Maternal attitudes towards pre-natal substance abuse,medical care,and treatment in a historically disadvantaged South African community

This study explored maternal substance abuse and the access to pre-natal medical care and treatment for substance abuse during pregnancy. Respondent mothers (n?=?102; mean age?=?27.8 years, SD?=?10.9 years) were from Mitchell’s Plain, a historically disadvantaged South African community. The mothers completed a mixed methods interview on the context and influences of their substance abuse during their pregnancy. Findings suggest that these mothers adopt the drug taking behaviour in their social environment. Women with prior histories of substance abuse were active consumers and dependent on drugs while childbearing. These findings may be important for possible intervention strategies among this particular group of vulnerable women.     

Cultural context and substance abuse in Hispanic adolescents

Much emphasis has been placed on the significant substance abuse problem being faced by Hispanic as well as other minority youth in the United States. However, little research has focused on the relative importance of culturally determined factors in the development of substance abuse in Hispanic youths. In this study, we propose an approach to measuring cultural factors through the activity orientations that youths endorse. We studied over 4000 Mexican-American and Mexican youths living along the U.S.-Mexico border with respect to their recent drug use, problem drug use, depressive symptomatology, and their activity orientation. While culturally related activity orientation does significantly increase risk for substance abuse, we found that symptoms of distress/depression and sociodemographic factors exerted a stronger effect on these youths.     

Photography as a therapeutic tool for substance abuse clients who have a history of sexual abuse

Symptoms of sexual abuse among persons in substance abuse treatment facilities may be difficult to recognise since presenting symptoms frequently mirror those associated with substance abuse. Additionally, treatment may be difficult due to a lack of previous verbal processing and shared negative defence mechanisms that are resistant to traditional talking therapy. The use of photography is presented here as a method of treatment initiation and exploration for substance abuse clients who have a history of sexual abuse. The paper reviews rationale, advantages, current applications and practitioner concerns associated with the use of photography as a therapeutic tool.     

An evaluation of the short-term impact of a media-based substance abuse prevention programme

A state-wide substance abuse prevention programme, entitled KidsInTouch, incorporated a multifaceted approach involving: (a) media-based interventions; and (b) parent training workshops. KidsInTouch was targeted at parents and their children, ages five to 12 years. The media-based interventions attempted to increase children's and parents' awareness and knowledge about substance abuse and prevention. In addition, the intervention advertised and solicited audience participation in parent training workshops. Parents participating in the parent training workshops, in comparison to the control parents, evidenced significant improvement in both alcohol and other drug knowledge and parenting skills. The implications of using the media and involving children and their parents in substance abuse prevention programmes are discussed.     

Comorbidity of drug abuse treatment

Research has suggested that comorbidity, the concurrence of substance abuse disorders with other psychiatric disorders, may have prognostic value and important implications for the treatment of substance abuse. Knowledge of the prevalence of comorbid disorder is important because it will enable treatment services to be appropriately configured and designed for clinical drug treatment populations. The form and duration of comorbidity may be influenced by a variety of factors, which include the class of drug being abused, the duration of drug use, the individual sensitivity to drug effects, and whether the drug effects are acute or due to withdrawal or residual conditions. This paper addresses three important scientific questions: (1) What is the prevalence of comorbid disorders in a drug abuser population? (2) What is the stability of psychiatric diagnoses in a drug abuser population? (3) Does the existence of a comorbid disorder influence the outcome of drug abuse treatment?     

Aids-risk behavior among homosexual males: The role of attitudes and substance abuse

Abstract

This paper reports the results of a broad survey of homosexual males regarding AIDS-risk behavior. A very high proportion reported both anxiety over possible HIV infection, and a high probability of exposure to HIV. Although over 80% of respondents reported changes in sexual behavior, the frequency of monogamous, stable relationships is unchanged from that found 16 years ago, and 19% reported continued frequent sexual partners. Consistent with “health belief” models, fear of future exposure and perceived control over behavior were strongly related to behavioral change. However, those who felt they had already been exposed were not substantially more likely to decrease current AIDS-risk behavior, which may have important public health ramifications. Alcohol and drug abuse were related to “high risk” behavior, particularly among respondents who are generally motivated to use substances to decrease “tension” or self-monitoring. Thus, using substances to decrease stress may not only relate to substance abuse itself, but to the role of substances in increasing AIDS-risk behavior.     

