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Substance Abuse Problems (substance + abuse_problem)
Selected AbstractsPrediction of mortality at age 40 in Danish males at high and low risk for alcoholismACTA PSYCHIATRICA SCANDINAVICA, Issue 6 2004J. Knop Objective:, This prospective high-risk study examined the influence of father's alcoholism and other archival-generated measures on premature death. Method:, Sons of alcoholic fathers (n = 223) and sons of non-alcoholic fathers (n = 106) have been studied from birth to age 40. Archival predictors of premature death included father's alcoholism, childhood developmental data, and diagnostic information obtained from the Psychiatric Register and alcoholism clinics. Results:, By age 40, 21 of the 329 subjects had died (6.4%), a rate that is more than two times greater than expected. Sons of alcoholic fathers were not more likely to die by age 40. Premature death was associated with physical immaturity at 1-year of age and psychiatric/alcoholism treatment. No significant interactions were found between risk and archival measures. Conclusion:, Genetic vulnerability did not independently predict death at age 40. Death was associated with developmental immaturities and treatment for a psychiatric and/or substance abuse problem. [source] Prevalence and correlates of traumatic brain injury among delinquent youthsCRIMINAL BEHAVIOUR AND MENTAL HEALTH, Issue 4 2008Brian E. Perron Background,Delinquent youth frequently exhibit high-risk behaviours that can result in serious injury. However, little is known about traumatic brain injuries (TBIs) and their correlates in this population. Aims,To examine the period prevalence and correlates of TBIs in delinquent youths. Method,Interviews were conducted with 720 (97.3%) residents of 27 Missouri Division of Youth Services rehabilitation facilities between March 1 and May 31, 2003. Participants [mean age (Mage) = 15.5, standard deviation (SD) = 1.2, 87% male] completed measures assessing TBI, substance use, psychiatric symptoms, and antisocial traits/behaviours. TBI was defined as ever having sustained a head injury causing unconsciousness for more than 20 minutes. Results,Nearly one-in-five youths (18.3%) reported a lifetime TBI. Youths with TBIs were significantly more likely than youths without to be male, have received a psychiatric diagnosis, report an earlier onset of criminal behaviour/substance use and more lifetime substance use problems and past-year criminal acts, evidence psychiatric symptoms, report lifetime suicidality, be impulsive, fearless, and external in locus of control and criminally victimized in the year preceding incarceration. Male gender and frequency of own criminal victimization were important predictors of TBI in multivariate analyses. Regression analyses adjusted for demographic factors, indicated that youths with TBIs were at significantly elevated risk for current depressive/anxious symptoms, antisocial behaviour, and substance abuse problems. Conclusions,TBI is common among delinquent youth and associated with wide ranging psychiatric dysfunction; however, the causal role of TBIs in the pathogenesis of co-morbid conditions remains unclear. Copyright © 2008 John Wiley & Sons, Ltd. [source] The Roles of Risk Perception and Borderline and Antisocial Personality Characteristics in College Alcohol Use and Abuse,JOURNAL OF APPLIED SOCIAL PSYCHOLOGY, Issue 7 2004Emily Crawford This study examined the relationships among risk perceptions, alcohol use and abuse, and borderline and antisocial personality characteristics in college students. College students who perceived themselves less able to avoid negative consequences reported drinking more and having more substance abuse symptoms than those who perceived themselves as more able to avoid negative consequences. College students who scored higher on borderline or antisocial personality tended to rate personal avoidability of negative consequences lower than those who scored lower on these personality characteristics. A multiple regression model accounted for 50% of the variance in self-reported substance abuse symptoms. Low perceived personal avoidability of negative drinking consequences and high borderline or antisocial personality characteristics are risk factors for substance abuse problems. [source] Twelve-Step Groups, Attributions of Blame for Personal Sadness, Psychological Well-Being, and the Moderating Role of Gender,JOURNAL OF APPLIED SOCIAL PSYCHOLOGY, Issue 3 2000J. B. Kingree Two studies investigated links among 12-step group participation, gender, attributions of blame for personal sadness, and psychological well-being. Study I used a correlational design to examine these links cross-sectionally among substance abusers who identified alcohol as their primary drug problem. Study 2 used an experimental design to examine prospective links