Association for Behavior Analysis International

Many behaviors posing significant risks to public health are characterized by repeated decisions to forego better long-term outcomes for immediate temptations. This steep discounting of delayed outcomes is correlated with addictions (e.g., substance abuse, obesity) and impactful behaviors such as seatbelt use and early sexual activity. As evidence accumulates that steep delay discounting plays a causal role in these maladaptive behaviors, researchers have begun identifying experimental methods for reducing discounting. This presentation will provide a systematic review of this literature, highlighting successes and areas in which further research is needed.

High levels of impulsivity (delay discounting [DD], relative preference for smaller but immediate rewards over larger but delayed rewards) are associated with various psychopathologies including alcohol use disorder. Data indicate that there are genetic influences on DD and on the development of alcohol use disorder, but the genetic relationships amongst DD and alcohol consumption and other heritable features of alcohol response are unclear. This presentation will describe several techniques used to examine the role of genetics in behavior in animal models and a series of studies using them to examine the genetically-based co-relationships between excessive alcohol use and steep delay discounting. In these studies, male mice were exposed to the adjusting amount procedure (Richards et al. 1997, J Exp Anal Behav, 67, 353-366). This procedures requires mice to choose between a small, immediate sucrose-solution reward and a larger sucrose-solution reward that is delayed 0, 2, 4, 8 or 12 s on different sessions. In one study, behavior for 11 inbred strains was assessed, and genetic correlations with ethanol-associated endophenotypes derived. Other studies assessed DD in lines selected for differing levels of ethanol withdrawal symptomatology or ethanol consumption, and correlations between DD and responses to passively administered ethanol in a heterogeneous mouse stock to identify novel phenotypic targets. Data suggest that DD has a heritable component in mice, and is genetically associated with chronic withdrawal and consumption, but that effect sizes are small. Implications for human alcohol use and delay discounting will be discussed and knowledge gaps identified.

Board certified behavior analysts; licensed psychologists; graduate students.

Board certified behavior analysts; licensed psychologists; graduate students.

Contingency management (CM) interventions are efficacious options for substance abuse treatments, but they are rarely implemented in clinical, non-research settings. In this presentation, we briefly review the evidence support for CM and introduce prize-based CM. We will highlight work that supports CM’s generalizability across diverse patient characteristics and settings. We will conclude with a discussion of potential implementation barriers and examples of real-world implementation efforts.

Contingency management is one of the most efficacious interventions to promote drug abstinence. Traditionally, contingency management has been delivered in person so that clinicians can confirm drug abstinence and provide access to additional therapeutic services. Now, new technologies not only permit remote confirmation of abstinence, but also remote delivery of incentives. I will discuss several technology-based tools to assess substance use, and new ways to deliver contingency management to promote tobacco and alcohol abstinence. These new tools have the potential to dramatically increase access while maintaining high levels of treatment fidelity. They also allow new ways of arranging contingencies that harness natural, online communities and consequences. Overall, there are unprecedented opportunities to link technology with contingency management to promote drug abstinence.

Board certified behavior analysts; licensed psychologists; graduate students.

Relative to nondrug reinforcers, illicit drugs may be variable in terms of their availability, quality, price, and time and effort to obtain. Thus, variability may be an important aspect that differs for illicit drugs relative to nondrug alternatives. Given our knowledge that (in the laboratory) reinforcers available under variable schedules tend to be chosen over reinforcers available under fixed schedules, variable access to illicit drugs like cocaine (in the natural environment) may more effectively compete with more predictable, nondrug alternatives. Conversely, cocaine choice may be more effectively reduced by making nondrug reinforcers available under variable schedules. In the current study, male and female rhesus monkeys chose between fixed and variable schedules of cocaine or food. In control conditions, both schedules were a fixed-ratio (FR) 50 or 100. In test conditions, the schedule of cocaine or food delivery was a mixed-ratio (MR) 50 or 100 on one lever and an FR 50 or 100 on the opposite lever. At sufficiently large values, choice of cocaine or food under an MR schedule was greater than choice of the same reinforcer under an FR schedule. However, there were individual differences in the degree to which the MR schedule was chosen across different schedule values. These findings suggest that unpredictable availability could contribute to excessive allocation of behavior toward procuring illicit drugs at the expense of more predictable, nondrug alternatives. Conversely, unpredictable delivery of nondrug reinforcers may more effectively decrease cocaine choice, which could inform modifications to therapies like prize-based contingency management.

There is a small but growing literature on the use of planarians for both pharmacological and toxicological investigations. Negative phototaxis, which is a tendency to move away from a light source, appears to be a reliable response in planarians that may have utility for measuring the behavioral effects of drugs. Recently, we have investigated the effects of ethanol, caffeine, and sodium chloride in planarians crossing a petri dish from a lighted to a darkened side. We describe a modified multiple-baseline design for documenting dose-dependent effects in individual planarians. Varying dose may be accomplished by either altering the concentration of drug in solution or by modifying the duration of exposure. Planarians have some practical advantages as a model organism. They are inexpensive to acquire and maintain and are not subject to as many welfare regulations as vertebrate models. We also describe an inexpensive though somewhat labor-intensive technique for documenting open-field activity in planarians with the use of tablet applications.

