Angela E Waldrop | University of California, San Francisco (original) (raw)

Papers by Angela E Waldrop

Addictive behaviors, 2007

This study highlights respondent sensitivity to daily hassles as it relates to situational cocain... more This study highlights respondent sensitivity to daily hassles as it relates to situational cocaine use and perceived long-term effects of adverse events in childhood. Data were drawn from a larger study on stress reactivity in cocaine dependent individuals. Participants (n=104) were cocaine dependent men and women without comorbid posttraumatic stress disorder (PTSD). They completed the Early Trauma Inventory (ETI), the Daily Hassles Scale (DHS), the Inventory of Drug-Taking Situations (IDTS), and the Time-Line Follow-Back (TLFB; for 90 days prior to interview). There were no gender differences in the amount or frequency of cocaine use, although the patterns of use differed between male and female users. Overall, there were some associations in the patterns of cocaine use and sensitivity to daily hassles, particularly the use in response to conflict with others. Early negative life events were positively related to response to daily hassles, but current triggers were more relevant. ...

Alcoholism, clinical and experimental research, 2014

The course of posttraumatic stress disorder (PTSD) is frequently and severely complicated by co-o... more The course of posttraumatic stress disorder (PTSD) is frequently and severely complicated by co-occurring alcohol use disorder (AUD), yet there are few reports of pharmacologic treatments for these comorbid conditions. The objective of this pilot study was to obtain a preliminary assessment of the efficacy and safety of topiramate in reducing alcohol use and PTSD symptoms in veterans with both disorders. This was a prospective 12-week, randomized, double-blind, placebo-controlled pilot trial of flexible-dose topiramate up to 300 mg/d in 30 veterans with PTSD and AUD. The primary outcome measure was frequency of drinking. Secondary outcomes consisted of other measures of alcohol use and PTSD symptom severity. Within-group analyses showed that topiramate treatment was associated with significant reductions in frequency and amount of alcohol use and alcohol craving from baseline through week 12. Between-group analyses showed that topiramate reduced frequency of alcohol use and alcohol ...

American Journal on Addictions, 2007

We examined predictors for age at onset of first alcohol use and onset of heaviest alcohol use am... more We examined predictors for age at onset of first alcohol use and onset of heaviest alcohol use among men (n ¼ 43) and women (n ¼ 46) with alcohol dependence and PTSD, PTSD only, alcohol dependence only, and controls, with a particular focus on individuals with child versus adult trauma. Using analysis of variance procedures, results showed differences in onset of first alcohol use and heaviest drinking between childhood and adulthood trauma victims. These preliminary results indicate that behavioral mechanisms associated with alcohol use patterns between individuals with childhood and adulthood trauma are dissimilar, suggesting greater psychopathological consequences for individuals with childhood trauma. (Am J Addict

Brief Treatment and Crisis Intervention, 2006

Substance use disorders (SUDs) and posttraumatic stress disorder (PTSD) frequently co-occur, and ... more Substance use disorders (SUDs) and posttraumatic stress disorder (PTSD) frequently co-occur, and this comorbidity results in a more severe clinical presentation and treatment outcome. Consensus is lacking regarding best practices; however, a number of integrated psychosocial treatments (e.g., Seeking Safety, Substance-Dependence PTSD Therapy, Concurrent Treatment of PTSD and Cocaine Dependence) have shown empirically supported promise in reducing symptoms of both disorders. Very little research has been conducted to date on pharmacological treatments for this dual diagnosis or on assessments. This article reviews the developing literature in this area and discusses future directions for research.

Journal of Traumatic Stress, 2007

Factors associated with suicidal ideation and attempts were examined among a national probability... more Factors associated with suicidal ideation and attempts were examined among a national probability sample of adolescents. Sample prevalences of suicidal ideation and attempts were 24.3% and 3.3%, respectively, yielding weighted population prevalence estimates of 23.3% and 3.1%. Suicidal ideation was positively associated with female gender, age, family alcohol and drug problems, violence exposure, lifetime depression, and posttraumatic stress disorder (PTSD). Suicide attempts were associated with female gender, age, sexual and physical assault, lifetime substance abuse or dependence, PTSD, and depression. Implications for intervention and prevention are discussed.

