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Substance Abuse (substance + abuse)
Kinds of Substance Abuse Terms modified by Substance Abuse Selected Abstracts[Commentary] TERRORIST ATTACKS AND SUBSTANCE ABUSEADDICTION, Issue 6 2009HAROLD A. POLLACK No abstract is available for this article. [source] Juramentos AND Mandas: TRADITIONAL CATHOLIC PRACTICES AND SUBSTANCE ABUSE IN MEXICAN COMMUNITIES OF SOUTHEASTERN PENNSYLVANIAANNALS OF ANTHROPOLOGICAL PRACTICE, Issue 1 2009Víctor García This article describes the use of traditional Catholic beliefs and practices by Mexican sojourners in southeastern Pennsylvania to deal with and overcome substance abuse. Two practices in particular are the focus: juramentos and mandas. Juramentos are ritual promises to a saint, made by a drinker or drug user, to abstain from drinking or using drugs; whereas mandas are requests or pleas for divine intervention in protecting a loved one from dangers, including from substance abuse, made by the wives and mothers of the substance users. These religious practices were observed and studied while conducting alcohol and drug abuse research in southeastern Pennsylvania and teaching an ethnographic field school in Mexican sending communities to this region of the United States. [source] Addiction research centres and the nurturing of creativity: The Swiss Institute for the Prevention of Alcohol and Drug Problems.ADDICTION, Issue 5 2009future, present ABSTRACT The aim of this paper is to offer an account of the history, the current status and the future of substance use research at the Swiss Institute for the Prevention of Alcohol and Drug Problems (SIPA). Although founded originally by the temperance movement in 1901, its policy has shifted over time towards one which accepts an alcohol-consuming culture made up of self-determined but well-informed consumers, while still supporting those who choose to live an abstinent life. In the beginning, SIPA was involved primarily in collecting alcohol-related information and making it available to professionals and the general public. From the late 1960s SIPA began conducting its own research projects; by the mid-1970s it had set up its own in-house research department. In 2001, SIPA was appointed a World Health Organization (WHO) Collaborating Centre for Substance Abuse, Research, Prevention and Documentation. As a private non-governmental organization, most of its funding comes from external research commissions. SIPA participates in a variety of international projects [e.g. Gender Alcohol and Culture: An International Study (GenACIS), European School Survey Project on Alcohol and Drugs (ESPAD) and Health Behaviour in School-aged Children (HBSC)] and contributes to numerous national research projects dealing with substance use. It has also forged close links with more than 50 other research institutions in Switzerland and world-wide. Thanks to its work over the last 30 years, SIPA has become a chief port of call for alcohol use research in Switzerland. In the future, SIPA will continue to monitor substance use, while stepping up its prevention research activities and ensuring that it is able to react more promptly to emerging phenomena. [source] Rethinking Substance Abuse: What the Science Shows, and What We Should Do About ItADDICTION, Issue 11 2007SARAH E. WOOLF No abstract is available for this article. [source] Integrated specialty mental health care among older minorities improves access but not outcomes: results of the PRISMe studyINTERNATIONAL JOURNAL OF GERIATRIC PSYCHIATRY, Issue 10 2008Patricia A. Areán Abstract Objective In this secondary data analysis of Primary Care Research in Substance Abuse and Mental Health for the Elderly (PRIMSe) study, we hypothesized that older minorities who receive mental health services integrated in primary care settings would have greater service use and better mental health outcomes than older minorities referred to community services. Method We identified 2,022 (48% minorities) primary care patients 65 years and older, who met study inclusion criteria and had either alcohol misuse, depression, and/or anxiety. They were randomized to receive treatment for these disorders in the primary care clinic or to a brokerage case management model that linked patients to community-based services. Service use and clinical outcomes were collected at baseline, three months and six months post randomization on all participants. Results Access to and participation in mental health /substance abuse services was greater in the integrated model than in referral; there were no treatment by ethnicity effects. There were no treatment effects for any of the clinical outcomes; Whites and older minorities in both integrated and referral groups failed to show clinically significant improvement in symptoms and physical functioning at 6 months. Conclusions