Amy Helstrom

University of Pennsylvania

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Document Type

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David W. Oslin

University of Pennsylvania

Suzy B. Gulliver

Baylor Scott & White Health

Barbara W. Kamholz

VA Boston Healthcare System

Angela D. Bryan

University of Colorado Boulder

Joel E. Streim

Philadelphia VA Medical Center

Shirley H. Leong

Philadelphia VA Medical Center

Jason T. Goodson

VA Salt Lake City Healthcare System

Sandra B. Morissette

The University of Texas at San Antonio

Kent E. Hutchison

University of Colorado System

Amy Benson

Environmental Protection Agency

Cooperative Institutions

Veterans Health Administration

United States Department of Veterans Affairs

University of Pennsylvania

Mental Illness Research, Education and Clinical Centers

Philadelphia VA Medical Center

VA Healthcare-VISN 4

Boston University

California University of Pennsylvania

VA Boston Healthcare System

National Center for PTSD

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Substance Abuse Comorbidity

Oxford University Press eBooks (2013)

David W. Oslin Amy Helstrom

Abstract While rates of alcohol and illicit drug use begin to decline with age, individuals who abuse alcohol and other substances in late life may be at increased risk of a number of negative physical and mental health outcomes that are often exacerbated with advancing age. Demographic changes in the population suggest that the prevalence of substance misuse in later life may be increasing. Depression is frequently comorbid with substance use and the presence of each disorder can negatively impact the course and recovery of the other. This chapter will focus on the intersection between the use and abuse of addictive substances and the presence and course of depressive disorders. Considerations for assessment and treatment for these comorbid presentations among older adults, such as integrated models of care, are discussed.

10.1093/med/9780199796816.003.0018

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Citations (2)

Treatment of Posttraumatic Stress Disorder in U.S. Combat Veterans: A Meta-Analytic Review

Psychological Reports (2011)

Jason T. Goodson Amy Helstrom Jacqueline M. Halpern Michael P. Ferenschak Seth J. Gillihan

Among U.S. veterans who have been exposed to combat-related trauma, significantly elevated rates of posttraumatic stress disorder (PTSD) are reported. Veterans with PTSD are treated for the disorder at Veterans Affairs (VA) hospitals through a variety of psychotherapeutic interventions. Given the significant impairment associated with PTSD, it is imperative to assess the typical treatment response associated with these interventions. 24 studies with a total sample size of 1,742 participants were quantitatively reviewed. Overall, analyses showed a medium between-groups effect size for active treatments compared to control conditions. Thus, the average VA-treated patient fared better than 66% of patients in control conditions. VA treatments incorporating exposure-based interventions showed the highest within-group effect size. Effect sizes were not moderated by treatment dose, sample size, or publication year. Findings are encouraging for treatment seekers for combat-related PTSD in VA settings.

10.2466/02.09.15.16.pr0.109.5.573-599

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Citations (84)

Motivational enhancement therapy for high-risk adolescent smokers

Addictive Behaviors (2007)

Amy Helstrom Kent E. Hutchison Angela D. Bryan

10.1016/j.addbeh.2007.02.009

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Citations (40)

A telephone-based intervention for chronic pain in older adults enrolled in a behavioral health care management program

American Journal of Geriatric Psychiatry (2014)

Josh Haratz Jacob Zimmerman Shirley H. Leong Amy Helstrom Amy Benson

Pace

10.1016/j.jagp.2013.12.118

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Reductions in Alcohol Craving Following Naltrexone Treatment for Heavy Drinking

Alcohol and Alcoholism (2016)

Amy Helstrom F. C. Blow Valerie Slaymaker Henry R. Kranzler Shirley H. Leong

The role of craving for alcohol as a response to alcohol treatment is not well understood. We examined daily diary ratings of craving over the course of 28 days among individuals participating in an inpatient substance abuse treatment program. Participants were alcohol dependent patients (n = 100) in the Hazelden residential treatment program who were offered and agreed to take naltrexone and an age- and gender-matched comparison group (n = 100) of alcohol-dependent patients in the same program who declined the offer of treatment with naltrexone. Changes in craving over time were compared between the two groups. The naltrexone-treated group reported a more rapid decrease in craving than the usual care group. The change in the trajectory of craving is consistent with prior reports suggesting that craving reduction is a mechanism of naltrexone's efficacy in treating alcohol dependence. Providing naltrexone to individuals seeking treatment for alcohol dependence may accelerate a reduction in their craving, consistent with a primary target of many addiction treatment programs. Craving ratings by 100 residential patients taking naltrexone for alcohol dependence were compared to ratings by 100 patients who did not take naltrexone. Craving for alcohol decreased more rapidly in the patients taking naltrexone. Providing naltrexone to individuals seeking treatment for alcohol dependence may accelerate a reduction in craving, which may benefit treatment efforts.

