Deborah Brief - Academia.edu (original) (raw)

Papers by Deborah Brief

Professional Psychology: Research and Practice, 1985

Existing training opportunities in clinical neuropsychology for predoctoral interns were examined... more Existing training opportunities in clinical neuropsychology for predoctoral interns were examined and evaluated using, where possible, the proposed International Neuropsychological Association (INS) training guidelines. In general, the results indicated a continued demand for clinical neuropsychology training opportunities in internship programs. The findings suggest that most internship programs, however, are not likely to produce competent practitioners due to the programs' present structure and limited training opportunities in clinical neuropsychology. Although formal postdoctoral experiences are a major recommendation of the INS training guidelines, postdoctoral positions were, reportedly, quite limited.

American Journal on Addictions, Mar 29, 2018

Background and Objectives: Substance use disorder (SUD) has increased among women, including mili... more Background and Objectives: Substance use disorder (SUD) has increased among women, including military veterans, yet SUD treatment was historically designed for males. This randomized controlled trial compared 12 individual sessions of a gender-focused SUD recovery model, A Woman's Path to Recovery (WPR) to an evidence-based, non-gender-focused SUD model, 12-Step Facilitation (TSF) for 66 women veterans with current severe SUD. Methods: The primary outcome was substance use; secondary outcomes were associated problems (e.g., psychological); coping skills, and 12-step attendance, with assessment at baseline, end-oftreatment, and 3-month followup. Results: Substance use decreased over time, with no difference between conditions. Decreases occurred from baseline to end-oftreatment and baseline to followup and, for drug severity, also from end-of-treatment to followup. Effect sizes were large for alcohol and medium otherwise. Secondary outcomes were largely consistent with this pattern of improvement. Urinalysis/breathalyzer supported selfreport. Treatment attendance was 62% for WPR and 57% for TSF (not significantly different). Twelve-step group attendance, surprisingly, did not increase in either condition. Discussion and Conclusions: WPR provides a useful addition to women's SUD treatment options, with outcomes no different than an established evidence-based model, TSF. Both showed positive impact on substance use and related areas. Our lack of differences based on gender-focus may reflect women veterans being acculturated to a male military environment. Limitations include lack of an untreated control, a sample limited to veterans, and use of a large effect size for power assumptions. Scientific Significance: This is the first RCT of a gender-focused approach for women veterans with SUD.

Drug and Alcohol Dependence, Apr 1, 2021

OBJECTIVE Proportionally more women use online alcohol interventions but also report less robust ... more OBJECTIVE Proportionally more women use online alcohol interventions but also report less robust treatment outcomes compared to men. Less is known about outcome disparities among veteran women, who are a growing demographic nationally. The current study examined gender differences among returning veteran men and women who used VetChange, a web-based intervention for hazardous drinking and posttraumatic stress symptoms (PTSS). METHOD Using data from a nationwide implementation study of returning combat veterans (n = 222), we performed hierarchical linear modeling to examine gender differences in alcohol and PTSS outcomes over six months following VetChange registration. Additional analyses examined gender differences in proportional changes in hazardous drinking and at each assessment point. RESULTS Returning veterans reported significant decreases in alcohol use and PTSS over time, yet men evidenced significantly greater reduction in average weekly drinks and drinks per drinking day compared to women. Follow up analyses indicated that women were significantly less likely than men to achieve low-risk drinking by one month post-registration. Proportional change in alcohol use yielded marginal and non-significant trends that were, nonetheless, consistent with the overall pattern of gender differences. CONCLUSION These results contribute to emerging literature suggesting that women use online alcohol use interventions at proportionately higher rates than do men, but do not reduce their drinking as much as men. There are a number of potential content changes that could improve outcomes for returning veteran women using online interventions, and data-driven adaptations based on stakeholder input are recommended.