While providing services in primary care results in better access to and use of these services, accessing these services is not enough for assuring adequate clinical outcomes. Copyright © 2008 John Wiley & Sons, Ltd. [source] Personal characteristics and depression-related attitudes of older adults and participation in stages of implementation of a multi-site effectiveness trial (PRISM-E)INTERNATIONAL JOURNAL OF GERIATRIC PSYCHIATRY, Issue 10 2005Marsha N. Wittink Abstract Background No study has assessed attitudes about depression and its treatment and participation at each step of recruitment and implementation of an effectiveness trial. Our purpose was to determine the association between personal characteristics and attitudes of older adults about depression with participation at each step of the Primary Care Research in Substance Abuse and Mental Health for the Elderly (PRISM-E) treatment effectiveness trial. Methods Information on personal characteristics and attitudes regarding depression and its treatment were obtained from all potential participants in PRISM-E. Results Persons who reported better social support were more likely to complete a baseline interview, but were less likely to meet with the mental health professional carrying out the intervention. Attitudes about taking medicines were significantly associated with uptake of the intervention, but not with earlier phases of recruitment. Persons were much more likely to have a visit with the mental health professional for treatment of depression if they were willing to take medicine for depression but did not endorse waiting for the depression to get better [odds ratio (OR),=,3.16, 95% confidence interval (CI),=,1.48,6.75], working it out on one's own (OR,=,5.18, 95% CI,=,1.69,15.85), or talking to a minister, priest, or rabbi (OR,=,2.01, 95% CI,=,1.02,3.96). Conclusion Social support and other personal characteristics may be the most appropriate for tailoring recruitment strategies, but later steps in the recruitment and implementation may require more attention to specific attitudes towards antidepressant medications. Copyright © 2005 John Wiley & Sons, Ltd. [source] Sample and design considerations in post-disaster mental health needs assessment tracking surveysINTERNATIONAL JOURNAL OF METHODS IN PSYCHIATRIC RESEARCH, Issue S2 2008Ronald C. Kessler Abstract Although needs assessment surveys are carried out after many large natural and man-made disasters, synthesis of findings across these surveys and disaster situations about patterns and correlates of need is hampered by inconsistencies in study designs and measures. Recognizing this problem, the US Substance Abuse and Mental Health Services Administration (SAMHSA) assembled a task force in 2004 to develop a model study design and interview schedule for use in post-disaster needs assessment surveys. The US National Institute of Mental Health subsequently approved a plan to establish a center to implement post-disaster mental health needs assessment surveys in the future using an integrated series of measures and designs of the sort proposed by the SAMHSA task force. A wide range of measurement, design, and analysis issues will arise in developing this center. Given that the least widely discussed of these issues concerns study design, the current report focuses on the most important sampling and design issues proposed for this center based on our experiences with the SAMHSA task force, subsequent Katrina surveys, and earlier work in other disaster situations. Copyright © 2008 John Wiley & Sons, Ltd. [source] Behavioral treatment of substance abuse in schizophreniaJOURNAL OF CLINICAL PSYCHOLOGY, Issue 8 2009Wendy N. Tenhula Abstract Co-occurring substance use disorders are highly prevalent among individuals with schizophrenia and other serious and persistent mental illnesses (SPMI) and are associated with clinically significant consequences. A multifaceted behavioral treatment called Behavioral Treatment for Substance Abuse in Serious and Persistent Mental Illness (BTSAS) can reduce substance abuse in persons with SPMI. The key treatment strategies in BTSAS include a urinalysis contingency, short-term goal setting, training in drug refusal skills, psychoeducation about the impact of drug use, and relapse prevention training. A case example illustrating the application of BTSAS is presented and relevant clinical issues are discussed. © 2009 Wiley Periodicals, Inc. J Clin Psychol: In Session 65: 1,11, 2009. [source] Does integrated trauma-informed substance abuse treatment increase treatment retention?JOURNAL OF COMMUNITY PSYCHOLOGY, Issue 7 2007Hortensia Amaro This article presents findings from a quasi-experimental, nonrandomized group design study that explored whether trauma-enhanced substance abuse treatment results in longer residential treatment stays and improved outcomes