title: The role of avoidance and inflexibility in characterizing response to contingency management for cocaine use disorders: A secondary profile analysis.
abstract: Contingency management (CM) is a reinforcement-based approach that provides tangible rewards for objectively verified drug abstinence. CM is the most effective available behavioral intervention for cocaine use disorders; however, response to CM is variable, with significant rates of nonresponse. In the present investigation, we conducted a secondary profile analysis to identify potentially modifiable cognitive-affective characteristics associated with CM response (abstinence vs. continued use) preceding a pharmacotherapy trial for cocaine dependence. Ninety-nine cocaine-dependent, treatment-seeking adults participated in a 4-week baseline CM procedure using high-value vouchers for submission of cocaine-negative urines. Separate profiles for responders and the nonresponders were established using standardized mean scores on relevant pretreatment measures of negative affect, experiential avoidance, cocaine withdrawal/craving, and impulsivity. Results indicated no differences between responder subgroups on baseline levels of negative affect, withdrawal/craving, or impulsivity; however, CM nonresponders, relative to responders, reported significantly higher levels of avoidance and behavioral inflexibility (p < .01) in the context of distressing cocaine-related thoughts, feelings, and bodily sensations. These data suggest that emotion regulation skills may serve as a therapeutic strategy for enhancing response to CM for cocaine use disorders. (PsycINFO Database Record
authors.affiliation: Department of Psychiatry and Behavioral Sciences, University of Texas Medical School at Houston.
authors.forename: Angela L
authors.initials: AL
authors.lastname: Stotts
authors.affiliation: Department of Psychiatry and Behavioral Sciences, University of Texas Medical School at Houston.
authors.forename: Anka
authors.initials: A
authors.lastname: Vujanovic
authors.affiliation: Department of Psychiatry and Behavioral Sciences, University of Texas Medical School at Houston.
authors.forename: Angela
authors.initials: A
authors.lastname: Heads
authors.affiliation: Department of Psychiatry and Behavioral Sciences, University of Texas Medical School at Houston.
authors.forename: Robert
authors.initials: R
authors.lastname: Suchting
authors.affiliation: Department of Psychiatry and Behavioral Sciences, University of Texas Medical School at Houston.
authors.forename: Charles E
authors.initials: CE
authors.lastname: Green
authors.affiliation: Department of Psychiatry and Behavioral Sciences, University of Texas Medical School at Houston.
authors.forename: Joy M
authors.initials: JM
authors.lastname: Schmitz
mesh_terms: D000293:Adolescent; D000328:Adult; D001521:Behavior Therapy / Q000379:methods*; D003042:Cocaine; D019970:Cocaine-Related Disorders / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012054:Reinforcement, Psychology; D012201:Reward; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D003042:Cocaine