Psychological Trauma: Theory, Research, Practice, and Policy, Mar 7, 2022

OBJECTIVE Rates of hazardous alcohol consumption and co-occurring posttraumatic stress disorder (... more OBJECTIVE Rates of hazardous alcohol consumption and co-occurring posttraumatic stress disorder (PTSD) are high among returning combat veterans and may adversely affect satisfaction with life (SWL). Improving life satisfaction represents a potential secondary outcome of web-based interventions for alcohol use and PTSD. Understanding the relationship between intervention targets and SWL may help inform future interventions and provide clarity regarding how improvements are manifesting. We examined returning veterans enrolled in VetChange, an evidence-based web intervention for co-occurring alcohol use and PTSD, to determine changes in SWL over time and as a function of changes in alcohol consumption and PTSD symptoms. METHOD Participants included 222 returning veterans who reported hazardous drinking. Veterans engaged in a nationwide implementation of VetChange and completed measures of average weekly drinks (AWD), PTSD symptoms, and SWL at baseline, 1, 3, and 6 months. We investigated the effects of changes in PTSD and AWD between baseline and 1 month on SWL over 6 months using linear mixed-effects modeling. RESULTS Across all veterans, SWL increased by 19% over 6 months. AWD and PTSD decreased between baseline and 1 month, but only change in PTSD predicted changes in SWL over the 6-month interval. CONCLUSIONS Reductions in PTSD symptoms within the first month of intervention use, and not reductions in drinking, predicted increased SWL over 6 months. SWL is an important marker for recovery and related quality of life, and an important assessment and intervention target of web-based interventions. Interventions may also target SWL, as improvements in SWL promote future recovery and sustained improvement. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Journal of Contemporary Psychotherapy, Feb 25, 2011

A substantial number of military personnel who have served in Iraq (Operation Iraqi Freedom; OIF)... more A substantial number of military personnel who have served in Iraq (Operation Iraqi Freedom; OIF) and Afghanistan (Operating Enduring Freedom; OEF) develop symptoms of posttraumatic stress disorder (PTSD) in response to their military experiences and many of these same individuals will drink in a risky or problematic manner following deployment. If left untreated, PTSD symptoms and alcohol problems can become chronic and have a significant, negative impact on the lives of veterans, their families and communities. Further, OIF and OEF service members are often reluctant to seek treatment for mental health symptoms or alcohol problems secondary to stigma. In order to reach this population it is essential that new strategies and venues for delivering evidence-based care are explored. Web-based interventions are uniquely suited to this cohort of veterans in that they have the potential to reach a significant number of veterans who commonly use the Web and who might not otherwise receive care. This article will review the prevalence of PTSD and alcohol problems among OIF and OEF veterans, common barriers they experience with accessing care in traditional mental health settings, and what is known about the effectiveness of Web-based approaches for PTSD and alcohol problems. It also describes the components of a new Web-based intervention, developed by the authors, that uses motivational enhancement and cognitive-behavioral strategies to intervene with returning veterans who report

Journal of Substance Abuse Treatment, Mar 1, 2021

This is a PDF file of an article that has undergone enhancements after acceptance, such as the ad... more This is a PDF file of an article that has undergone enhancements after acceptance, such as the addition of a cover page and metadata, and formatting for readability, but it is not yet the definitive version of record. This version will undergo additional copyediting, typesetting and review before it is published in its final form, but we are providing this version to give early visibility of the article. Please note that, during the production process, errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.

Addictive Behaviors, Aug 1, 2020

Objective:Veterans of Iraq and Afghanistan conflicts report high rates of drinking, PTSD, and low... more Objective:Veterans of Iraq and Afghanistan conflicts report high rates of drinking, PTSD, and low rates of treatment engagement. Web interventions may help address unmet treatment need; unfortunately, little is known regarding outcomes or adherence to these interventions. In this study, we examined VetChange treatment outcomes and downstream effects of alcohol reduction on PTSD symptoms and intervention dropout rates over six months.Method:Participants included 222 veterans (77.5% men, 78.3% White) between 22 and 57 (mean age = 36.02, SD = 7.19). All VetChange users completed a brief alcohol assessment and received personal feedback, then received full access to intervention content including psychoeducation; motivational and cognitive-behavioral modules for relapse prevention, goal-setting, social support, stress, anger, and sleep management; and mood and drink tracking. Veterans completed self-report measures of alcohol use and PTSD symptoms at baseline, one, three, and six months.Results:Alcohol use dropped by 43% over six months, p < .001, with the largest decrease occurring within the first month. Greater alcohol reduction in the first month predicted higher subsequent PTSD hyperarousal severity. Over half (52.3%) dropped out by month one, followed by 12.2% and 37.6% by months three and six. Hyperarousal symptoms, hypervigilance specifically, but not alcohol use predicted subsequent intervention dropout.Conclusion:These results highlight the importance of attending to the association between alcohol use and PTSD symptom change in web-based interventions for veterans. The fact that hyperarousal symptoms were associated with elevated risk for intervention dropout signifies the need for online intervention refinement aimed at tailoring content to time-varying symptom presentations.