compared with treatment-as-usual. We used a subsample (N = 461) of participants in the Women, Co-Occurring Disorders and Violence Study, which was sponsored by the Substance Abuse and Mental Health Services Administration. The intervention group was 31% less likely to discontinue treatment within 4 months. Baseline mental health and trauma symptoms and alcohol and drug severity scores predicted neither overall length of time in treatment nor differences in retention between intervention and comparison groups. Substance abuse and mental health symptoms improved with increased duration of treatment, particularly for women with more severe baseline symptoms. © 2007 Wiley Periodicals, Inc. J Comm Psychol 35: 845,862, 2007. [source] Development and implementation of a multisite evaluation for the Women, Co-Occurring Disorders and Violence StudyJOURNAL OF COMMUNITY PSYCHOLOGY, Issue 4 2005Julienne Giard In this article we describe the development and implementation of the Substance Abuse and Mental Health Services Administration's (SAMHSA's) multisite Women, Co-Occurring Disorders and Violence Study (WCDVS), highlighting some of the challenges encountered, decisions made, and lessons learned. Four themes are discussed. First, the unique contributions of the consumer/survivor/recovering (C/S/R) women to the research process are described through instances where their knowledge and advocacy were clearly influential. Second, the solutions chosen to address research design challenges are recounted, as are the ways in which these choices played out. Third, the procedures for standardizing recruitment, data collection, and data management across sites are described. Finally, the strategies employed by the nine sites to retain contact with this challenging population are reviewed and successful techniques are highlighted. © 2005 Wiley Periodicals, Inc. J Comm Psychol 33: 411,427, 2005. [source] Insight Into the Relationship Between Impulsivity and Substance Abuse From Studies Using Animal ModelsALCOHOLISM, Issue 8 2010Catharine A. Winstanley Drug use disorders are often accompanied by deficits in the capacity to efficiently process reward-related information and to monitor, suppress, or override reward-controlled behavior when goals are in conflict with aversive or immediate outcomes. This emerging deficit in behavioral flexibility and impulse control may be a central component of the progression to addiction, as behavior becomes increasingly driven by drugs and drug-associated cues at the expense of more advantageous activities. Understanding how neural mechanisms implicated in impulse control are affected by addictive drugs may therefore prove a useful strategy in the search for new treatment options. Animal models of impulsivity and addiction could make a significant contribution to this endeavor. Here, some of the more common behavioral paradigms used to measure different aspects of impulsivity across species are outlined, and the importance of the response to reward-paired cues in such paradigms is discussed. Naturally occurring differences in forms of impulsivity have been found to be predictive of future drug self-administration, but drug exposure can also increase impulsive responding. Such data are in keeping with the suggestion that impulsivity may contribute to multiple stages within the spiral of addiction. From a neurobiological perspective, converging evidence from rat, monkey, and human studies suggest that compromised functioning within the orbitofrontal cortex may critically contribute to the cognitive sequelae of drug abuse. Changes in gene transcription and protein expression within this region may provide insight into the mechanism underlying drug-induced cortical hypofunction, reflecting new molecular targets for the treatment of uncontrolled drug-seeking and drug-taking behavior. [source] The Search for Mechanisms of Behavior Change in Evidence-Based Behavioral Treatments for Alcohol Use Disorders: OverviewALCOHOLISM, Issue 2007Robert B. Huebner Background:, Over the past three decades, the main question of interest to alcohol treatment researchers has concerned the main effects of a particular behavioral intervention or what works. Increasingly, alcohol treatment researchers are turning their attention to the underlying psychological, social, and even neurophysiologic processes or "active ingredients" that are driving therapeutic change. Method:, The articles contained in this supplement to Alcoholism: Clinical and Experimental Research grew out of invited presentations given at a one-day satellite session immediately preceding the 28th Annual Meeting of the Research Society on Alcoholism (RSA). The conference was a collaborative effort of the Center on Alcoholism, Substance Abuse, and Addiction at the University of New Mexico, the Center on Addiction and Substance Abuse at Columbia