Contact
Biomedical Research Center251 Bayview Blvd.
Suite 200
Baltimore, MD 21224
Phone: 667-312- 5077
Email: brenda.curtis@nih.gov
Education
Ph.D., Health Communication - Annenberg School for Communication - University of Pennsylvania - Philadelphia, PA
M.A. Health Communication - Annenberg School for Communication - University of Pennsylvania - Philadelphia, PA
M.S.P.H. Public Health, University of Illinois - Urbana-Champaign, IL
B.S. Biology - University of Illinois - Urbana-Champaign, IL
Research Interests
Dr. Curtis is a Tenure-Track Clinical Investigator since January 2019. She is Chief of the TTRU and NIH Distinguished Scholar. The Curtis Lab pairs traditional methodologies with computational psychiatry to study the digital phenotypes of people who use drugs. While much of the labs focus is on converting raw signals from digital data sources into useful clinical insights, the TTRU is very much committed to solving problems experienced by people in recovery and undergoing substance use treatment. Through clinical research, the Curtis lab intersects addiction treatment, computational psychiatry, and innovative technologies. Using natural-language processing, digital phenotyping, and deep learning, the lab focuses on enhancing precision assessment of substance use and behavioral predictors using intensive longitudinal data and integrating passive sensor data from smartphones and wearable devices. Among others, an overall goal is to develop personalized smartphone interventions for individuals living with SUD to enhance the recovery experience. Other areas of research focus on the intersect between addiction and Covid and on the impact of stigma on addiction.
Publications
Selected Publications
2022 |
Devoto, Amanda; Himelein-Wachowiak, McKenzie; Liu, Tingting; Curtis, Brenda Women's Substance Use and Mental Health During the COVID-19 Pandemic Journal Article In: Women's Health Issues, 2022. @article{devoto2022women, |
2021 |
Himelein-Wachowiak, McKenzie; Giorgi, Salvatore; Devoto, Amanda; Rahman, Muhammad; Ungar, Lyle; Schwartz, H Andrew; Epstein, David H; Leggio, Lorenzo; Curtis, Brenda Bots and Misinformation Spread on Social Media: Implications for COVID-19 Journal Article In: J Med Internet Res, vol. 23, no. 5, pp. e26933, 2021, ISSN: 1438-8871. @article{himeleinwachowiak2021covid, |
Shaw, Philip; Blizzard, Sam; Shastri, Gauri; Kundzicz, Paul; Curtis, Brenda; Ungar, Lyle; Koehly, Laura A daily diary study into the effects on mental health of COVID-19 pandemic-related behaviors Journal Article In: Psychological Medicine, pp. 1–9, 2021. @article{shaw2021daily, |
Panlilio, Leigh V; Stull, Samuel W; Bertz, Jeremiah W; Burgess-Hull, Albert J; Lanza, Stephanie T; Curtis, Brenda L; Phillips, Karran A; Epstein, David H; Preston, Kenzie L Beyond abstinence and relapse II: momentary relationships between stress, craving, and lapse within clusters of patients with similar patterns of drug use Journal Article In: Psychopharmacology, vol. 238, no. 6, pp. 1513–1529, 2021. @article{panlilio2021beyond, |
Delgado, Mucio Kit; Shofer, Frances; Wetherill, Reagan; Curtis, Brenda; Hemmons, Jessica; Spencer, Evan; Branas, Charles; Wiebe, Douglas J; Kranzler, Henry R Accuracy of Consumer-marketed smartphone-paired alcohol breath testing devices: A laboratory validation study Journal Article In: Alcoholism: Clinical and Experimental Research, vol. 45, no. 5, pp. 1091–1099, 2021. @article{delgado2021accuracy, |
Moon, Andrew M; Curtis, Brenda; Mandrekar, Pranoti; Singal, Ashwani K; Verna, Elizabeth C; Fix, Oren K Alcohol-Associated Liver Disease Before and After COVID-19---An Overview and Call for Ongoing Investigation Journal Article In: Hepatology communications, vol. 5, no. 9, pp. 1616–1621, 2021. @article{moon2021alcohol, |
Kwarteng, Amy E; Rahman, Muhammad M; Gee, Dylan G; Infante, M Alejandra; Tapert, Susan F; Curtis, Brenda L Child reward neurocircuitry and parental substance use history: Findings from the Adolescent Brain Cognitive Development Study Journal Article In: Addictive Behaviors, vol. 122, pp. 107034, 2021. @article{kwarteng2021child, |
McKay, James R; Gustafson, David H; Ivey, Megan; Pe-Romashko, Klaren; Curtis, Brenda; Thomas, Tyrone; Oslin, David W; Polsky, Daniel; Quanbeck, Andrew; Lynch, Kevin G Efficacy and comparative effectiveness of telephone and smartphone remote continuing care interventions for alcohol use disorder: a randomized controlled trial Journal Article In: Addiction, 2021. @article{mckay2021efficacy, |
2020 |
Pasipanodya, Elizabeth C.; Kohli, Maulika; Fisher, Celia B.; Moore, David J.; Curtis, Brenda In: Harm Reduction Journal, vol. 17, no. 1, pp. 41, 2020, ISBN: 1477-7517. @article{cite-keye, Methamphetamine use poses a barrier to antiretroviral therapy (ART) adherence. Black and Hispanic men who have sex with men living with HIV (PLWH) shoulder much of the health burden resulting from the methamphetamine and HIV syndemic. Smartphones are nearly ubiquitous in the USA and may be promising vehicles for delivering interventions for ART adherence and drug use cessation. However, the acceptability of using applications to collect sensitive information and deliver feedback in this population has not been adequately explored. |
