Publications by authors named "Rachel Luba"

13 Publications

  • Page 1 of 1

A Default Option to Improve Nutrition for Adults With Low Income Using a Prefilled Online Grocery Shopping Cart.

J Nutr Educ Behav 2021 Sep;53(9):759-769

Department of Psychology, University at Albany, State University of New York, Albany, NY.

Objective: To determine whether a prefilled online grocery shopping (default) cart improves the nutritional quality of groceries purchased compared with receiving nutrition education (NE).

Design: Longitudinal study.

Setting: Three food pantries in the US.

Participants: Thirty-eight adults with low income.

Intervention: Groceries were purchased online for 5 consecutive weeks. After a baseline shopping trip, participants were randomized to receive NE or a nutritionally balanced prefilled online grocery shopping cart (ie, default cart) before shopping (from week 1 [T1] to week 4 [T4]).

Main Outcome Measures: Diet quality (Healthy Eating Index [HEI-2015] scores), energy, and energy density of each online cart (ie, grocery purchases).

Analysis: Piecewise linear mixed-effects models.

Results: From baseline to T1, HEI-2015 scores in the default condition significantly increased (95% confidence interval [CI], 9.79-23.39), whereas total calories (95% CI, -10,942 to -1,663) and energy density (95% CI, -0.70 to -0.45) significantly decreased compared with NE. Improved HEI-2015 scores were maintained through T4. Calories and energy density increased from T1 to T4 in the default condition, but values remained lower (ie, more healthful) than the NE condition. In the NE condition, outcomes did not significantly change during the intervention.

Conclusions And Implications: Providing an online default cart may improve the nutritional quality of grocery purchases. However, future research is warranted to assess whether adding a second nudge later in the intervention or combining the NE and default cart further promotes healthy purchasing behavior.
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http://dx.doi.org/10.1016/j.jneb.2021.06.011DOI Listing
September 2021

Impulsivity in cocaine users compared to matched controls: Effects of sex and preferred route of cocaine use.

Drug Alcohol Depend 2021 Sep 2;226:108840. Epub 2021 Jul 2.

Division on Substance Use Disorders, New York State Psychiatric Institute and Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons and Columbia University Irving Medical Center, 1051 Riverside Drive, New York, NY, 10032, USA.

Background: Impulsivity has been identified as playing a role in cocaine use. The purpose of this study was to explore self-report measures of impulsivity in large groups of male and female cocaine users and matched controls and to determine if differences in impulsivity measures within a group of cocaine users related to self-reported money spent on cocaine and route of cocaine use.

Methods: Eight self-report impulsivity measures yielding 34 subscales were obtained in 230 cocaine users (180 M, 50 F) and a matched group of 119 healthy controls (89 M, 30 F). Correlational analysis of the questionnaires revealed 2 factors: Impulsive Action (Factor 1) consisting of many traditional impulsivity measures and Thrill-seeking (Factor 2) consisting of delay discounting, sensation and thrill seeking.

Results: Sex influenced within group comparisons. Impulsive Action scores did not vary as a function of sex within either group. But, male controls and male cocaine users had greater Thrill-seeking scores than females within the same group. Sex also influenced between group comparisons. Male cocaine users had greater Impulsive Action scores while female cocaine users had greater Thrill-seeking scores than their sex-matched controls. Among cocaine users, individuals who preferred insufflating ("snorting") cocaine had greater Thrill-seeking scores and lower Impulsive Action scores than individuals who preferred smoking cocaine. Individuals who insufflate cocaine also spent less money on cocaine.

Conclusions: Greater Impulsive Action scores in males and Thrill-seeking scores in females were associated with cocaine use relative to controls.
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http://dx.doi.org/10.1016/j.drugalcdep.2021.108840DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8355072PMC
September 2021

Factor analysis of a short form of the Protective Behavioral Strategies for Marijuana scale.

Addict Behav 2021 06 4;117:106852. Epub 2021 Feb 4.

Department of Psychology, University at Albany, State University of New York, USA.

Objective: The Protective Behavioral Strategies for Marijuana Scale (PBSM), a 17-item scale targeting strategies for mitigating the negative consequences of cannabis use, highlights a range of behaviors that can reduce harm beyond straightforward decreases in quantity or frequency. The 17-item scale's factor structure remains under-examined but could reveal meaningful distinctions among strategies. This study aimed to confirm the factor structure of the short form of the PBSM.