University, Brown University, and the National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health. Results:, The conference featured a mix of full-length presentations on conceptual and methodological issues, reports of original research findings, and lively discussion among speakers and conference participants. Understanding mechanisms of behavior change will benefit the field by identifying the key aspects of therapy that must be present for maximum effect, irrespective of the specific technique being applied; provide a new way to approach patient,treatment interactions; and lay the groundwork for understanding how change is affected by social and other extratreatment factors. Conclusions:, Although not a new topic to the field, understanding mechanisms of behavior change has begun to capture the interest of an increasing number of alcohol treatment researchers. Understanding behavior change is an exceedingly complex enterprise and innovative thinking and creative research designs will be required to advance the field. [source] Reclaiming Futures: A Model for Judicial Leadership in Community Responses to Juvenile Substance AbuseJUVENILE AND FAMILY COURT JOURNAL, Issue 3 2006JUDGE MICHAEL ANDEREGG ABSTRACT Juvenile courts across the country have become the leading service delivery system for youths with substance abuse problems, not by choice, but by necessity. At 10 communities around the nation, judges and project staff are in their fifth year of pioneering changes to the way the juvenile justice system helps teens in trouble with drugs, alcohol, and crime. These judges are part of Reclaiming Futures, an initiative of the Robert Wood Johnson Foundation, and they are working with local leaders to re-invent the way law enforcement, courts, probation, detention facilities, treatment providers, families, schools, and the community work together to help troubled youths succeed. Together, they have written a guide for judges, court administrators, government entities, community leaders, and interested citizens to share the knowledge and experience they have gained from the nationwide Reclaiming Futures initiative. Their goal is to encourage and motivate others to launch similar projects in their communities, and to provide a blueprint for judges and others striving to undertake this level of collaboration. [source] An Ecological Model of Maternal Substance Abuse and Child Neglect: Issues, Analyses, and RecommendationsAMERICAN JOURNAL OF ORTHOPSYCHIATRY, Issue 4 2003Scottye J. Cash PhD This study examined an ecological model of maternal substance abuse and child neglect. Data are presented that identified an interplay among family history, interpersonal risk factors, current family functioning, and community networks in examinations of child neglect in a sample of substance-abusing women entering treatment. [source] Implementation of school-based wellness centersPSYCHOLOGY IN THE SCHOOLS, Issue 5 2003Nancy G. Guerra This article describes the planning, implementation, and evaluation of school-based Wellness Centers operated by the Riverside Unified School District in Riverside, CA, as part of the Safe Schools/Healthy Students Initiative funded by the Substance Abuse and Mental Health Services Administration (SAMHSA). We describe the program as planned in terms of the theoretical model for the intervention and the evaluation design, and discuss the actual implementation including accomplishments and challenges. The program was designed to promote positive development and wellness for individual students via self- and teacher-referrals for personal and mental health problems handled through a case management and referral process, support groups, and other activities such as after-school programs, mentoring, tutoring, and parent training. An effort was also made to promote wellness at the school level by providing wellness campaigns, information, and compatible policies and procedures designed to enhance healthy development. Our observations are based on a qualitative assessment that was a component of the evaluation. A more detailed evaluation examining the impact of school-wide and student-focused activities on academic and behavioral outcomes is currently underway. However, we do include comments from students suggesting that the Wellness Center concept holds much promise for school-based mental health and violence prevention services. © 2003 Wiley Periodicals, Inc. Psychol Schs 40: 473,487, 2003. [source] The Violence Proneness Scale of the DUSI-R Predicts Adverse Outcomes Associated with Substance AbuseTHE AMERICAN JOURNAL ON ADDICTIONS, Issue 2 2009Levent Kirisci PhD Accuracy of the Violence Proneness Scale (VPS) of the Drug Use Screening Inventory (DUSI-R)1 was evaluated in 328 boys for predicting use of illegal drugs, DUI, selling drugs, sexually transmitted disease, car accident while