Factor validation of the addiction severity index scale structure in persons with concurrent disorders

Confirmatory factor analysis was used to test the scale structure of the Addiction Severity Index (ASI) in a sample of 1,802 substance abusers (43% alcohol dependent) with a concurrent psychiatric disorder (46% with mood disorders). The fit of the original composite score model based on the work of P. L. McGahan, J. A. Griffith, R. Parente, and A. T. McLellan (1990) was compared with the evaluation indices (EIs) developed by A. I. Alterman et al. (1998). The 5-dimensional model based on the EIs was an overall better fit to the data. Internal consistency (Cronbach's alpha) for the EIs ranged from.66 (family domain) to.75 (legal domain). The 5 EIs were moderately correlated (rs =.42-.72) with the interviewer severity ratings from the ASI. Evaluation studies involving concurrent disordered substance abusers should use the EIs as summary measures of change.     

Adapted character styles of Vietnam veterans with Posttraumatic Stress Disorder

A total of 189 male Vietnam veterans who were admitted to a specialized inpatient treatment program were evaluated using the Millon Clinical Multiphasic Personality Inventory to assess character styles. The veterans were assessed for Posttraumatic Stress Disorder by using a subscale of the Minnesota Multiphasic Personality Inventory (MMPI) and 72% of the patients were classified as having Posttraumatic Stress Disorder. The character styles of passive-aggressive, schizoid, avoidant, and borderline were significantly associated with these patients. The most common 2-point profile was passive-aggressive and avoidant (8-2 or 2-8) and was significantly related to the diagnosis. While drug and alcohol abuse were common problem areas for the entire sample, the profile of patients with Posttraumatic Stress was different from those of substance abusers. These results indicate that treating Vietnam veterans with this disorder requires adopting strategies which include a character style focus as well as a symptom focus.     

Effect of incentives on retention in an outpatient treatment for cocaine addicts

The high drop-out rate in treatment programs is one of the most important problems in the area of drug addictions. This study evaluated the effect of the use of incentives on retention in an outpatient program for cocaine addicts. The effect of individual variables on program drop-out was also analysed. Participants were 66 subjects who were randomly assigned to one of three treatment groups: standard treatment, treatment with incentives I, and treatment with incentives II. The patients of these two groups received incentives contingent on cocaine abstinence with two different magnitudes. Retention rate at six months was 35% in the standard treatment, 78.6% in the treatment with incentives I, and 53.3% in the treatment with incentives II. The global prognostic capacity of the individual variables (sociodemographic, history and consumption pattern, psychopathological variables, and EuropASI scores) was 85.7%, with the psychopathological variables being more closely related to retention. These results suggest that the use of incentives may be an effective strategy to improve retention in outpatient treatments for cocaine addiction.     

Effects of unavoidable electric shocks on voluntary alcohol consumption in the rat

The purpose of this experiment was to study the effects of electric shocks on voluntary alcohol intake in rats. Alcohol intake was measured using individually determined alcohol concentrations. Contrary to many previous studies, alcohol intake was reduced during the stressful treatment. It is concluded that accounting for individual differences in alcohol intake is important when studying the effect of stress on alcohol consumption.     

Weekend alcoholism in youth and neurocognitive aging

Numerous studies have shown that alcohol intake causes neuropsychological disorders that affect various brain structures. The ?premature ageing? hypothesis proposes that the brain areas of alcoholics undergo deterioration similar to that observed in old age. We investigated whether alcohol abuse by young people (binge drinking) causes alterations comparable to some found in elderly people. Ninety-one people were divided into four groups: a) young people who abused alcohol; b) young people who drank alcohol in moderation; c) young people who did not drink alcohol; and d) elderly adults without any significant cognitive deterioration. All of them were assessed with a neuropsychological battery. We observed some similarities in the results obtained by young drinkers and the elderly participants, which would provide some support for the hypothesis of premature aging. The tasks that young drinkers performed worse were those related to executive functions, in which the prefrontal cortex plays an essential role. We also found differences between the two groups of young drinkers (moderate and high consumption), which leads us to believe that the amount of alcohol consumed and the pattern of consumption are factors to consider in relation to cognitive impairment.     

