Keith Humphreys
Dados Biográficos
| ID | 387981 |
|---|---|
| NOME | Keith Humphreys |
| PRENOMES | Keith |
| SOBRENOME | Humphreys |
| ASSINATURA | HUMPHREYS K |
| AFILIAÇÕES | Stanford University |
| ORCID | 0000-0003-0694-5761 |
| VERIFICADO | Sim |
| TOTAL DE OBRAS | 53 |
| TOTAL DE CITAÇÕES | 52 |
| TOTAL COMO AUTOR | 55 |
| TOTAL COMO EDITOR | 0 |
| PRIMEIRO ANO DE PUBLICAÇÃO | 1989 |
| ANO MAIS RECENTE DE PUBLICAÇÃO | 2024 |
| ÍNDICE H | 4 |
Does the advent of depot therapy represent a step change in our understanding of opioid use disorder and its treatment
After years of minimal innovation in pharmacotherapeutics, impressive outcomes in the treatment of opioid use disorder are being obtained from a new way of delivering an old medication; long‐acting injectable formulations of buprenorphine appear to produce compelling reductions in relapse to illicit opioid use not only during use but also following depot discontinuation. This commentary discusses potential mechanisms behind this observation, asks…
Suicide and Its Nexus
In Indonesia, suicide research has largely overlooked structural factors at the meso and macro levels, whether as primary causes, contributing factors, or considerations for prevention strategies. The dominance of psychological and psychiatric approaches has marginalized sociological perspectives, limiting a more holistic understanding of suicide. Existing heuristic models primarily frame suicide as a consequence of mental health disorders or eco…
Addiction: A Very Short Introduction
Abstract Addiction: A Very Short Introduction presents the basic facts about addiction. What is addiction? How and why do some people become addicted and others do not? This VSI explores the what, why, and how of addiction and its corresponding treatment and societal response. Addiction involves public and personal interests; societal and criminal justice issues; and family, social, and medical responses. The VSI also assesses how laws and regula…
Cost-effectiveness of Increasing Buprenorphine Treatment Initiation, Duration, and Capacity Among Individuals Who Use Opioids
This modeling analysis simulated the effects of implementing several intervention strategies across the buprenorphine cascade of care and found that strategies that were concurrently associated with increased buprenorphine treatment initiation, duration, and capacity were cost-effective
Addiction
Responding to the opioid crisis in North America and beyond
Has the Opioid Crisis Affected Student Learning? A National Analysis of Growth Rates
The potential spillover effects of the United States’ opioid epidemic on children’s educational outcomes have received surprisingly little attention from researchers. Accordingly, this study leverages national datasets of county-level opioid prescription rates and public school students’ third- to eighth-grade academic achievement to provide the first analysis of associations between community opioid prevalence and children’s learning rates. We f…
Our Other Epidemic
Distribution of vaccines against COVID-19 prompts conversations about our "return to normal
Mitigating and learning from the impact of Covid‐19 infection on addictive disorders
The COVID-19 pandemic and the measures required to address it are cutting a swathe through people's lives and the global economy. People with addictive disorders are particularly badly affected as a result of poverty, physical and mental health vulnerabilities and disruption of access to services. The pandemic may well increase the extent and severity of some addictive disorders. Current research is suffering from the termination of face-to-face …
Reducing Violent Incidents between Police Officers and People with Psychiatric or Substance Use Disorders
This article describes evidence-based strategies designed to reduce the prevalence of police encounters with people in behavioral crisis (PBCs) and to make such encounters less dangerous for all parties when they do occur. Some of these strategies are implemented by law enforcement, including gun violence restraining orders and the training of officers to provide time, distance, and cover during encounters with PBCs. Other strategies involve broa…
Designing Studies for Sex and Gender Analyses
Accelerating the Growth of Evidence-Based Care for Women and Men Veterans
Drug Policy and the Public Good
Drug Policy and the Public Good presents the accumulated scientific knowledge of direct relevance to the development of drug policy on local, national, and international levels. The book explores both illicit drug use and non-medical use of prescription medications within a public health perspective. A conceptual basis for a rational drug policy is presented, along with new epidemiological data on the global dimensions of drug misuse, significant…
Supply control for illegal markets
Supply control approaches to drug problems focus on the production, distribution, and sale of illicit psychoactive substances, and include alternative development programmes in producer nations, control of precursor chemicals used to produce certain drugs (e.g. methamphetamines) interdiction at national borders, and the incarceration of drug dealers at all levels. There is no evidence that promoting alternative development as part of global drug …
Criminalization and decriminalization of drug possession