Hubach, Randolph D; O'Neil, Andrew; Stowe, Mollie; Giano, Zachary; Curtis, Brenda; Fisher, Celia B In: Arch Sex Behav, pp. 1-10, 2020, ISSN: 1573-2800 (Electronic); 0004-0002 (Linking). @article{Hubach:2020aa, Although men who have sex with men (MSM) within rural communities are disproportionately impacted by HIV, limited HIV research and programmatic resources are directed to these communities within the U.S. There is a need for improved behavioral data collection methods to obtain more detailed information on the relationship between rural environments, sexual behavior, and substance use. Utilization of mobile health (mHealth) technologies, such as ecologic momentary assessment (EMA), has been advocated for; however, limited research has evaluated its utility among rural MSM. Forty MSM residing in rural Oklahoma were recruited to complete in-depth interviews related to participating online/mobile-based HIV prevention research. Men described a willingness to participate in HIV and substance use studies that use EMA methodologies for data collection; however, they raised various research-related concerns. In particular, participants indicated potential privacy and confidentiality concerns related to the use of the mobile technology-based EMA in public and the storage of data by researchers. Given the varying degree of sexual orientation and substance use disclosure by participants, rural MSM were largely concerned with being inadvertently "outed" within their communities. Men described the various strategies they could employ to protect private information and methods to minimize research risk. Study findings suggest that EMA is an acceptable research methodology for use among rural MSM in the context of HIV and sexual health information, when privacy and confidentiality concerns are adequately addressed. Input from community members and stakeholders is necessary to identify potential areas of concerns for participants prior to data collection. |
Giorgi, Salvatore; Yaden, David B; Eichstaedt, Johannes C; Ashford, Robert D; Buffone, Anneke E K; Schwartz, Andrew H; Ungar, Lyle H; Curtis, Brenda Cultural Differences in Tweeting about Drinking Across the US. Journal Article In: Int J Environ Res Public Health, vol. 17, no. 4, 2020, ISSN: 1660-4601 (Electronic); 1660-4601 (Linking). @article{Giorgi:2020aa, Excessive alcohol use in the US contributes to over 88,000 deaths per year and costs over $250 billion annually. While previous studies have shown that excessive alcohol use can be detected from general patterns of social media engagement, we characterized how drinking-specific language varies across regions and cultures in the US. From a database of 38 billion public tweets, we selected those mentioning "drunk", found the words and phrases distinctive of drinking posts, and then clustered these into topics and sets of semantically related words. We identified geolocated "drunk" tweets and correlated their language with the prevalence of self-reported excessive alcohol consumption (Behavioral Risk Factor Surveillance System; BRFSS). We then identified linguistic markers associated with excessive drinking in different regions and cultural communities as identified by the American Community Project. "Drunk" tweet frequency (of the 3.3 million geolocated "drunk" tweets) correlated with excessive alcohol consumption at both the county and state levels (r = 0.26 and 0.45, respectively, p < 0.01). Topic analyses revealed that excessive alcohol consumption was most correlated with references to drinking with friends (r = 0.20), family (r = 0.15), and driving under the influence (r = 0.14). Using the American Community Project classification, we found a number of cultural markers of drinking: religious communities had a high frequency of anti-drunk driving tweets, Hispanic centers discussed family members drinking, and college towns discussed sexual behavior. This study shows that Twitter can be used to explore the specific sociocultural contexts in which excessive alcohol use occurs within particular regions and communities. These findings can inform more targeted public health messaging and help to better understand cultural determinants of substance abuse. |