Psychoactive drugs produce multiple effects that may influence their abuse liability—including alterations of learning and remembering. For example, stimulants are widely used in the treatment of attention-deficit hyperactivity disorder, whereas drugs, such as NMDA antagonists, are believed to impair remembering. However, stimulants generally fail to enhance remembering in animals on tasks such as delayed matching to sample and NMDA antagonists generally produce non-specific impairments. It has been argued that the delayed matching task, which requires remembering a single stimulus across a delay, is limited as an animal model of more complex human remembering. The present study used an incrementing non-matching to samples procedure (INMTS) which required rats to remember up to 12 different odors during a 45 min session. Six rats were trained to make nose-poke responses to odors presented with a 15 channel olfactometer. When an odor was presented for the first time, responses were reinforced on an FI 5-s schedule, but responses were never reinforced when an odor was repeated. Rats developed high rates of responding to session-novel odors and low rates to repeated odors. Methylphenidate enhanced, and ketamine impaired, discriminative control in most rats, suggesting that the INMTS may provide a valuable procedure to study remembering.

Humans frequently report the use of certain stimulant drugs for general cognitive enhancement. For example, college students sometimes use d-amphetamine and other ADHD medication to perform on exams, and many adult smokers report that nicotine improves everyday cognitive performance. The purpose of the present study was to determine the effects of these drugs on specific aspects of behavior, remembering and motivation, in an animal model. In Experiment 1, pigeons responded in a titrating delayed matching-to-sample (TDMTS) task. In this task, a DMTS procedure was in place, but the delay between the presentation of the sample stimulus and the comparison stimuli was titrated based on the pigeon’s performance on the task; i.e., correct responses resulted in an increase in delay and incorrect responses resulted in a decrease. In Experiment 2, pigeons responded according to a progressive ratio schedule. In this task, the fixed-ratio (FR) requirement was increased after each food delivery (e.g., FR1, FR2, FR3, etc.). There were no systematic effects of d-amphetamine or nicotine on remembering or motivation at doses that did not produce psychomotor impairment.

Assessing variables that affect behavioral skills training aimed at reducing alcohol-related risk is important to inform prevention and intervention efforts. Participants trained to pour a standard drink of beer received a dose of alcohol or a placebo dose and completed two additional free-pours along the blood alcohol concentration (BAC) curve. Data collected to date (n = 2; both experimental condition) suggest that participants were able to pour a standard drink of beer within the 10% training criteria range after a stimulus fading training procedure (M = 10.91, SD = 0.27). After receiving a dose of alcohol (Mean BrAC = .085), free-pours remained as accurate (M = 11.0, SD = 0.35) as training pours on the ascending limb of the BAC curve, and as well as on the descending limb (M = 11.0, SD = 0.17) of the BAC curve. These preliminary data suggest that free-pouring a standard drink of beer is a trainable skill that persists despite a moderate dose of alcohol. However, additional data are necessary to support these conclusions.

Twenty-one percent of adult smokers have tried an electronic cigarette (e-cig). Those with ADHD are more likely to try and become dependent on traditional cigarettes. We investigated whether this relationship also occurs with e-cig use (vaping). Three hundred participants completed a survey on nicotine use, ADHD, nicotine dependence, and motivation to quit. Participants chose between hypothetical money ($0.01-$5.12) and puffs from either a cigarette or e-cig. Most (66%) believed that vaping is safer than smoking, but more e-cigarette users (83.7%) endorsed this belief. Men (60%) more likely to have tried an e-cig than women (44%). Women (63%) were more likely to be current nonsmokers than men (44%). More dual users (M=2.79, SD=1.50) met ADHD criteria than cigarette-only smokers (M=1.75, SD=1.73). Cigarette smokers were more likely to have higher dependence than dual users. Dual users had higher dependence on e-cigarettes than cigarettes. Cigarette users (M=2.03, SD=2.04) valued cigarette puffs more than dual users (M=.90, SD=1.37).

The temporal window over which reinforcers are integrated is a principle contributor to the acquisition and maintenance of maladaptive behaviors. A short temporal window is characterized by a reinforcer pathology or choosing overvalued and immediate, maladaptive reinforcers over delayed, prosocial reinforcers. One recently developed method for intervening on reinforcer pathology is Episodic Future Thinking (EFT). In EFT, individuals are asked to create cues of future events that aim to expand their temporal window. 160 cigarette smokers recruited through Amazon Mechanical Turk generated a series of future-focused (EFT) cues or cues related to recent events that were then displayed as the participant completed a cigarette purchase task, a monetary delay-discounting task, and the Experimental Tobacco Marketplace (ETM). In the ETM, participants were given a budget based on their 5-day tobacco product consumption and then allowed to purchase a variety of hypothetical nicotine products. Across trials, the price of conventional cigarettes increased while the prices of the alternative nicotine products remained constant. EFT was effective at reducing demand for cigarettes and in some conditions, increasing the substitutability of electronic cigarettes. EFT also reduced delay discounting. We conclude that EFT is effective at increasing the temporal window and intervening on reinforcer pathologies.

African Americans are at increased risk for cardiovascular disease. Risk factors for cardiovascular disease include high body mass index (BMI) and smoking. Studies show associations between discounting, BMI, and smoking in primarily Caucasian populations. Meanwhile, there are inconsistent findings related to discounting and stress. Our objective is to determine whether: (1) stressors lead to steeper discounting of delayed gains in African Americans; (2) stressors lead to higher BMI and smoking; (3) delay discounting mediates the relation between stressors, smoking, and BMI. The Life Stressor Checklist was used to determine stress levels among African Americans living in high poverty neighborhoods. Structural Equation Models were used to assess potential pathways in two different models. Preliminary results revealed four main pathways. First, higher numbers of life stressors lead to steeper discounting (ß=-0.02, z=-4.79, 95%CI -0.03, -0.01), higher smoking (ß=0.06, z=9.22, 95%CI 0.05, 0.08), but lower BMI (ß=-0.27, z=-2.46, 95%CI -0.48, -0.05). Steeper discounting, in turn, leads to smoking (ß =-0.23, z=-3.36, p<.001), but not higher BMI. Discounting of delayed gains appears to be a more important predictor of smoking than BMI in African Americans.

