This application is designed to provide the candidate, Dr. Sarah Book, with skills and expertise in the treatment of alcoholism and co-occurring psychiatric disorders (psychiatric comorbidity), in general, and co-occurring alcoholism and social phobia, in particular. Psychiatric comorbidity is an area of recent interest to NIAAA, and one where well trained psychiatric researchers are needed. Perhaps more than 60% of individuals with alcoholism suffer from psychiatric comorbidity. This population is more likely to seek alcoholism treatment, their alcohol problems are more severe, and their outcomes tend to be more complicated and less favorable than for those without psychiatric comorbidity. In the past decade, there has been interest in using psychiatric comorbidity to sub-group alcoholics for treatment matching. The anxiety area has received considerably less attention than depression comorbidity, and more research is needed. Dr. Book's goal is to be a clinical-scientist with unique expertise in the treatment of alcoholism and anxiety disorder comorbidity. She desires K23 training to permit the development of a research program to enable her to conduct research, treat patients, and educate future medical professionals about the challenges faced in treating alcoholic individuals with comorbidity. The proposed research integrates her skills developed in clinical treatment of anxiety disorders with more recently acquired ones in treatment of alcohol dependence as inpatient attending in the Center for Drug and Alcohol Programs. The training plan identifies areas to be developed, including mastery of the literature, delivery of cognitive behavioral therapy for alcohol treatment, and exploration of gender differences in alcohol use disorders and psychiatric comorbidity. She will refine skills in critical reasoning, and develop skills in quantitative methods and grant writing. This award will allow Dr. Book protected time from her extensive clinical, education, and administrative responsibilities as an inpatient attending to further develop her research skills. Her ultimate goal is to become an independent clinical researcher, while still treating patients and providing didactic substance abuse education to future generations of medical professionals.

National Institute of Health (NIH)
National Institute on Alcohol Abuse and Alcoholism (NIAAA)
Mentored Patient-Oriented Research Career Development Award (K23)
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Study Section
Health Services Research Review Subcommittee (AA)
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Huebner, Robert B
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Medical University of South Carolina
Schools of Medicine
United States
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Book, Sarah W; Thomas, Suzanne E; Smith, Joshua P et al. (2012) Severity of anxiety in mental health versus addiction treatment settings when social anxiety and substance abuse are comorbid. Addict Behav 37:1158-61
Smith, Joshua P; Book, Sarah W (2010) Comorbidity of generalized anxiety disorder and alcohol use disorders among individuals seeking outpatient substance abuse treatment. Addict Behav 35:42-5
Tonigan, J Scott; Book, Sarah W; Pagano, Maria E et al. (2010) 12-Step Therapy and Women with and without Social Phobia: A Study of the Effectiveness of 12-Step Therapy to Facilitate AA Engagement. Alcohol Treat Q 28:151-162
Book, Sarah W; Thomas, Suzanne E; Dempsey, Jared P et al. (2009) Social anxiety impacts willingness to participate in addiction treatment. Addict Behav 34:474-6
Thomas, Suzanne E; Randall, Patrick K; Book, Sarah W et al. (2008) A complex relationship between co-occurring social anxiety and alcohol use disorders: what effect does treating social anxiety have on drinking? Alcohol Clin Exp Res 32:77-84
Smith, Joshua P; Book, Sarah W (2008) Anxiety and Substance Use Disorders: A Review. Psychiatr Times 25:19-23
Book, Sarah W; Thomas, Suzanne E; Randall, Patrick K et al. (2008) Paroxetine reduces social anxiety in individuals with a co-occurring alcohol use disorder. J Anxiety Disord 22:310-8
Book, Sarah W; Myrick, Hugh (2005) Novel anticonvulsants in the treatment of alcoholism. Expert Opin Investig Drugs 14:371-6