Epstein, David H; Tyburski, Matthew; Kowalczyk, William J; Burgess-Hull, Albert J; Phillips, Karran A; Curtis, Brenda L; Preston, Kenzie L Prediction of stress and drug craving ninety minutes in the future with passively collected GPS data Journal Article In: npj Digital Medicine, vol. 3, no. 1, pp. 26, 2020, ISBN: 2398-6352. @article{Epstein:2020aa, Just-in-time adaptive interventions (JITAIs), typically smartphone apps, learn to deliver therapeutic content when users need it. The challenge is to ``push''content at algorithmically chosen moments without making users trigger it with effortful input. We trained a randomForest algorithm to predict heroin craving, cocaine craving, or stress (reported via smartphone app 3x/day) 90 min into the future, using 16 weeks of field data from 189 outpatients being treated for opioid-use disorder. We used only one form of continuous input (along with person-level demographic data), collected passively: an indicator of environmental exposures along the past 5 h of movement, as assessed by GPS. Our models achieved excellent overall accuracy---as high as 0.93 by the end of 16 weeks of tailoring---but this was driven mostly by correct predictions of absence. For predictions of presence, ``believability''(positive predictive value, PPV) usually peaked in the high 0.70s toward the end of the 16 weeks. When the prediction target was more rare, PPV was lower. Our findings complement those of other investigators who use machine learning with more broadly based ``digital phenotyping''inputs to predict or detect mental and behavioral events. When target events are comparatively subtle, like stress or drug craving, accurate detection or prediction probably needs effortful input from users, not passive monitoring alone. We discuss ways in which accuracy is difficult to achieve or even assess, and warn that high overall accuracy (including high specificity) can mask the abundance of false alarms that low PPV reveals. |
2019 |
Ashford, Robert D; Giorgi, Salvatore; Mann, Beau; Pesce, Chris; Sherritt, Lon; Ungar, Lyle; Curtis, Brenda In: J Subst Abuse Treat, vol. 109, pp. 50–55, 2019, ISSN: 1873-6483 (Electronic); 0740-5472 (Linking). @article{Ashford:2020aa, BACKGROUND: Recovery support services, including in vivo (i.e., face to face) peer-based supports and social networks, are associated with positive effects on substance use disorder recovery outcomes. The translation of in vivo supports to digital platforms is a recent development that is mostly unexamined. The types of users and their engagement patterns of digital recovery support services (D-RSS), and the utility of objective and self-report data in predicting future recovery outcomes require further study to move the recovery support field forward. METHODS: De-identified individual user data from Sober Grid, a recovery social network site (R-SNS) smartphone application, for the years 2015-2018 was analyzed to identify the demographics, engagement patterns, and recovery outcomes of active users. Analysis of variance (ANOVA) tests were used to examine between generational group differences on activity variables and recovery outcomes. Logistic and linear regressions were used to identify significant predictors of sobriety length and relapse among users. RESULTS: The most active tercile of users (n = 1273; mAge = 39 years; 62% male) had average sobriety lengths of 195.5 days and had experienced 4.4 relapses on average since sign-up. Users have over 33,000 unilateral and nearly 14,000 bilateral connections. Users generated over 120,000 unique posts, 507,000 comments, 1617,000 likes, 12,900 check-ins, and 593,000 chats during the period of analysis. Recovery outcomes did not vary between generations, though user activity was significantly different between Generations (Millennials, Generation X, and Baby Boomers), with baby boomers and generation X having higher levels of engagement and connection among all activity markers. Logistic regression results revealed gender (female) was associated with a lower likelihood of reporting loneliness or sexual feelings as an emotional trigger. Linear regressions revealed generation, number of unilateral connections, and number of check-ins was associated with sobriety length, while generation and number of check-ins was associated with number of relapses. CONCLUSIONS: Active users of Sober Grid engage in several platform features that provide objective data that can supplement self-report data for analysis of recovery outcomes. Most commonly uses features are those similar to features readily available in open-ecosystem social network sites (e.g., Facebook). Prediction model results suggest that demographic factors (e.g., age, gender) and activity factors (e.g., number of check-ins) may be useful in deploying just-in-time interventions to prevent relapse or offer additional social support. Further empirical examination is needed to identify the utility of such interventions, as well as the mechanisms of support that accompany feature use or engagement with the D-RSS. |