Psychopathy and aggressive behaviour among Nigerian male prison inmates: The moderating role of substance abuse

This study investigated the moderating role of substance abuse in the relationship between psychopathy and aggression among male prison inmates. Two hundred and sixty-seven male prison inmates from the Nigerian Prison Services were participants. The inmates were incarcerated for armed robbery (27.3%), theft (31.1%), murder (12.8%), rape/assault/child abuse (19.1%), burglary/arson (5.6%) and kidnapping (1.5%) in Enugu prisons, Nigeria. Their mean age was 28.32; SD = 5.53. Their length of time in prison ranges from 1 to 12 years, with a mean of 3.38 years. Participants responded to self-reported measures of aggression, psychopathy, and drug abuse. The result of the moderated regression analysis indicated substance abuse to moderate the relationship between primary psychopathy and verbal aggression, and between secondary psychopathy and hostility. The study findings underscore the importance of psychological intervention aimed at addressing aggression among prison inmates with histories of substance abuse and psychopathy.     

Impact of substance abuse and child maltreatment training on service utilization in a rural setting

Substance abuse and child maltreatment have been recognized as co-morbid problems encountered in families presenting in the child protective services (CPS) system. Nonetheless, utilization rates of substance abuse treatment services have generally lagged well behind what the research would suggest are prevalence rates for substance abuse disorders in this population, suggesting problems in recognition and referral practices among CPS workers. In response to this, 25 training programs were funded by the National Center on Child Abuse and Neglect. This study reports data from one program. Trainees indicated a high level of satisfaction and demonstrated significant knowledge gains. More importantly, utilization of substance abuse services increased significantly across time in a multi-county region receiving training relative to a comparison region receiving none. The gain was limited, suggesting that while increased knowledge may translate into increased service utilization, additional barriers to accessing needed services must also be addressed.     

Psychological trauma and PTSD symptoms as predictors of substance dependence treatment outcomes

Psychological trauma and post-traumatic stress disorder (PTSD) may complicate and reduce the effectiveness of treatment for substance use disorders (SUDs). This study assessed trauma history and symptoms of simple and complex PTSD at baseline in a randomized trial of contingency management (CM) compared to standard treatment (ST) with 142 cocaine- or heroin-dependent outpatients. History of exposure to each of eight types of psychological trauma was unrelated to treatment outcome, except for witnessed assaults and emotional abuse. Complex PTSD symptoms were inversely associated with short-term treatment outcomes, and PTSD symptoms were positively related to long-term outcome, independent of the effects of demographics, psychological distress, baseline substance use status, and treatment modality. Complex PTSD symptoms warrant further study as a potential negative prognostic factor in SUD interventions.     

Effects of family therapy for substance abuse: A systematic review of recent research

One of the most serious psychosocial problems worldwide is substance abuse because of its repercussions not only on the physical and psychological health of the abuser but also on their relational functioning. Among the well-established therapeutic approaches for the treatment of substance abuse is family therapy, which, in addition to influencing personal variables, promotes changes in family dynamics. The main objective of this study is to review the scientific literature published from 2010 to the present on the efficacy and effectiveness shown by family-based treatment approaches for substance use problems both in adolescent and adult samples. In addition, the effect on secondary variables such as family functioning and behavioral problems is evaluated. The empirical evidence accumulated in the last decade and reviewed in the present study indicates that the incorporation of family members in the treatment of substance abuse produces benefits by diminishing consumption and improving family functioning. Limitations of this study and of the research reviewed are discussed and directions for future research are provided.     

Physical characteristics of residential psychiatric and substance abuse programs: Organizational determinants and patient outcomes

Described the Physical and Architectural Characteristics Inventory (PACI), which assesses the physical characteristics of hospital- and community-based psychiatric and substance abuse residential treatment programs for adults. Developed using data from 94 representative programs, the PACI has 7 dimensions that assess community accessibility, physical features that add convenience, aid recreation, and provide support for patients, and space for patient and staff functions. In comparison to community-based programs (n=63), hospital programs (n=31) had more social-recreational and prosthetic aids, safety features, staff facilities, and space. The PACI dimensions were also related to other organizational features, such as facility ownership and program size and staffing level. Programs with more physical amenities had patients who were more involved in self-initiated and community activities and were more likely to successfully complete the program and be discharged to independent living situations and paid jobs. Programs with more social-recreational and prosthetic aids, space, and access to community resources also had better patient outcomes. In addition, PACI dimensions were related to observers' ratings of facility attractiveness. Potential applications of the PACI and the full inventory of which it is a part are discussed.     