under acute effects of drugs/alcohol, trading drugs for sex, injuries from a fight, and traumatic head injury. Boys were prospectively tracked from age 16 to 19 at which time these outcomes were documented in the interim period. The results demonstrated that the VPS score is a significant predictor of all outcomes. Prediction accuracy ranged between 62%,83%. These findings suggest that the VPS may be useful for identifying youths who are at high risk for using illicit drugs and commonly associated adverse outcomes. [source] Substance Abuse and Domestic Violence Interventions: The Need for Theoretical Based ResearchTHE AMERICAN JOURNAL ON ADDICTIONS, Issue 4 2008Caroline J. Easton PhD No abstract is available for this article. [source] Pain Management in Patients with Substance Abuse: Treatment Challenges for Pain and Addiction SpecialistsTHE AMERICAN JOURNAL ON ADDICTIONS, Issue 5 2007Vania Modesto-Lowe MD No abstract is available for this article. [source] Comorbid Schizophrenia and Substance Abuse: A Review of Epidemiology and CourseTHE AMERICAN JOURNAL ON ADDICTIONS, Issue 5 2006Joseph Westermeyer MD, PhDArticle first published online: 18 FEB 2010 Over the last dozen years, our knowledge regarding comorbid schizophrenia (SCZ) and substance use disorder (SUD) has evolved in several ways. First, the rate of lifetime comorbid SCZ-SUD appears to have increased another 20,30%, so now about 70,80% of persons with SCZ have lifetime SUD. Second, early remission of SUD has become commonplace among patients with SCZ, perhaps outnumbering the number of SCZ-only patients as well as those with active SCZ-SUD. Third, sustained SUD remission is well demonstrated, though the rates may yet be low. Fourth, research on comorbid SCZ-SUD is filling out our knowledge in many areas, including the characteristics of SCZ patients at risk for SUD, reasons SCZ patients seek out substances, effects of various substances on SCZ course and symptoms, and obstacles to SUD recovery in people with SCZ. The influence of SUD treatment and self-help on epidemiology and course has not been adequately evaluated. Primary prevention and early treatment of SUD in SCZ patients are still relatively neglected, though they offer our greatest hope for enhancing the lives of people with SCZ and improving the cost efficacy of care. [source] Club Drug Use among Youths in Treatment for Substance AbuseTHE AMERICAN JOURNAL ON ADDICTIONS, Issue 1 2006Christian Hopfer MD We describe lifetime rates of club drug use among 782 youths in treatment for substance abuse. Rates (%) for youths under eighteen (N=486) were methylenedioxy-methamphetamine (MDMA), 32.3; gamma-hydroxybutyrate (GHB), 7.0; lysergic acid diethylamide (LSD), 48.6; ketamine, 18.3; and methamphetamine, 30.2. For youths 18,32 (N = 289) rates (%) were MDMA, 37.0; GHB, 13.1; LSD, 42.9; ketamine, 17.0; and methamphetamine, 31.5. Older youths reported significantly more use of GHB than younger youths (p<.01). Youths reported using club drugs frequently outside of rave settings. Club drug use is common among youths in treatment for substance abuse and has spread beyond the rave culture. [source] Substance Abuse During Pregnancy: Clinical and Public Health ApproachesTHE JOURNAL OF LAW, MEDICINE & ETHICS, Issue 3 2003Philip H. Jos First page of article [source] Substance Abuse by Youth and Young Adults in Rural AmericaTHE JOURNAL OF RURAL HEALTH, Issue 3 2008David Lambert PhD ABSTRACT:,Purpose:Addressing substance abuse in rural America requires extending our understanding beyond urban-rural comparisons to how substance abuse varies across rural communities of different sizes. We address this gap by examining substance abuse prevalence across 4 geographic levels, focusing on youth (age 12-17 years) and young adults (age 18-25 years). Methods: The analysis is based on 3 years (2002-2004) of pooled data from the National Survey on Drug Use and Health. We measure rurality using a four-tier consolidation of the 2003 Rural-Urban Continuum Codes: urban, rural-adjacent, rural-large, and rural-small and medium. Findings: Rural youth have higher alcohol use and methamphetamine use than urban youth and the more rural the area, the higher the use. Rural young adults living in rural-large areas have higher rates of substance abuse than their urban peers; those living in the most rural areas have nearly twice the rate of methamphetamine use as urban young adults. Rural youth are more likely than urban youth to have engaged in the high-risk behavior of driving under the influence of alcohol or other illicit drugs. Conclusions: Higher prevalence rates, coupled with high-risk behavior, place rural youth and young adults at risk of continued substance use and problems associated with this use. Rural community infrastructure should be enhanced to support substance abuse prevention and intervention for these