Physiology & Behavior, Oct 1, 1982

Streptozotocin diabetic rats received four daily subcutaneous injections of glycerol or a glycero... more Streptozotocin diabetic rats received four daily subcutaneous injections of glycerol or a glycerol solution in place of water for a seven day period. Both night and total food intake in the subcutaneous glycerol group were significantly suppressed below untreated diabetic controls. The oral glycerol group showed a nonsignificant decrease in night food intake and a significant reduction in day and total food intake. Consumption of additional fluid calories by the oral glycerol group contributed to the suppression of food intake in this group, but suppression in the subcutaneous group was unrelated to calculated calories obtained from glycerol. The oral glycerol group also consumed more of the glycerol solution than the other diabetic groups did of water. Results of this study support previous findings that subcutaneous and oral glycerol suppress food intake in normal rats although suppression with oral glycerol may have been related to caloric intake, and suggest that low plasma concentrations of insulin do not interfere with the effects obtained with glycerol in normal animals. Glycerol Diabetes Food intake Body weight Streptozotocin

Journal of Drug Issues, Sep 10, 2020

This study examined associations among cannabis use disorder (CUD), 12-step program participation... more This study examined associations among cannabis use disorder (CUD), 12-step program participation, and cannabis and other drug use at baseline and 3-and 6-month follow-ups. Participants were age 50 or older in a study of veterans receiving medical management of alcohol and/or opioid withdrawal (N = 171). Generalized estimating equations examined the extent to which time point, 12-step program participation, and CUD were associated with change in number of cannabis and non-cannabis drug use days. Also examined was whether having CUD was associated with 12-step program participation. From baseline through the 6-month follow-up, 12-step program participation increased, non-cannabis drug use decreased, and cannabis use remained stable. Twelve-step program participation at baseline was associated with better outcomes at follow-ups. Participants with CUD reported less 12-step program participation and more cannabis use days at follow-ups. Older adults with CUD may need other types of psychosocial treatments due to low participation in 12-step programs.

Applied Psychology: Health and Well-being, May 4, 2021

Understanding associations between chronic pain and health outcomes among detoxification patients... more Understanding associations between chronic pain and health outcomes among detoxification patients may help improve treatment outcomes and abstinence rates. Exercise is a modifiable lifestyle factor that may reduce the effect of pain on outcomes in this population. The current study examined whether baseline pain, exercise, and their interaction were associated with psychiatric and medical severity, and abstinence self‐efficacy, over six months following detoxification. Participants were veteran patients in alcohol or opioid detoxification treatment (N = 298) who were followed for six months (91.1%). Psychiatric severity and abstinence self‐efficacy improved over the six months after detoxification; medical severity was stable. More intense pain at baseline was associated with poorer psychiatric and medical outcomes during the post‐detoxification period. Regular exercise at baseline was associated with less psychiatric severity and more abstinence self‐efficacy during the post‐detoxification period. A significant pain by exercise interaction at baseline indicated that regular exercise was associated with more abstinence self‐efficacy during the post‐detoxification period only among participants with less intense pain. Pain by exercise interactions was not significant for the outcomes of psychiatric and medical severity. Among detoxification patients, exercise may be beneficial in improving outcomes among those with less intense pain.

Page 296. Chapter 15 Assessment of PTSD and Its Comorbidities in Adults Terence M. Keane, Deborah... more Page 296. Chapter 15 Assessment of PTSD and Its Comorbidities in Adults Terence M. Keane, Deborah J. Brief, Elizabeth M. Pratt, and Mark W. Miller The initial inclusion of posttraumatic stress disorder (PTSD) in the third edition ...

Substance Use & Misuse, Oct 28, 2009

Adverse psychosocial outcomes can be anticipated among youth exposed to Hurricane Katrina. Adoles... more Adverse psychosocial outcomes can be anticipated among youth exposed to Hurricane Katrina. Adolescents are particularly vulnerable to the consequences of this natural disaster and may suffer lasting consequences in the form of psychological morbidity and the development of negative health behaviors due to their exposure. We review existing literature on the effects of exposure to natural disasters and similar traumas on youth and, where data on youth are unavailable, on adults. The effect of natural disasters is discussed in terms of risk for three negative health outcomes that are of particular concern due to their potential to cause long-term morbidity: post-traumatic stress disorder, substance use disorder, and HIV-risk behavior. Where available, data from studies of the effects of Hurricane Katrina are included.