Methods: This study recruited cannabis-using undergraduates (N = 454,M = 19.6, 68.8% female, 39% White), who reported using cannabis approximately 2.3 days per week with mild cannabis-related consequences (CAPQ; M = 9.74).

Results: A confirmatory factor analysis demonstrated poor fit for the one-factor model of the PBSM, prompting an exploratory factor analysis. Analyses revealed two internally reliable factors: a "Quantity" factor, strategies specific to mitigating overuse and limiting amounts consumed and an "Context" factor loosely related to troubles with others. This two-factor model accounted for over half of the total variance; invariance testing indicated reduced fit as models became more restrictive. Though each of the factors covaried negatively with both days of use and problems, Context had a stronger relation to both variables compared to Quantity. Only Context predicted fewer cannabis problems and use.

Conclusions: The two-factor solution suggests further work on the psychometric properties of the scale could provide heuristic information to allow for more nuanced approaches in clinical and research settings. Theoretically, each factor might have novel links to some constructs but not others in ways that could assist harm-reduction strategies and treatment.
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http://dx.doi.org/10.1016/j.addbeh.2021.106852DOI Listing
June 2021

Gender-based differential item functioning in the Cannabis-Associated Problems Questionnaire: A replication and extension.

Addict Behav 2021 01 13;112:106658. Epub 2020 Sep 13.

Department of Psychology, University at Albany, State University of New York, Albany, NY, USA.

Background: Gender bias in measures of cannabis problems may differentially affect how men and women endorse items. This gender invariance might mask, exaggerate, or otherwise obscure true distinctions in experiences of cannabis consequences.

Methods: The Cannabis-Associated Problems Questionnaire (CAPQ), a measure of interpersonal deficits, occupational impairment, psychological issues, and physical side effects related to cannabis use, contained items with gender-based differential item functioning (DIF) in previous work-a finding we aim to replicate and extend (Lavender, Looby, & Earleywine, 2008).

Results: In a sample of 4053 cannabis users, gender differences were apparent in global scores on the CAPQ. A DIF analysis revealed two gender-biased items, including one identified previously. Removal of these items did not significantly alter the scale's relation to cannabis use. Gender differences on the CAPQ persisted after removal of the two problematic items, indicating true gender differences still exist in men and women's experiences of cannabis-related consequences. Gender appeared to significantly contribute to scores on the full CAPQ and the short-form of the CAPQ with biased item removed, even after controlling for indices of cannabis use.

Conclusions: These findings suggest that the CAPQ evidences less gender bias than previously thought, perhaps due to diminishing gender-based stereotypes. Future work might opt to use the short form of the CAPQ to minimize gender-based DIF. In addition, potential biases in measures of substance use problems deserve more attention.
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http://dx.doi.org/10.1016/j.addbeh.2020.106658DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7810355PMC
January 2021

Savoring Moderates the Link between Marijuana Use and Marijuana Problems.

Subst Use Misuse 2020 25;55(2):291-295. Epub 2019 Sep 25.

University at Albany, State University of New York, Albany, New York, USA.

The changing legal landscape for marijuana requires concerted efforts toward minimizing the potential harms related to use of the plant. Identifying buffers against negative consequences in regular users could help researchers fashion prevention efforts that could appeal to those who are uninterested in messages related to abstinence. Savoring, a positively-focused, mindful approach to making the most of positive experiences, appears to overlap with facets of treatment that have proven successful with problem users. The present study examined the role of savoring in the development of marijuana-related problems. We examined the potential role of savoring as a buffer against marijuana problems in 195 participants (27.3% female). Participants in this sample used cannabis 3.06 days per week on average. Correlations revealed that problems decreased as savoring increased. In addition, a significant interaction revealed that savoring moderated the impact of frequent use on problems. As savoring increased, the positive association between frequency of use and negative consequences decreased, suggesting that those who are high on savoring experience fewer negative consequences than those who are low on savoring even when they use marijuana as frequently. These data support the idea of incorporating savoring into the prevention of marijuana problems.
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http://dx.doi.org/10.1080/10826084.2019.1666145DOI Listing
October 2020

Aversiveness and Meaningfulness of Uncomfortable Experiences with Edible Cannabis.

