Biochemical marker of use is a better predictor of outcomes than self-report metrics in a contingency management smoking cessation analog study.

BACKGROUND AND OBJECTIVES: This investigation compared cotinine (primary metabolite of nicotine) at study intake to self-report metrics (e.g., Fagerstrom Test of Nicotine Dependence [FTND]) and assessed their relative ability to predict smoking outcomes. METHODS: We used data from an analog model of contingency management for cigarette smoking. Non-treatment seeking participants (N = 103) could earn money in exchange for provision of a negative carbon monoxide (CO) sample indicating smoking abstinence, but were otherwise not motivated to quit. We used intake cotinine, FTND, percent of friends who smoke, and years smoked to predict longitudinal CO and attendance, time-to-first positive CO submission, and additional cross-sectional outcomes. RESULTS: Intake cotinine was consistently predictive (p < .05) of all outcomes (e.g., longitudinal CO and attendance, 100% abstinence, time-to-first positive CO sample), while years smoked was the only self-report metric that demonstrated any predictive ability. CONCLUSIONS AND SCIENTIFIC SIGNIFICANCE: Cotinine could be more informative for tailoring behavioral treatments compared to self-report measures.

Children discover the spectral skeletons in their native language before the amplitude envelopes.

Much of speech perception research has focused on brief spectro-temporal properties in the signal, but some studies have shown that adults can recover linguistic form when those properties are absent. In this experiment, 7-year-old English-speaking children demonstrated adultlike abilities to understand speech when only sine waves (SWs) replicating the 3 lowest resonances of the vocal tract were presented, but they failed to demonstrate comparable abilities when noise bands amplitude-modulated with envelopes derived from the same signals were presented. In contrast, adults who were not native English speakers but who were competent 2nd-language learners were worse at understanding both kinds of stimuli than native English-speaking adults. Results showed that children learn to extract linguistic form from signals that preserve some spectral structure, even if degraded, before they learn to do so for signals that preserve only amplitude structure. The authors hypothesize that children's early sensitivity to global spectral structure reflects the role that it may play in language learning.

Urban and rural utilization of evidence-based practices for substance use and mental health disorders.

PURPOSE: The purpose of the investigation was to examine variations in evidence-based practice (EBP) utilization between rural and urban mental health and substance abuse prevention provider agencies in Washington State. METHODS: We conducted a secondary analysis of the 2007 EBP Survey, which was administered to 250 of Washington State Department of Social and Health Services' contracted mental health and substance abuse treatment agencies. The survey solicited input from solo and group practices across the state on EBP implementation, successes, and challenges. FINDINGS: Most mental health and substance abuse treatment agencies used more than 1 EBP, although rural substance abuse agencies were less likely to do so than urban agencies. Rural substance abuse agencies were more likely to be solo than group practices. Urban agencies reporting significantly more collaboration with universities for EBP training, although training by internal staff was the most commonly reported training mechanism regardless of agency focus or location. Over half of agencies reported conducting no systematic assessment of EBPs, and of those who did report systematic assessment, most used outcome monitoring more than program evaluation or benchmarking. Urban and rural mental health and substance abuse prevention providers reported shortages of appropriately trained workforce and financing issues available to pay for EBPs as the greatest barriers to utilization. CONCLUSIONS: Challenges to EBP utilization and fidelity should be monitored as EBPs contribute to the delivery of high-quality care. Collaborations between universities and rural agencies may support an agency's abilities to adopt EBPs, train staff, and systematically assess impact.

Investigating reinforcer magnitude and reinforcer delay: a contingency management analog study.

The influence of reinforcer magnitude and reinforcer delay on smoking abstinence was studied using an analog model of contingency management. Participants (N = 103, 74% men) visited our laboratory 3 times daily for 5 days and received money for providing a breath sample that indicated smoking abstinence (carbon monoxide level ≤6 parts per million). Using a factorial design, we assigned participants randomly to 1 of 4 groups that could earn a total of either $207.50 (high-magnitude condition) or $70.00 (low-magnitude condition), and received earnings either at each visit (no-delay condition) or in a single lump sum 1 week following the study (delay condition). High-magnitude reinforcement, regardless of delay, was associated with higher rates of abstinence than was low-magnitude reinforcement. High magnitude of reinforcement provided immediately but in incremental amounts was associated with longer intervals to relapse during treatment in comparison with high-magnitude reinforcement provided in a single lump sum after a delay. Low rates of responding in the low-magnitude conditions made interpretation of the impact of delay in those conditions difficult. These findings further demonstrate that high magnitude of reinforcement results in better outcomes than does low magnitude of reinforcement, and that a delay to reinforcement can be detrimental-even when a high magnitude of reinforcement is provided.