populations. [source] Multisystemic Therapy (MST) for Youth Offending, Psychiatric Disorder and Substance Abuse: Case Examples from a UK MST TeamCHILD AND ADOLESCENT MENTAL HEALTH, Issue 3 2010Charles Wells Background:, The paper illustrates the MST treatment model with three types of presenting problem in young people aged 14,15. Method:, The MST model is described and then illustrated with detailed case material from a violent young person convicted of robbery, a young person with a history of serious self-harming behaviour and hospitalisation, and a young person persistently smoking cannabis. Results:, All three cases improved after the MST intervention despite disparate presenting problems that included re-offending, the elimination of self-harming behaviour and a significant reduction in the use of cannabis. The three young people were re-integrated into the education system. Conclusion:, This case series illustrates the potential uses of the MST model in CAMHS although RCT data are needed to replicate the effectiveness of MST in the British context. [source] Birth-cohort and dual diagnosis effects on age-at-onset in Brazilian patients with bipolar I disorderACTA PSYCHIATRICA SCANDINAVICA, Issue 6 2009P. V. Da Silva Magalhães Objective:, Substance use disorders and birth-cohort have been associated with an earlier onset in bipolar disorder (BD). This study aimed at evaluating the inter-relations of these factors in age-at-onset in bipolar illness. Method:, Two-hundred and thirty patients with bipolar I disorder were cross-sectionally evaluated. Patients were categorized into four age groups for analysis. Lifetime comorbidity and age-at-onset were derived from the Structured Clinical Interview for DSM-IV. Results:, There was a strong linear association between age group and age-at-onset. Lifetime alcohol and drug use disorders were also associated with age-at-onset. Illicit drug and alcohol use disorders and age group remained significant in the multivariate model. No interactions appeared. Conclusion:, Both age group and dual diagnoses had strong and independent impacts on age-at-onset in out-patients with BD. Substance abuse may be partly accountable for earlier symptom onset, but other features of BD in younger generations are still in need to be accounted for. [source] Mephentermine dependence without psychosis: a Brazilian case reportADDICTION, Issue 6 2010Henrique Faria De Sousa ABSTRACT Background Substance abuse is a serious health concern. This report presents the case of a 22-year-old Brazilian man with a history of mephentermine use who fulfils all the criteria for chemical dependence listed by ICD-10. Mephentermine is a sympathomimetic agent derived from methamphetamine which, in Brazil, is restricted to veterinary use. Case description The subject used the substance at a high dose (120 mg) to improve his physical performance while working out at a gym. His symptoms included anorexia and insomnia. After days of intense activity, he felt fatigue and soreness. A physical examination revealed scars on both forearms from the injections and a psychological examination revealed moderate speech and motor agitation. Conclusions Cases such as this may be common among the general public. They should have some bearing upon medical practice and public health policies involving drugs. [source] Epidemiology of Adult Psychiatric Visits to U.S. Emergency DepartmentsACADEMIC EMERGENCY MEDICINE, Issue 2 2004Sara B. Hazlett MD Objectives: To characterize psychiatric-related emergency department visits (PREDVs) among adults in the United States for the year 2000 and to analyze PREDV trends from 1992 to 2000. Methods: Emergency department (ED) visit data from the National Hospital Ambulatory Medical Care Survey were used to estimate the number of PREDVs for adults aged 18 years and older. A PREDV was defined as any visit with a psychiatric discharge diagnosis (ICD N290, N312) or a suicide attempt (ICD E950,E959). Results: Approximately 4.3 million PREDVs occurred in the United States in the year 2000, yielding an annual rate of 21 visits per 1,000 adults. The PREDV rates increased 15% between 1992 and 2000. The PREDVs accounted for 5.4% of all ED visits. Substance abuse (27%), neuroses (26%), and psychoses (21%) were the most common conditions. African Americans had significantly higher visit rates (29/1,000; 95% CI = 27/1,000 to 31/1,000) compared with whites (23/1,000; 95% CI = 22/1,000 to 25/1,000). Persons with Medicaid (66/1,000; 95% CI = 64/1,000 to 68/1,000) had double the rate of PREDVs than the uninsured (33/1,000; 95% CI = 31/1,000 to 35/1,000) and almost eight times the rate of those privately insured (8/1,000; 95% CI = 7/1,000 to 10/1,000). Patients with psychiatric diagnoses had a higher admission rate (22%) than those with nonpsychiatric diagnoses (15%). The uninsured were the least