J Psychoactive Drugs 2019 Nov-Dec;51(5):413-420. Epub 2019 Jul 29.

Department of Psychology, University at Albany, State University of New York, Albany, USA.

Cannabis remains the most frequently used illicit drug in the United States. As its legal status has changed, more people have turned to oral administration ("edibles"). 172 individuals who reported an uncomfortable experience with edible cannabis completed an online survey. Despite the aversive nature of the experience, 62.9% of the sample reported that the edible experience was at least somewhat meaningful and the majority of participants (95.2%) did not report any medical problems. The most common non-medical problem reported was going to bed early or lying down (75.8%). Most participants (69.2%) reported that dose was the key contributor to their negative experience. Participants who rated the experience as more aversive were less likely to use edibles again, r (167) = - .180, < . 05. In addition, the duration of the aversive experience correlated positively with aversiveness rating, r (167) = . 244, < . 05. With increased legalization of cannabis, edible use may rise. Dose seems to be associated with uncomfortable experiences with edible cannabis. Notwithstanding these uncomfortable experiences, the vast majority of the sample used cannabis edibles again, reported that the experience was at least somewhat meaningful, and did not report significant problems associated with the experience.
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http://dx.doi.org/10.1080/02791072.2019.1645371DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7472878PMC
June 2020

The Role of Impulsivity and Expectancies in Predicting Marijuana Use: An Application of the Acquired Preparedness Model.

J Psychoactive Drugs 2018 Nov-Dec;50(5):411-419. Epub 2018 Sep 5.

a Department of Psychology , University at Albany, State University of New York, Albany, NY, USA.

Impulsivity and substance use covary. Smith and Anderson's acquired preparedness model proposes that impulsivity predicts substance use through a mediational model such that substance use expectancies mediate the relation between impulsivity and drug use. The present study seeks to examine the relation between positive urgency, an important component of impulsivity with specific relations to substance use behavior, marijuana expectancies, and marijuana use patterns. The study focused on a sample of frequent marijuana users (n = 3,616) and assessed positive urgency using the UPPS-P, expectancies using the Biphasic Marijuana Effects Scale, an adapted form of the Biphasic Alcohol Effects Scale to measure the sedative and stimulant properties of marijuana, and also assessed use patterns. Findings suggest that stimulant expectancies predict heavier, more frequent marijuana use than sedative expectancies and that marijuana expectancies vary based on the limb of marijuana intoxication. Examination of the acquired preparedness model revealed that positive urgency's link to marijuana use was fully mediated by expectancies.
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http://dx.doi.org/10.1080/02791072.2018.1511877DOI Listing
October 2019

Cannabis in End-of-Life Care: Examining Attitudes and Practices of Palliative Care Providers.

J Psychoactive Drugs 2018 Sep-Oct;50(4):348-354. Epub 2018 May 1.

a Department of Psychology , University at Albany, State University of New York , Albany , NY , USA.

Medical cannabis research has become quite extensive, with indications ranging from glaucoma to chemotherapy-induced nausea. Despite increased interest in cannabis' potential medical uses, research barriers, cannabis legislation, stigma, and lack of dissemination of data contribute to low adoption for some medical populations. Of interest, cannabis use appears low in palliative care settings, with few guidelines available to palliative care providers. The present study sought to examine the attitudes, beliefs, and practices of palliative care providers regarding the use of cannabis for terminally ill patients. Palliative care providers (N = 426) completed a one-time online survey assessing these attitudes, beliefs, and practices. Results demonstrated that palliative care providers endorse cannabis for a wide range of palliative care symptoms, end-of-life care generally, and as an adjuvant medication. Nevertheless, the gap between these beliefs and actual recommendation or prescription appears vast. Many who support the use of cannabis in palliative care do not recommend it as a treatment. These data suggest recommendations for healthcare providers and palliative care organizations.
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http://dx.doi.org/10.1080/02791072.2018.1462543DOI Listing
October 2019

Chronic pain and opioid abuse: Factors associated with health-related quality of life.

Am J Addict 2017 Dec 21;26(8):815-821. Epub 2017 Nov 21.

Division on Substance Use Disorders, New York State Psychiatric Institute and Department of Psychiatry, College of Physicians and Surgeons of Columbia University, New York, New York.

