Traumatic stressor exposure and post-traumatic symptoms in homeless veterans.

Objectives: To better understand potential risk factors for post-traumatic stress disorder (PTSD) and homelessness in veterans, we studied trauma exposure and responses in archival data on 115 homeless veterans.

Methods: Rates of exposure to military and a variety of civilian high magnitude stressor (HMS) and persistent post-traumatic distress (PPD) events and symptoms of post-traumatic stress were assessed. The relationships between frequency of different trauma types and symptoms of post-traumatic stress were examined.

Development and validation of a brief self-report measure of trauma exposure: the Trauma History Screen.

Although information about individuals' exposure to highly stressful events such as traumatic stressors is often very useful for clinicians and researchers, available measures are too long and complex for use in many settings. The Trauma History Screen (THS) was developed to provide a very brief and easy-to-complete self-report measure of exposure to high magnitude stressor (HMS) events and of events associated with significant and persisting posttraumatic distress (PPD). The measure assesses the frequency of HMS and PPD events, and it provides detailed information about PPD events.

Motivational interview improves treatment entry in homeless veterans.

Motivational Interviewing (MI) has successfully been used to facilitate entry and compliance in drug and alcohol treatment programs. Some questions have been raised as to the effectiveness of MI in severely distressed populations. This study aims to assess the effectiveness of MI in a population of homeless, unemployed, and substance dependent veterans who are being wait-listed for entry into a residential treatment program.

Client predictors of treatment retention and completion in a program for homeless veterans.

This study assessed the value of a specific set of client variables in predicting treatment retention and completion of a rehabilitation program for homeless veterans. Participants were 596 (22 female) military veterans admitted to the Palo Alto, California Veterans Administration domicilary program between 1992 and 1995. Information was collected on a number of demographic and background characteristics previously used to predict treatment retention and outcomes.

Causes of death among male veterans who received residential treatment for PTSD.

Previous studies have shown elevated mortality among psychiatric and substance abusing patients, including veterans with PTSD. Although early studies showed elevated deaths from external causes among Vietnam veterans in the early postwar years, more recent studies have also shown increased health problems among veterans with PTSD. This study compared mortality due to behavioral causes versus other diseases among 1,866 male veterans treated for PTSD.

A comparison of self-report measures of nicotine dependence among male drug/alcohol-dependent cigarette smokers.

This study examined the psychometric properties and validity of the Fagerström Tolerance Questionnaire (FTQ), the Fagerström Test for Nicotine Dependence (FTND), and the Heaviness of Smoking Index (HSI) when used as self-report measures of nicotine dependence among male drug/alcohol-dependent smokers (n=191 participants in a large stop-smoking study). All three measures had fairly low internal consistency. The FTQ and FTND had similar two-factor structures, but the FTND factor structure accounted for a greater percentage of the item variance.

A controlled smoking cessation trial for substance-dependent inpatients.

Smoking treatment for newly recovering drug and alcohol-dependent smokers in a residential rehabilitation program was examined. The randomly assigned conditions (n = 50 each) were multicomponent smoking treatment (MST), MST plus generalization training of smoking cessation to drug and alcohol cessation (MST+G), or usual care (UC). Fifty participants who declined smoking treatment (treatment refusers) also were studied.

Issues related to smoking cessation among substance abusers.

Initial studies have found that stop-smoking treatments for newly recovering substance abusers have been neither harmful to sobriety nor effective in achieving smoking cessation. The development of more effective stop-smoking treatments for this population could be aided by delineating their particular smoking-related characteristics. This article describes the biopsychosocial characteristics of newly recovering substance abusers that are relevant to smoking cessation, and suggests that there are notable differences between abusers and nonabusers that may contribute to abusers' greater difficulty in quitting smoking.

Cigarette smoking in alcohol and cocaine abusers.

This study compared the cigarette smoking of substance abusers whose primary substance of abuse was cocaine (cocaine group: n = 18) or alcohol (alcohol group: n = 23). Cigarette smoking and smoking topography was assessed daily (via self-report and single cigarette topography assessments) at baseline and following a switch to a cigarette brand with 30% lower nicotine. The alcohol and cocaine groups did not differ at baseline on cigarettes smoked per day, cigarette nicotine, smoking topography, or the Fagerstrom Tolerance Questionnaire.

Substance-dependent inpatients who accept smoking treatment.

Delineating the characteristics of substance-dependent inpatients who are interested in receiving smoking treatment is critical to developing effective recruitment strategies and interventions for this population. Thus, this study comprehensively assessed and compared substance-dependent inpatients who accepted (n = 75) versus refused (n = 25) a stop-smoking treatment. Univariate analyses found treatment acceptors were younger, more addicted to nicotine, had more smoking-related health problems, had more positive attitudes about quitting smoking, and had more positive attitudes about the relationship between smoking cessation and drug/alcohol sobriety (e.

A cognitive-behavioral therapeutic community for substance dependent and homeless veterans: treatment outcome.

This paper presents data regarding a residential rehabilitation program that integrates cognitive-behavioral and therapeutic community techniques to treat homelessness and substance abuse. The study cohort was 110 military veterans admitted to a Domiciliary Care for Homeless Veterans program of the Department of Veterans Affairs. The cohort had multiple psychosocial problems at admission, and all had drug/alcohol abstinence as a treatment goal.

A computer-directed program for smoking cessation treatment.

