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.     

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?     

High fatigue and its associations with health and work related factors among female medical personnel at 54 hospitals in Zhuhai,China

The present study aimed to investigate the prevalence of fatigue and determine factors associated with fatigue in female medical personnel. Based on a cross-sectional study, a total of 1608 female medical personnel at 54 hospitals in Zhuhai, China were recruited by a multistage stratified cluster sampling method. The Symptoms Checklist-90-Revised and Chalder Fatigue Scale were used to assess psychiatric symptoms and fatigue, respectively. Data regarding demographic, health, and work related variables were also collected. Multivariate logistic regression model was constructed to determine the influencing factors of fatigue. Approximately 83% of participants had experienced fatigue in the past week. The risk of fatigue was higher in aged 30–39 years old than older or younger participants; Longer sleeping time predicted a lower prevalence of fatigue (OR = .35), while tense physician-patient relationship predicted a higher prevalence of fatigue (OR = 1.77). Depression (OR = 1.76) and anxiety (OR = 1.96) were found related to fatigue. Additionally, fatigue was associated with marital status, occupation, health related factors (exercise, regular diet, and health status), and work related factors (hospital rank and turnover intention). These study findings might facilitate development and implementation of targeted interventions and preventive measures.     

Psychological assessment of quality of life following liver transplantation

Administered measures of functional status, psychological distress, and quality of life to a consecutive series of 48 liver transplant recipients in follow-up clinic. Results showed that nearly total functional recovery was the norm. Thirty-six patients (75%) had a Karnofsky Performance Status (KPS) score of 80–100. Twelve transplant recipients had KPS scores below 80; none were employed, and most had been transplanted within 1 year. In spite of their impaired financial status, eight of these 12 reported being mostly satisfied on the self-report Quality-of-Life Scale (QLS). For the posttransplant sample as a whole, 83% were mostly satisfied with their quality of life. Pre- and posttransplant patient samples were not significantly different in reporting mild emotional distress. Results for the small subgroup with significant objective or subjective problems in achieving acceptable quality of life following liver transplantation were reviewed. Higher than normal emotional distress on the Symptom Checklist (SCL-90-R) was consistently reported by these patients. Prospective studies are needed to identify predictor variables of quality-of-life problems and to develop prevention and rehabilitation interventions.     

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).     

Social problem-solving in dual diagnosis patients

Social problem-solving skills among dual-diagnosis patients were compared to two control groups: psychiatric patients without substance abuse problems and community volunteers. A standardized, behavioral role-play test consisting of four scenarios representing interpersonal problems yielded two reliable dependent variables: (a) specificity, or elaboration, of the problem-solving response and (b) overall effectiveness of the response. Analyses of covariance (using a measure of intellectual function as the covariate) indicated that both dual-diagnosis patients and psychiatric controls were significantly poorer problem-solvers than were community controls. The overall pattern of the results indicated that deficits observed in a dual-diagnosis sample are not necessarily compounded due to the presence of the coexisting disorders. Implications of these findings, strengths and limitations of this study, and suggestions for future research are discussed.This research was supported in part by Grant DA04593-01 from the National Institute on Drug Abuse.Portions of this article were presented at the 22nd Annual Meeting of the Association for the Advancement of Behavior Therapy during November 1988 in New York.     

The Relationship Between Parental Alcoholism and Adolescent Psychopathology: A Systematic Examination of Parental Comorbid Psychopathology

The relationship between parental alcohol dependence (with and without comorbid psychopathology) and adolescent psychopathology was examined in a sample of 665 13-17 year-old adolescents and their parents. Results indicated that adolescents who had parents diagnosed with alcohol dependence only did not significantly differ from adolescents who had parents with no psychopathology in regard to any of the measures of psychological symptomatology (substance use, conduct disorder, and depression) or clinical diagnoses (alcohol dependence, marijuana dependence, conduct disorder, or depression) assessed. In contrast, adolescents who had parents diagnosed with alcohol dependence and either comorbid drug dependence or depression were more likely to exhibit higher levels of psychological symptomatology. In addition, adolescents who had parents diagnosed with alcohol dependence, depression, and drug dependence were most likely to exhibit psychological problems. These findings underscore the importance of considering parental comorbid psychopathology when examining the relationship between parental alcoholism and offspring adjustment.     

Individual differences in the response to forgone payoffs: an examination of high functioning drug abusers

This study evaluates the effect of forgone payoffs in decision‐making tasks used for studying individual differences. We investigate whether the disclosure of forgone payoffs (defined as payoffs associated with un‐chosen alternatives) has selective effects for drug abusers. Evidence suggests that drug abusers are hypersensitive to signals of positive reward. Accordingly, because the forgone payoffs of risky high‐variability options include rewarding outcomes, this may create a distraction and lead drug abusers to make more risky choices. In a controlled experiment, we examined the behavior of high‐functioning drug abusers and healthy controls using the Iowa gambling task. The results showed that in a forgone payoff condition, drug abusers made more risky choices. The results demonstrate that adding information about forgone payoffs can be useful for studying individual differences, and that studying individual differences can be valuable in evaluating the effects of forgone payoffs. Copyright © 2005 John Wiley & Sons, Ltd.     

