Homelessness and dual diagnosis.

People who are dually diagnosed with severe mental illness and substance use disorders constitute 10%-20% of homeless persons. They are a heterogeneous and extremely vulnerable subgroup with complex, poorly understood needs. In this article recent research on the epidemiology, subject characteristics, and service needs of the dually diagnosed homeless population is reviewed. Also, the range of evolving approaches to providing social services, housing, and mental health and substance-abuse treatments; the relevant system issues and legal issues; and problems with current research, as well as future research directions, are discussed. The importance of the distinction between providing appropriate living environments and mental health treatments emerges throughout.     

Individual and contextual predictors of involvement in twelve-step self-help groups after substance abuse treatment

Drawing on ecological and narrative theories of self-help groups, this study tests a multilevel model predicting self-help group involvement among male veterans who received inpatient substance abuse treatment. Following K. Maton (1993), the study moves beyond the individual-level of analysis to encompass variables in the treatment and post-treatment social ecology. Surveys administered to patients (N = 3,018) and treatment staff (N = 329) assessed these predictor domains and self-help group involvement 1 year after discharge. A hierarchical linear model fit to the data indicates that greater involvement in 12-step groups after discharge is predicted by the compatibility between personal and treatment belief systems. The implications of these findings for efforts to facilitate transitions between inpatient professional treatment and community-based self-help groups are discussed.     

Racial Diversity, Religion, and Morality: Examining the Moral Views of Multiracial Church Attendees

Previous research has identified an important link between participation in a racially diverse faith community and more progressive views on racial, political, and social issues, but researchers have yet to examine whether multiracial church attendees differ from racially-homogeneous church attendees in terms of their moral views. This research note utilizes national data (2005 Baylor Religion Survey) to examine the relationship between involvement in a multiracial congregation and views toward activities that are understood to be morally contentious. I estimate logistic regression models to isolate the relationship between multiracial church attendance and support for nine morally contentious activities related to sexuality, families, substance use, and suicide. Analyses reveal that, net of other factors, persons who attend multiracial congregations are more likely to express support for extramarital sex, premarital cohabitation, planned unwed pregnancy, marijuana use, and euthanasia, compared to persons who attend homogeneous congregations where they are the majority race. Multiracial church attendees thus appear to hold more permissive moral views on certain issues relative to attendees of racially homogeneous congregations. Significant interactions are also found between multiracial church attendance, race, and religious tradition. Alternative explanatory accounts (social contact vs. self-selection) are considered.     

Religious Congregations as Mediating Structures for Social Justice: a Multilevel Examination

Scholars in the field of community psychology have called for a closer examination of the mediating role that religious congregations serve in society, especially in relation to the promotion of social justice. The current study provides such an examination, offering a multilevel examination of religious individuals (n = 5,123) nested within religious congregations (n = 62) with a particular focus on how individual and congregational level variables (i.e. theological orientation, frequency of religious attendance, bonding and bridging social capital) predict individual prioritization of and participation in congregational social justice activities. Findings indicated that individual level theological orientation was associated with prioritization, and demographics and social capital bonding were associated with prioritization and participation. Furthermore, congregational bridging social capital was associated with the prioritization of justice, whereas congregational theological orientation moderated the associations between frequency of religious participation for both prioritization of and participation in congregational justice activities. These findings show that specific aspects of the congregational setting (i.e., congregational theological orientation) are important to the individual prioritization of and participation in social justice activities. These findings provide support for the role of religious congregations as mediating structures for social justice. Implications for future research are also discussed.     

A Psychotherapy of Schizophrenia: Direct Analysis by Albert E. Scheflen

This article studies the impact of outpatient group therapy on medical care at a large city–county hospital. Of the 65 group therapy outpatients, 33 persons met the criterion of having attended at least 12 group sessions over the course of a year. We compared a control period (the year prior to initiating group therapy) with a study period (months 6–18 after starting group) and found a sharp decrease in the number of hospitalizations and in-hospital days. There was significantly increased use of neuroleptics and nonpsychotropics and increased attendance at nonpsychiatric clinics.     