This report describes a computer-directed cigarette smoking cessation program that individualizes nicotine fading schedules for smokers based upon their daily smoking behavior. Previous outcome data from minimal intervention and intensive stop-smoking treatment studies are presented. Preliminary urinary cotinine data also are presented to validate the program's underlying assumption that computer-directed nicotine fading results in across-treatment reductions in biological levels of nicotine.

Drug and alcohol abuse inpatients' attitudes about smoking cessation.

Attitudes about quitting cigarette smoking were assessed at admission to a substance abuse treatment program for homeless veterans. The majority were interested in quitting smoking, believed that inpatient drug/alcohol treatment was the best time to quit, and that quitting would not threaten their sobriety. Using cluster analysis, four subgroups of inpatients with different levels of interest, confidence, and motivation regarding quitting smoking were identified.

The abstinence violation effect and very low calorie diet success.

This study evaluated the relationship between Marlatt and Gordon's (1985) Abstinence Violation Effect (AVE) and fasting outcomes of patients enrolled in a Very Low Calorie Diet (VLCD) and behavior education program. Within the first 11 weeks of the VLCD, 41 of 76 patients reported a fasting lapse and rated this lapse on an attribution scale. Patients reporting greater characterological attributions for their first lapse (i.

Batter up! Relapse prevention for homeless veteran substance abusers via softball team participation.

Thirty-four veterans of a residential rehabilitation program for homelessness and substance abuse participated on a community-based softball team. Compared to nonparticipants, participants stayed in treatment longer and were more likely to complete all aspects of the program (inpatient and outpatient). They also were more likely to be abstinent from drugs/alcohol, employed, and housed 3 months postdischarge.

Smoking cessation for substance abuse inpatients.

The impact of a smoking cessation program on substance abuse inpatients was investigated. Thirty-nine male veterans were randomly assigned to stop-smoking (n = 19) or wait-list conditions (n = 20), and followed up 3- and 6-months postdischarge. Compared to wait-list subjects, stop-smoking subjects were more likely to continue inpatient treatment at least 30 days following study enrollment and reported greater posttreatment reductions in cigarette nicotine delivery.

Characteristics of telephone applicants to a residential rehabilitation program for homeless veterans.

This study gathered descriptive data on 163 individuals who applied by telephone to a residential rehabilitation program for homeless veterans and compared these data with general veteran and homeless populations. Ss were a young (M = 40.82 years) and educated (M = 13.

Computerized smoking cessation program for the worksite: treatment outcome and feasibility.

This study demonstrated the effectiveness of a computer-delivered smoking cessation program for the worksite. 58 VA Medical Center employees were randomly assigned to a computer group (computerized nicotine fading and stop-smoking contest) or a contest-only group. In comparison with the contest-only group, the computer group had nonsignificantly higher abstinence rates across follow-up, had marginally lower CO levels at the 3- and 6-month follow-ups, and smoked cigarettes with lower nicotine levels at the 10-day and 6-month follow-ups.

Squamous cell carcinoma causing blindness and ophthalmoplegia in a cat.

Ophthalmoplegia and blindness caused by squamous cell carcinoma were reported in a cat. Unilateral functional deficits of cranial nerves II, III, IV, and VI and of the sympathetic nerve supply caused blindness, complete ophthalmoplegia, and Horner syndrome. Radiography and computed tomography revealed a proliferating bony lesion associated with the right tympanic bulla, right temporal bone, right side of the mandible, and left frontal bone.

Self-efficacy and relapse among inpatient drug and alcohol abusers: a predictor of outcome.

Monthly intreatment ratings of self-efficacy to avoid drug and alcohol abuse were examined among 419 substance abuse inpatients of a residential treatment community. Posttreatment interviews were conducted with 81 patients approximately 6 months following discharge to assess the relationship between self-efficacy and relapse. As expected, self-efficacy increased during treatment and was higher among abstainers than relapsers at follow-up.

Can across-treatment changes in cumulative puff duration predict treatment outcome during nicotine fading.

The smoking behavior of 10 male and 15 female smokers was assessed weekly during a standardized nicotine fading program to examine the relationship between compensatory smoking (i.e., increases in the number of cigarettes smoked per day, expired air carbon monoxide (CO), or the frequency and duration of puffs) and posttreatment abstinence from tobacco.

Tobacco smoking: a comparison between alcohol and drug abuse inpatients.

This study compared the tobacco smoking of alcohol and drug abuse patients. The subjects were male inpatients (67 alcohol, 60 drug, and 13 mixed alcohol and drug abusers) of a Veterans Administration substance abuse program who had completed the Tolerance Questionnaire (Fagerstrom, 1978) and the Michigan Alcohol Screening Test (Skinner, 1979) as part of routine intake assessment procedures. As expected, an extremely high percentage (89.

Smoking topography and carbon monoxide levels in smokers.

Factors which effect the expired air carbon monoxide (CO) levels of smokers were examined in matched subject pairs who smoked an equal number of daytime cigarettes but had different CO levels (mean difference = 15.4 ppm). Measures of puff number, duration, and spacing, as well as the amount of CO increase per cigarette (CO boost), were assessed while subjects smoked a single cigarette in daily laboratory sessions.

Smoking following myocardial infarction: a critical review of the literature.

This paper critically reviews the available research on the effects of smoking cessation following acute myocardial infarction (MI). Studies that have examined the rate of smoking cessation following an MI indicate that approximately 1/3 to 1/2 of the smokers who suffer from MI subsequently reduce or quit smoking. Furthermore, studies that have examined subsequent mortality and morbidity suggest that individuals who quit smoking following MI exhibit lower mortality and morbidity than those who continue to smoke.