Psychoneuroendocrinology, 2006

Hypothalamic pituitary adrenal (HPA) axis and subjective stress response to a cold-water immersio... more Hypothalamic pituitary adrenal (HPA) axis and subjective stress response to a cold-water immersion task, the cold pressor task (CPT), in individuals (NZ89) with post-traumatic stress disorder (PTSD) were examined. All tests were conducted at 08:00 h after an overnight hospital stay. Plasma adrenocorticotrophin hormone (ACTH), cortisol, and subjective stress were examined at baseline and five post-task time points in controls (nZ31), subjects with PTSD as a result of an index trauma during childhood (i.e. before age 18; nZ25), and subjects with PTSD as a result of an index trauma as an adult (nZ33). Approximately, 50% of individuals in both trauma groups were alcohol dependent, and the impact of this comorbidity was also examined. Subjects with PTSD, regardless of age of index trauma, had a less robust ACTH response as compared to controls. Regardless of the presence or absence of comorbid alcohol dependence, subjects with childhood trauma had lower cortisol at baseline and at all post-task measurement points and did not demonstrate the decrease in cortisol over the course of the 2 h monitoring period seen in subjects with adult index trauma and controls. The findings reveal differences in the neuroendocrine response to the CPT in individuals with PTSD compared to control subjects, and differences in PTSD subjects when examined by age of index trauma. Q

The Journal of Nervous and Mental Disease, 2005

The Clinical Journal of Pain, 2009

Objectives-Patients prescribed opioids often display one or more aberrant prescription use behavi... more Objectives-Patients prescribed opioids often display one or more aberrant prescription use behaviors (e.g., requesting early refills, borrowing medication from family), which raise concern among health care professionals. Little is known about gender differences in specific types of aberrant behaviors or gender-specific predictors of such behaviors. The current study aimed to begin addressing this gap in the literature Methods-A battery of anonymous, self-report assessments was administered to 121 (49 men, 72 women) chronic pain patients enrolled in an outpatient pain management clinic. The majority of participants were Caucasian women with an average age of 51.6 years (SD = 13.2).

Behavior Modification, 2005

Behavioral and cognitive behavioral treatment interventions have been shown to be effective for t... more Behavioral and cognitive behavioral treatment interventions have been shown to be effective for the treatment of trauma-related problems in children. However, many children and families in need of treatment do not have adequate access to services and do not have access to effective, evidence-based treatment services. The present article describes a community-based program that provides in-home and in-school treatment services, based on behavioral and cognitive behavioral approaches to addressing trauma-related emotional and behavioral problems in children.

Archives of General Psychiatry, 2009

Context-Corticotropin-releasing hormone (CRH), through the hypothalamic pituitary adrenal (HPA) a... more Context-Corticotropin-releasing hormone (CRH), through the hypothalamic pituitary adrenal (HPA) axis and other brain stress systems, is involved in the emotional dysregulation associated with cocaine dependence. Little is known about the response of cocaine-dependent individuals to CRH administration.

The American Journal on Addictions, 2014

This study examined the role of lifetime trauma exposure in a longitudinal study of adults with c... more This study examined the role of lifetime trauma exposure in a longitudinal study of adults with cardiovascular disease to determine the unique contribution of trauma exposure to risk for drug and alcohol problems and smoking. Data were drawn from the Heart and Soul Study, a prospective cohort study designed to determine the mechanisms of associations between psychological factors and increased risk of cardiovascular events in high-risk patients (n = 1,022). Lifetime exposure to a higher number of trauma types predicted substance use outcomes beyond risk explained by PTSD and depression. In addition, across trauma types, interpersonal traumas were most strongly associated with substance use problems. Our results suggest that, though PTSD and depression play a role in the association between trauma exposure and substance use, many other factors also contribute; therefore focusing on these psychological comorbidities alone is not sufficient. The integration of mental health care and/or case management support with primary and specialty medical care may improve detection and treatment for patients with substance use and comorbid mental and physical health problems. Screening for trauma exposure is an important part of good clinical care.

The American Journal of Drug and Alcohol Abuse, 2008

This study investigated the link between exposure to early life trauma, sensitivity to current da... more This study investigated the link between exposure to early life trauma, sensitivity to current daily stressors, and cocaine dependence. Individuals with (n = 105) or without (n = 53) cocaine dependence completed the Early Trauma Inventory and the Daily Hassles Scale. In comparison to controls, cocaine-dependent individuals reported almost twice as many daily hassles and perceived those hassles more negatively (p < .001). For participants with cocaine dependence, a significant relationship between exposure to early life trauma and negative perception of current daily hassles was observed (p < .01), whereas no such relationship was observed for participants without cocaine dependence. Adverse childhood events may lead to an altered view of the environment that contributes to increased irritability with daily life events among cocaine-dependent individuals.