The non-medical use of prescription stimulants (NMUPS), such as Ritalin and Adderall, is a rising trend in America, particularly among college students. Survey research has identified reasons students are engaging in NMUPS that may be useful in understanding the different reinforcing functions of stimulants, but no research has examined if reinforcing efficacy differs by function. Behavioral economic demand curve analysis may allow us to quantify reinforcer efficacy and see if it changes according to its function. To test this, we developed a measure that asks participants to rank eight stimulant-like drug effects and complete separate hypothetical purchase tasks (HPT) to examine if demand (quantity of drug consumed at a given price) varies based on preference. Initial results indicate that certain stimulant-like drug effects were consistently ranked higher than others, supporting the hypothesis that there are multiple reinforcing functions for NMPSU. Pilot demand curve analysis also found differential performance on the HPT based on ranked order, providing preliminary support that rank-ordered preference produces quantifiable demand differences. These initial results support the ability to measure reinforcer efficacy by different reinforcer functions and allow us to continue using this approach to measure abuse liability in experienced users and, in future studies, non-users.

The Cigarette Purchase Task (CPT) is a behavioral economic method for simulating demand for cigarettes. Growing interest in behavioral correlates of tobacco use in clinical and general populations, as well as empirical efforts to inform policy, have seen an increase in published articles employing the CPT. Accordingly, an examination of the published methods and procedures for obtaining these behavioral economic metrics is timely. The purpose of this investigation was to provide a review of published approaches to using the CPT. We identified 38 empirical articles published through the year 2017 that reported administering a CPT. Articles were coded for participant characteristics (e.g., sample size, population type, age), CPT task structure (e.g., price framing, number and sequence of prices; vignettes, contextual factors), and data analytic approach (e.g., method of generating indices of cigarette demand). Results of this review indicate no standard approach to administering the CPT and bring to bear the need for replicability of these behavioral economic measures for the purpose of guiding clinical and policy decisions.

Ultraviolet indoor tanning (UVIT) is ubiquitous in American youth, and is associated with skin cancer, as well as other risky health decisions such as drug and alcohol use. Given that researchers have begun discussing indoor tanning as a reinforcement pathology and behavioral addiction, this study aimed to investigate the relationship between demand and discounting within UVIT users. Undergraduates (N= 93) completed a hypothetical purchase task noting how many times they would pay to use an indoor tanning bed in the span of a month at prices ranging from $0.00-$150.00 per use. Participants also completed a discounting task framed in terms of a probabilistic health gain: how likely they are to stop engaging in a hobby that would permanently increase their chances of being alive and cancer-free by various probabilities (ranging from 5% to 95%) in 30 years. Hyperbolic discounting rates indicate that participants with a higher breakpoint for UVIT discounted health gains (cancer risk reduction) significantly more than participants with lower breakpoints for tanning demand (p< 0.0001; α= 0.05). Additional analyses explore the interaction between general health demographics and tanning demographics to identify specific predictor variables of risky health decisions with known cancer risks.

Purchase tasks are a technology commonly used to assess demand and relative reinforcer efficacy for addictive substances and activities (e.g., UV indoor tanning, alcohol, etc.). Past research explored the effects of exposure to cues for other addictions; there remains little evidence related to gambling. The purpose of the present study is to assess the effects of cue-elicited exposure across multiple gambling dimensions (i.e. cover charge, wager, and chip price). Recreational and at-risk gamblers were recruited for this study and asked to complete the Gambling Purchase Task in two environments, neutral then gambling. In the neutral environment, participants were asked to read a magazine of their choice in an office setting before completing the purchase task. In the gambling environment, participants were asked to play a preferred game in a replica casino setting; participants could earn raffle tickets based on earnings. Results to date demonstrate that participants had greater inelastic demand and maximum expenditure in the gambling environment for cover charge and credit price over the neutral environment. These findings suggest gamblers are less responsive to change in price and bet riskier when exposed to gambling cues; findings replicate past research regarding the effects of cues on demand for addictive behaviors.

Since past research on gambling behavior has mostly focused on rule following, the purpose of the present study was to (a) replicate the findings of Dixon (2000) and (b) extend the methods to risky choice making. Four participants, were exposed to an electronic Blackjack game that was operating on random reinforcement schedule and different rules throughout the study in a multiple baseline design. Participants were exposed to three conditions in the specified order- no rule (baseline), faulty rule, and correct rule. The baseline condition involved no rules for each participant, followed by a faulty rule condition wherein participants were exposed to the rule that let it ride bets increased the odds of winning. Following that, participants were then exposed to a correct rule condition under which they exposed to the rule that let it ride bets did not increase odds of winning and were in fact riskier wagers. Participants showed significant increases in risky betting during the faulty rules condition, and three participants decreased risky betting following the presentation of the correct rule. Therefore, rules impact the play of gamblers, and the effect of a rule on play can be weakened through contradictory rules.