Characteristics of seriously emotionally disturbed youth with and without substance abuse in intensive case management

Youth with emotional disturbance who have substance abuse problems are of particular concern to child-serving agencies. Approximately 22% of the youth served in New York State's Intensive Case Management Program for Children and Youth (CYICM) have identified substance abuse problems. We compared youths enrolled in CYICM who abuse substances with those who do not abuse substances. Adolescents with substance abuse problems differed from non-abusing adolescents. The abusing cohort was most likely to be emancipated minors, not enrolled in school, less likely to be members of a minority group, and more likely to have private health care coverage. They also evidenced a different constellation of symptoms than the non-abusing cohort, with abusers tending to display suicidal symptoms and behaviors and sexual acting out. Abusers were also more likely to have been admitted to private psychiatric hospitals and to have had crisis contacts in emergency rooms. Similar to non-abusers, however, abusers spent significantly fewer days as inpatients in state hospitals, and had fewer admissions to these hospitals following their enrollment in CYICM.     

Ethnic differences in psychiatric disorders among adolescent substance abusers in treatment

The present study describes the diagnostic profile of over 800 adolescents admitted to residential therapeutic community programs for treatment of drug abuse and related problems. The relationship between race/ethnicity and psychiatric disturbance is examined, and the association among these factors to outcome is investigated. Over 90% of the sample had a DSM-III-R nonsubstance diagnosis. There were significant differences among the race/ethnic groups on attention deficit-hyperactivity and the disruptive behavior and affective disorders. In general, African-American adolescents yielded the lowest rates of disturbance across all categories of disorders. There was no relationship among race/ethnicity, psychiatric disturbance, and 1-year posttreatment outcomes.     

Effectiveness of self-help and support groups for cancer patients: A Review

Abstract

Following the recognition of the psychological difficulties faced by cancer sufferers, there has been a rapid growth in forms of group help. There is a wide variety of types, and nomenclature is far from consistent. Evaluation studies are reviewed, and issues of potential harmfulness are considered.     

Treatment of co-occurring child maltreatment and substance abuse

Despite high prevalence and severe negative consequences of child maltreatment (e.g., Brown, G. R., & Anderson, B., (1991). Psychiatric morbidity in adult inpatients with childhood histories of sexual and physical abuse. American Journal of Psychiatry, 148, 55–61; Jaudes, P. K., Ekwo, E., & Van Voorhis, J.V., (1995). Association of drug abuse and child abuse. Child Abuse and Neglect, 19, 1065–1075; Murphy, J. M., Jellinek, M., Quinn, D., Smith, G., & Goshkom, M., (1991). Substance abuse and serious child mistreatment: Prevalence, risk, and outcome in a court sample. Child Abuse and Neglect, 15, 197—211), the treatment of perpetrators and victims of child abuse and neglect remains grossly understudied (Behl, L. E., Conyngham, H. A., & May, P. F., (2003). Trends in child maltreatment literature. Child Abuse and Neglect, 27, 215–229). More than half of parentes founded for the abuse and neglect of their children have evidenced drug abuse, yet no treatments have been validated that concurrently address these problems. The reciprocal interaction between substance abuse and child maltreatment supports the need to concurrently treat these problems. This article illustrates the relationship between child maltreatment and parental substance abuse and proposes a behavioral model to explain the reciprocal influence of drug abuse and child maltreatment. A behavioral treatment plan that is designed to concurrently address drug abuse and child abuse is proposed and suggestions are made for future directions in this area.     

