Alan Sirota | Brown University (original) (raw)

Papers by Alan Sirota

Journal of studies on alcohol, 1993

Alcoholics' reactions to drinking-related stimuli (cue reactivity) have been well documented ... more Alcoholics' reactions to drinking-related stimuli (cue reactivity) have been well documented and alcohol cue exposure treatment has been conducted recently in several clinical trials. Prior to conducting large-scale clinical trials it is important to know what effects detoxification may have on cue reactivity. However, no information is available about the effects of stage of detoxification or of detoxification medication on alcohol cue reactivity. In this study, 45 male alcoholics, detoxified without medication, were assessed during either their second, fourth or sixth day of withdrawal. Further, their reactivity was compared to that of alcoholics detoxified with chlordiazepoxide (n = 15), and to that of alcoholics in their fourth week after drinking (n = 28). Cue reactivity assessment investigated salivation and urge to drink after 3 minutes of water cue exposure and then after 3 minutes of alcohol cue exposure. Urges to drink were assessed during an additional 15 minutes of a...

Journal of studies on alcohol, 1994

The present study investigates reaction time (RT) as a measure of attentional deficits produced d... more The present study investigates reaction time (RT) as a measure of attentional deficits produced during alcohol cue exposure. Twenty-four male alcoholic patients responded to a series of computer-generated tones as rapidly as possible during baseline and again during either an alcohol cue exposure period or exposure to a control beverage (water). Patients required increased time to respond to the tones when exposed to alcohol cues. No such increase in RT was found during exposure to a control beverage. In addition, RT was significantly correlated with self-reported urge to drink. These data provide initial validation for the use of RT as an objective measure of cue reactivity. Both theoretical and clinical implications for the use of RT as a measure of the effects of cue exposure are discussed.

Psychosomatics, 1981

Most patients experience considerable distress when faced with the loss of a limb.' We recently p... more Most patients experience considerable distress when faced with the loss of a limb.' We recently provided psychiatric consultation for two patients who were demanding leg amputations in the absence of clinical indications. This report, which as far as we know is the first to describe such patients, documents our experience in assessing and managing this clinical dilemma.

Psychosomatic Medicine, 1993

In a series of three exploratory studies, we examined the endocrine correlates of elation and sad... more In a series of three exploratory studies, we examined the endocrine correlates of elation and sadness produced by the Velten Mood Induction Procedure (VMIP). In Study 1, 10 college females participated in elation and sadness mood inductions on separate days. In Study 2, 12 college females participated in a neutral mood induction. In Study 3, 16 college-aged actresses participated in elation and sadness mood inductions as in Study 1. At regular intervals in each study, we assessed subjective ratings of emotions, serum cortisol and growth hormone, and heart rate and blood pressure. Results demonstrated that the VMIP induced the desired moods. Serum cortisol increased equally in response to both the sadness and elation mood inductions, but showed no change in response to the neutral mood induction. Select associations between affect and cortisol levels were also observed. Interestingly, our data from Study 3 also suggest that an association may exist between elation and growth hormone. These endocrine changes did not appear to be a function of general arousal as indexed by cardiovascular changes. We conclude that elation and sadness are associated with endocrine concomitants and that the VMIP is a viable method for examining such associations. These previously unreported affect-endocrine relationships are discussed and implications for psychobiological theories of emotion are considered.

Psychophysiology, 1987

... The experiment included a number of parts: a prc-mood induction part during which various cog... more ... The experiment included a number of parts: a prc-mood induction part during which various cognitive and motor ... For zygomatic activity, no significant effects were observed. ... greater for Depres-sion than Elation subjects and tends to grow over time, suggesting a carry-over of the ...

Journal of Psychopathology and Behavioral Assessment, 1985

The present research was concerned with identifying and validating the problematic interpersonal ... more The present research was concerned with identifying and validating the problematic interpersonal situations of male veteran drug addicts. In Study I, 20 addicts self-monitored the situations with which they had difficulty coping and their associated characteristics throughout a 2-week period. Fifty situations were obtained and then rewritten into specific interpersonal scenarios. In Study II, a second group of 36 addicts

Journal of Consulting and Clinical Psychology, 1976

Reports the systematic application of a self-instructional treatment program for the elimination ... more Reports the systematic application of a self-instructional treatment program for the elimination of psychotic speech in a hospitalized 47-yr-old single male schizophrenic. Marked improvement of verbal behavior resulted in the patient's being discharged, and at 6-mo follow-up he was employed part-time.

Journal of Clinical Psychology, 1985

Eight male smokers with chronic pulmonary and/or cardiac disease participated in a 9-week treatme... more Eight male smokers with chronic pulmonary and/or cardiac disease participated in a 9-week treatment program that consisted of gradual nicotine withdrawal, self-management techniques, and relapse prevention strategies. At 1-year follow-up, 50% remained abstinent, while those who relapsed were smoking substantially less than prior to treatment. Reductions in CO and thiocyanate levels were both statistically significant and clinically meaningful. Nonspecific factors of group influence and support, as well as weekly feedback of CO levels, were judged as particularly important components of treatment. The availability of non-aversive strategies for smoking cessation in persons with chronic illness is important. These promising though preliminary findings indicate the need for additional applications of multi-component behavioral approaches with this population.