Early onset of gambling and alcohol use have been linked to development of later gambling problems, however the combined effect of the two has yet to be assessed. The present study included data from 2,417 respondents that took part in the Gambling Impact Behavior Study (GIBS; 1997-1999). The primary dependent variable was gambling severity, a scale created using questions from the GIBS that closely related to the Diagnostic and Statistical Manual 5 diagnostic criteria. Two models were tested, a multinomial logistic regression and to achieve more stable estimates a logistic regression were fitted to the data to determine how the association between age of onset and gambling severity is moderated by alcohol and substance use. The models also controlled for gender, region, race, family income, and age. The results of the analysis demonstrated that by themselves early age of onset and alcohol use are risk factors for being at-risk or for developing greater symptoms of gambling disorder. These findings suggest that the effect of age of onset is moderated by alcohol use. These findings are significant in that they are nationally representative and can generalize to the population, as opposed to past studies that have used clinical samples.

Gamblers place larger bets when money has recently been added to balance they have available to wager (i.e., the "house money effect"). We replicated this effect in a simulated-slot-machine task: participants wagered more money on a machine with a higher balance. We also investigated whether higher machine balances affected preference. In an initial exposure phase, participants played on each of two machines. In a second, preference test phase, participants could switch between the two machines. Participants allocated more spins to a machine which had had a higher balance during the exposure phase, even though this was unrelated to the current machine balance or pay-off. The effect of balance was present even when, in a second experiment, machines also varied in whether they offered a free-spins feature: which previous research has found strongly drives machine preference. This provides initial evidence that capping machine balances might be a useful component of gambling-harm-reduction interventions.

Aim: Contingency management (CM) interventions have gained considerable interest due to their success in the treatment of addiction. However they require frequent monitoring of behaviour change and differential delivery of incentives making their implementation resource intensive and burdensome for clinical staff. Telephone-based systems offer a low-cost alternative, allowing greater accessibility to services; remote therapeutic contact and monitoring of behaviour; minimise issues of staffing and resources; and allow for services to stay in contact with patients over a longer period to support recovery. This review aimed to assess the effectiveness of telephone-delivered CM to promote abstinence and treatment adherence among individuals receiving substance use treatment, from studies using randomised controlled trial design. Participants: 18years+, in treatment for substance use disorder (opiates, stimulants and alcohol), receiving telephone-delivered CM or treatment as usual. Methods: Selected databases were systematically searched (from 1995 to Present) using inclusion/exclusion criteria. Data Analysis: A systematic review of findings will be undertaken and if appropriate, a meta-analysis will be performed. Results/Conclusions: 1303 records were identified with 61 retained after initial screening to be investigated as full text. The review will examine what behaviours have been successfully targeted using telephone-delivered CM (abstinence, adherence) and effectiveness across different types of substances.

The traditional criminal justice response to prostitution and drug crime is expensive and ineffective. Behaviorally based drug abuse treatments such as the therapeutic workplace may help improve outcomes if incorporated into diversion to treatment strategies in the context of criminal justice. In the therapeutic workplace people with problem drug use can work and earn wages contingent on provision of drug free urine samples. The purpose of this study was to assess the therapeutic workplace as a means of increasing drug abstinence and decreasing HIV risk behaviors in women arrested for prostitution. Participants (N=38) were opiate dependent adults arrested for prostitution whose cases were being processed in early resolution court. All participants were either enrolled in methadone or buprenorphine treatment prior to enrolling in this study. Participants were randomly assigned to usual care or usual care plus the therapeutic workplace. Drug abstinence contingencies were implemented in four steps (No drug abstinence contingencies, cocaine abstinence, cocaine and opiate abstinence, cocaine, opiate, marijuana, and amphetamine abstinence). Results show that the opiate abstinence contingency increased opiate abstinence in opiate-dependent adults charged with prostitution. Results also show that the intervention decreased the frequency of HIV risk behaviors in the therapeutic workplace group.

Diabetes Mellitus (DM) represents a serious health problem around the world. It is known that one of the factors associated with the onset of DM is tobacco consumption, and those who have DM and smoke have bigger risk of developing health consequences. The objective of this study is to evaluate the impact on the number of daily smoked cigarettes of a smoking cessation treatment for people with DM. For this, a baseline assessment (BL), four treatment sessions (S1-S4), a post-treatment evaluation and two follow-ups were carried out in people with DM who want to quit smoking. Because this is a study that is not finished, preliminary data from 4 participants (P1-P4) are presented. P2 smoked an average of 24.23 cigarettes a day in BL, 19.14 in S1, 16 in S2, 13.71 in S3 and 5.33 in S4, while P4 smoked 43.8 cigarettes a day in BL, 43 in S1, 19.5 in S2 and 15 in S3. This preliminary data shows important reduction of daily cigarettes smoked when using this treatment. With this information and with all data that will be obtained at the end of this study, there will be enough evidence of the efficacy of this smoking cessation treatment for people with DM, treatment that can be used as a standard for this type of population and can help to reduce important health consequences that occurs when diabetics smoke.