Factor structure and psychometric properties of the Anxiety Sensitivity Index in a sample of Croatian adults

Anxiety sensitivity (AS) refers to a person's tendency to fear anxiety-related symptoms due to the belief that these symptoms may have harmful consequences. The most widely used operationalization of AS in adults is the Anxiety Sensitivity Index (ASI). The factor structure, gender stability, and psychometric properties of the ASI in a sample of Croatian adults (N = 984) were evaluated. Results confirm the multidimensional and hierarchical structure of the ASI, which consisted of three lower-order factors (Physical Concerns, Psychological Concerns, and Social Concerns) and a single higher-order factor, AS. Furthermore, the achievement of normative scores for the ASI in a Croatian adult sample demonstrates the cross-national stability of the ASI. Reliability coefficients for the ASI, Physical Concerns, and Psychological Concerns are high and satisfactory in the total sample and for both genders. Overall, the results confirmed the cross-national stability, gender stability, reliability, and validity of the ASI in a sample of Croatian adults.     

Transient versus enduring depression among alcoholics in inpatient treatment

The purposes of this study are (1) to determine the incidence of significant clinical depression among alcoholics at treatment intake at a Veterans Medical Center, (2) to subdivide alcoholics who show significant clinical depression into enduring and transient depressive subgroups, and (3) to identify demographic and psychometric variables useful in discriminating between these two subgroups. Results indicate that of the 60% of VA inpatient alcoholics who showed evidence of significant clinical depression at intake, approximately equal numbers met criteria for inclusion in transient and enduring depressive subgroups. Patients with enduring and transient depression, as defined in this study, were differentiated on the basis of age, drinking pattern, and selected scales from two psychometric instruments which measure depression, confused and disorganized thinking, and an avoidant personality style. These findings may be useful in assisting clinicians in differentiating between alcoholic patients with transitory depression associated with alcohol consumption and/or withdrawal and alcoholic patients with more serious and enduring depression, which may require additional pharmacologic and/or psychotherapeutic intervention.     

American Indian methamphetamine and other drug use in the Southwestern United States

To investigate the extent of methamphetamine and other drug use among American Indians (AIs) in the Four Corners region, we developed collaborations with Southwestern tribal entities and treatment programs in and around New Mexico. We held nine focus groups, mostly with Southwestern AI participants (N = 81) from three diverse New Mexico communities to understand community members, treatment providers, and clients/relatives views on methamphetamine. We conducted a telephone survey of staff (N = 100) from agencies across New Mexico to assess perceptions of methamphetamine use among people working with AI populations. We collected and analyzed self-reported drug use data from 300 AI clients/relatives who completed the Addiction Severity Index (ASI) in the context of treatment at three diverse addiction treatment programs. Each focus group offered a unique perspective about the effect of drugs and alcohol on each respective community. Though data from the phone surveys and ASIs suggested concerning rates of methamphetamine use, with women more adversely affected by substance use in general, alcohol was identified as the biggest substance use problem for AI populations in the Southwest. There appears to be agreement that methamphetamine use is a significant problem in these communities, but that alcohol is much more prevalent and problematic. There was less agreement about what should be done to prevent and treat methamphetamine use. Future research should attend to regional and tribal differences due to variability in drug use patterns, and should focus on identifying and improving dissemination of effective substance use interventions.     

Long-term outcomes of Acceptance and Commitment Therapy in drug-dependent female inmates: A randomized controlled trial

The general aim of this randomized controlled trial was to test the long-term efficacy of acceptance and commitment therapy (ACT) compared to a cognitive behavioural therapy (CBT) condition in the treatment of drug abuse. Participants were 37 polydrug incarcerated females assessed with Mini International Neuropsychiatric Interview, Addiction Severity Index-6, Anxiety Sensitivity Index (ASI) and Acceptance and Action Questionnaire II at pre, post, and at 6-, 12- and 18-months follow-ups. The mixed lineal model analyses showed reductions in drug abuse, ASI levels and avoidance repertoire in both conditions, without any differences between groups. However, the percentages of mental disorders were reduced only in ACT participants. At the 18-month follow-up, ACT was better than CBT in the maintaining of abstinence rates. This data support the incubation pattern showed in previous ACT studies. To conclude, the ACT intervention seems to be an adequate treatment option for addictive behaviours and co-occurring disorders in incarcerated women.     