among these variables for substance abusers who were also adult children of alcoholics. Females engaged in more blame than did males, and personal blame was negatively related to psychological well-being in Studies 1 and 2. Most significantly, 12-step group participation was associated with lower personal blame among females but not among males across both studies. These results indicate that 12-step groups can reduce personal blame among females who have substance abuse problems. [source] Identifying and screening for psychological and comorbid medical and psychological disorders in medical settings,JOURNAL OF CLINICAL PSYCHOLOGY, Issue 3 2009Rodger Kessler Abstract There is increased attention to the medical and economic consequences of psychological problems comorbid with medical issues. There is also a clear awareness that most psychological problems are assessed and responded to in nonpsychiatric medical settings. This has furthered interest and attention in implementing screening procedures to better identify psychological, behavioral, and substance abuse problems in medical settings. Such interest is taking the form of recommendations from federal government task forces, and the funding of large projects to include screening in medical settings. At the same time there has been further attention to brief, valid, and reliable measures with which to capture psychological comorbidities. However, there have been multiple concerns raised about a variety of issues concerning the utility and effectiveness of such screening procedures and the identification of multiple issues to be considered in screening design. The author outlines and reviews the rationale and concerns about screening, identifies the issues that need to be considered in screening program development, and describes the efforts to develop a screening capacity in a rural family practice. © 2009 Wiley Periodicals, Inc. J Clin Psychol: In Session 65:1,15, 2009. [source] Perceptions about services and dropout from a substance abuse case management programJOURNAL OF COMMUNITY PSYCHOLOGY, Issue 5 2007Michael R. Sosin This article uses event history analysis to examine certain determinants of dropout from a case management program that serves homeless adults with substance abuse problems. The examined determinants are perceptions of conventional treatment services: (a) client perceptions concerning the value of the conventional services that case managers help them to obtain, (b) the views of use services held by social contacts, and (c) client perceptions of the legitimacy of conventional services. The findings, some of which involve statistical interactions, suggest that clients drop out of case management services more slowly (a) when they favor pursuit of particularly efficacious conventional programs; (b) when they find conventional programs to be of low legitimacy; (c) when, under special conditions, they perceive that conventional services are less caring; or (d) when social contracts do not pressure them. These findings generally imply that clients look to case management services when they are more skeptical about conventional services. The variables predicting dropout from case management poorly predict continuation in conventional substance abuse services, indicating that dropout is linked to perceptions of services in context-specific ways. © 2007 Wiley Periodicals, Inc. J Comm Psychol 35: 583,602, 2007. [source] Injury Risk Among Medically Identified Alcohol and Drug AbusersALCOHOLISM, Issue 1 2001Ted R. Miller Background: Although nonfatal injury prevalence is higher among substance abusers than in the general population, few studies have estimated the injury risk for clinically recognized substance abusers. The extant studies, moreover, analyze rates of visits for injury treatment rather than rates of injury events. This study estimates the excess risk of medically treated and hospitalized nonoccupational injury for people under age 65 with medically identified substance abuse problems and private health care coverage. Method: We conducted a retrospective cohort study by using medical claims data from Medstat Systems, Inc., with a longitudinal database of health care claims for 1.5 million people with health care coverage from 70 large corporations. Claims histories for anyone who had an alcohol-related or drug-related primary or secondary diagnosis during 1987 to 1989 were analyzed. A random sample was selected from the remaining people without a substance abuse diagnosis in their medical records. Injury rates were compared among groups. We used logistic regression to estimate odds of medically treated and hospitalized injury, controlling for demographics. Results: Medically identified substance abusers had an elevated risk of injury in a 3-year period; alcohol and drug abusers had the highest risk (58%), followed by drug-only