Adult marijuana users (N = 291) seeking treatment were randomly assigned to an extended 14-session cognitive-behavioral group treatment (relapse prevention support group; RPSG), a brief 2-session individual treatment using motivational interviewing (individualized assessment and intervention; IAI), or a 4-month delayed treatment control (DTC) condition. Results indicated that marijuana use, dependence symptoms, and negative consequences were reduced significantly in relation to pretreatment levels at 1-, 4-, 7-, 13-, and 16-month follow-ups. Participants in the RPSG and IAI treatments showed significantly and substantially greater improvement than DTC participants at the 4-month follow-up. There were no significant differences between RPSG and IAI outcomes at any follow-up. The relative efficacy of brief versus extended interventions for chronic marijuana-using adults is discussed.

DNA double strand breaks (DSBs) in repetitive sequences are a potent source of genomic instability, due to the possibility of non-allelic homologous recombination (NAHR). Repetitive sequences are especially at risk during meiosis, when numerous programmed DSBs are introduced into the genome to initiate meiotic recombination 1. Within the budding yeast repetitive ribosomal (r)DNA array, meiotic DSB formation is prevented in part through Sir2-dependent heterochromatin 2,3. Here, we demonstrate that the edges of the rDNA array are exceptionally susceptible to meiotic DSBs, revealing an inherent heterogeneity within the rDNA array. We find that this localised DSB susceptibility necessitates a border-specific protection system consisting of the meiotic ATPase Pch2 and the origin recognition complex subunit Orc1. Upon disruption of these factors, DSB formation and recombination specifically increased in the outermost rDNA repeats, leading to NAHR and rDNA instability. Strikingly, the Sir2-dependent heterochromatin of the rDNA itself was responsible for the induction of DSBs at the rDNA borders in pch2Δ cells. Thus, while Sir2 activity globally prevents meiotic DSBs within the rDNA, it creates a highly permissive environment for DSB formation at the heterochromatin/euchromatin junctions. Heterochromatinised repetitive DNA arrays are abundantly present in most eukaryotic genomes. Our data define the borders of such chromatin domains as distinct high-risk regions for meiotic NAHR, whose protection may be a universal requirement to prevent meiotic genome rearrangements associated with genomic diseases and birth defects.

No abstract

The large number of rural older adults suffering from untreated psychiatric illnesses suggests that stigma may be a significant barrier to the utilization of mental health services in this population. The current study examines self-stigma, public stigma, and attitudes toward specialty mental health care in a community sample of older adults living in a geographically isolated rural area, a rural area adjacent to a metropolitan area, and an urban area. One hundred and 29 older adults age 60 and above from the 3 geographic areas completed self-report measures of these constructs, and differences on the measures were assessed among the groups. Results indicated that older adults living in isolated rural counties demonstrated higher levels of public and self-stigma and lower levels of psychological openness than older adults in urban areas even after accounting for education, employment, and income. However, no differences emerged in reported willingness to use specialized mental health care in the event of significant distress. Results are discussed in the context of rural values, beliefs, and community structural factors. We further suggest that conventional binary rural/urban distinctions are not sufficient to understand the relationship between rurality and stigma.

Attrition from smoking cessation treatment by individuals with a history of major depression was investigated. An investigation of preinclusion attrition examined differences between eligible smokers who did (n = 258) and did not (n = 100) attend an initial assessment session. Postinclusion attrition was investigated by comparing early dropouts (n = 33), lale dropouts (n = 27), and treatment completers (n = 117). Those who failed to attend the assessment session were more likely to be female, to smoke cigarettes with higher nicotine content, and to have a history of psychotropic medication use. Early-treatment dropouts reported a higher smoking rate than late-treatment dropouts and endorsed more symptoms of depression than late dropouts and treatment completers. Results are compared with previous investigations of smoking cessation attrition, and implications for treatment and attrition prevention are discussed.Attrition from treatment poses a considerable problem for both researchers evaluating interventions (Howard, Cox, & Saunders, 1990) and clinicians delivering treatment (Stark, 1992). In studying attrition, investigators have found it useful to distinguish between preinclusion attrition-which occurs prior to entering a study, during screening or during intake evaluations-and postinclusion attrition, which occurs during treatment or posttreatment follow-ups (Howard et al., 1990). For example, evaluations of smoking cessation programs have noted preinclusion attrition rates of 30%-50% (Curry, Marlatt, Gordon, & Baer, 1988;Kviz, Crittenden, Madura, & Warnecke, 1994;Hall, Muñoz, & Reus, 1994) and postinclusion attrition rates that range from less than 10% (Curry, Thompson, Sexton, & Omenn, 1989;Zelman, Brandon, Jorenby, & Baker, 1992) to approximately 50% (Curry et al., 1988;Klesges et al., 1988).Although they are significant, these rates of attrition may be even higher in selected high-risk groups of smokers, such as those with psychiatric comorbidity. Disproportionately high rates of psychiatric comorbidity with cigarette smoking have been found in both adolescent (Brown, Lewinsohn, Seeley, & Wagner, 1996) and adult ) community samples. In adult smoking cessation programs, rates of past major depressive disorder (MDD) have ranged from 31% (Hall et al., 1994) to 61% (Glassman et al., 1988 smokers with a history of major depression have been shown to have elevated negative mood at pretreatment (Ginsberg, Hall, Reus, & Muñoz, 1995;Hall et al., 1994), to experience mood disturbance following cessation Ginsberg et al., 1995), and to relapse at higher rates than smokers without past MDD (Glassman et al., 1988;Glassman, 1993).As the overall prevalence of cigarette smoking decreases (Centers for Disease Control, 1994), those remaining smokers are likely to have more difficulty quitting because of factors such as psychiatric comorbidity and high nicotine dependence (Coambes, Kozlowski, & Ferrence, 1989;Hughes, 1993). Smoking cessation programs are increasingly faced with the prospect of delivering treatment ...