Background And Objectives: While research on the separate relationships between health-related quality of life (HRQOL) and chronic pain, and HRQOL and opioid abuse has been sparse, even less work has investigated the factors associated with HRQOL in individuals who have both chronic pain and meet criteria for opioid use disorder. The data presented in this analysis should allow a better understanding the factors important to quality of life among this dual-diagnosed population.

Methods: Individuals with dual diagnoses of chronic pain and opioid use disorder were recruited for clinical research studies at Columbia University Medical Center. Participants (n = 47) completed inventories to assess pain (Brief Pain Inventory), opioid (ab)use, and depression (Beck Depression Inventory). Variable from these and other inventories, along with demographic factors (age, race, sex, pain severity, depressive symptoms, duration of opioid use, route of opioid use, amount of opioid use) were entered into a regression analysis in order to identify the strongest predictors of SF-36 Health Survey score.

Results: In the bivariate analysis we found that demographic and drug use variables were rarely associated with HRQOL. Typically, ratings of pain severity and pain interference were the best predictors. In the multivariate analysis, we found that across the several HRQOL dimensions greater Brief Pain Inventory (BPI) ratings of pain "interference" and Beck Depression Inventory (BDI) scores were consistently associated with lower HRQOL.

Conclusions And Scientific Significance: These data suggest that insufficient pain management and depression are significant variables contributing to lower quality of life among individuals with chronic pain and opioid use disorder. (Am J Addict 2017;26:815-821).
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http://dx.doi.org/10.1111/ajad.12637DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6166874PMC
December 2017

Placebo Effects of Edible Cannabis: Reported Intoxication Effects at a 30-Minute Delay.

J Psychoactive Drugs 2017 Nov-Dec;49(5):393-397. Epub 2017 Aug 3.

d Adjunct Assistant Professor, Department of Psychiatry , Perelman School of Medicine, University of Pennsylvania , Philadelphia , PA , USA.

Previous research has demonstrated the ability of non-active smoked cannabis cigarettes to induce subjective effects of intoxication (i.e., placebo effect). No studies have been conduced to test whether edible forms of cannabis, which are associated with a significant delay in onset of effect, are able to induce a placebo effect. In the present study, 20 participants were told that they would receive an edible cannabis lollipop containing a high dose of tetrahydrocannabinol (THC), but were instead given a placebo control. Measures of intoxication and mood were taken at baseline, 30 minutes, and 60 minutes post-ingestion of the placebo lollipop. Results of four repeated-measures ANOVAs found significant and quadratic changes across time in cannabis (ARCI m-scale) intoxication (F(2,18) = 4.90, p = .01, η = .22) and negative mood (F(2,18) = 3.99, p = .05, η = .19). Changes in positive mood and the overall measure of general intoxication (ARCI) failed to reach significance. The present study provides preliminary evidence that a placebo effect can be induced with inert edible agents when participants are told that they are receiving active THC. This is the first known study to demonstrate an edible cannabis intoxication placebo effect.
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http://dx.doi.org/10.1080/02791072.2017.1354409DOI Listing
July 2018

Racial Differences in HIV and HCV Risk Behaviors, Transmission, and Prevention Knowledge among Non-Treatment-Seeking Individuals with Opioid Use Disorder.

J Psychoactive Drugs 2017 Jan-Mar;49(1):59-68. Epub 2016 Dec 5.

e Research Assistant, Department of Psychiatry, Division on Substance Abuse , New York State Psychiatric Institute & Columbia University Medical Center , New York , NY , USA.

In light of New York's recently reinforced strategy to end the AIDS epidemic by expanding testing, treatment, and access to pre-exposure prophylaxis (PrEP), we assessed drug use and sexual risk behaviors, along with HIV/Hepatitis C virus (HCV) transmission and prevention knowledge among non-treatment-seeking adults with opioid use disorder (OUD) in New York City. Over the course of 18 months, volunteers screening for research studies in the Opioid Laboratory at the New York State Psychiatric Institute completed a locally developed self-assessment questionnaire. A total of 138 adults with OUD (24 female, 114 male) with a mean age of 46.5 years (SD = 9.5 yrs) were assessed. Significant differences among the four racial/ethnic subgroups (n = 65 African-Americans, n = 34 Hispanics, n = 31 Caucasians or Whites, n = 8 Multiracial) were found. Whites were the youngest (p = 0.001), most frequently injecting drugs (p < 0.001), and engaged more often in risky drug use and sexual behaviors, although their virus transmission knowledge was comparable to that of the other subgroups. Few participants had heard about PrEP. White opioid users showed the most risk behaviors among races/ethnicities, despite comparable prevention knowledge. Better HIV/HCV prevention interventions targeting individuals with opioid use disorders who are not currently in treatment would be desirable, given their large health burden.
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http://dx.doi.org/10.1080/02791072.2016.1259518DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5950713PMC
December 2017

The effects of heroin administration and drug cues on impulsivity.