Psychological Distress and Symptoms of Posttraumatic Stress Disorder in Jewish Adolescents Following a Brief Exposure to Concentration Camps

We investigated the psychological impact of an organized visit to Polish concentration camps on Jewish-American adolescents. Eighty-seven adolescents who participated in a B'nai B'rith memorial visit to concentration camps in Poland completed measures of general psychological adjustment and posttraumatic stress disorder (PTSD) at four time-points: pretest, posttest, 6-month follow-up and 12-month follow-up. Measures included the SCL-90-R, the Mississippi Scale for PTSD, and the Impact of Events Scale (IES) for PTSD. On the SCL-90-R, changes in somatization, interpersonal sensitivity, obsessive-compulsive tendencies, depression, anxiety, and phobic anxiety were observed over time, with peak symptom scores at posttest and 6-month follow-up. Scores on the Mississippi Scale for PTSD and the IES Intrusion subscale also increased at 6-months. Predictors of PTSD symptoms on the Mississippi Scale included previous psychiatric treatment and SCL-90-R symptoms of paranoia, depression, and psychosis. Elevated psychotic symptoms on the SCL-90-R predicted PTSD symptoms on the IES. Jewish adolescents with preexisting symptoms of generalized distress or psychoticism appeared at increased risk for PTSD symptoms following exposure to Holocaust stimuli. This study contributes a prospective, multi-measure assessment of trauma reactions in adolescents.     

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.     

The association between retrospective outcome evaluations and pre-post-treatment changes in psychodynamic group-psychotherapy

In the present study of 203 patients in psychodynamic group psychotherapy, we explore associations between patient and therapist global retrospective outcome evaluations (ROE), and pre-post-treatment changes on the Symptom Check List 90 Revised (SCL-90-R) and non-symptomatic focus of therapy. There were no significant associations between ROE, diagnoses and demographic variables, and pre-treatment SCL-90-R associations were negligible (less than 4% of overlapping variance). SCL-90-R subscale improvement expressed as residual gain score explained the overall largest percent of variance in both patients and therapists (44% and 25%, respectively) when compared with raw difference scores (32% and 18%), and percent reduction from baseline (34% and 23%). Moreover, ROE/end-state adjustment associations were substantial (42% and 24%). Therapists' evaluation of change showed the strongest association with improvement in non-symptomatic focus of therapy, while patients' evaluation had the strongest association with improvement in SCL-Depression. It is concluded that retrospective evaluations reflect changes related to treatment. However, unexplained variance may be independent of symptomatic state, and associated with personality factors or domains not captured by standard questionnaires.     

五省部分地区农民工子女心理健康调查

目的：了解农民工子女的心理现状,以提高其心理健康水平。方法：本研究的被试采用《症状自评量表-SCL90》进行测试。结果：（1）农民工子女心理问题的发生率为18．73％,排在前四位的影响因子是：人际敏感、抑郁、焦虑和偏执。（2）农民工子女的人际敏感、抑郁、焦虑、偏执、强迫和精神病性6因子均分显著高于常模;女生的人际敏感、偏执、敌对、强迫和精神病性5因子均分显著高于男生;非独生子女的强迫、人际敏感、忧郁和精神病性4因子均分显著高于独生子女。（3）“留守子女”的抑郁、焦虑、偏执、强迫和精神病性5因子均分显著高于随父母进城的农民工子女。结论：农民工子女的心理健康总体水平不高,社会应给予高度关注。     

我国研究生心理健康研究述评

研究生心理健康目前已逐渐引起人们的关注。本文以近年来我国有关研究生心理健康的研究为依据。对我国研究生心理健康的研究进行了总结与分析，提出了目前研究生心理健康研究的特点与问题，并提出未来研究发展的建议，以期加快我国研究生心理健康的研究步伐。     

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.     

The Effectiveness of Substance Abuse Treatment in Reducing Violent Behavior

The use of alcohol and other drugs has long been associated with violence. Yet relatively little is known about the effect of treatment on specific violent behaviors. This study examines violent behaviors in the National TreatmentImprovement Evaluation Study (NTIES), and assesses the extent to which treatment appears to reduce violence for each measured behavior. It also examines these reductions by gender, treatment modality, and whether the client wasa victim of violence in addition to being a perpetrator. The results indicate large reductions in violence among clients actively violent during the pretreatment period, with virtually no increase in violence among clients not actively violent during that same period, irrespective of gender, modality, or victimization status. On their face, the results strongly suggest that substance abuse treatment is effective in reducing violent behavior. Alternative explanations areproposed and assessed, followed by implications for policy, practice, and future research.     

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.     

民办高校大一新生心理健康状况调查

采用症状自评量表对民办高校8111名大一新生进行问卷调查。结果表明,民办高校的大一新生在强迫、恐怖、精神病性三个因子上的得分显著高于全国常模,在躯体化、人际关系、敌对、抑郁、偏执五个因子上的得分显著低于全国常模;女生在各个因子上的得分均显著高于男生;本科生的心理健康水平低于总体学生的平均水平。     

特区大学生心理健康状况的调查分析

通过对特区886名高职院校大学生心理健康状况的检测,探讨了当前高职院校大学生心理健康的基本状况及存在的问题,并提出了相应的教育对策.     

我国医生的心理状况meta分析

回顾目前近5年我国医生的心理状况实证性研究,以了解医生的心理健康,通过CNKI、维普、万方数据库进行文献检索,得到30篇文献,9篇符合纳入条件,采用Meta统计方法分析数据。结果显示,近5年我国医生的心理健康水平普遍低于全国常模,SCL-90症状自测量表中有8项高于普通成年人,其中以焦虑和偏执郁最为严重,其次为抑郁,强...     

On beyond urine: clinically useful assessment instruments in the treatment of drug dependence

Although there are a wealth of clinically useful, brief, and low-cost assessment instruments available for use with drug-dependent populations, relatively few are broadly used in clinical practice. With an emphasis on: (1). the multidimensional nature of drug users' problems; and (2). assessments that can be integrated into empirically validated treatments, clinically useful assessments in four general categories (evaluation and diagnosis of drug dependence, identifying concurrent disorders and problems, treatment planning, and evaluation of treatment outcome) are briefly summarized. Progress in the field of drug abuse treatment has been significantly hampered by the failure to adopt, across research and clinical settings, a common set of assessments.