Although contingency management (CM) interventions for smoking cessation can initiate abstinence, relapse is the most likely outcome, as with all smoking cessation interventions. A primary public health goal is to develop and test more effective techniques for initiating and maintaining smoking abstinence. This study sought to co-opt preexisting social support networks to provide continued reinforcement for abstinence through social support (SS) skills training sessions. Participants (N = 12) were consented and randomized into 3 groups: CM alone (n = 6; M_age = 42, SD_age = 10.6), CM plus SS (CM+SS) training (n = 3; M_age = 29, SD_age = 19.8), or TAU (n = 3; M_age = 34.7, SD_age = 13.4). Retention rates were 83%, 0%, and 33% respectively. Attrition was particularly high among individuals assigned to CM+SS and TAU. Participants recruited into the CM alone condition were generally successful, with three participants reducing cigarette use during treatment. A general pattern of non-adherence was observed among the remaining participants. The presented methodological changes seek to address concerns related to attrition and recruitment. The proposed intervention reorients the focus of treatment towards non-smoker skills training in order to promote treatment entry and the utilization of evidence-based interventions via Community Reinforcement and Family Therapy Treatment Entry Training.

Nearly 80% of pregnancies among women with opioid use disorder (OUD) are unintended. Long-acting reversible contraceptives (LARC), namely intrauterine devices (IUDs) and implants, are the most effective reversible forms of contraception because they are user-independent. Nevertheless, only ~30% of women in opioid agonist treatment (OAT) for OUD report they are likely to use LARC. Women in OAT for OUD (N=200) completed a survey assessing familiarity with and perceived knowledge about LARC, T/F questions testing actual LARC knowledge, and reasons that may have prevented LARC initiation. Results indicate only 41% have heard of LARC. While 73% reported “little” or “no” knowledge about LARC, women answered 50% of knowledge items correctly. Of the 121 women who have never used an IUD, and 169 women who have never used an implant, 46 (38%) and 48 (28%), respectively, reported that they have thought about using the method but decided not to. The top two reasons for deciding against either method were concerns about side effects and preferring a “controllable” method. Results suggest women have moderate knowledge about LARC methods. Consistent with other reports, concerns about side effects were common. Concerns about controllability of the method, however, are more unique and should be explored further.

Alcohol is the most commonly used psychoactive substance in the world. (CICAD, 2015). In Mexico, excessive consumption trends in the last survey (ENCODAT 2016-2017) went from 28% to 33.6%. The objective of this work is to review the results of research conducted in Mexico during several years, applying an intervention for excessive consumers of alcohol. It is a brief motivational, cognitive-behavioral intervention that uses self-control procedures, functional analysis of drinking behavior, identification of risk situations and development of coping strategies. We present the results of follow-ups at 6 and/or 12 months found in research carried out over these years (see Table 1), with statistically significant changes by reducing the amount consumed, maintaining them through follow-ups, reducing the problems associated with this form of consumption and the increase in the self-efficacy of users to control episodes of loss of control. DISCUSSION The process of dissemination in spaces of the health sector, the barriers and the importance of disseminate the benefits of IB in countries with limited resources such as Mexico are discussed, as they are low cost options and the possibility to address a public health problem.

The level at which health professionals are implementing evidence-based addiction interventions and their relation to the change in client behavior remains unknown, so it is necessary to identify which specific procedures are related to the achievement of client goals and the successful conclusion of the intervention. The objective of the study was to analyze the relationship between the level of implementation of procedures based on principles of learning with therapist under supervision and the conclusion of the intervention of the client in natural settings. 270 health professionals participated and 270 clients with alcohol and marijuana abuse levels. A direct observation system of the therapist-user interaction was used, consisting of a collated list of levels of implementation and sequential interaction record. The therapists videotaped each intervention session with their assigned clients, with the informed consent of the client and therapists and an expert supervisor recorded and gave feedback via email on the execution of the professional in the sessions. The results showed that the procedures of setting goals of consumption and alternative behavior and promotion of role playing are predictors of the successful conclusion of the client from a brief intervention. The minimum dose of implementation required to promote the conclusion of the brief intervention and the achievement of the client's goal is discussed.

The tobacco use is a public health problem both in the world and in Mexico and it is associated with chronic degenerative, irreversible, disabling and deadly diseases. According to the National Survey of Addictions (2017), 17.6% of the population aged 12-65 years is active and average smoker, and states that they started the daily consumption at 20.1 years. Although there are standardized smoking cessation interventions and research in Mexico which have proved their effectiveness, it is essential to evaluate the effectiveness of smoking cessation treatments for women, particularly those aimed at students, as it is known that a significant percentage of women start smoking in the college, and they become occasional smokers or daily smokers of tobacco. Therefore, this study (which is still under way) was aimed to evaluate the effectiveness of a cognitive behavioral intervention for college female students, compared with a standard intervention (with self monitoring, problem solving, relaxation, exposure and nicotine fading techniques) trough a randomized clinical trial. Participants were 26 college students who smoked less than 10 cigarettes daily, with an average age of 21.96 years. The pattern of consumption was obtained and compared before, during treatment and at six months follow-up. The results are discussed in terms of abstinence rates obtained at the end of treatment and at six months follow-up, which sets the tone for the establishment of effective strategies for earlier detection in college women.

Given that for many in drug and/or alcohol recovery their immediate family members will be their greatest support system, it is essential that the interactions between recovering addict and the family members be seen as "reinforcing" by both, and especially important that the interactions do not lead to discord, disagreement, and strife to the extent that the addict seeks a different environment. The presentation outlines a systematic approach to identifying both supportive and problematic patterns of interaction behavior, and deconstruct them into components that can be changed to increase the likelihood of desired interactions that strengthen the family bonds, making habits of such, and decrease the likelihood of interactions that weaken those recovering addict/family bonds, and thus increase the likelihood of emitting behaviors that lead to situational changes that then increase the likelihood of relapse.