Annals of Behavioral Medicine, Sep 1, 1995

This study examined whether self-efficacy was associated with lipid lowering and dietary change a... more This study examined whether self-efficacy was associated with lipid lowering and dietary change among men undergoing dietary counseling to lower cholesterol levels. Twenty-five hyperlipidemic men (total cholesterol >-220 mg/dL) participated in four weeks of dietary instruction. Plasma lipids were measured prior to treatment, at posttreatment, and at three-and twelvemonth follow-up. Dietary intake and self-eJficacy as measured by the revised Eating Self-Efficacy Scale (ESES-R) were assessed at pretreatment, posttreatment, and three-month follow-up. Pretreatment to posttreatment increases in self-efftcacy in situations characterized by negative affect were related to extent of lipid lowering and dietary change. Although subjects showed significant reductions in cholesterol levels following treatment, by one year, lipid levels had returned to pretreatment values. Factors related to long-term maintenance of dietary change and lipid lowering among hyperlipidemics merit further research.

Brain Research Bulletin, May 1, 1984

crnd hcdy tt,rig/zr hy c~hrot~ic~ i/~rru~c~,?tric.u/ar insulin infirsion. BRAIN RES BULL 12(5) 57... more crnd hcdy tt,rig/zr hy c~hrot~ic~ i/~rru~c~,?tric.u/ar insulin infirsion. BRAIN RES BULL 12(5) 571-575, 1984.-This study examined the effect of chronic infusions of insulin in one of three doses (S. 7.5 or IO mu/day) into the third ventricle. 'A Portion of these results was previously reported at the Society for Neuroscience. Los Angeles, 1982. 'Requests for reprints should be addressed to .I. D. Davis.

BACKGROUND eHealth tools have the potential to meet the mental health needs of individuals who ex... more BACKGROUND eHealth tools have the potential to meet the mental health needs of individuals who experience barriers to accessing in-person treatment. However, most users have less than optimal engagement with eHealth tools. Coaching from peer specialists may increase their engagement with eHealth. OBJECTIVE This pilot study aims to test the feasibility and acceptability of a novel, completely automated web-based system to recruit, screen, enroll, assess, randomize, and then deliver an intervention to a national sample of military veterans with unmet mental health needs; investigate whether phone-based peer support increases the use of web-based problem-solving training compared with self-directed use; and generate hypotheses about potential mechanisms of action for problem-solving and peer support for future full-scale research. METHODS Veterans (N=81) with unmet mental health needs were recruited via social media advertising and enrolled and randomized to the self-directed use of a web-based problem-solving training called Moving Forward (28/81, 35%), peer-supported Moving Forward (27/81, 33%), or waitlist control (26/81, 32%). The objective use of Moving Forward was measured with the number of log-ins. Participants completed pre- and poststudy measures of mental health symptoms and problem-solving confidence. Satisfaction was also assessed post treatment. RESULTS Automated recruitment, enrollment, and initial assessment methods were feasible and resulted in a diverse sample of veterans with unmet mental health needs from 38 states. Automated follow-up methods resulted in 46% (37/81) of participants completing follow-up assessments. Peer support was delivered with high fidelity and was associated with favorable participant satisfaction. Participants randomized to receive peer support had significantly more Moving Forward log-ins than those of self-directed Moving Forward participants, and those who received peer support had a greater decrease in depression. Problem-solving confidence was associated with greater Moving Forward use and improvements in mental health symptoms among participants both with and without peer support. CONCLUSIONS Enrolling and assessing individuals in eHealth studies without human contact is feasible; however, different methods or designs are necessary to achieve acceptable participant engagement and follow-up rates. Peer support shows potential for increasing engagement in web-based interventions and reducing symptoms. Future research should investigate when and for whom peer support for eHealth is helpful. Problem-solving confidence should be further investigated as a mechanism of action for web-based problem-solving training. CLINICALTRIAL ClinicalTrials.gov NCT03555435; http://clinicaltrials.gov/ct2/show/NCT03555435

