Browsing by Author "Argyriou, Evangelia"

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    Age and Impulsive Behavior in Drug Addiction: A Review of Past Research and Future
    (Elsevier, 2018-01) Argyriou, Evangelia; Um, Miji; Carron, Claire; Cyders, Melissa A.; Department of Psychology, School of Science
    Impulsive behavior is implicated in the initiation, maintenance, and relapse of drug-seeking behaviors involved in drug addiction. Research shows that changes in impulsive behavior across the lifespan contribute to drug use and addiction. The goal of this review is to examine existing research on the relationship between impulsive behavior and drug use across the lifespan and to recommend directions for future research. Three domains of impulsive behavior are explored in this review: impulsive behavior-related personality traits, delay discounting, and prepotent response inhibition. First, we present previous research on these three domains of impulsive behavior and drug use across developmental stages. Then, we discuss how changes in impulsive behavior across the lifespan are implicated in the progression of drug use and addiction. Finally, we discuss the relatively limited attention given to middle-to-older adults in the current literature, consider the validity of the measures used to assess impulsive behavior in middle-to-older adulthood, and suggest recommendations for future research.
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    HiTOP-based Optimal Personalized Assignment to Abstinence from Alcohol: A Precision Medicine Approach
    (2024-08) Argyriou, Evangelia; Cyders, Melissa; Wu, Wei; Stewart, Jesse; Plawecki, Martin
    Abstinence from drinking has traditionally been the primary goal of alcohol use disorder (AUD) treatment; however, there is evidence that individuals respond differently when trying to be abstinent from alcohol. The main goal of my study was to use a novel precision medicine approach to optimize assignment to short-term abstinence from alcohol based on a variety of individual characteristics. The sample consisted of 97 moderate-to-heavy drinkers aged 21-35. A within-subjects design was employed where each participant completed two counter-balanced intravenous alcohol sessions (one following abstinence and one during usual drinking). For the primary aim of this study (N = 47), crossover generalized outcome weighted learning was used to estimate an optimal individualized assignment rule to short-term abstinence based on prescriptive factors, including HiTOP-relevant dimensions and other characteristics. For a secondary aim (N = 50), logistic regression was used to test whether the subgroups estimated by the optimal rule were associated with a set of genetic and behavioral factors related to AUD, and subjective perceptions to alcohol intoxication. Findings showed that an estimated rule with higher granularity – higher-specificity traits and demographics – led to lower alcohol consumption overall compared with one-size-fits-all rules (i.e., assigning everyone to abstinence or assigning no one to abstinence). The effect sizes of the difference were small-to-medium and fell short of statistical significance. Family history of AUD had a positive trend association with benefit from abstinence, with one standard deviation increase in family history of AUD being associated with twice as high odds of being assigned to abstinence. Due to the limited sample size, the results should be interpreted with caution. Study results provided preliminary evidence that an individualized assignment rule based on relatively simple and easily accessible individual characteristics can lead to lower alcohol consumption than that observed if everyone or no one was assigned to abstinence (i.e., one-size-fits-all approach). Genetic predispositions reflected in family history of AUD may be a potential mechanism linking the assessed prescriptive factors with abstinence response, which is worth further exploration.