Research suggests that punishing drug users has some limitations as a major component of drug policy. An increasing number of countries and sub-national jurisdictions have therefore been reducing or eliminating criminal penalties for possession of small amounts of drugs for personal use, on grounds both of proportionality and effectiveness-oriented policy. Most decriminalization or depenalization programmes involve the substitution of civil penal…
Illegal markets
Illegal drugs are commodities that are bought and sold in markets. Many farmers are engaged in small amounts of drug growing in the producing countries, but there are comparatively small numbers of refiners, smugglers, and top-level importers. Compared to most legal markets, there are many sellers relative to the number of buyers in drug markets. One consequence of the network character of drug distribution is its resilience. Eliminating individu…
Modeling Health Benefits and Harms of Public Policy Responses to the US Opioid Epidemic
Objectives. To estimate health outcomes of policies to mitigate the opioid epidemic. Methods. We used dynamic compartmental modeling of US adults, in various pain, opioid use, and opioid addiction health states, to project addiction-related deaths, life years, and quality-adjusted life years from 2016 to 2025 for 11 policy responses to the opioid epidemic. Results. Over 5 years, increasing naloxone availability, promoting needle exchange, expandi…
How Medicaid Can Strengthen the National Response to the Opioid Epidemic
The Affordable Care Act Transformation of Substance Use Disorder Treatment
The authors reflect on changes involving substance use disorder (SUD) treatment under the U.S. Patient Protection and Affordable Care Act (ACA), and it mentions American President Barack Obama's public health legacy, as well as the potential impact that the ACA will have on an opioid epidemic in the country. Medications for opioid use disorder patients are examined, along with health insurance coverage for SUD treatment services and the U.S. 2008…
A call to include people with mental illness and substance use disorders alongside ‘regular’ smokers in smoking cessation research
This commentary points out that smoking is increasingly concentrated among people with psychiatric problems and other substance use disorders (eg, alcohol use disorder), and argues that for clinical, ethical and efficiency reasons, such individuals should be routinely enrolled in smoking cessation research
State-Level Relationships Cannot Tell Us Anything About Individuals
AffiliationsAlex H. S. Harris, Keith Humphreys, and John W. Finney are with the Center for Innovation to Implementation, VA Palo Alto Health Care System, Menlo Park, CA. Keith Humphreys is also with Stanford University, Stanford, CA
Personality and Psychopathology in African Unaccompanied Refugee Minors
Dopamine, working memory, and training induced plasticity
Cognitive deficits and particularly deficits in working memory (WM) capacity are common features in neuropsychiatric disorders. Understanding the underlying mechanisms through which WM capacity can be improved is therefore of great importance. Several lines of research indicate that dopamine plays an important role not only in WM function but also for improving WM capacity. For example, pharmacological interventions acting on the dopaminergic sys…
Why Health Care Process Performance Measures Can Have Different Relationships to Outcomes for Patients and Hospitals
Relationships between health care process performance measures (PPMs) and outcomes can differ in magnitude and even direction for patients versus higher level units (e.g., health care facilities). Such discrepancies can arise because facility-level relationships ignore PPM–outcome relationships for patients within facilities, may have different confounders than patient-level PPM–outcome relationships, and may reflect facility effect modification …
Assessing why substance use disorder patients drop out from or refuse to attend 12-step mutual-help groups
Substance use disorder (SUD) patients who become involved in 12-step mutual-help groups (MHGs), such as Alcoholics Anonymous, experience better outcomes and have reduced healthcare costs. In spite of this, many do not attend at all and other initial attendees drop out. Reasons for non-attendance and dropout have not been systematically studied, yet such knowledge could enhance the efficiency of twelve-step facilitation (TSF) efforts or help clini…
Modeling Health Benefits and Harms of Public Policy Responses to the US Opioid Epidemic
Objectives. To estimate health outcomes of policies to mitigate the opioid epidemic. Methods. We used dynamic compartmental modeling of US adults, in various pain, opioid use, and opioid addiction health states, to project addiction-related deaths, life years, and quality-adjusted life years from 2016 to 2025 for 11 policy responses to the opioid epidemic. Results. Over 5 years, increasing naloxone availability, promoting needle exchange, expandi…
Individual and Contextual Predictors of Involvement in Twelve‐Step Self‐Help Groups After Substance Abuse Treatment