Ashford, R. D.; Bergman, B. G.; Kelly, J. F.; Curtis, B. Systematic review: Digital recovery support services used to support substance use disorder recovery Journal Article In: Human Behavior and Emerging Technologies., 2019. @article{Ashford2019, Substance use, misuse, and disorders (SUDs) are estimated to cost the United States over $500 billion annually. While there are effective SUD behavioral interventions and treatments, there is mounting evidence that technology‐based, digital recovery support services (D‐RSS) have the potential to prevent SUD, complement formal treatment, and improve individual recovery‐related outcomes. This preregistered systematic review focuses on D‐RSS that provide SUD recovery support through websites, smartphone applications, recovery social network sites, or any combination thereof. Data sources included studies found in searching CINAHL Plus (EBSCO), EMBASE, MEDLINE (EBSCO), Index Medicus/MEDLINE (NLM), Psychology & Behavioral Sciences Collection (EBSCO), PsycINFO (ProQuest), ProQuest Psychology Journals (ProQuest), and retrieved references. Observational, mixed‐methods, qualitative, or experimental studies, published in English, between January 1985 and January 2019, that characterized users and recovery‐related outcomes of any D‐RSS were included. The initial search yielded 5,278 abstracts. After removing duplicates, as well as reviewing titles and abstracts and removing studies not indicating an examination of recovery (i.e., treatment or prevention focused) and digital supports, 78 abstracts remained. Final included studies (n = 22) characterized international users of multiple D‐RSS types, including websites, digital recovery forums, recovery social networking sites, smartphone applications, and short messaging service texting programs. Experimental evidence was lacking as most studies were observational or qualitative in nature (n = 18). The review suggests that the evidence base for most D‐RSS is still lacking in terms of demonstrating benefit for recovery‐related outcomes. Descriptively, D‐RSS have high usage rates among engaged participants, across a range of SUD and recovery typologies and phenotypes, with 11% of U.S. adults who have resolved a SUD reporting lifetime engaging with at least one D‐RSS. D‐RSS deployment can help ameliorate barriers related to accessibility and availability of more traditional recovery supports, and may well be a valuable tool in addressing SUD and supporting recovery as uptake increases across the United States. |
Ashford, Robert D; Brown, Austin M; Ashford, Arielle; Curtis, Brenda Recovery dialects: A pilot study of stigmatizing and nonstigmatizing label use by individuals in recovery from substance use disorders. Journal Article In: Exp Clin Psychopharmacol, 2019, ISSN: 1936-2293 (Electronic); 1064-1297 (Linking). @article{Ashford2019b, Previous research has found language used to describe individuals with a substance use disorder (SUD; e.g., "addict," "substance abuser") contributes to and elicits negative bias among the general public and health care professionals. However, the prevalence in which recovering individuals use these labels to self-identify and the impact of such labels are unknown. The current pilot study, a cross-sectional design, examined the usage of two labels ("addict," "person with a SUD") as well as the differences in recovery outcomes among individuals in recovery. Participants (n = 54) used both labels at high rates ("addict": 66.67%; "person with a SUD": 38.89%), though mutually exclusive use was lower ("addict" only: 35.19%, "person with a SUD" only: 7.5%). Common label use settings included mutual-aid recovery meetings, with friends and family, and on social media. Analysis of variance tests found no statistically significant differences between label groups for recovery capital, self-esteem, internalized stigma and shame, flourishing, or length in recovery. Descriptively, participants using only "person with a SUD" had more positive outcomes, although these individuals also had higher levels of internalized shame. Results suggest that language may have only a marginal impact on individuals in recovery, although professionals and the general public should continue to avoid using stigmatizing labels. Additionally, many individuals in recovery have the ability to discern context and setting, switching between positive and negative labels as appropriate. Future research is warranted given these pilot findings and should focus on long-term impacts of self-labeling and internalized stereotypes among individuals in recovery. (PsycINFO Database Record (c) 2019 APA, all rights reserved). |
Curtis, Brenda L; Ashford, Robert D; Magnuson, Katherine I; Ryan-Pettes, Stacy R In: J Med Internet Res, vol. 21, no. 4, pp. e13050, 2019, ISSN: 1438-8871 (Electronic); 1438-8871 (Linking). @article{Curtis2019, BACKGROUND: Problematic substance use in adolescence and emerging adulthood is a significant public health concern in the United States due to high recurrence of use rates and unmet treatment needs coupled with increased use. Consequently, there is a need for both improved service utilization and availability of recovery supports. Given the ubiquitous use of the internet and social media via smartphones, a viable option is to design digital treatments and recovery support services to include internet and social media platforms. OBJECTIVE: Although digital treatments delivered through social media and the internet are a possibility, it is unclear how interventions using these tools should be tailored for groups with problematic substance use. There is limited research