Alcohol Dependence

Relapse prevention

10.1093/alcalc/agw038

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Citations (25)

Tobacco and Alcohol Use as an Explanation for the Association Between Externalizing Behavior and Illicit Drug Use Among Delinquent Adolescents

Prevention Science (2004)

Amy Helstrom Angela D. Bryan Kent E. Hutchison Paula Riggs Elaine A. Blechman

Health psychology

Monitoring the Future

Conduct disorder

Association (psychology)

Illicit drug

10.1023/b:prev.0000045360.23290.8f

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Citations (68)

Smoking cessation and alcohol abstinence: what do the data tell us?

PubMed (2006)

Suzy B. Gulliver Barbara W. Kamholz Amy Helstrom

Cigarette smoking and nicotine dependence commonly co-occur with alcohol dependence. However, treatment for tobacco dependence is not routinely included in alcohol treatment programs, largely because of concerns that addressing both addictions concurrently would be too difficult for patients and would adversely affect recovery from alcoholism. To the contrary, research shows that smoking cessation does not disrupt alcohol abstinence and may actually enhance the likelihood of longer-term sobriety. Smokers in alcohol treatment or recovery face particular challenges regarding smoking cessation. Researchers and clinicians should take these circumstances into account when determining how best to treat these patients' tobacco dependence.

Sobriety

Alcohol Dependence

Nicotine dependence

Affect

Source

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Citations (82)

Feeling Better and Smoking Less: The Relationship Between Trauma Symptoms and Smoking Over Time

Cognitive Therapy and Research (2008)

Amy Helstrom Margret E. Bell Suzanne L. Pineles

Affect

Longitudinal Study

10.1007/s10608-008-9183-0

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Citations (10)

Subsyndromal posttraumatic stress disorder symptomatology in primary care military veterans: Treatment implications.

Psychological Services (2012)

Sara L. Kornfield Johanna Klaus Caroline Mae McKay Amy Helstrom David W. Oslin

Subsyndromal posttraumatic stress disorder (PTSD) is highly prevalent in Veterans Affairs Medical Centers' primary-care clinics and is associated with significant impairment. We used a cross-sectional design to examine PTSD symptoms and depressive disorders endorsed by two cohorts of Veterans meeting less than full PTSD criteria who presented to primary care at the Philadelphia VA Medical Center (i.e., those from Operation Enduring Freedom/Operation Iraqi Freedom/Operation New Dawn (OEF/OIF/OND) and non-OEF/OIF/OND Veterans). The Philadelphia VA Behavioral Health Lab (BHL) assessed 141 Veterans who screened positive for subsyndromal PTSD. Avoidance was endorsed significantly less often than arousal in the total group. When the groups were split by cohort era, higher levels of avoidance and lower levels of arousal were reported in the non-OEF/OIF/OND group than the OEF/OIF/OND group. Comorbid depression was present in 43.9% of the total group with no significant differences between groups. Exposure-based treatments for PTSD offered in specialty mental health clinics target avoidance symptoms. Because the endorsement of avoidance symptoms was low in both of the cohorts that were studied this may not be the most effective treatment target for Veterans with subsyndromal PTSD receiving treatment in primary care settings. For these Veterans, treatments that target reexperiencing and arousal symptoms and/or comorbid depression may be more effective.

Veterans Affairs

Depression

Specialty

10.1037/a0028082

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Citations (19)

Experience of Pain in the Elderly in Relation to Mood, Anxiety and Physical Quality of Life in a PACE/BHL Program

American Journal of Geriatric Psychiatry (2013)

Melanie Asbury Amy Helstrom Amy Benson Shirley H. Leong Jacob Zimmerman

Irritability

Depression

Depressed mood

Pain catastrophizing

10.1016/j.jagp.2012.12.146

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Citations (0)