Drawing on ecological and narrative theories of self‐help groups, this study tests a multilevel model predicting self‐help group involvement among male veterans who received inpatient substance abuse treatment. Following K. Maton (1993), the study moves beyond the individual‐level of analysis to encompass variables in the treatment and post‐treatment social ecology. Surveys administered to patients ( N = 3,018 ) and treatment staff ( N = 329 ) as…
Sequential validation of cluster analytic subtypes of homeless veterans
To identify subgroups within the homeless population, a number of researchers have employed cluster analytic statistical procedures. Although this is an appropriate application of cluster analysis, many studies have not employed important statistical safeguards against arbitrary results. This study demonstrates a cluster analytic procedure—sequential validation—that enhances the replicability, external validity, and cross‐validity of cluster solu…
The Influence of Posttreatment Mutual Help Group Participation on the Friendship Networks of Substance Abuse Patients
The effect of 12‐step mutual help groups (e.g., Narcotics Anonymous) on members' friendship networks has received little attention. This 1‐year longitudinal study examined such effects in a sample of 2,337 male substance abuse inpatients, 57.7% of whom became significantly involved in 12‐step activities (e.g., reading program literature, attending meetings) after treatment. An a priori model of the interplay of 12‐step involvement and friendship …
The Affordable Care Act Transformation of Substance Use Disorder Treatment
The authors reflect on changes involving substance use disorder (SUD) treatment under the U.S. Patient Protection and Affordable Care Act (ACA), and it mentions American President Barack Obama's public health legacy, as well as the potential impact that the ACA will have on an opioid epidemic in the country. Medications for opioid use disorder patients are examined, along with health insurance coverage for SUD treatment services and the U.S. 2008…
Improving Medicare coverage of psychological services for older Americans
Professional psychology's ability to meet older Americans' psychological needs and to simultaneously thrive as a profession will be closely tied to the federal Medicare program over the coming decades. Despite legislative changes in the 1980s providing professional autonomy to psychologists and expanding coverage for mental health services, Medicare coverage policies, reimbursement mechanisms, and organizational traditions continue to limit older…
A Randomized Trial of a Mental Health Consumer‐Managed Alternative to Civil Commitment for Acute Psychiatric Crisis
This experiment compared the effectiveness of an unlocked, mental health consumer‐managed, crisis residential program (CRP) to a locked, inpatient psychiatric facility (LIPF) for adults civilly committed for severe psychiatric problems. Following screening and informed consent, participants ( n = 393) were randomized to the CRP or the LIPF and interviewed at baseline and at 30‐day, 6‐month, and 1‐year post admission. Outcomes were costs, level of…
Has the Opioid Crisis Affected Student Learning? A National Analysis of Growth Rates
The potential spillover effects of the United States’ opioid epidemic on children’s educational outcomes have received surprisingly little attention from researchers. Accordingly, this study leverages national datasets of county-level opioid prescription rates and public school students’ third- to eighth-grade academic achievement to provide the first analysis of associations between community opioid prevalence and children’s learning rates. We f…
Reducing Violent Incidents between Police Officers and People with Psychiatric or Substance Use Disorders
This article describes evidence-based strategies designed to reduce the prevalence of police encounters with people in behavioral crisis (PBCs) and to make such encounters less dangerous for all parties when they do occur. Some of these strategies are implemented by law enforcement, including gun violence restraining orders and the training of officers to provide time, distance, and cover during encounters with PBCs. Other strategies involve broa…
State-Level Relationships Cannot Tell Us Anything About Individuals
AffiliationsAlex H. S. Harris, Keith Humphreys, and John W. Finney are with the Center for Innovation to Implementation, VA Palo Alto Health Care System, Menlo Park, CA. Keith Humphreys is also with Stanford University, Stanford, CA
Dopamine, working memory, and training induced plasticity
Cognitive deficits and particularly deficits in working memory (WM) capacity are common features in neuropsychiatric disorders. Understanding the underlying mechanisms through which WM capacity can be improved is therefore of great importance. Several lines of research indicate that dopamine plays an important role not only in WM function but also for improving WM capacity. For example, pharmacological interventions acting on the dopaminergic sys…
Life Stories of Moderation Management Mutual Help Group Members
This study analyzed life story themes of 30 Moderation Management (MM) members. MM is the only mutual-help organization in the U.S. that supports problem drinkers who wish to moderate their alcohol consumption. Qualitative interview data indicated that MM involvement was often precipitated by a conscious rejection of the 12-step philosophy espoused in Alcoholics Anonymous and in many professional treatment programs. In particular, MM members did …