comparing consumer trends of use of social media platforms, use of platform features, and vulnerability of exposure to drug cues online. The goal of this study was to compare digital platforms used among adolescents (Generation Zs, age 13-17) and emerging adults (Millennials, age 18-35) attending outpatient substance use treatment and to examine receptiveness toward these platforms in order to support substance use treatment and recovery. METHODS: Generation Zs and Millennials enrolled in outpatient substance use treatment (n=164) completed a survey examining social media use, digital intervention acceptability, frequency of substance exposure, and substance use experiences. Generation Zs (n=53) completed the survey in July 2018. Millennials (n=111) completed the survey in May 2016. RESULTS: Generation Zs had an average age of 15.66 (SD 1.18) years and primarily identified as male (50.9%). Millennials had an average age of 27.66 (SD 5.12) years and also primarily identified as male (75.7%). Most participants owned a social media account (Millennials: 82.0%, Generation Zs: 94.3%) and used it daily (Millennials: 67.6%, Generation Zs: 79.2%); however, Generation Zs were more likely to use Instagram and Snapchat, whereas Millennials were more likely to use Facebook. Further, Generation Zs were more likely to use the features within social media platforms (eg, instant messaging: Millennials: 55.0%, Generation Zs: 79.2%; watching videos: Millennials: 56.8%, Generation Zs: 81.1%). Many participants observed drug cues on social media (Millennials: 67.5%, Generation Zs: 71.7%). However, fewer observed recovery information on social media (Millennials: 30.6%, Generation Zs: 34.0%). Participants felt that social media (Millennials: 55.0%, Generation Zs: 49.1%), a mobile phone app (Millennials: 36.9%, Generation Zs: 45.3%), texting (Millennials: 28.8%, Generation Zs: 45.3%), or a website (Millennials: 39.6%, Generation Zs: 32.1%) would be useful in delivering recovery support. CONCLUSIONS: Given the high rates of exposure to drug cues on social media, disseminating recovery support within a social media platform may be the ideal just-in-time intervention needed to decrease the rates of recurrent drug use. However, our results suggest that cross-platform solutions capable of transcending generational preferences are necessary and one-size-fits-all digital interventions should be avoided. |
Ashford, Robert D; Brown, Austin M; McDaniel, Jessica; Curtis, Brenda Biased labels: An experimental study of language and stigma among individuals in recovery and health professionals. Journal Article In: Subst Use Misuse, vol. 54, no. 8, pp. 1376–1384, 2019, ISSN: 1532-2491 (Electronic); 1082-6084 (Linking). @article{Ashford2019c, BACKGROUND: Labels such as "addict" and "substance abuser" have been found to elicit implicit and explicit stigma among the general public previously. The difference in the levels of this bias among individuals in recovery and those employed in the health profession has not yet been identified, however. The current study seeks to answer this question using measures of implicit bias. METHODS: A subset sample (n = 299) from a previously completed study (n = 1288) was selected for analysis. Mixed-model ANOVA tests were completed to identify variance between d-prime automatic association scores with the terms "addict" and "substance abuser" among individuals in recovery and those identified as working in the health professions. RESULTS: Individuals in recovery did not have lower negative associations with either term, whereas individuals employed as health professionals had greater negative associations with the term "substance abuser" but did not have greater negative associations with the term "addict." CONCLUSIONS: Results provide further evidence that previously identified stigmatizing labels have the potential to influence medical care and medical practitioner perceptions of individuals with substance use disorders and should be avoided. Further exploration into the role negative associations derived from commonly used labels have in the individual recovery process is needed to draw appropriate recommendations. |
Ashford, Robert; Brown, Austin; Ryding, Rachel; Curtis, Brenda Building Recovery Ready Communities: The Recovery Ready Ecosystem Model and Community Framework Journal Article In: Addiction Research and Theory, vol. 28, no. 1, pp. 1-11, 2019. @article{articleb, |
Ashford, Robert; Brown, Austin; Canode, Brent; McDaniel, Jessica; Curtis, Brenda A Mixed-Methods Exploration of the Role and Impact of Stigma and Advocacy on Substance Use Disorder Recovery Journal Article In: Alcoholism Treatment Quarterly, vol. 37, no. 4, pp. 462-480, 2019. @article{Ashford:2019aa, |
Bragard, Elise; Fisher, Celia B; Curtis, Brenda L ``They know what they are getting into:'' Researchers confront the benefits and challenges of online recruitment for HIV research Journal Article In: Ethics & Behavior, vol. 0, no. 0, pp. 1-15, 2019. @article{doi:10.1080/10508422.2019.1692663, |