Physiology & Behavior, Jun 1, 1992

We examined the effect of acute third intraventricular (IVT) injections of either saline or NPY (... more We examined the effect of acute third intraventricular (IVT) injections of either saline or NPY (0.95, 3.0, 9.5, or 30.0 ug in 1 ul) on the 1-, 4-, and 22-hour postinjection food and water intake of female obese (fa/fa), heterozygous lean (Fa/fa), and homozygous lean (Fa/Fa) Zucker rats. None of the doses of NPY had an effect on either food or water intake of fa/fa rats. A significant increase of food intake was seen in Fa/Fa rats at 1 and 4 hours after the 3.0 ug injection of NPY and at 1, 4, and 22 hours after the 9.5 #g injection of NPY. Both 3.0 and 9.5 ug of NPY also stimulated 1-and 4-hour postinjection food intake of Fa/fa rats, although this effect was significant only at 4 hours after the 3.0/~g dose. NPY had a less reliable effect on water intake; 3.0 ug of NPY stimulated 1-hour postinjection water intake of Fa/fa rats and 4-hour postinjection water intake of Fa/Fa rats. These results indicate that lean, but not obese Zucker rats, respond by eating more to centrally administered NPY. This deficit is similar to the effects seen with IVT insulin injections and may be a result of a common receptor-mediated mechanism.

Aids and Behavior, Aug 9, 2008

This study assessed adherence to HAART among 67 HIV-infected adults, and the degree to which gend... more This study assessed adherence to HAART among 67 HIV-infected adults, and the degree to which gender and psychological factors-including depression, drug and alcohol use, quality of life, and medication side effects-influenced adherence. Although overall adherence was greater than rates reported in similar studies, no significant difference in adherence was observed between men and women in the present sample. Medication side effects were a significant predictor of non-adherence in the sample at large and among women in particular, while alcohol dependence was a significant predictor of non-adherence only in women. Possible explanations are explored.

Physiology & Behavior, Sep 1, 1982

Male rats were provided with flavored solutions (0.3 M glucose, 0.3 M glycerol or 0.6 M glycerol)... more Male rats were provided with flavored solutions (0.3 M glucose, 0.3 M glycerol or 0.6 M glycerol) or water before and after the induction of diabetes by streptozotocin. Normal animals given 0.3 M glucose showed a significant increase in fluid intake but normal animals offered the glycerol solutions did not show an increase in intake compared to animals given water. After the onset of diabetes, exposure to the same flavored solutions resulted in significant increases in fluid intake by animals offered both the glycerol and glucose solutions. The animals offered glucose consumed significantly more than did the animals offered the glycerol solutions. The animals offered 0.6 M glycerol consumed significantly more than did the animals offered 0.3 M glycerol on 8 out of the 10 days of exposure. Therefore, while diabetes does not appear to modify the palatability of glucose it seems to produce an enhanced palatability for glycerol not seen in normal rats. Glycerol Glucose Palatability Diabetes Streptozotocin (I) Water Water Water Water (2) 0.3MGlucose Water 0.3MGlucose Water (3) 0.3 M Giycerol Water 0.3 M Glycerol Water (4) 0.6MGlycerol Water 0.6MGlycerol Water Water Water Water 0.3 M Glucose Water 0.3 M Glycerol Water 0.6MGlycerol

Journal of Substance Abuse Treatment, May 1, 2015

Although completion of detoxification (detox) and a successful transition from detox to substance... more Although completion of detoxification (detox) and a successful transition from detox to substance use disorder (SUD) treatment and/or mutual-help groups are associated with better SUD outcomes, many patients do not complete detox or do not receive SUD care following detox. The purpose of this structured evidence review, summarizing data extraction on a yield of 26 articles, is to identify patient, program, and system factors associated with the outcomes of completion of alcohol detox and successful transitions from alcohol detox to SUD treatment and mutual-help group participation. The review found wide variability among studies in the rates at which patients complete a detox episode (45 to 95%) and enter SUD treatment or mutual-help groups after detox (14 to 92%). Within program factors, behavioral practices that contribute to both detox completion and transitioning to SUD care after detox entail involving the patient's family and utilizing motivational-based approaches. Such practices should be targeted at younger patients, who are less likely to complete detox. Although more studies using a randomized controlled trial design are needed, the evidence suggests that barriers to detox completion and transition to SUD care can be overcome to improve patient outcomes.