are poised to capture increasing attention. Depiction and clinical case studies of the progression and features of sex addiction are limited in the research literature due to ethics of confidentiality and the taboo nature of the topic. This article puts a human face to the question of sex addiction through the use of cinema as a ‘cultural text’ with the film Shame (2011). A framework for addiction comprising of the 3C’s: (1) craving; (2) loss of control; and (3) negative consequences, is used to analyze the protagonist’s behavior. Parallels to alcohol and gambling disorders are drawn. Momentous shifts in society’s sexual environment and norms that currently re-shape sexual behaviors are highlighted. The article points to avenues of research and its urgency to society and its individuals. Clear neurobiological and behavioral markers to define sex addiction can reduce shame and alleviate the suffering of those afflicted through appropriate treatment. A fortified understanding of sex addiction has significant individual, family and social implications.
The First mHealth App for Managing Cannabis Use: Gauging its Potential Helpfulness
Cannabis use disorder is both common and costly. The impact of standard services for treating cannabis use and related problems has been inhibited by supply, accessibility, and perceived stigma. Thus, private, readily accessible methods of delivering evidencebased treatment on a large scale and at low cost are urgently needed. Accordingly, we developed the first mHealth smartphone app for managing cannabis use (Assess, Plan, Track, Tips; APTT). This study examines 10 cannabis users’ (50% men, aged 17-38) reactions to APTT after participating in a 2-hour in-house testing session. Eligibility criteria required participants to be interested in evaluating, reducing, or ceasing their cannabis use. Participants were satisfied with APTT overall, but rated its ease of use slightly higher than its helpfulness. Specifically, participants gave higher ratings of its goal monitoring and tracking of cannabis use than of its ability to increase insight and provide motivation or strategies to address cannabis use. Qualitative responses suggested that the helpfulness of APTT may be increased by providing more information about harms from using cannabis and benefits of quitting, clarifying how strategies for use reduction might be applied to different situations such as withdrawal, and incorporating professional assistance. These results will assist in determining what changes need to be made to APTT in order to ensure that it is evidence-based and user preferred.