Senior Research Scientist
Learning-based processes of addiction; the application of basic behavioral research to the development of new clinical interventions; alcohol craving; affect regulation and pretreatment change.
Preliminary data on pretreatment change in drinking indicate
that a subset of individuals make rapid, substantial changes prior
to starting treatment and maintain these changes during and after
treatment; others do not change substantially prior to treatment
and show only modest improvements after entering treatment.
This application proposes to investigate trajectories of
pretreatment changes in drinking and to examine the relationship of
pretreatment change to treatment outcome. Grant funded by NIAAA in the
amount of $2,708,039, 2014-2019.
In this study, Dr. Stasiewicz investigated Cognitive Behavioral Therapy (CBT), an empirically-supported treatment for alcohol dependence and its effects on coping skills, as well as four additional theoretically-relevant behavioral mechanisms of change specifically: increasing self-efficacy and self confidence, reducing positive outcome expectancies for alcohol use, increasing the therapeutic alliance, and reducing/regulating negative emotional states for their impact on treatment outcome. The study included 72 alcohol-dependent men and women participating in a 12-week trial of CBT for alcohol dependence. In addition, comprehensive research assessments were conducted with patients at baseline, end of treatment, and three months posttreatment. The goal of this study was to map the process of change in successful CBT by measuring the aforementioned theoretically relevant behavioral mechanisms of change on weekly occasions during treatment. Results are expected to contribute to a refinement of existing treatment procedures, a clearer picture of the processes of recovery, treatment dropout, poor response, and relapse. Dr. Stasiewicz’s co-investigator on the study is Dr. Clara M. Bradizza, RIA. Funded by a grant of $757,030 from NIAAA. This project was supported through funds provided by the American Recovery and Reinvestment Act (ARRA), 2009-2012.
Coffey | Stasiewicz
There is a high level of comorbidity between posttraumatic stress disorder (PTSD) and alcohol dependence. However, there are few controlled trials testing whether concurrent treatment of the two conditions improves alcohol treatment outcomes. In this randomized, controlled clinical trial, an established PTSD treatment was administered in a sample of alcohol dependent treatment seekers with PTSD to assess if reductions in PTSD symptom severity leads to improved alcohol treatment outcomes at 3- and 6-month follow-up. Moreover, a brief trauma-focused motivational enhancement session was utilized to test if retention during alcohol dependence-PTSD treatment can be improved. Funded by NIAAA, with a subaward to RIA from the University of Mississippi Medical Center, 2007-2012.
In this study, Dr. Stasiewicz examined whether a reduction of negative emotional responses to drinking trigger situations, via prolonged imaginal exposure, would produce a concomitant reduction in alcohol craving produced by those same cues. Secondly, he examined whether a reduction in negative emotional responses and negative affect-elicited alcohol craving was associated with positive treatment outcomes among alcohol dependent men and women. Alcohol dependent men and women received six sessions of prolonged imaginal exposure to negative affect drinking situations delivered concurrent with a standard 12-session Treatment as Usual (TAU) for alcohol dependence. The prolonged exposure intervention incorporated two laboratory sessions (pre- and post-treatment) intended to assess change in cue-elicited negative emotions and alcohol craving. Co-investigator on the study is Clara M. Bradizza, PhD. Funded by a grant of $416,063 from NIAAA, 2007-2010.
In this study, Dr. Paul Stasiewicz and colleagues developed and piloted a clinical intervention that addresses the problem of negative affect as it relates to alcohol use and alcohol relapse. Currently, negative affect is a component of nearly half of all relapses to alcohol use among men and women in treatment, however no well-developed, empirically-tested, efficacious treatments specifically address the impact of negative affect on relapse. This project will assist individuals in treatment to regulate and cope with negative affective episodes that threaten relapse to alcohol use. Phase one will develop a 12-session treatment manual for Affect Regulation Training (ART) delivered concurrently with a standard 12-session Treatment as Usual (TAU). Phase two will encompass a pilot study of outcomes for individuals participating in ART and TAU compared to individuals who receive TAU and a Health and Lifestyle Supplement (HLS). The long-term objective of this line of research is to make a brief, effective affect regulation intervention available to clinicians to enhance treatments for alcohol dependence. Dr. Stasiewicz’s colleagues on the project included Drs. Clara Bradizza, RIA, Scott Coffey, University of Mississippi’s Department of Psychiatry, and Suzy Bird Gulliver, Boston University’s Department of Psychiatry. Funded by a grant of $1,937,729 from NIAAA, 2005-2011.
The aims of this research are to look at factors that predict who continues to drink following alcohol and mental health treatment versus those individuals who are able to maintain abstinence from alcohol. We anticipate that some of the important factors affecting these relationships will include the extent and severity of psychiatric symptoms, how long the alcohol problem has existed, how regularly dual-diagnosis treatment is attended, and the types of coping skills project participants have to deal with difficult situations involving alcohol or other drugs. This four-year study will result in a better understanding of the kinds of factors that are most likely to lead to continued problem drinking among severely mentally ill individuals and in turn, help in the design of treatment programs that better meet the needs of this population. Dr. Clara Bradizza's co-investigators are Drs. Gerard Connors and Paul Stasiewicz of RIA and Stephen Maisto, Syracuse University. Funded by a grant of $1,567,083 from NIAAA, 2002-2007.
Context has long been known to play a vital role in modulating acquired behavior. This project represented a test of the effect of context on alcohol craving and alcohol cue reactivity in treatment-seeking alcoholics. This research has implications for the development of alternative methods of conducting behavioral cue exposure treatments with the potential to enhance the generalization of treatment effects in the alcoholic's natural environment. Funded by a grant of $687,095 from NIAAA, 1999-2004.
Coffey | Stasiewicz
Using an empirically supported behavioral treatment for Posttraumatic Stress Disorder (PTSD), this project examined whether a reduction in negative emotion leads to a reduction in alcohol craving in persons with comorbid PTSD and alcohol dependence (AD). The study was a collaboration across University at Buffalo departments by the Department of Psychiatry’s Scott Coffey, principal investigator and RIA’s Paul Stasiewicz, co-investigator. Funded by NIAAA, 2001-2004.