Lesia Ruglass - Academia.edu (original) (raw)

Papers by Lesia Ruglass

Tobacco Induced Diseases

INTRODUCTION Tobacco use remains a primary cause of health disparities between Black and White Am... more INTRODUCTION Tobacco use remains a primary cause of health disparities between Black and White Americans. Current approaches have not improved tobaccorelated racial health disparities. This study aimed to identify differences in factors associated with tobacco product use among Black and White adolescents. METHODS This cross-sectional design used data from Wave One (2013-2014) of the Population Assessment of Tobacco and Health Study. Adolescents aged 12-17 years who identified as non-Hispanic Black or African American (n=1800) or non-Hispanic White (n=6495) were included. Primary outcomes were the ever use and current use of any tobacco products. Sociocultural, household environment, psychological, and behavioral factors were included. Logistic regressions, stratified by race, were used to determine significance. Dominance analysis was used to rank significant factors by their level of importance. RESULTS Although there were many Black-White commonalities, there were also important differences. Black adolescents in the Northeast were more likely to have ever used tobacco compared to those in the South (OR=0.6; 95% CI: 0.6-0.7, p<0.001) and Midwest (OR=0.6; 95% CI: 0.5-0.7, p<0.001). White adolescents in the Northeast were less likely to use tobacco products than in other regions. Peer influences (OR=1.9; 95% CI: 1.1-3.2, p<0.05) were uniquely associated with ever use among Black adolescents. Access to tobacco in the home (OR=2.0; 95% CI: 1.4-3.0, p<0.001) and thinking that tobacco use would help reduce stress (OR=1.3; 95% CI: 1.1-1.6, p<0.01) were uniquely associated with current use among Black adolescents. CONCLUSIONS There are significant Black-White differences in the factors associated with tobacco use. Factors uniquely associated with Black adolescent tobacco use should be considered in developing strategies to prevent adolescent tobacco use in Black communities.

American Journal of Psychiatry

Journal of Psychoactive Drugs, 2021

Several health inequities exist among racial/ethnic minoritized populations (REMPs) who use subst... more Several health inequities exist among racial/ethnic minoritized populations (REMPs) who use substances including disparities in use patterns, inequities in health and legal consequences of use, as well as in treatment access and effectiveness. To address these inequities, more research is needed to examine the associated factors and identify areas for improving treatment. Divided into three categories, this special issue includes papers that examine the social and contextual factors that are associated with substance use among REMPs, papers that consider the role of racism and discrimination on substance use, and papers that explore racial/ethnic differences in treatment access and outcomes. Recommendations for advancing health equity in substance use research are also included.

Journal of Traumatic Stress, 2020

The present study introduced a modernized approach to Jacobson and Truax's (1991) methods of esti... more The present study introduced a modernized approach to Jacobson and Truax's (1991) methods of estimating treatment effects on individuallevel (a) movement from the clinical to the normative range and (b) reliable change on posttraumatic stress disorder (PTSD) severity. Participants were 450 trauma-exposed women (M age = 39.2 years, SD = 8.9, range: 18-65 years) who presented to seven geographically diverse community mental health and substance use treatment centers. Data from 53 of these women, none of whom met the criteria for full or subthreshold PTSD, were used to establish the normative range. Using moderated nonlinear factor analysis (MNLFA) scale scoring, which weights symptoms by their clinical relevance, a significantly larger proportion of participants moved into the normative range for PTSD severity scores and/or exhibited reliable changes after treatment compared to the same individuals' movement when using symptom counts. Further, approximately 24% of the participants showed discrepant judgments on reliable change indices (RCI) between MNLFA scores and symptom counts, likely due to the false assumption that the standard error of measurement is equal for all levels of underlying PTSD severity when estimating RCIs with symptom counts. An MNLFA approach to estimating underlying PTSD severity can provide clinically meaningful information about individual-level change without the de facto assumption that PTSD symptoms have equivalent weight. Study implications are discussed with regard to a joint emphasis on (a) measurement models that highlight differential symptom weighting and (b) treatment-arm differences in individual-level outcomes rather than the current overemphasis of treatment-arm differences on group-averaged trajectories. The primary goal of most psychosocial and pharmacological treatments is to help patients return to a healthy or normative level of functioning. Unfortunately, the typical focus of most treatment outcome studies puts a larger emphasis on evaluating the differences between one group of patients who received