Substance Abuse Prognosis with an Additional Psychiatric Diagnosis
Patients with alcohol and other substance abuse problems have poorer prognoses if there is a concomitant psychiatric diagnosis. However, because severity of psychiatric problems contributes more than the specific psychiatric diagnosis to prognosis, the nature of the interaction between substance abuse treatment outcome and an accompanying psychiatric diagnosis can be questioned. In this article an attempt is made to understand the poor-prognosis-…
From the community mental health movement to the war on drugs
From the community mental health movement to the war on drugs
In the 1980s, the Reagan and Bush administrations reduced funding for community mental health programs and began instead to support substance abuse treatment agencies. One reason for this shift in policy was that the social problem of mental illness had been captured by progressives in the community mental health movement. Conservatives, therefore, needed a new problem to redefine and use to enact new social control policies. The conservatives' c…
Applying a stress and coping framework to research on mutual help organizations
Few studies of mutual help have been guided by coherent conceptual frameworks. We introduce a stress and coping model that can guide research on self-help groups and contribute to conceptualizing them as normative social groupings. Our model suggests that coping responses, life stressors, and social resources influence the processes by which persons become involved in mutual help organizations and, in turn, are influenced by involvement in mutual…
Sequential validation of cluster analytic subtypes of homeless veterans
To identify subgroups within the homeless population, a number of researchers have employed cluster analytic statistical procedures. Although this is an appropriate application of cluster analysis, many studies have not employed important statistical safeguards against arbitrary results. This study demonstrates a cluster analytic procedure—sequential validation—that enhances the replicability, external validity, and cross‐validity of cluster solu…
Clinical Psychologists as Psychotherapists
As managed care and other cost-containment strategies become central features of the American health care system, doctoral-level clinical psychologists will be increasingly supplanted in the role of psychotherapist by lower cost providers such as social workers, marriage and family counselors, and masters-level psychologists. To provide one basis for clinical psychologists to make judgments about their role in psychotherapy; this article describe…
Clinical Psychologists as Psychotherapists
Money and the mission of clinical psychology
Money and the mission of clinical psychology
Do Health Care Workplaces Affect Treatment Environments
Previous research has demonstrated that characteristics of the health care workplace influence staff outcomes such as morale and burnout, but the potential effect of health care workplaces on the treatment environment has been little studied. Building on a model proposed by Schaefer and Moos (1993), we propose that the workplace factors of supervisory work environment (e.g. support from supervisors, managerial control) and programme philosophical…
The Influence of Posttreatment Mutual Help Group Participation on the Friendship Networks of Substance Abuse Patients
The effect of 12‐step mutual help groups (e.g., Narcotics Anonymous) on members' friendship networks has received little attention. This 1‐year longitudinal study examined such effects in a sample of 2,337 male substance abuse inpatients, 57.7% of whom became significantly involved in 12‐step activities (e.g., reading program literature, attending meetings) after treatment. An a priori model of the interplay of 12‐step involvement and friendship …
The Latent Markov Chain with Multivariate Random Effects
An analytically tractable latent Markov chain with correlated random effects from Gamma distributions is developed by combining techniques developed in latent class modeling and random effects modeling of survival and recurrent binary events data. Continuous unobserved heterogeneity in both classification error and latent class membership is allowed for. The model is used to compare a number of instruments that measure male labor market status in…
Treatment involvement and outcomes for four subtypes of homeless veterans
A longitudinal study examined treatment services and outcomes in a nationwide sample of 565 homeless veterans who were classified as alcoholic, psychiatrically impaired, multiproblem, or best-functioning. All four groups experienced some improvement in their primary problem area, in employment status, and in residential quality at eight-month follow-up, but there were significant differences in degree of improvement across groups. Implications fo…
Latent Transition Analysis with Covariates, Nonresponse, Summary Statistics and Diagnostics
Latent transition analysis (LTA) is one approach for the testing of stage theories in developmental psychology. In this article we describe how the practicability of the approach can be enhanced by incorporating recent developments in latent class regression modelling. We describe LTA extended to incorporating partial nonresponse and allowing the values of parameters associated with latent class membership to be dependent on auxiliary variables. …
