Gender, Behavioral Assessment of Negative Reinforcement Driven Risk Taking Propensity, and Cigarette Smoking

Cigarette smoking remains the leading preventable cause of death and disability in the United States and most often is initiated during adolescence. An emerging body of research suggests that a negative reinforcement model may explain factors that contribute to tobacco use during adolescence and that negative reinforcement processes may contribute to tobacco use to a greater extent among female adolescents than among male adolescents. However, the extant literature both on the relationship between negative reinforcement processes and adolescent tobacco use as well as on the relationship between gender, negative reinforcement processes, and adolescent tobacco use is limited by the sole reliance on self-report measures of negative reinforcement processes that may contribute to cigarette smoking. The current study aimed to further disentangle the relationships between negative reinforcement based risk taking, gender and tobacco use during older adolescence by utilizing a behavioral analogue measure of negative reinforcement based risk taking, the Maryland Resource for the Behavioral Utilization of the Reinforcement of Negative Stimuli (MRBURNS). Specifically, we examined the relationship between pumps on the MRBURNS, an indicator of risk taking, and smoking status as well as the interaction between MRBURNS pumps and gender for predicting smoking status. Participants included 103 older adolescents (n=51 smokers, 50.5% female, Age (M(SD) = 19.41(1.06)) who all attended one experimental session during which they completed the MRBURNS as well as self-report measures of tobacco use, nicotine dependence, alcohol use, depression, and anxiety. We utilized binary logistic regressions to examine the relationship between MRBURNS pumps and smoking status as well as the interactive effect of MRBURNS pumps and gender for predicting smoking status. Controlling for relevant covariates, pumps on the MRBURNS did not significantly predict smoking status and the interaction between pumps on the MRBURNS and gender also did not significantly predict smoking status. These findings highlight the importance of future research examining various task modifications to the MRBURNS as well as the need for replications of this study with larger, more diverse samples.

THE TERMINATION PHASE: THERAPISTS’ PERSPECTIVE ON THE THERAPEUTIC RELATIONSHIP AND OUTCOME

The termination phase of treatment is recognized as a significant aspect of the therapy process and yet remains vastly understudied in psychotherapy literature. In the present study, therapists’ perspectives were used to examine how three elements of the therapy relationship (working alliance, real relationship and transference) during the termination phase relate to perceived client sensitivity to loss, termination phase evaluation and overall treatment outcome. Self-report data was gathered from 233 therapists, recruited from two Divisions of the American Psychological Association. Therapists completed measures for their work with a client with whom they could identify a termination phase of treatment. Results revealed that the working alliance and real relationship during the termination phase related positively to termination phase evaluation and overall treatment outcome, whereas negative transference during the termination phase related negatively to overall treatment outcome. Therapists’ perceptions of client sensitivity to loss related positively to both negative and positive transference during the termination phase. Post-hoc analyses revealed only the working alliance during the termination phase uniquely predicted overall treatment outcome in a model with the three therapy relationship elements examined together. On the other hand, all three therapy relationship variables during the termination phase uniquely predicted termination phase evaluation, when examined together. Limitations and implications of these findings are discussed, and recommendations for future study are suggested.