Affective antecedents and consequences of revealing and concealing a lesbian, gay, or bisexual identity.

This study examined affect as it relates to the identity management (IM) experiences of lesbian, gay, and bisexual (LGB) workers. We integrate IM theories and evidence (Chaudoir & Fisher, 2010; Pachankis, 2007) within the framework of affective events theory (Weiss & Cropanzano, 1996) to predict relationships among mood, identity management, and emotion at work. LGB participants rated aspects of positive and negative affect each work morning and immediately following IM situations at work over 3 weeks, making it possible to examine within-person changes and next-day consequences of IM. Our results provided little support for the notion that LGB workers' IM behaviors are driven by affect. However, there do appear to be affective consequences of IM behaviors. After concealment, participants experienced diminished positive affect and increased negative affect; in contrast, revealing was associated with increased positive affect and diminished negative affect. Additionally, these immediate affective consequences of identity management continued into the following day for some facets of affect. We examine these findings as they relate to the identity management and affect literatures, thereby building new insights into their intersections. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

A Naturalistic Evaluation of Extended-Release Naltrexone in Clinical Practice in Missouri.

The purpose of this study was to compare the naturalistic outcomes of individuals with alcohol or opioid use problems who were treated with extended-release naltrexone (XR-NTX) to those treated with psychosocial treatment only and also to those treated with other medication-assisted therapies in Missouri during 2010 to 2011. We analyzed intake and discharge data collected as part of SAMHSA's Treatment Episode Data Set assessments. Patients who received XR-NTX during their treatment episode were compared, for those reporting alcohol (but not opioids) as their problem (N=21,137), to those who received oral naltrexone, acamprosate, and psychosocial treatment only, and for those who reported opioids as a problem (N=8996), to those receiving oral naltrexone, buprenorphine/naloxone, and psychosocial treatment only. Group differences were adjusted using propensity score weighting, with propensity scores derived from 18 intake variables. For the alcohol sample, patients who received XR-NTX vs. the oral naltrexone group had superior composite outcomes on a measure combining abstinence, self-help participation, employment, and arrests. For the opioid sample, XR-NTX was found to have significantly better outcomes than oral naltrexone on the composite outcome measure. For both the alcohol and opioid samples, the group that received XR-NTX stayed in treatment longer vs. psychosocial treatment only. In the opioid sample, those receiving buprenorphine/naloxone remained in treatment longer than those receiving XR-NTX.

Predicting outcome of substance abuse treatment in a feedback study: Can recovery curves be improved upon?

OBJECTIVE: The goal of the study was to evaluate whether enhanced normative feedback recovery curves are needed for treatment of substance use problems. METHOD: Patient predictors of outcome were examined using data from four substance abuse treatment clinics. RESULTS: Baseline severity of symptoms/functioning, employment, and craving were found to be associated with rate of change in symptoms/functioning. Several other variables were associated with rate of change in alcohol use, although in the opposite direction than found in efficacy trials. CONCLUSIONS: The results point to the complexity of designing feedback systems using normative recovery curves for those with substance use problems and highlight the important differences between real-world treatment of those with substance use problems compared to data from efficacy trials.

Moving evidence-based practice forward successfully: commentary on Laska, Gurman, and Wampold.

Laska, Gurman, and Wampold (2014, pp. 467-481) present their common factors (CF) model as an alternative/complement to existing empirically supported treatments. The CF model is largely based on nonrandomized studies and a post hoc interpretation of a lack of differences between psychotherapies in their outcomes. Our view is that the CF model would be advanced through randomized experiments that test the specific components that Laska et al. (2014) hypothesize as necessary and sufficient for change. With some notable exceptions, we agree with many of the points made by Laska et al. (2014) regarding the relevance of the CF perspective to the delivery of psychotherapy in general, but suggest that prospective studies that control for potential confounds are needed to successfully advance the CF model or any other model of psychotherapy.

Combined medication and CBT for generalized anxiety disorder with African American participants: reliability and validity of assessments and preliminary outcomes.

Using data from a study of combined cognitive behavioral therapy (CBT) and venlafaxine XR in the treatment of generalized anxiety disorder (GAD), the current article examines the reliability and convergent validity of scales, and preliminary outcomes, for African American compared with European American patients. Internal consistency and short-term stability coefficients for African Americans (n=42) were adequate and similar or higher compared with those found for European Americans (n=164) for standard scales used in GAD treatment research. Correlations among outcome measures among African Americans were in general not significantly different for African Americans compared with European Americans. A subset of patients with DSM-IV-diagnosed GAD (n=24 African Americans; n=52 European Americans) were randomly selected to be offered the option of adding 12 sessions of CBT to venlafaxine XR treatment. Of those offered CBT, 33.3% (n=8) of the African Americans and 32.6% (n=17) of the European Americans accepted and attended at least one CBT treatment session. The outcomes for African Americans receiving combined treatment were not significantly different from European Americans receiving combined treatment on primary or secondary efficacy measures.

Predictors and moderators of outcomes of HIV/STD sex risk reduction interventions in substance abuse treatment programs: a pooled analysis of two randomized controlled trials.

BACKGROUND: The objective of the current study was to examine predictors and moderators of response to two HIV sexual risk interventions of different content and duration for individuals in substance abuse treatment programs. METHODS: Participants were recruited from community drug treatment programs participating in the National Institute on Drug Abuse Clinical Trials Network (CTN). Data were pooled from two parallel randomized controlled CTN studies (one with men and one with women) each examining the impact of a multi-session motivational and skills training program, in comparison to a single-session HIV education intervention, on the degree of reduction in unprotected sex from baseline to 3- and 6- month follow-ups. The findings were analyzed using a zero-inflated negative binomial (ZINB) model. RESULTS: Severity of drug use (p < .01), gender (p < .001), and age (p < .001) were significant main effect predictors of number of unprotected sexual occasions (USOs) at follow-up in the non-zero portion of the ZINB model (men, younger participants, and those with greater severity of drug/alcohol abuse have more USOs). Monogamous relationship status (p < .001) and race/ethnicity (p < .001) were significant predictors of having at least one USO vs. none (monogamous individuals and African Americans were more likely to have at least one USO). Significant moderators of intervention effectiveness included recent sex under the influence of drugs/alcohol (p < .01 in non-zero portion of model), duration of abuse of primary drug (p < .05 in non-zero portion of model), and Hispanic ethnicity (p < .01 in the zero portion, p < .05 in the non-zero portion of model). CONCLUSION: These predictor and moderator findings point to ways in which patients may be selected for the different HIV sexual risk reduction interventions and suggest potential avenues for further development of the interventions for increasing their effectiveness within certain subgroups.