J Clin Exp Neuropsychol 2016 Aug 10;38(6):709-20. Epub 2016 Apr 10.

a Division on Substance Abuse , New York State Psychiatric Institute, Columbia University Medical Center , New York , NY , USA.

Drug addiction is a chronic relapsing disorder characterized by compulsive drug seeking and continued use despite negative consequences. Behavioral impulsivity is a strong predictor of the initiation and maintenance of drug addiction. Preclinical data suggest that heroin may exacerbate impulsive characteristics in an individual but this has yet to be assessed in clinical samples. The current secondary data analysis sought to investigate the effects of heroin on impulsivity along with the effects of exposure to drug cues. Using the current data set, we also tentatively assessed the etiological relationship between impulsivity and heroin abuse. Sixteen heroin-dependent participants were recruited to complete Immediate Memory Task/Delayed Memory Task (IMT/DMT) and GoStop tasks following repeated heroin administration, following acute heroin administration, and following a drug cue exposure session. Four preceding days of active heroin availability, compared to four preceding days of placebo drug availability, increased impulsivity assessed using the IMT and DMT. Presentation of drug cues similarly acted to increase impulsivity assessments on all three tasks. It also appears that heavier users were more susceptible to the influence of drug cues on impulsivity. The present study represents a step toward a more comprehensive understanding of the interaction between opioid abuse and impulsivity. A better understanding of these factors could provide critical insight into the maintenance of heroin use and relapse.
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http://dx.doi.org/10.1080/13803395.2016.1156652DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4981922PMC
August 2016

Searching for evidence of genetic mediation of opioid withdrawal by opioid receptor gene polymorphisms.

Am J Addict 2016 Jan 21;25(1):41-8. Epub 2015 Dec 21.

Division of Substance Abuse, New York Psychiatric Institute and Department of Psychiatry, College of Physicians and Surgeons of Columbia University, 1051 Riverside Drive, Unit 120, 10032, New York, New York.

Background: Previous research has identified many genetic polymorphisms that appear to mediate the effects of opioid drugs. However, the relationship between genetic polymorphisms and the severity of opioid withdrawal has not yet been characterized.

Methods: Data were collected from 48 daily heroin users who previously completed a standardized abstinence-induced or naloxone-precipitated withdrawal procedure to assess opioid dependence. The total withdrawal severity score (based on the COWS) from this procedure was correlated with genotype information for variants of OPRM1 (rs1799971; rs6848893), OPRD1 (rs10753331; rs2234918; rs581111; rs678849; rs1042114), and OPRK1 (rs6473797; rs963549). Genotype and other participant variables (age, race, sex, duration of drug use, concomitant drug use, route of opioid use) were used as predictors.

Results: Of these variables, those individually correlated with a p < .2 were entered into a multivariate regression in order to identify the most predictive model. Three polymorphisms were significantly associated with severity of abstinence-induced withdrawal (n = 19) in the bivariate analysis (R): OPRM1 rs6848893 (.45), OPRD1 rs10753331 (.03), and rs678849 (.08), but only the OPRM1 rs6848893 was retained in the multivariate model (p < .001). For participants who underwent naloxone-precipitated withdrawal (n = 29) only OPRK1 rs6473797 (-.23) was significant in the bivariate analysis, though not retained in the final model.

Conclusions: These data provide evidence for genetic modulation of opioid withdrawal severity, and suggest there may be qualitative differences between withdrawal resulting from abstinence and antagonist-precipitated withdrawal.

Scientific Significance: This study demonstrates the importance and feasibility of incorporating genetic information into clinical addiction research.
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http://dx.doi.org/10.1111/ajad.12316DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5444323PMC
January 2016
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