Journal of Substance Abuse Treatment, 2020

Introduction: The "Women and Trauma" Study (WTS) conducted in the National Drug Abuse Treatment C... more Introduction: The "Women and Trauma" Study (WTS) conducted in the National Drug Abuse Treatment Clinical Trials Network (CTN-0015) resulted in research publications, presentations, and a train-the-trainer workshop to support dissemination efforts for skills-based trauma treatment in substance use community treatment. Twelve years after its completion, this paper aims to examine whether and how the WTS contributed to knowledge in the field of trauma and addictions and inspired community treatment programs (CTPs) to train staff to identify and provide trauma-related services. Method: We present findings from two different analyses that explored longer term study impacts on treatment and dissemination: (1) a post-study site survey covering 4 domains from 4/7 programs that participated in delivering the WTS to evaluate their perceptions of study impact on their treatment community; and (2) an analysis of citations of its publications to determine impact on the scientific community. Results: Surveys from responding sites indicated that participation in the study significantly increased their agencies'' awareness of the need to take a focused approach to treating trauma issues in this population. Specifically, these sites increased their commitment to using skills-based trauma treatment with the study's target population of female patients with SUD and trauma histories, as well as expanding it to other groups affected by trauma. Citation analysis revealed that according to the Web of Science, as of August 2019, the number of citations of 24 CTN-0015 articles, ranged from 1 to 135 (Mean = 20, SD = 33; Median = 6). Four of the most influential are discussed. Conclusions: This manuscript provides original information about the contributions of the WTS study, demonstrating how the study contributed to serving women with trauma in community substance use treatment. 1. Introduction An integral part of the National Drug Abuse Treatment Clinical Trials Network (CTN) vision is to address the need for treatment providers to adopt new and effective treatments for diverse client populations, using research to promote the adoption of such treatments. The Women and Trauma Study (WTS, CTN-0015) is the largest multisite randomized clinical trial testing the feasibility and safety of

Neuroscience & Biobehavioral Reviews, 2021

Neuroscience Letters, 2020

Black cigarette smokers experience higher craving, lower cessation rates, and increased health co... more Black cigarette smokers experience higher craving, lower cessation rates, and increased health complications from tobacco use than Whites. We examined psychophysiological and behavioral differences in attentional bias to smoking cues between Black and White smokers. Thirty-one participants (Blacks, n = 20; MAge = 45 and Whites, n = 11, MAge = 47.64) discriminated line orientations while ignoring temporally flanking lines and smoking-related, positive-, negative-, and neutral-images as behavioral responses and event-related potentials (ERPs) were recorded. Results revealed a three-way interaction in reaction time among Group (White, Black), Congruity (congruent vs. incongruent flankers) and Cue (smoking-related, positive, negative) factors, F (2,58) = 3.63, p = .03, MSe = .001, η2 = .002. Smoking-related cues yielded the largest congruity effects in Whites, but the smallest congruity effects in Blacks. Random presentation of smoking-*

Journal of Psychopathology and Behavioral Assessment, 2020

Optimizing treatment for co-occurring post-traumatic stress disorder and substance use disorder (... more Optimizing treatment for co-occurring post-traumatic stress disorder and substance use disorder (PTSD+SUD) is critically important. Whereas treatments have been designed that target PTSD +SUD with some success, these treatments do not benefit all. Data-driven approaches that combine person-and variable-centered methods, such as parallel process latent class growth analysis (PP-LCGA) can be used to identify response-to-treatment trajectories across both PTSD symptoms and substance use. The current study employed PP-LCGA separately in two randomized clinical trials (study 1 n = 81, Mean age = 40.4 years, SD = 10.7; study 2 n = 59, Mean age = 44.7 years, SD = 9.4) to examine PTSD symptom response and percentage of days using substances across treatment trials comparing Concurrent Treatment of PTSD and SUD using Prolonged Exposure and Relapse Prevention. Results revealed four PTSD+SUD profiles for study one and three PTSD+SUD profiles for study two. For PTSD symptoms, response trajectories could be broadly classified into treatment responders and non-responders across both studies. For substance use, response trajectories could be broadly classified into declining, moderately stable, Terms of use and reuse: academic research for non-commercial purposes, see here for full terms. http://www.springer.com/gb/openaccess/authors-rights/aam-terms-v1