abusers (49%), alcohol-only abusers (46%), and controls (38%). Alcohol and drug abusers were almost four times as likely to be hospitalized for an injury in a 3-year period when compared with controls. Injury risks were elevated substantially more for female then male substance abusers. Conclusions: This study greatly improves on available information about the risk of injury for drug and multiple-substance abusers. Medically identified substance abusers, especially adult women, have a higher probability of injury, more hospitalized injuries, and more injury episodes per person injured than nonabusers. More aggressive identification and subsequent treatment of female substance abusers appear warranted. [source] The RWJF Reclaiming Futures Initiative: Improving Substance Abuse Interventions for Justice-Involved YouthsJUVENILE AND FAMILY COURT JOURNAL, Issue 4 2006LAURA BURNEY NISSEN ABSTRACT Juvenile justice systems in the United States do not always respond effectively to substance abuse problems among young offenders. In 2002, the Robert Wood Johnson Foundation launched a 10-community demonstration project to address this problem. Reclaiming Futures (RF) relies on community partnerships to improve treatment quality, strengthen local leadership, expand inter-organizational collaboration, and create systems of shared performance management. The initial findings of a cross-site evaluation suggest that Reclaiming Futures is yielding important and positive change. Bi-annual surveys of key informants measure the quality and integration of juvenile justice and substance abuse treatment systems in each community. Of 13 indices measured by the surveys, 11 showed significant improvements between 2003 and 2005. [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] Coming In: An Examination of People With Co-Occurring Substance Use and Serious Mental Illness Exiting Chronic HomelessnessAMERICAN JOURNAL OF ORTHOPSYCHIATRY, Issue 2 2009Alisa K. Lincoln PhD Despite national efforts, the number of people who are chronically homeless in our cities remains high. People with serious mental illness and substance abuse problems continue to represent the majority of those experiencing long-term homelessness. Traditional shelters have difficulty engaging and addressing the needs of this group; however, there are an increasing number of alternative models, including the Safe Haven shelter program, developed to better meet their needs. In this article, the authors examine responses from 28 qualitative interviews conducted with 16 residents of a Safe Haven shelter serving chronically homeless people, at 3 and 9 months after entry. All had a severe mental illness and were actively substance abusing. The importance of a model that respects personhood, a place that feels like home, and challenges faced by residents as they "come in" are emphasized. [source] Psychiatric disorders in advanced cancerCANCER, Issue 8 2007Michael Miovic MD Abstract BACKGROUND. Emotional distress and psychiatric disorders are common among patients with advanced cancer. Oncologists play an important role in screening for these conditions, providing first-line treatment and referring patients for further evaluation and treatment when indicated. METHODS. The literature on psycho-oncology was reviewed, focusing on the epidemiology, assessment, and treatment of psychiatric disorders (adjustment disorders, major depression, anxiety and post-traumatic stress, personality disorders, substance abuse, and major mental disorders such as schizophrenia and bipolar disorder) in patients with advanced cancer. Communication skills and the role of the oncologist in dealing with end-of-life issues were also reviewed. Relevant data were summarized from the most recent systematic reviews, epidemiological studies, and intervention trials. Clinical recommendations are provided. RESULTS. About 50% of patients with advanced cancer meet criteria for a psychiatric disorder, the most common being adjustment disorders (11%,35%) and major depression (5%,26%). Both psychosocial and pharmacological treatments are effective for anxiety and depression, although existing studies have methodological limitations. Collaboration with mental health specialists is recommended for patients with personality disorders, major mental illness, and substance abuse problems. Effective communication involves active listening, exploring emotion and meaning, addressing prognosis, and discussing end-of-life issues when relevant. CONCLUSIONS. Treating psychiatric conditions improves quality of life in patients with advanced cancer. Oncologists play a key role in screening for psychiatric disorders, initiating first-line treatments for depression and anxiety, and communicating with patients and caregivers about prognosis and end-of-life issues. Cancer 2007. © 2007 American Cancer Society. [source] | |||||||||||||