Life Stories of Moderation Management Mutual Help Group Members
This study analyzed life story themes of 30 Moderation Management (MM) members. MM is the only mutual-help organization in the U.S. that supports problem drinkers who wish to moderate their alcohol consumption. Qualitative interview data indicated that MM involvement was often precipitated by a conscious rejection of the 12-step philosophy espoused in Alcoholics Anonymous and in many professional treatment programs. In particular, MM members did …
Community narratives and personal stories in alcoholics anonymous
Storytelling is an extremely common activity in the spiritually-based mutual help organization Alcoholics Anonymous (A.A.). This paper describes the typical content, function(s), and structure of five types of A.A. stories, devoting particular attention to the interplay between the A.A. community narrative and the life stories of individual members. The information presented here suggests that a narrative point of view can fruitfully guide future…
Communication patterns in an on‐line mutual help group for problem drinkers
This study analyzed 376 randomly selected messages (known as “posts”) to investigate the features, patterns, and functions of communication in an on-line mutual help group (OMHG) for problem drinkers. Consistent with previous OMHG research, the most prevalent form of communication was providing self-disclosure, followed by providing information/advice. As in face-to-face groups, conflict was infrequent and communication was generally warm and sup…
Communication patterns in an on-line mutual help group for problem drinkers
This study analyzed 376 randomly selected messages (known as “posts”) to investigate the features, patterns, and functions of communication in an on-line mutual help group (OMHG) for problem drinkers. Consistent with previous OMHG research, the most prevalent form of communication was providing self-disclosure, followed by providing information/advice. As in face-to-face groups, conflict was infrequent and communication was generally warm and sup…
Individual and Contextual Predictors of Involvement in Twelve‐Step Self‐Help Groups After Substance Abuse Treatment
Drawing on ecological and narrative theories of self‐help groups, this study tests a multilevel model predicting self‐help group involvement among male veterans who received inpatient substance abuse treatment. Following K. Maton (1993), the study moves beyond the individual‐level of analysis to encompass variables in the treatment and post‐treatment social ecology. Surveys administered to patients ( N = 3,018 ) and treatment staff ( N = 329 ) as…
Expanding self‐help group participation in culturally diverse urban areas
Accumulating research attests to the benefits of self‐help groups for people who have various chronic health problems. Expansion of self‐help group participation may enable a broader portion of society to experience these health benefits. The Media and Education for Self‐Help (MESH) Project was an effort to increase interest in health‐related self‐help groups among middle‐ and lower‐income people in two California urban areas with minority–majori…
Does Writing Affect Asthma? A Randomized Trial
OBJECTIVE: Nonpharmacologic treatments for asthma may act as useful adjuncts to pharmacotherapy but should be recommended to patients only after several well-controlled studies provide evidence of efficacy. Research demonstrating that written emotional expression can improve pulmonary function in patients with asthma consists of one impressive yet unreplicated study. Our main objective was to test and extend previous research finding that written…
Prevention of Peer Rejection Through a Classroom-Level Intervention in Middle School
Inquirers, triers, and buyers of an alcohol harm reduction self-help organization
Moderation Management (MM) is the only self-help organization designed to help problem drinkers who wish to moderate their alcohol consumption rather than abstain. Experienced MM members tend to be highly educated and employed and have minimal signs of physical dependence on alcohol or co-occurring drug use. As a result, MM is sometimes dismissed as an organization that attracts only “the worried well”, or, is initially accessed by a wide range o…
Is addiction's collateral damage culturally invariant
Is addiction's collateral damage culturally invariant?." Addiction Research & Theory, 14(6), pp. 647–648
Improving Medicare coverage of psychological services for older Americans
Professional psychology's ability to meet older Americans' psychological needs and to simultaneously thrive as a profession will be closely tied to the federal Medicare program over the coming decades. Despite legislative changes in the 1980s providing professional autonomy to psychologists and expanding coverage for mental health services, Medicare coverage policies, reimbursement mechanisms, and organizational traditions continue to limit older…
Psychology (40 obras) · Medicine (30 obras) · Psychiatry (23 obras) · Substance Abuse Treatment and Outcomes (22 obras) · Political science (18 obras) · Clinical Psychology (12 obras) · Social Psychology (12 obras) · Nursing (11 obras) · Law (10 obras) · Mental health (8 obras)