Assessing Community Participation: Comparing Self‐Reported Participation Data with Organizational Attendance Records

How well do self‐reported levels of community and organizational participation align with recorded acts of community and organizational participation? This study explores this question among participants in social action community organizing initiatives by comparing responses on a community participation scale designed to retrospectively assess community participation (T1, n = 482; T2, n = 220) with individual participants' attendance records in various social action organizing activities over two 1‐year periods. By testing the self‐reported measure's overall and item‐by‐item association with documented participation in various types of organizing activities, we find that the self‐report measure is positively, but weakly correlated with actual participation levels in community organizing activities. Moreover, associations between self‐report and recorded acts of participation differ by types of activity. Examining this unique source of data raises important questions about how community participation is conceptualized and measured in our field. Implications are explored for theory and measurement of participation in community and organizational contexts.     

Do social networks explain 12-step sponsorship effects? A prospective lagged mediation analysis

Sponsorship is a basic and important part of the 12-step approach to recovery from substance abuse (Alcoholics Anonymous, 2005) and research has shown that having a sponsor is associated with increased involvement in 12-step programs and improved outcomes (Bond, Kaskutas, & Weisner, 2003; Tonigan & Rice, 2010). However, little is known about how sponsorship improves outcomes. Given research demonstrating bivariate associations between sponsorship and social support for abstinence (Majer, Jason, Ferrari, Venable, & Olson, 2002), we hypothesized that the association between having a sponsor and increased abstinence outcomes would be explained by increases in one's abstinence-based social network. Prospective fully lagged mediational analyses did not support this hypothesis and these results ran counter to findings of five previous studies (cf. Groh, Jason, & Keys, 2008). A review of these studies showed that researchers often used cross-sectional or partially lagged methods to test mediation and the mediational effect of the social network was small in magnitude. Results suggest that the prospective association between sponsorship and abstinence is not explained by increases in the abstinence-based social network and demonstrate the need for future studies to use rigorous and time-lagged methods to test social support for abstinence as a mediator of the effects of 12-step involvement.     

Changes in Religious Coping and Relapse to Drug Use Among Opioid-Dependent Patients Following Inpatient Detoxification

Relapse rates remain high among people with opioid dependence. Identifying psychosocial factors associated with outcomes is important for informing behavioral treatments. This study examined religious coping, opioid use, and 12-step participation among 45 participants receiving inpatient opioid detoxification at baseline and follow-up. At baseline, higher positive coping was related to less frequent opioid use pre-admission (β?=?-.44, p?相似文献   

The Influence of Posttreatment Mutual Help Group Participation on the Friendship Networks of Substance Abuse Patients

The effect of 12-step mutual help groups (e.g., Narcotics Anonymous) on members' friendship networks has received little attention. This 1-year longitudinal study examined such effects in a sample of 2,337 male substance abuse inpatients, 57.7% of whom became significantly involved in 12-step activities (e.g., reading program literature, attending meetings) after treatment. An a priori model of the interplay of 12-step involvement and friendship networks was tested using structural equation modeling, and found to have excellent fit to the data. Twelve-step group involvement after treatment predicted better general friendship characteristics (e.g., number of close friends) and substance abuse-specific friendship characteristics (e.g., proportion of friends who abstain from drugs and alcohol) at follow-up. Results are discussed in terms of how mutual help group involvement benefits patients and how the self-help group evaluation paradigm should be broadened.     

Religious Attendance and Social Support: Integration or Selection?

Although numerous studies have shown that religious attendance is associated with greater social support, concerns remain about selection into religious attendance and more supportive relationships. In this paper, we employ data collected from the 2011 Miami-Dade Health Survey (n?=?444) to assess the extent to which the association between religious attendance and social support is due to selection processes related to personality, health behavior, and health status. In our multinomial logistic regression of attendance, we find that the odds of weekly attendance are increased by extraversion and reduced by smoking. We also observe that religious attendance does not vary according to level of agreeableness, self-esteem, alcohol consumption, psychological distress, or physical health. In our regression of support, we find that respondents who attend religious services weekly or more tend to report more social support than respondents who never attend. This association persisted with adjustments for age, gender, race, immigrant status, interview language, education, employment status, household income, financial strain, marital status (parent and respondent), the presence of children, family difficulties, personality (agreeableness, extroversion, and self-esteem), health behavior (smoking, binge drinking, and substance use), and health status (psychological distress, activity limitations, and overall physical health). Across models, the association between weekly attendance and social support is attenuated by no more than 7%. This attenuation is due to personality (extraversion), not health behavior or health status. We conclude that the association between religious attendance and social support is primarily driven by integration processes rather than any selection processes we have considered.