Alcoholism: Clinical and Experimental Research, 2006

Background: The association between stress and alcohol dependence has been well established. Abno... more Background: The association between stress and alcohol dependence has been well established. Abnormalities in stress reactivity and hypothalamic-pituitary-adrenal axis (HPA) function may be involved in the mechanistic connection between stress and the initiation, development, and/or maintenance of alcohol dependence. Posttraumatic stress disorder (PTSD) commonly co-occurs with alcohol dependence and is characterized by HPA axis abnormalities. This study investigated the relationship between subjective and neuroendocrine stress reactivity to the cold pressor task (CPT) and prospective alcohol use among individuals with alcohol dependence, with and without comorbid PTSD.

Addictive Behaviors, 2007

The present study compared high-risk triggers and substance use situations among 72 (34 men, 38 w... more The present study compared high-risk triggers and substance use situations among 72 (34 men, 38 women) individuals with alcohol (AD) or cocaine dependence (CD), with or without comorbid PTSD. Consistent with the self-medication hypothesis, individuals with PTSD reported significantly greater use of substances in response to negative situations, such as unpleasant emotions and physical discomfort, as compared to individuals without PTSD. CD individuals were significantly more likely than AD individuals to report using in temptation situations, regardless of PTSD status. Also, CD individuals with PTSD reported greater use of cocaine during pleasant times with others, as compared to those without PTSD. The findings highlight the importance of addressing individualspecific high-risk situations in relapse prevention.

Addictive Behaviors, 2008

Sleep disturbances commonly appear in the context of both posttraumatic stress disorder (PTSD) an... more Sleep disturbances commonly appear in the context of both posttraumatic stress disorder (PTSD) and alcohol use disorders. Sleep symptoms typically reported among clinical populations include delayed sleep onset, poor sleep continuity, early morning awakening, and disturbed sleep architecture. The aim of the present study was to examine multiple forms of sleep disturbances among individuals with comorbid PTSD and alcohol dependence, PTSD only, alcohol dependence only, and a control group. Both PTSD and alcohol dependence diagnoses were associated with multiple forms of sleep disturbance, but comorbidity of the two disorders did not appear to increase the risk over and above either single disorder for reporting any of the sleep difficulties examined. As PTSD symptom severity increased, so did sleep latency, mid-sleep wakening, and early morning wakening. However, contrary to our hypothesis, no significant direct relationship between severity of alcohol use and sleep disturbances was revealed. These findings suggest a need for thorough assessment of sleep symptoms in patients presenting with PTSD or alcohol dependence.

Journal of Family Violence, 2004

This paper examines the current literature regarding coping among battered women. It considers a ... more This paper examines the current literature regarding coping among battered women. It considers a number of contextual factors that are related to women's choices in coping with partner abuse, including factors related to the relationship (e.g., frequency and severity of abuse, length of relationship) and women's resources (e.g., social support, financial resources). Relationships between different forms of coping and psychological outcomes are also examined. As the research in domestic violence coping is somewhat lacking in coherence, theories, and models from the broader coping literature are used to organize the findings from the domestic violence field. Methodological concerns, such as research methods, measurement issues, and sampling, are raised throughout the paper. Suggestions for future research are made.

Journal of Traumatic Stress, 2003

Few studies have examined the impact of trauma research participation upon trauma survivors. Empi... more Few studies have examined the impact of trauma research participation upon trauma survivors. Empirical data regarding reactions to research participation would be very useful to address the question of whether it is harmful for trauma survivors to participate in trauma studies. We examined participant reactions to different trauma assessment procedures in domestic violence (N = 260), rape (N = 108), and physical assault (N = 62) samples. Results indicated that participation was very well tolerated by the vast majority of the trauma survivors. Participants generally found that the assessment experience was not distressing and was, in fact, viewed as an interesting and valuable experience. The findings suggest that trauma survivors are not too fragile to participate in trauma research even in the acute aftermath of a traumatic experience.