Journal of Behavior Therapy and Experimental Psychiatry, 1974

ABSTRACT

Journal of Abnormal Psychology, 1982

26 18–30 yr old female Ss read a standard set of self-referent statements and imagined scenes wit... more 26 18–30 yr old female Ss read a standard set of self-referent statements and imagined scenes with elated, depressed, and neutral content. The dependent measures were subjective mood ratings (Self-Rating Depression Scale) and left and right zygomatic- and corrugator-muscle activity. The self-statements elicited feelings of elation and depression in approximately 70% of Ss. Among these Ss, elation was accompanied by

Journal of Abnormal Psychology, 1976

In anticipation of receiving painful stimuli, 20 female Ss learned to regulate their heart rate (... more In anticipation of receiving painful stimuli, 20 female Ss learned to regulate their heart rate (HR) when provided with meter biofeedback and monetary bonuses for HR changes and instructions to increase or decrease their rate. Voluntary slowing of HR was associated with a relative reduction in perceived aversiveness of the stimuli, particularly in those Ss who scored high on a

Brain and Cognition

We studied the neural substrates of sustained attention using the Sustained Attention to Response... more We studied the neural substrates of sustained attention using the Sustained Attention to Response Task (SART). The task was administered with and without random alerting tones in order to study the effects of exogenous engagement of sustained attention. As predicted, the SART was associated with activations in right dorsolateral prefrontal cortex, inferior parietal lobe, and thalamus. Alerting tones diminished these activations, yet they were also associated with increased activation in key regions of this same network during a control condition with low demands on endogenous engagement of sustained attention. Alerting tones may stimulate the maintenance of the goal-state, reducing reliance on the top-down control of prefrontal cortex, but this effect appears to be dependent on the level of endogenous engagement of the baseline task.

Advances in Behaviour Research and Therapy, 1992

Social learning models of relapse have included a focus on the learned reactions of substance abu... more Social learning models of relapse have included a focus on the learned reactions of substance abusers to the presence of substance use cues, but the relative roles played by cue-elicited psychophysiological reactions and urges to use have been unclear. The relationships of these kinds of cue-elicited reactions to each other, to measures of individual differences, to attentional processes, and to relapse are reviewed across three recent studies (published or to be published elsewhere). Alcoholic males who participated in one of three studies were assessed for cue reactivity (salivation and urge to drink while sniffing an alcoholic beverage versus water) as well as individual difference measures. Salivation and urge to drink have a weak or nonsignificant relationship to each other. Cue-elicited urge to drink generally correlates with negative mood, awareness of somatic reactions, attention to alcohol, and enjoyment of the sight and smell of alcohol. Salivation tends not to be related to these conscious processes although it is greater among those who expect more positive effects from alcohol, and among those with more alcohol dependence. Salivation but not urge to drink was predictive of quantity and frequency of drinking during the first three months post-detoxification. Results are generally consistent with appetitive-motivation models of alcohol use and with Tiffany's (1990) hypothesis .hat automatic processes are more important than conscious processes in drug-use behavior.

Journal of substance abuse treatment, Jan 12, 2015

Residential drug treatment provides an opportunity to intervene with smokers with substance use d... more Residential drug treatment provides an opportunity to intervene with smokers with substance use disorders (SUD). A randomized controlled clinical trial compared: (1) contingent vouchers (CV) for smoking abstinence to noncontingent vouchers (NCV), crossed with (2) motivational interviewing (MI) or brief advice (BA), for 184 smokers in SUD treatment. During the voucher period, 36% of carbon monoxide readings indicated smoking abstinence for those receiving CV versus 13% with NCV (p<.001). Post-treatment (3-9 months) point-prevalence abstinence rates were low (3-4% at each follow up), with more abstinence when CV was combined with MI (6.6% on average) than with BA (0% on average). No differential effects on drug use or motivation to quit smoking occurred. Thus, CV had limited effects on long-term smoking abstinence in this population but effects were improved when CV was combined with MI. More effective methods are needed to increase motivation to quit smoking and quit rates in this...

Addictive Behaviors, 2015

Identifying predictors of abstinence with voucher-based treatment is important for improving its ... more Identifying predictors of abstinence with voucher-based treatment is important for improving its efficacy. Smokers with substance use disorders have very low smoking cessation rates so identifying predictors of smoking treatment response is particularly important for these difficult-to-treat smokers. Intolerance for Smoking Abstinence Discomfort (IDQ-S), motivation to quit smoking, nicotine dependence severity (FTND), and cigarettes per day were examined as predictors of smoking abstinence during and after voucher-based smoking treatment with motivational counseling. We also investigated the relationship between IDQ-S and motivation to quit smoking. Smokers in residential substance treatment (n=184) were provided 14days of vouchers for complete smoking abstinence (CV) after a 5-day smoking reduction lead-in period or vouchers not contingent on abstinence. Carbon monoxide readings indicated about 25% of days abstinent during the 14days of vouchers for abstinence in the CV group; only 3-4% of all participants were abstinent at follow-ups. The IDQ-S Withdrawal Intolerance scale and FTND each significantly predicted fewer abstinent days during voucher treatment; FTND was nonsignificant when controlling for variance shared with withdrawal intolerance. The one significant predictor of 1-month abstinence was pretreatment motivation to quit smoking, becoming marginal (p&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;.06) when controlling for FTND. Lower withdrawal intolerance significantly predicted 3month abstinence when controlling for FTND. Higher withdrawal intolerance pretreatment correlated with less motivation to quit smoking. Implications for voucher-based treatment include the importance of focusing on reducing these expectancies of anticipated smoking withdrawal discomfort, increasing tolerance for abstinence discomfort, and increasing motivation.

Journal of Substance Abuse, 1996