likely to be admitted for all major psychiatric conditions except suicide (p < 0.0001). Conclusions: Psychiatric-related ED visits represent a substantial and growing number of ED visits each year. Patient characteristics influence the likelihood of a PREDV. Further research is needed to better understand the role that hospital EDs play in the delivery of health care services to those with mental illness. [source] Enhancing the effectiveness of residential treatment for substance abusing pregnant and parenting women: Focus on maternal reflective functioning and mother-child relationshipINFANT MENTAL HEALTH JOURNAL, Issue 5 2006Marjukka Pajulo Substance abuse during early motherhood has become a significant problem and has led to accelerated efforts to develop specific treatment facilities for these mothers and children. Despite the often intensive treatment efforts in residential settings, there is surprisingly little evidence of their efficacy for enhancing the quality of caregiving. The situation of these mother-child pairs is exceptionally complex and multilevel, and has to be taken into account in the content and structuring of treatment. Intensive work in the "here and now" focusing on the mother-child relationship from pregnancy onwards in an effort to enhance maternal reflective capacity and mindedness is considered a key element for better treatment prognosis, in terms of both abstinence and quality of parenting. Pioneering work with such a focus is described in this article. [source] Personality pathology and substance abuse in eating disorders: A longitudinal studyINTERNATIONAL JOURNAL OF EATING DISORDERS, Issue 3 2008Heather Thompson-Brenner PhD Abstract Objective: Substance abuse has been shown to predict poor outcome in eating disorder (ED) samples, and prior cross-sectional data on personality subtypes of EDs suggest that substance abuse is associated with dysregulated and possibly avoidant-insecure subtypes. This study investigates longitudinal associations between personality and substance use. Method: Personality pathology and substance use were assessed in 213 individuals with anorexia nervosa and bulimia nervosa at baseline; substance use was assessed at regular follow-up intervals over a 9-year period. Results: Of the five personality factors identified, the obsessional-sensitive and high-functioning types were negatively associated with substance abuse at baseline, while the behaviorally dysregulated type was positively associated with substance abuse at baseline. Longitudinal associations were observed, suggesting that obsessional-sensitive personality type was protective against the development of substance abuse. Longitudinal associations between the other personality types and substance abuse were nonsignificant after baseline substance abuse history was included as a covariate in the model. Conclusion: Substance use demonstrates cross-sectional associations with personality style, but substance abuse history appears to be the most important predictor of future substance abuse in women with eating disorders. © 2007 by Wiley Periodicals, Inc. Int J Eat Disord 2008 [source] Does integrated trauma-informed substance abuse treatment increase treatment retention?JOURNAL OF COMMUNITY PSYCHOLOGY, Issue 7 2007Hortensia Amaro This article presents findings from a quasi-experimental, nonrandomized group design study that explored whether trauma-enhanced substance abuse treatment results in longer residential treatment stays and improved outcomes compared with treatment-as-usual. We used a subsample (N = 461) of participants in the Women, Co-Occurring Disorders and Violence Study, which was sponsored by the Substance Abuse and Mental Health Services Administration. The intervention group was 31% less likely to discontinue treatment within 4 months. Baseline mental health and trauma symptoms and alcohol and drug severity scores predicted neither overall length of time in treatment nor differences in retention between intervention and comparison groups. Substance abuse and mental health symptoms improved with increased duration of treatment, particularly for women with more severe baseline symptoms. © 2007 Wiley Periodicals, Inc. J Comm Psychol 35: 845,862, 2007. [source] Substance abuse and the impaired providerJOURNAL OF HEALTHCARE RISK MANAGEMENT, Issue 1 2010CPHRM, Derek Watkins MS Physicians have a similar rate of substance abuse as the general population, though their choice of substance may tend to be different. The impact on the physician and his or her patients seriously compromises the delivery of safe and effective medical care. This article reviews our knowledge base regarding the physician with substance abuse issues and presents a methodology to assist in mitigating the risks presented to the provider and patients. 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