A number of systematic and meta-analytic reviews have suggested that family behavior therapy may be effective in decreasing adolescent behavioral and substance misuse. For this study, a systematic review of 10 published articles will be used to compare family behavior therapy (FBT) and another condition of treatment for adolescents with behavior problems and substance misuse. This meta-analysis summarizes FBT to control groups (CTL), treatment as usual (TAU), or alternative treatments (ATL) during the treatment process of adolescent with behavior and substance abuse disorders. Data from studies of untreated control groups, treatments as usual, and alternating treatments will be analyzed separately. The results will be displayed on a flow chart. The aim of this study is to provide a comprehensive meta-analysis of the effectiveness of FBT for adolescent with behavioral problems and substance misuses. The results we will find in this study will show and support the effectiveness of family behavior therapy compared to CTL, TAU, ATL.

Training in life skills such as control of emotions, problem solving, decision making and communication, acts as a preventive measure for addictive behavior, in addition to impact on the reduction of aggressive physical and verbal behavior, and increase behaviors Communication. The objective of this study was to reduce antisocial behavior, through training in life skills. 80 teenagers participated with an average of 12.18 years of age, presenting a comic of 4 chapters, through which they modeled behaviors of characters with characters that were at their end, it was done at the time of recess, it was registered through a Placheck record.

Cigarette smoking remains the number one cause of preventable morbidity and mortality in the U.S. One third to one half of smokers attempt to quit at least once; however, approximately 94% of quit attempts result in relapse. Inspired is a mobile videogame-based contingency management intervention for smoking cessation. The intervention is a mobile application using in-game virtual rewards that are delivered contingent on smoking abstinence. These rewards can be used to meet game objectives and interact with other players. The prototype was tested with treatment seeking-smokers (N=28) who reported that the intervention would be helpful for quit attempts, but that the game lacked variety. The prototype testing was used to develop a full version of the game, specifically designed to compete with smoking. Researchers addressed the prototype feedback by designing levels with different enemy types, graphical design, level structure, and weapons depending on the level played. Players must submit negative CO samples with a mobile CO monitor to gain access to cosmetic points which are multiplied if the player submits consecutive negative samples. A clinical trial with 114 treatment-seeking smokers will be conducted to provide support for Inspired as a rigorous, yet enjoyable, intervention for smoking cessation.

Patients undergoing recovery from addiction, especially following an acute inpatient rehabilitation experience, often experience a period of time during which they are "spared" from typical daily activities, responsibilities, and reinforcers. During this time, particularly if living "back at home," demands on them are initially reduced, or non existent, but ideally should gradually increase, commensurate with ongoing successfulnhabit development, but too often, they don't do so. Unfortunately, for some patients, their families, their rehabilitation clinicians, their healthcare payers/insurers, the legal system, their friends, and other key stakeholders in their recovery, either in being well intentioned..or simply by not paying attention.., set up an environment sheltering them not only from responsibilities "too much for them to handle" at this time, but unfortunately also from the many natural consequences that would bring life back to them, shaping their behaviors, overt and private, to assist to return them to (ideally, improved versions of) their "normal" lives. While they might participate in some sort of outpatient "program," sadly the absence of a systematically implemented, reevaluated, revised, and increased set of responsibilities and actions expected of them within their family or other living situation, outside of their formal outpatient drug rehab program activities, can allow them, or arguably, cause them, to become "permanent teenagers," returning from their outpatient program activities to their home, where they can isolate themselves into their rooms, pajamas, snack foods, phone, computer, and up all night schedules of internet or video or game controller or tv reruns, often absent even much interaction with other family members in the house. Instead of focusing on "esteem building," behavioral activation robustly employed, with a goal of developing patterns of behavior useful to returning to a (more desirable) day to day life going forward, can get them showered dressed, out of their rooms, out of their houses, and into volunteer or part time job activities which will, if guided well, expose them to natural reinforces that will train them, rehabilitate them, reanimate them, redefine them, and reintegrate them into the (hopefully well chosen) worlds around them, and increase the likelihood they will be fortified against the stimuli, internal and external, that might lead them to emit behaviors of relapse.

A review of the Journal of Applied Behavior Analysis has provided some articles focusing on this substance abuse and addiction. Presented below are data regarding the publication of articles with a focus on these areas of interest in the Journal of Applied Behavior Analysis from the years 1995 to 2017. These articles include the examination of addiction as a �disorder of choice� (2012), trial contingency management in a drug court (2008), internet based vouchers to reduce cigarette smoking (2007) and other pertinent topics such as gambling (2012). In addition, the different areas of research and practice where the study of addiction may be relevant. Options available for the dissemination of behavior analysis to these areas of interest are discussed. In particular, the use of research on substance abuse and addiction can aid in the understanding of crime and delinquency. Crime is viewed as having a special relationship to the problem of addiction, and both areas are of interest from the behavior analytic point of view.

There is a growing recognition of the importance of using evidence-based practices (EBP) to inform our decisions in treatment. Importantly, the use of EBP allows for improved outcomes by mitigating harms that might arise with the improper provision of services. Contingency Management (CM) has been hailed by researchers as an efficacious treatment for numerous addictive populations and among a diverse clientele. Despite its documented efficacy, CM continues to be underused within addictions treatment. Attitudes and beliefs towards EBP have been identified as a major predictor towards the uptake and use of EBP. Thus, this study will examine how attitudes toward EBP impact attitudes toward CM in both the managers and service providers in substance abuse treatment organizations across Canada. Additionally, we will gauge manager and service providers knowledge of CM and the prevalence of its use to better understand the targets for later implementation. We will describe our plan to carry out this research including the background, proposed methods, implications, and future directions. Preliminary findings will be presented. Importantly, this research will allow us to understand whether misperceptions about CM are rooted in misunderstandings about EBP, allowing us to better target erroneous beliefs prior to the implementation of CM interventions.