Psychology of Trauma 101 is part of the Psych 101 Series that includes Motivation 101, Emotional ... more Psychology of Trauma 101 is part of the Psych 101 Series that includes Motivation 101, Emotional Intelligence 101, and so forth. The goal, I infer, is to bring the basics of psychology to the public, one topic at a time. Psychology of trauma is not typically presented to students or the public this way. Typically, an introductory psychology class would cover stress, mental health,

Substance Use & Misuse, 2019

Background: Cannabis and tobacco use are significant public health concerns among young adults, w... more Background: Cannabis and tobacco use are significant public health concerns among young adults, with concurrent (in the same time period) and simultaneous (at the same time so the effects overlap) use of both substances on the rise. Few studies have examined these behaviors among college students. Objective: We examined the prevalence of concurrent and simultaneous cannabis and cigarette (combustible or electronic) use among a sample of college students and characterized the psychosocial predictors of concurrent and simultaneous use compared to using cannabis alone.

Journal of the National Medical Association, 2019

Background: African American smokers suffer disproportionately from tobacco-related disease cause... more Background: African American smokers suffer disproportionately from tobacco-related disease caused, in part, by lower rates of smoking cessation. We examined whether smoke-free home policies and delay discounting were differentially associated with cigarettes smoked per day (CPD) and nicotine dependence (ND) among African Americans and Whites.

Journal of consulting and clinical psychology, 2018

To advance understanding of the effectiveness of evidence-based treatments for comorbid posttraum... more To advance understanding of the effectiveness of evidence-based treatments for comorbid posttraumatic stress disorder (PTSD) and substance use disorder (SUD), research must provide a more nuanced picture of how substance use affects change in PTSD symptoms over the course of treatments and whether prolonged exposure techniques can be efficacious during active substance use. A data set that included patients with PTSD/subthreshold-PTSD and SUD treated with an exposure-based intervention provided an opportunity to conduct a secondary analysis to test how patients' substance use impacted PTSD change over treatment. We applied growth models to week-to-week PTSD symptom and substance use changes during treatment and follow-up of a randomized controlled trial of two cognitive-behavioral treatments for PTSD and SUD: Concurrent Treatment of PTSD and SUD Using Prolonged Exposure (COPE) and Relapse Prevention Therapy (RPT). Cross-lagged analyses were used to determine whether prior week s...

Frontiers in human neuroscience, 2018

Two groups of healthy young adults were exposed to 3 weeks of cognitive training in a modified ve... more Two groups of healthy young adults were exposed to 3 weeks of cognitive training in a modified version of the visual flanker task, one group trained to discriminate the target (discrimination training) and the other group to ignore the flankers (inhibition training). Inhibition training, but not discrimination training, led to significant reductions in both Garner interference, indicating improved selective attention, and in Stroop interference, indicating more efficient resolution of stimulus conflict. The behavioral gains from training were greatest in participants who showed the poorest selective attention at pretest. Electrophysiological recordings revealed that inhibition training increased the magnitude of Rejection Positivity (RP) to incongruent distractors, an event-related potential (ERP) component associated with inhibitory control. Source modeling of RP uncovered a dipole in the medial frontal gyrus for those participants receiving inhibition training, but in the cingulat...

Biological psychology, 2018

The current study investigated links between trauma exposure, Post-traumatic Stress Disorder (PTS... more The current study investigated links between trauma exposure, Post-traumatic Stress Disorder (PTSD) symptoms, and inhibitory control assessed using a modified version of the visual flanker task. The study had three aims: (1) specifically confirm general non-affective deficits in sustained attention in PTSD; (2) probe the influence of threatening and trauma-related stimuli on inhibitory control; and (3) explore neural correlates connecting PTSD, facets of dissociation, and inhibitory control. Participants with PTSD (n = 16), trauma-exposed individuals without PTSD (TE; n = 14), and healthy controls (n = 15) discriminated line orientations while ignoring temporally flanking lines and images depicting threatening or non-threatening scenes or faces. Electrophysiological recordings were made during task performance. Relative to TE participants, PTSD participants had poor sustained non-affective attention, but nevertheless exhibited greater inhibition of distractors (i.e., high event-rela...

