Evolutionary Science as a Method to Facilitate Higher Level Thinking and Reasoning in Medical Training.

Evolutionary science is indispensable for understanding biological processes. Effective medical treatment must be anchored in sound biology. However, currently the insights available from evolutionary science are not adequately incorporated in either pre-medical or medical school curricula.

Sexual Hookup Culture: A Review.

"Hookups," or uncommitted sexual encounters, are becoming progressively more engrained in popular culture, reflecting both evolved sexual predilections and changing social and sexual scripts. Hook-up activities may include a wide range of sexual behaviors, such as kissing, oral sex, and penetrative intercourse. However, these encounters often transpire without any promise of, or desire for, a more traditional romantic relationship.

Change in human social behavior in response to a common vaccine.

Purpose: The purpose of this study was to test the hypothesis that exposure to a directly transmitted human pathogen-flu virus-increases human social behavior presymptomatically. This hypothesis is grounded in empirical evidence that animals infected with pathogens rarely behave like uninfected animals, and in evolutionary theory as applied to infectious disease. Such behavioral changes have the potential to increase parasite transmission and/or host solicitation of care.

Hooking up: gender differences, evolution, and pluralistic ignorance.

"Hooking-up"--engaging in no-strings-attached sexual behaviors with uncommitted partners--has become a norm on college campuses, and raises the potential for disease, unintended pregnancy, and physical and psychological trauma. The primacy of sex in the evolutionary process suggests that predictions derived from evolutionary theory may be a useful first step toward understanding these contemporary behaviors. This study assessed the hook-up behaviors and attitudes of 507 college students.

HIV prevention among incarcerated male adolescents in an alternative school setting.

This pilot project tested the feasibility of an evidence-based HIV Intervention Program (HIP) program among 64 male youth, most of whom were African American or Hispanic, in Los Angeles County probation camps. Comparisons were made between adolescents who participated in HIP and a control group on changes in (a) condom use, (b) sexual intercourse under the influence of drugs, (c) knowledge of HIV prevention behaviors, and (d) attitudes toward condom use. Compared to the control group, the intervention group demonstrated significant increases in condom use and significant decreases in their endorsement of the attitude, ''If you want to use a condom, your boy-friend or girlfriend might think you don't trust them.

Evolution for epidemiologists.

Because humans are biological organisms, human health and disease should be understandable within the context of modern evolutionary theory. Although health is not necessarily maximized by evolution and disease is not generally adaptive, a vast amount of human suffering can be captured with relatively few explanatory categories that are consistent with evolutionary logic. Synthesizing epidemiology and evolutionary thinking can generate novel insights into causes and prevention, intervention, and treatment strategies for disease.

Risk behaviors in a rural community with a known point-source exposure to chronic wasting disease.

Background: The emergence and continuing spread of Chronic Wasting Disease (CWD) in cervids has now reached 14 U.S. states, two Canadian provinces, and South Korea, producing a potential for transmission of CWD prions to humans and other animals globally.

An evolutionary model of premenstrual syndrome.

PMS has existed at least since the beginning of medical writing, and is estimated to affect large proportions of women worldwide. But the etiology remains unknown, diagnostic definition and methods vary tremendously, and treatment is wholly symptom-oriented. This poor state of understanding has been attributed to a lack of theoretical perspective.

A comparison of contingency management and cognitive-behavioral approaches for stimulant-dependent individuals.

Aims: Previous research has reported that both contingency management (CM) and cognitive-behavioral therapy (CBT) are efficacious interventions for the treatment of stimulant abusers. The present study sought to directly compare the effectiveness of (CM) and (CBT) alone and in combination in reducing stimulant use.

Design: Randomized clinical trial.

Randomized controlled pilot trial of cabergoline, hydergine and levodopa/carbidopa: Los Angeles Cocaine Rapid Efficacy Screening Trial (CREST).

Aim: This study tested three dopaminergic medications against a common unmatched placebo condition: hydergine 1 mg three times daily (n = 15); levodopa/carbidopa 25/100 mg three times daily (n = 15); cabergoline 0.5 mg per week (n = 15); and placebo three times daily (n = 15) as potential pharmacotherapies for cocaine dependence.

Design: The four-parallel group, Cocaine Rapid Efficacy Screening Trial (CREST) design featured a 2-week baseline period followed by randomization to an 8-week medication condition that included 1 hour per week of cognitive behavioral drug counseling.

Bringing buprenorphine-naloxone detoxification to community treatment providers: the NIDA Clinical Trials Network field experience.

In October 2002, the U.S. Food and Drug Administration approved buprenorphine-naloxone (Suboxone) sublingual tablets as an opioid dependence treatment available for use outside traditionally licensed opioid treatment programs.

A multi-site comparison of psychosocial approaches for the treatment of methamphetamine dependence.

Aims: The Center for Substance Abuse Treatment (CSAT) Methamphetamine Treatment Project (MTP) is the largest randomized clinical trial of treatments for methamphetamine (MA) dependence to date. The objective of the study was to compare the Matrix Model, a manualized treatment method, with treatment-as-usual (TAU) in eight community out-patient settings in the Western United States.

Design: Over an 18-month period between 1999 and 2001, 978 treatment-seeking, MA-dependent people were randomly assigned to receive either TAU at each site or a manualized 16-week treatment (Matrix Model).

Abuse and violence history of men and women in treatment for methamphetamine dependence.

The Methamphetamine Treatment Project offers the opportunity to examine the history of abuse and violence in a sample of 1016 methamphetamine users participating in a multisite study between 1999-2001. Reporting of abuse and violence was extensive, with 80% of women reporting abuse or violence from a partner. Men were more likely to report experiencing violence from friends and others.

A comparison of contingency management and cognitive-behavioral approaches during methadone maintenance treatment for cocaine dependence.

Background: This study compared 2 psychosocial approaches for the treatment of cocaine dependence: contingency management (CM) and cognitive-behavioral therapy (CBT).

Methods: Patients with cocaine dependence who were receiving methadone maintenance treatment (n = 120) were randomly assigned to 1 of 4 conditions: CM, CBT, combined CM and CBT (CBT + CM), or treatment as usual (ie, methadone maintenance treatment program only [MMTP only]) (n = 30 per cell). The CM procedures and CBT materials were comparable to those used in previously published research.

Predicting treatment success at multiple timepoints in diverse patient populations of cocaine-dependent individuals.

The quest for predictive utility of baseline demographic and drug use characteristics has been difficult. The present article draws data from two studies of cocaine-dependent individuals (N = 297) in treatment at clinics in Los Angeles, and examines the utility of socio-demographic characteristics of patients and in-treatment performance variables as predictors of success at treatment end, 6 and 12 month follow-up assessments. Socio-demographic variables examined are age, gender, ethnicity, and educational attainment; drug use variables include years of cocaine use, self-reported days of cocaine use, the Addiction Severity Index drug composite score, and two composite measures cited in the literature.

Drugs and sexual effects: role of drug type and gender.

This study investigated gender differences in the relationship between psychoactive substance use and sexual thoughts, feelings, and behaviors. Participants (N = 464) were male and female alcohol, opiate, cocaine, and methamphetamine users enrolled in an outpatient treatment program at any of 8 sites. A self-report survey that inquired about the specific sexual thoughts, feelings, and behaviors of the participant during previous instances of being under the influence of their primary drug of dependence served as the data source.