Posttraumatic stress disorder (PTSD) is common among treatment-seeking substance abusers. Despite the high prevalence of these co-occurring conditions, few PTSD screening tools have been evaluated for their utility in identifying PTSD in substance use disorder (SUD) populations. The present study evaluated the psychometric properties of the Impact of Event Scale-Revised (IES-R) in a sample of 124 substance dependent individuals. All participants had a history of a DSM-IV Criterion A traumatic event, and 71 individuals met diagnostic criteria for PTSD. Participants with comorbid PTSD reported significantly more symptoms of anxiety, depression, and PTSD compared to substance dependent individuals without PTSD. Acceptable internal consistency and convergent validity of the IES-R were established among a substance dependent sample. Examination of diagnostic effectiveness suggested a cutoff value of 22 as optimal for a substance using population, resulting in adequate classification accuracy, sensitivity, and specificity.

The structure of posttraumatic stress is of both theoretical and clinical interest. In the present study, seven models of posttraumatic stress were compared using confirmatory factor analysis. A sample of 528 Western New York undergraduate students was assessed 1 and 3 months after the September 11th, 2001 terrorist attacks. At the Month 1 assessment, the current three-factor Diagnostic and Statistical Manual of Mental Disorders (DSM-IV; American Psychiatric Association, 1994) model, which consists of Intrusions, Avoidance/Numbing, and Hyperarousal, did not provide a good fit to the data; however, a four-factor model consisting of factors labeled Intrusions, Avoidance, Dysphoria, and Hyperarousal did fit the data well and provided better fit than the three-factor model and other competing models. Importantly, Dysphoria spans symptoms from the traditional DSM Numbing and Hyperarousal clusters. The four-factor model continued to fit the data well at Month 3. These findings parallel the results of earlier studies which suggest that a four-factor model better reflects the nature of posttraumatic stress than do simpler models, including the DSM. The present work is consistent with a dimensional model of stress responses and calls for further longitudinal work in this area.

Impulsivity and risk taking propensity were assessed in participants with borderline personality disorder (BPD-only; n = 19), BPD and a current or past substance use disorder (BPD-SUD; n = 32), and a matched comparison group (MC; n = 28). Participants were administered behavioral measures of two facets of the multidimensional construct of impulsivity [GoStop, delay discounting task (DDT)], one measure of risk-taking propensity [Balloon Analog Risk Task (BART)], and two self-report measures of impulsivity (i.e., Barrett Impulsiveness Scale, Eysenck Impulsiveness Scale). The BPD-SUD group, but not the BPD-only group, discounted delayed rewards faster than the MC group on the DDT, suggesting that the BPD-SUD/MC group difference may be because of the SUD rather than BPD. In contrast, both the BPD-SUD and BPD-only groups exhibited poorer behavioral response inhibition compared with the MC group, but the two BPD groups did not differ from one another. This finding suggests that the differences in behavioral response inhibition may be because of BPD rather than SUD and that behavioral response disinhibition may be a core feature of BPD. None of the groups differed on the measure of risk-taking propensity (i.e., BART). On self-report questionnaires, the BPD-SUD group reported more impulsivity than the BPD-only group and both BPD groups reported more impulsivity than the MC group. Data from the DDT and self-report measures provide partial support for the hypothesis that BPD individuals with a SUD are more impulsive than BPD individuals without a SUD on some facets of impulsivity (e.g., desire to obtain a smaller immediate reward rather than wait to obtain a larger reward in the future). Results suggest that behavioral response inhibition may be a novel treatment outcome variable for BPD treatment studies.

Rationale & Objective-Research on nicotine and attention has mainly utilized samples of deprived smokers and tasks requiring volitional responses, raising the question of whether nicotine improves attention or simply alleviates withdrawal or improves motor speed. This study used the startle eyeblink reflex to assess nicotine effects on auditory attention in non-smokers.Method-Sixty-seven healthy young adult non-smokers completed a tone discrimination task. Acoustic startle probes were presented 60, 120, 240, or 4500 ms after onset of 2/3 of the tones and during intertrial intervals. Attention was assessed via 1) short-lead prepulse inhibition (PPI) of startle, a measure of early filtering; 2) long-lead prepulse facilitation (PPF) of startle, a measure of sustained processing, and 3) the modification of PPI and PPF by focused attention. Participants completed two lab sessions, once while wearing a 7 mg transdermal nicotine patch, and once while wearing a placebo patch. Patches were administered in a double-blind procedure.Results-Nicotine increased overall PPI, η p 2 = .09. Attention increased long-lead PPF η p 2 = .25, but not short-lead PPI. Nicotine did not reliably enhance early or late controlled attentional processing in the sample overall. However, correlational analyses demonstrated that nicotine most improved attentional modification of short-lead PPI among participants with the weakest early attentional processing under placebo conditions. Conclusions-Nicotine enhanced early attentional filtering in general, and the effects of nicotine on early, focused attention were dependent upon individual differences in placebo levels of attentional processing. The present data suggest the effects of nicotine on attention extend beyond the alleviation of withdrawal and simple motor speeding.

Short-lead prepulse inhibition and long-lead prepulse facilitation of startle are greater during attended than ignored prestimuli. The present work examined whether this attentional modification is influenced by monetary incentive. Participants (43 college students) were randomly assigned to receive a small performance-based monetary incentive or were instructed to try their best. The task was to judge the duration of tones of one of two pitches during a series of 48 tones. Prepulse inhibition of startle eyeblink EMG was assessed at 60, 120, and 240 ms, and prepulse facilitation was assessed at 4,500 ms following tone onset. Short-lead percent prepulse inhibition was greater during attended than ignored prestimuli only at 120 ms among paid participants. Long-lead prepulse facilitation was greater for attended than ignored tones, but this effect did not vary with incentive condition. This study demonstrates that attentional modification of short-lead prepulse inhibition is sensitive to a monetary incentive and provides a basis for further examination of motivational effects on early attentional processing.

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The current study compared the psychometric properties and clinical/research utility of four distinct factor/subscale models of alcohol craving (three factor-derived models, and one rationally-derived model) as measured by the Alcohol Craving Questionnaire-Now in social (n = 52) and alcohol dependent (n = 71) drinkers. All participants completed a self-report measure of alcohol abuse in addition to engaging in a structured interview and cue reactivity protocol. Participants provided selfreported craving, as well as desire to approach or avoid drinking, during a cue exposure task using separate analogue scales. Factor/subscale models were compared in terms of internal consistency, convergent and divergent validity, and ability to predict cue-elicited approach and craving in addition to diagnostic status. All models demonstrated high levels of internal consistency, convergent and divergent validity, and the ability to predict both cue-elicited craving and alcohol dependence status. Specific strengths and weaknesses of each model are examined and the theoretical, clinical, and research utility of the current findings are discussed.