Recovery from addiction is a process defined by choice for the long-term benefits of abstinence despite the immediate temptations of substance use. Social systems and recovery communities are promoted to support the recovery process. We explored the relationships between social connectedness and impulsive choice in recovery from addiction using the International Quit and Recovery Registry. 181 individuals in recovery (63% alcohol-, 3% cigarette-, 15% cocaine/stimulant-, 14% opioid-, 3% marijuana-, and 1% tranquilizer-users) completed a recovery assessment and the Lubben Social Network Scale, a measure of social connectedness. Of these, 49 participants also completed a $1000 delay discounting task, which assesses impulsive choice between smaller, immediate and larger, delayed reinforcement. Individuals who reported substance use within the past year had significantly lower social connectedness scores than individuals who did not report past-year use (mdn=27, n=40; and mdn=34, n=141 for past-year- and not-in-past-year-use, respectively; p = 0.0057). Furthermore, among individuals who completed the delay discounting task, social connectedness was significantly correlated with discount rate (r = -0.37, p = 0.0092), with relatively more impulsive individuals also demonstrating lower social connectedness. These results suggest that successful individuals in recovery demonstrate greater social connectedness and less impulsive choice.

The proposed statistical optimization employs complete enumeration to evaluate all possible diagnostic criteria sets and rules (DCSRs; i.e., combinations of diagnostic criteria with all possible thresholds) of a given set to identify more efficient diagnostic rules. All DCSRs are assessed by identifying a diagnostic criteria set and threshold that maximally separates diagnostic groups on a predefined objective function (i.e., Cohen�s d) with respect to relevant disorder-specific correlates. This approach has been used to identify alcohol use disorder (AUD) DCSRs that best differentiate diagnostic groups based on AUD-specific correlates, such as heaviness of consumption (e.g., Steinley et al., 2016). To date, the generalizability of the optimization approach to other substances has yet to be examined. Using data from the National Epidemiological Study on Alcohol and Related Conditions-III, we use statistical optimization to derive AUD and cannabis use disorder (CUD) DCSRs that maximally separate diagnostic groups on heaviness of consumption. The optimization analyses were restricted to past year drinkers (N=20,495) and cannabis users (N=3,701). Both optimal DCSRs consisted of a criteria set with 7 symptoms and a diagnostic threshold of 3; however, only 4 symptoms were consistent across DCSRs. This could suggest the need for substance-specific decision rules for AUD and CUD.

Given recent changes of marijuana legalization in the United States, it is an important concern whether more lenient marijuana laws associate with increased marijuana use. Reports on the relationship between changes in marijuana use and legalization vary. Some studies suggest no significant changes in use, while others report increases in use related to legalization. The present study examined whether prospective legalization can impact intentions to begin using marijuana based on specific marijuana-related contexts (eight scenarios) and expectancies among young adults. Participants (N = 319) completed a survey on their marijuana use, expectancies, and use intentions in legal versus nonlegal contexts. Results indicated that participants projected themselves as more likely to use marijuana in a legal versus illegal context, t(318) = 15.14, p <.001. In addition, a regression analysis showed that marijuana use expectancies specifically predicted nonusers� intent to begin using marijuana, R2 = .18, F(6, 129) = 4.57, p < .001. Nonusers who reported fewer expectations of cognitive or behavioral impairment related to marijuana use also reported greater intentions to initiate use (� = -.27, p = .007) with legalization. These findings suggest potential targets for future prevention of initiation to regular or problematic use among young adults.

College students present different difficulties that affect their health and put them at risk of consuming substances; the data indicate that 13% of the global burden of disease is due to mental health problems and that these constitute one of the three leading causes of death among people aged 15-35 years (WHO, 2009). The aim of this study was to identify early the risk of presenting mental health problems in the university population, and the link of these problems with the consumption of substances. The sample was 355 university students with an average age of 19 years (24% men and 76% women); the ASSIST screening instrument (WHO, 2010) and a screening instrument based on the mhGAP guide (WHO, 2010) were used. The results indicate that 74.6% of college students consume alcohol at a low level of risk, while 4.7% consume tobacco, 16% consume marijuana and 6.3% consume other illegal substances, all of the above with moderate risk. To mental health problems, it was identified that 63.2% had two or more symptoms of depression, 14% had two or more symptoms of anxiety, 12.4% had symptoms of psychosis and 11.3% reported a risk of self-harm.

Twitter is a popular social media platform among young adults. Young Twitter users are exposed to and often participate in tweets that promote risky behaviors, such as blunt use. Blunts are hollowed out cigars or cigarillos that are filled with marijuana. The current pilot study was designed to determine the prevalence rates and characteristics of African American, Hispanic and White young adult Twitter users who reported past month blunt use. Method: Young adults (N = 753) who reported past month blunt use were recruited via Twitter to participate in a brief anonymous online survey about their blunt use. Results: Findings revealed that African American young adults initiated blunt smoking at an earlier age, reported more days of blunt smoking in the past month and smoked more blunts in the past month than their Hispanic and White counterparts. Further, several racial/ethnic differences were found on thoughts about blunt use, reasons for initiating and continuing to smoke blunts and obstacles to quitting blunt smoking. Conclusions: Findings suggest that blunt use among Twitter users, especially African Americans, is high and that cognitions related to blunt use vary by race/ethnicity. Future online and offline prevention and treatment interventions should specifically target African American young adult blunt smokers, as well as perceptions regarding blunt use among African American, Hispanic and White young adults.