     

Are Religiosity and Spirituality Associated with Obesity Among African Americans in the Southeastern United States (the Jackson Heart Study)?

There are several lines of evidence that suggest religiosity and spirituality are protective factors for both physical and mental health, but the association with obesity is less clear. This study examined the associations between dimensions of religiosity and spirituality (religious attendance, daily spirituality, and private prayer), health behaviors and weight among African Americans in central Mississippi. Jackson Heart Study participants with complete data on religious attendance, private prayer, daily spirituality, caloric intake, physical activity, depression, and social support (n = 2,378) were included. Height, weight, and waist circumference were measured. We observed no significant association between religiosity, spirituality, and weight. The relationship between religiosity/spirituality and obesity was not moderated by demographic variables, psychosocial variables, or health behaviors. However, greater religiosity and spirituality were related to lower energy intake, less alcohol use, and less likelihood of lifetime smoking. Although religious participation and spirituality were not cross-sectionally related to weight among African Americans, religiosity and spirituality might promote certain health behaviors. The association between religion and spirituality and weight gain deserves further investigation in studies with a longitudinal study design.     

Religious Congregations and Social Justice Participation: A Multilevel Examination of Social Processes and Leadership

Religious congregations have potential to be mediating structures for social justice participation. However, research has yet to examine the specific social processes or leadership characteristics within congregations that may promote social justice participation. In this study, we use data from 176,901 participants nested within 1,938 congregations to test how social processes (i.e., religious attendance at worship services, extra-worship participation, bonding social capital, a congregational norm for justice) and leadership characteristics (i.e., leader modeling of justice, horizontal leadership style) predict personal social justice involvement through the congregation (i.e., participation in social justice activities sponsored by the congregation) as well as personal social justice involvement outside the congregation (i.e., participation in social justice activities not sponsored by the congregation). We use multilevel logistic regression to examine these social processes and leadership characteristics at both individual and congregational levels of analysis. Results showed distinct patterns of associations at individual and congregational levels of analysis and that different social processes and leadership characteristics predicted personal social justice participation through or outside the congregation. These findings reveal the importance of social processes and leadership characteristics in understanding how congregations may mediate social justice participation. Implications for community psychology research and practiced also are discussed.     

Integrating group psychotherapy and 12-step work: a collaborative approach

Group therapists can expect to treat an increasing number of patients who are active in a 12-step program or other addiction-related self-help groups. The value of simultaneous participation in these two modalities has been recognized; 12-step work supports abstinence necessary for the focus on emotional growth in psychotherapy. However, mere simultaneous participation in the two modalities fails to incorporate the benefits of a collaborative relationship where both modalities are used to support both abstinence and emotional growth. The conjoint approach to group and individual treatment is used to (a) argue for the possibility of a collaborative relationship between psychotherapy and a patient's 12-step work, (b) understand the benefits and challenges to collaboration, and (c) provide guidelines for how to work collaboratively with a 12-step program. Illustrations are provided of typical issues raised by this type of collaborative relationship.     

STACKING THE DECK: TEACHING SOCIAL SKILLS TO RETARDED ADULTS WITH A MODIFIED TABLE GAME

This study developed and evaluated a social skills training program for institutionalized mildly or moderately retarded and dually diagnosed individuals. Social skills were conceptualized as requiring an action or reaction within six skill areas: compliments, social interactions, politeness, criticism, social confrontation, and questions/answers. The program taught social skills using a commercially available table game, Sorry, and a specially designed card deck. Each card represented one of the skill areas and was designed to train either an actor or reactor response. The program featured response specific feedback, self-monitoring, individualized reinforcers, and individualized performance criterion levels. A multiple baseline across two groups (N = 3 per group) revealed that the game contingencies increased social skills in all targeted areas. After training, the subjects displayed their newly learned skills at or above their trained levels in two different settings with novel persons present. Although untargeted, the complexity of the subjects' responses increased across conditions, since there was a steady increase in the number of words they used per response. The program appears to be a viable means of training social skills since it uses standardized training procedures, requires only one facilitator, and is in itself a social situation that may encourage interactions with peers, cooperation, competition, and politeness.     