Child Abuse & Neglect, 2017

Psychotherapy and psychosomatics, 2017

To test whether an integrated prolonged exposure (PE) approach could address posttraumatic stress... more To test whether an integrated prolonged exposure (PE) approach could address posttraumatic stress disorder (PTSD) symptoms effectively in individuals with co-occurring substance use disorders (SUD), we compared concurrent treatment of PTSD and SUD using PE (COPE) to relapse prevention therapy (RPT) for SUD and an active monitoring control group (AMCG). We conducted a randomized 12-week trial with participants (n = 110; 64% males; 59% African Americans) who met Diagnostic and Statistical Manual of Mental Disorders, fourth edition, text revision criteria for full or subthreshold PTSD and SUD. Participants were randomly assigned to COPE (n = 39), RPT (n = 43), or AMCG (n = 28). At the end-of-treatment, COPE and RPT demonstrated greater reduction in PTSD symptom severity relative to AMCG (COPE-AMCG = -34.06, p < 0.001; RPT-AMCG = -22.58, p = 0.002). Although the difference between COPE and RPT was not significant in the complete sample, the subset of participants with full (vs. subth...

Journal of abnormal psychology, 2017

The use of fear conditioning and extinction paradigms to examine intermediate phenotypes of anxie... more The use of fear conditioning and extinction paradigms to examine intermediate phenotypes of anxiety and stress-related disorders has facilitated the identification of neurobiological mechanisms that underlie specific components of abnormal psychological functioning. Across species, acute pharmacologic manipulation of the endogenous cannabinoid system has provided evidence of its critical role in fear extinction, but the effects of chronic cannabis on extinction are relatively understudied. In rats, chronic cannabinoid administration impairs fear extinction in a drug-free state. Here we examine whether chronic cannabis use is associated with impaired fear extinction in humans. Participants were healthy chronic cannabis users (n = 20) and nonuser controls with minimal lifetime cannabis use (n = 20) matched on age, sex, and race who all screened negative for psychiatric disorders. A 2-day differential fear conditioning paradigm was used to test the hypothesis that chronic cannabis use ...

Journal of clinical medicine, Jan 7, 2017

Research has demonstrated a strong link between trauma, posttraumatic stress disorder PTSD and su... more Research has demonstrated a strong link between trauma, posttraumatic stress disorder PTSD and substance use disorders (SUDs) in general and cannabis use disorders in particular. Yet, few studies have examined the impact of cannabis use on treatment outcomes for individuals with co-occurring PTSD and SUDs. Participants were 136 individuals who received cognitive-behavioral therapies for co-occurring PTSD and SUD. Multivariate regressions were utilized to examine the associations between baseline cannabis use and end-of-treatment outcomes. Multilevel linear growth models were fit to the data to examine the cross-lagged associations between weekly cannabis use and weekly PTSD symptom severity and primary substance use during treatment. There were no significant positive nor negative associations between baseline cannabis use and end-of-treatment PTSD symptom severity and days of primary substance use. Cross-lagged models revealed that as cannabis use increased, subsequent primary subs...

Psychiatry research, Jan 30, 2016

Posttraumatic stress disorder (PTSD) research has focused largely on fear processing. However, in... more Posttraumatic stress disorder (PTSD) research has focused largely on fear processing. However, interpersonal trauma exposure can also impact interpersonal functioning and the perception of the trustworthiness of others. The present study examined facial perceptions of fearfulness and trustworthiness in individuals with PTSD (n=29), trauma-exposed without PTSD (n=19), and healthy controls (n=18). The PTSD group was hypothesized to exhibit a bias to perceive more fear and untrustworthiness in faces relative to controls. Participants rated the level of fearfulness or trustworthiness of faces that were parametrically morphed along a fear or trustworthiness dimension. The PTSD group was biased to perceive faces as more trustworthy compared to the trauma-exposed healthy controls, yet there were no differences between groups in fear processing. A trustworthiness bias in PTSD may represent a vulnerability factor. Conversely, lower trustworthiness perception may represent a protective dispos...