Topic: The placebo effect refers to the observation that the mere expectation that a drug or treatment will have an effect, e.g. reduce pain, can indeed induce that effect. Question: The study manipulated the information provided to patients receiving dental treatment, and investigated whether the effect of anaesthesia on pain could be modulated by whether that information was administrated single or double blind in two experiments. Participants: forty-four and 52 patients in Experiment 1 and 2, respectively. All received drilling in a molar. Methods: Pain induced by drilling in a molar was the primary dependent variable. The Extended information groups received information that enhanced expectations about the anaesthesia and did not include emotionally negative words. The Standard Information groups received information that is normally provided. The information was given by the dentist (single-blind), or by a dental technician without the knowledge of the dentist (double-blind). Results and data analysis: Extended information administrated single-blind reduced pain by about 50% compared to Standard Information. Reduced negative emotions predicted the decrease in pain. However, when administrated double blind, pain levels were the same in both groups. Conclusions: Preliminary analysis suggests that the method of administration can enhance or decrease the effect of expectations.

While the immediate family of the recovering addict is often the primary support system post discharge from a rehabilitation program, programs rarely are found to dedicate time to directly focus on making that home environment more reinforcing (and less likely to irritate the returning recovering addict to the point of leaving the home and relapsing) by deliberately focusing on identifying problematic behaviors of the family members, and modifying them to decrease the likelihood of problem interactions with the recovering addict, and increase the likelihood of continued building of stronger family relationships and patterns of behavior, thus decreasing the likelihood of being irritated by the family environment, and leaving to seek reinforcement elsewhere, possibly involving relapse. This presentation outlines a program in which in a systematic fashion deliberate attention is made to identifying past behavior and interaction problems within the family, and focus directly on changing those family member habits, and similarly, build upon prior family habits previously reinforcing. The applied behavior analyst is uniquely well positioned to apply the principles of behavior change in a robust fashion to the many habits that don’t simply go away by talking about them, thru the systematic application of techniques in the behavioral modification armamentarium including, but not limited to functional assessment, changing factors in the antecedent and consequent states, and directly modifying the topography of family member behaviors, as well as the differential reinforcement/punishment of competing, alternative, or incompatible behaviors.

This study targets public education points of interest that would contribute to behavior changes preventing short- and long-term disabilities caused by four addiction behaviors: smoking, over-eating, alcohol over-drinking, and using illegal drugs. This analysis promotes the understanding of disabilities caused by addictions from a social model approach, adding to the literature on prevention and treatment of addiction disabilities. The healthicization of addiction requires changes in lifestyles, and the present study is meant to contribute to this understanding. A Canonical Correspondence Analysis identified 13 (out of 38) explanatory variables as statistically significant predictors impacting the length of disabilities due to alcohol, drug, food, and tobacco addictions [final model: F13 = 5.64, p < 0.001 after 1,000 permutations, which captured 0.131 of the total inertia (i.e., weighted variance) in the dataset]. The results revealed that three national political factors, three national economic factors, and seven national and global socio-cultural factors are interacting at a significant level with the four addictive behaviors. In conclusion, the multivariate analysis of globalization variables, addiction factors, and the developmental status of a country provide a better understanding how each addictive behavior is impacted by the unique combination of the factors in different countries.

Behavioral economic demand analyses quantify the degree to which organisms defend baseline consumption of reinforcers against increasing constraints (e.g., costs, effort). Such analyses thereby provide a quantitative marker of hedonic scaling. One advantage of the exponential demand equation is its specification of a single parameter (a) to describe the rate of change in elasticity across the entire curve. However, because a is not independent of k (range of consumption in logarithmic units), Hursh (2014) proposed a generalized essential value (EV) formula that corrects for this interaction. The current study sought to evaluate the utility of this metric by comparing EV and Pmax (price associated with unit elasticity) across and within commodities of abuse (e.g., cigarettes, alcohol). After conducting a review of the purchase task literature focused on demand for these commodities, we used software to extract raw data from published demand curves. We then re-analyzed these data using both the EV formula and the Hursh (2014) Pmax formula to assess the transitional validity of Pmax and EV. Results indicate the importance of correctly specifying demand parameters when using quantitative models. Implications for research, model development, and policy will be discussed.

The purpose of this research was to investigate the effects of a treatment package to reduce prescription drug abuse in high school aged youth. The treatment package consisted of four components: a one hour didactic workshop, a community-led coalition, on-going evidence-based educational workshops for youth and parents, and public awareness campaigns. The first component, the one hour didactic workshop utilizing a research-based curriculum called RX360, will be discussed in this poster. Ninety-seven parents/guardians and 1997 youth between the ages of 14 and 18 participated. Pre and post measures of participant knowledge were measured. Results indicated that both groups significantly increased their knowledge on prescription drug abuse with youth demonstrating an overall knowledge increase of 16.9% and adults at 32.3%. In order to determine the effect of learning on behavior, longitudinal studies of individual and group behavior should be investigated. Implications of selection of behavior at the individual and cultural level will be discussed.