Processes of participation in a mother-infant program as modified by stress and impulse control

Six groups of mothers participating in a comprehensive neighborhood-based parent educational support program for low-income mothers of new infants were studied for 1 year. Participation in the program was assessed using structured observations of verbal participation in group discussions, records of attendance, and a self-disclosure measure of peer ties. The sample of 42 white women was dichotomized on attitudes toward impulse control. More expressive mothers produced more verbal behavior and showed consistent correlations between early verbal behavior and later attendance and peer tie development. More controlled mothers showed correlations between aspects of program participation and preprogram measures of need, impulse control, and family support. A second dichotomy contrasted 15 persons showing indications of acute stress with 26 persons showing less stress. The acute-stress subsample received more service from staff members, showed lower attendance, and were delayed in participating in group processes of interaction and development of peer ties. Implications of the findings for theoretical perspectives on adult behavior, the design of parent programs, and evaluation research paradigms are discussed.     

Social Contact,Loneliness, and Mass Media Use: A Test of Two Hypotheses1

The possible connections between social variables such as frequency of social activity and subjective loneliness on the one hand, and extent of mass media use on the other, have received relatively little empirical attention. In this investigation, two related hypotheses concerning such links are proposed. The compensation hypothesis holds that persons with little social contact or greater loneliness will be more likely to utilize mass media to compensate for social impoverishment. The buffering hypothesis more specifically predicts that such compensation is effective; that is, persons “at risk” for loneliness because of diminished social contact may be at least partially protected from subjective loneliness due to heavy use of mass media. The hypotheses were tested in two samples: college students and a group of adolescent males attending a summer camp. Little support was found for the compensation hypothesis. While limited support was found for the buffering hypothesis, analyses also revealed an unexpected opposite effect; for the music variable, heavy media use actually intensified the association between social deficits and subjective loneliness. Some limitations of this study are discussed, and issues related to the unexpected “intensification” effects are presented.     

"Do social networks explain 12-step sponsorship effects? A prospective lagged mediation analysis": Correction to Rynes and Tonigan (2011)

Reports an error in "Do social networks explain 12-step sponsorship effects? A prospective lagged mediation analysis" by Kristina N. Rynes and J. Scott Tonigan (Psychology of Addictive Behaviors, Advanced Online Publication, Sep 5, 2011, np). There is an error in the last paragraph of the Participants section. It was reported that 14.8% of the sample were Asian, however, 14.8% of the participants were American Indian or Alaskan Native and no participants were Asian. (The following abstract of the original article appeared in record 2011-20052-001.) Sponsorship is a basic and important part of the 12-step approach to recovery from substance abuse (Alcoholics Anonymous, 2005) and research has shown that having a sponsor is associated with increased involvement in 12-step programs and improved outcomes (Bond, Kaskutas, & Weisner, 2003; Tonigan & Rice, 2010). However, little is known about how sponsorship improves outcomes. Given research demonstrating bivariate associations between sponsorship and social support for abstinence (Majer, Jason, Ferrari, Venable, & Olson, 2002), we hypothesized that the association between having a sponsor and increased abstinence outcomes would be explained by increases in one's abstinence-based social network. Prospective fully lagged mediational analyses did not support this hypothesis and these results ran counter to findings of five previous studies (cf. Groh, Jason, & Keys, 2008). A review of these studies showed that researchers often used cross-sectional or partially lagged methods to test mediation and the mediational effect of the social network was small in magnitude. Results suggest that the prospective association between sponsorship and abstinence is not explained by increases in the abstinence-based social network and demonstrate the need for future studies to use rigorous and time-lagged methods to test social support for abstinence as a mediator of the effects of 12-step involvement. (PsycINFO Database Record (c) 2012 APA, all rights reserved).     

Cognitive Social Maturity, Life Change Events, and Health Risk Behaviors among Adolescents: Development of a Structural Equation Model

Purpose: To examine the roles of cognitive social maturity and life change events in a structural equation model (SEM) to explain adolescents' use of marijuana, tobacco, and alcohol. Methods: Data were derived from 1322 9th and 10th graders in a HIV prevention study. Students completed a survey of their cognitive social maturity, recent life events and substance use habits. A model from a study on the metabolic control of adolescents with diabetes was modified to apply to health risk behaviors. Results: A SEM was tested and fit the data well. Lower cognitive social maturity and greater life change events significantly predicted health risk behaviors. Life events partially mediated the relationship between cognitive social maturity and health risk behaviors. Conclusions: Adolescents' social thought processes are related to their recent life events, which in turn are related to their substance use behaviors. Suggestions are made for interventions to improve adolescents' cognitive social maturity.