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    Individual factors predict substance use treatment course patterns among patients in community-based substance use disorder treatment
    (Public Library of Science, 2023-01-12) Argyriou, Evangelia; Bakoyannis, Giorgos; Wu, Wei; Rattermann, Mary Jo; Cyders, Melissa A.; Psychology, School of Science
    Background and objectives: Substance use disorders (SUDs) usually involve a complex natural trajectory of recovery alternating with symptom reoccurrence. This study examined treatment course patterns over time in a community SUD clinic. We examined depressive symptoms level, primary SUD assigned at each admission, and lifetime misuse of multiple substances as potential risk factors for premature treatment termination and subsequent treatment readmission. Methods: De-identified longitudinal data were extracted from charts of 542 patients from an SUD treatment center. Survival analysis methods were applied to predict two time-to-event outcomes: premature treatment termination and treatment readmission. Results: Primary opioid (vs alcohol) use disorder diagnosis at admission was associated with higher hazard of premature termination (HR = 1.91, p<0.001). The interaction between depressive symptoms level and substance use status (multiple vs single use) on treatment readmission was significant (p = 0.024), such that higher depressive symptoms level was predictive of readmission only among those with a history of single substance use (marginally significant effect). Lifetime use of multiple (vs single) substances (HR = 1.55, p = 0.002) and age (HR = 1.01, p = 0.019) predicted increased hazard of readmission. Conclusions: Findings did not support a universal role for depressive symptoms level in treatment course patterns. Primary SUD diagnosis, age, and history of substance misuse can be easily assessed and incorporated into treatment planning to support SUD patients and families. This study is the first to our knowledge that afforded a stringent test of these relationships and their interactions in a time-dependent, recurrent event, competing risks survival analysis examining both termination and readmission patterns utilizing a real-world clinic-based sample.
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    Integrating Preclinical and Clinical Models of Negative Urgency
    (Frontiers, 2019-05-23) Halcomb, Meredith; Argyriou, Evangelia; Cyders, Melissa A.; Radiology and Imaging Sciences, School of Medicine
    Overwhelming evidence suggests that negative urgency is robustly associated with rash, ill-advised behavior, and this trait may hamper attempts to treat patients with substance use disorder. Research applying negative urgency to clinical treatment settings has been limited, in part, due to the absence of an objective, behavioral, and translational model of negative urgency. We suggest that development of such a model will allow for determination of prime neurological and physiological treatment targets, the testing of treatment effectiveness in the preclinical and the clinical laboratory, and, ultimately, improvement in negative-urgency-related treatment response and effectiveness. In the current paper, we review the literature on measurement of negative urgency and discuss limitations of current attempts to assess this trait in human models. Then, we review the limited research on animal models of negative urgency and make suggestions for some promising models that could lead to a translational measurement model. Finally, we discuss the importance of applying objective, behavioral, and translational models of negative urgency, especially those that are easily administered in both animals and humans, to treatment development and testing and make suggestions on necessary future work in this field. Given that negative urgency is a transdiagnostic risk factor that impedes treatment success, the impact of this work could be large in reducing client suffering and societal costs.
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    Optimizing Allocation to Telehealth and In-Person Prolonged Exposure for Women Veterans with Military Sexual Trauma: A Precision Medicine Approach
    (MDPI, 2024-10-24) Argyriou, Evangelia; Gros, Daniel F.; Hernandez Tejada, Melba A.; Muzzy, Wendy A.; Acierno, Ron; Psychiatry, School of Medicine
    Military sexual trauma-related post-traumatic stress disorder (PTSD) is highly prevalent and costly among women veterans, making the need for effective and accessible treatment of critical importance. Access to care is a key mechanism of mental health disparities and might affect differential response to treatment. The goal of this study was to estimate an individualized treatment rule based on readily available individual characteristics related to access to care to optimize allocation to in-person vs. telehealth delivery of prolonged exposure for PTSD in military sexual trauma survivors. The following variables were used as prescriptive factors: age, race, disability status, socioeconomic status, rural vs. urban status, and baseline PTSD level. The rule was estimated using a machine-learning approach, Outcome Weighted Learning. The estimated optimal rule outperformed a one-size-fits-all rule where everyone is universally assigned to telehealth; it led to markedly lower mean PTSD levels following 6 months from treatment (Vdopt - VTelehealth = -14.55, 95% CI: -27.24, -1.86). However, the rule did not significantly discriminate for in-person therapy (Vdopt - VIn-person = -11.86, 95% CI: -25.83, 2.12). Upon further validation with larger and more diverse samples, such a rule may be applied in practice settings to aid clinical decision-making and personalization of treatment assignment.