Parent,child, and contextual predictors of childhood physical punishment

Data gathered over the course of an 18‐year longitudinal study of 1025 New Zealand children were used to: (a) develop a profile of the maternal, child, and contextual factors associated with differing levels of exposure to maternal physical punishment, and (b) identify the key predictors of maternal physical punishment as reported by young people at age 18. Results revealed the presence of clear linear associations between the extent of young people's reported exposure to physical punishment and a wide range of maternal, child, and contextual factors. The key predictors of physical punishment suggested that the psychosocial profile of those mothers at greatest risk of physically punishing or mistreating their child was that of a young woman with a personal history of strict parenting who entered motherhood at an early age, and who was attempting to parent a behaviourally difficult child within a dysfunctional family environment characterized by elevated rates of inter‐parental violence and childhood sexual abuse. These findings were consistent with a cumulative risk factor model in which increasing risk factor exposure is associated with increasing levels of child physical punishment/maltreatment. Copyright © 2002 John Wiley & Sons, Ltd.     

Prediction of drug and alcohol abuse in hospitalized adolescents: comparisons by gender and substance type

The authors examined psychosocial correlates of drug and alcohol abuse in 462 hospitalized adolescents, and the extent to which these associations may be affected by gender or by substance type. Participants completed a battery of psychometrically-sound, self-report measures of psychological functioning, environmental stress, drug abuse, and alcohol abuse. Four multiple regression analyses were conducted to determine the joint and independent predictors of drug abuse and alcohol abuse, for males and for females. Multiple regression analysis revealed that seven variables--age, depression, impulsivity, low self-esteem, delinquent predisposition, low peer insecurity, and history of child abuse--jointly predicted both drug and alcohol abuse, for both males and females. However, several differences were found with respect to which variables made independent contributions to the predictive models--with only delinquent predisposition making a significant independent contribution for all four conditions. We found distinct patterns of psychosocial predictor variables for drug and alcohol abuse, as well as distinct patterns for males and females. These results may reflect differing risk factors for drug abuse and alcohol abuse in adolescent psychiatric patients--and differing risk factors for males and females. Such differences have potential implications for prevention and treatment.     

Assessment of substance abusers on the MCMI-III and the Rorschach

We examined 60 substance abusers (SA) on the Millon Clinical Multiaxial Inventory-III (MCMI-III; Millon, 1994) and on eight Rorschach variables from the Comprehensive System (CS; Exner, 2003). On the MCMI-III, SA scored above the cutoff for clinical significance (M > or = BR 70) on Drug Dependence (94.77), Antisocial (82.95), Depressive (74.33), Self-Defeating (71.48), and Alcohol Dependence (70.70). On seven of the CS variables (M+,o,u, XA%, X-%, WSum6Lv2%, M-%, SumT%, and Pure H%) the scores of the SAs suggested significant more psychopathology compared to the scores of 60 university students, whereas the SA's scores on six of these variables (M+,o,u, XA%, X-%, WSum6Lv2%, SumT%, and Pure H%) suggested significantly less psychopathology compared to the scores of 36 schizophrenics. The effect sizes for the significant differences were in the small, medium and large range (d= 0.31 to d= 1.87).     

The influence of maternal optimality and infant temperament on parenting stress at 12 months among mothers with substance abuse and psychiatric problems

The present prospective longitudinal study aimed to investigate the long‐term impact of maternal optimality assessed during pregnancy on parenting stress at infant age 12 months. In this study the concept of optimality was utilized to investigate maternal variations regarding resources during pregnancy in relation to later parenting stress, among three different groups of mothers that were recruited from substance abuse treatment, psychiatric outpatient treatment and well‐baby clinics respectively. The influence of infant temperament on parenting stress was also examined. All mothers were interviewed during pregnancy. At 12 months, infant temperament (Colorado Childhood Temperament Inventory; Rowe & Plomin, 1977) and stress in the parent and child domain (Parenting Stress Index; Abidin, 1955) were assessed. Results demonstrated higher levels of parenting stress among mothers in the clinical groups, compared to the non‐clinical group. Furthermore, it was the maternal psychiatric optimality index in combination with child temperament characteristics (child emotionality) that contributed uniquely to stress in the parent domain, while stress in the child domain was significantly associated only with child temperament characteristics (both child emotionality and soothability). The association between maternal psychiatric optimality assessed in pregnancy, infant temperament and parenting stress when the infants were 12 months old, points to the importance of simultaneously addressing the mothers' own psychological distress, and to support positive mother–infant interactions. Each woman's individual optimality profile may be used to display needs of follow‐up in order to prevent enduring effects of non‐optimality on parenting stress.