INCREASING CALORIE CONSUMPTION IN CHILDREN WITH CYSTIC FIBROSIS: REPLICATION WITH 2-YEAR FOLLOW-UP

Three mildly malnourished children with cystic fibrosis and their parents participated in a behavioral group-treatment program that focused on promoting and maintaining increased calorie consumption. Treatment included nutritional education, gradually increasing calorie goals, contingency management, and relaxation training, and was evaluated in a multiple baseline design across four meals. Children's calorie intake increased across meals, and total calorie intake was 32% to 60% above baseline at posttreatment. Increased calorie consumption was maintained at the 96-week follow-up (2 years posttreatment). The children's growth rates in weight and height were greater during the 2 years following treatment than the year prior to treatment. Increases in pace of eating and calories consumed per minute were also observed 1 year posttreatment. These findings replicated and extended earlier research supporting the efficacy of behavioral intervention in the treatment of malnutrition in children with cystic fibrosis.     

Subtypes of drug-addicts in treatment: empirical support for a distinction between Type A and Type B

This study examines the possibility of replicating and generalizing a multidimensional typology of drug-addicts by means of the evaluation of 320 participants who were receiving outpatient treatment for their problem of addiction. A two-stage cluster analysis was performed, revealing the existence of two typologies of consumers, called type A and Type B. The participants classified as Type B showed various indicators of chronicity (higher mean age, higher unemployment rate), more severity of their problem of drug consumption and of medical aspects, employment support, legal, family/social and psychiatric problems in comparison with Type A. Participants from the latter group reported active employment as their main source of income and they had consumed drugs for fewer years. However, they presented more severity associated with alcohol consumption. In view of these data, Type A is called functional drug-addict and Type B chronic drug-addict. Once the groups of drug-addicts were delimited, a more specific characterization was made, taking seven problem areas into account: medical, employment support, alcohol, drugs, legal, family/social, and psychiatric areas. As a general conclusion, more psychosocial severity was observed in Type B as compared with Type A. Lastly, the implications and usefulness of grouping drug-addicts into typologies is discussed.     

Anxiety sensitivity index: normative data and its differentiation from trait anxiety

In the present study we report: (1) normative data on the Spanish version of the Anxiety Sensitivity Index (ASI); and (2) empirical evidence related to differentiation between the constructs of anxiety sensitivity and trait anxiety. A sample of 390 university students (ranging in age from 18 to 34 years) completed the ASI and Spielberger's Trait Anxiety Scale (STAI-T). The means and standard deviations for the Spanish version of the ASI are similar to the ones reported by Peterson and Reiss (Anxiety Sensitivity Index Manual, 2nd edition. Worthington, OH: International Diagnostic Systems, 1992) for the English version. Factor analysis of the joint ASI and STAI-T items yielded two different factors; the STAI-T items load onto one factor (i.e., the trait anxiety factor) and the ASI items load onto the other factor (i.e., the anxiety sensitivity factor). Findings provide empirical support for validation of the Spanish ASI and are consistent with a construct distinction between anxiety sensitivity and trait anxiety.     

Changes in alcohol intake in response to transdiagnostic cognitive behaviour therapy for eating disorders

Objective

The aim of this study was to examine how alcohol intake changes during and after transdiagnostic cognitive behaviour therapy for eating disorders (CBT-E). Additionally, the paper considers the relationship between alcohol consumption, eating disorder diagnosis and current major depressive episode at the time of first assessment.

Method

One hundred and forty nine outpatients with an eating disorder (body mass index over 17.5) were divided into high or low alcohol intake groups (HIG and LIG) according to their intake at pre-treatment assessment. Their alcohol intake and eating disorder psychopathology were examined over the course of treatment and follow-up.

Results

There was no difference between the groups on response of the eating disorder to treatment. The HIG significantly reduced their alcohol intake following treatment whilst the intake of the LIG remained stable over the course of treatment and follow-up. There were no group differences in major depression and overall severity of eating disorder at baseline.

Conclusions

The response to CBT-E was not influenced by baseline level of alcohol use. The mean alcohol intake of the heavy drinking subjects decreased without being specifically addressed by the treatment.     

Quality of life in patients with alcohol dependence disorder with personality disorders: relation to psychological adjustment and craving

The purpose of this study is to determine the self-perceived quality of life of abstinent patients with alcohol dependence disorder during the first month of treatment, and how the presence of personality disorders, psychological adjustment, and the level of craving affect this perception. For this purpose, a sample was used comprising 65 participants with mean age of 43.26 years, of whom 70.8% were male and 29.2% female, with a mean duration of addiction to alcohol consumption of 11.83 years. The results show that quality of life is not related to the duration of abstinence or the course of the addiction. Moreover, the patients who present a personality disorder perceive poorer quality of life in areas such as health status, mood, and social relations. Self-perception of quality of life is affected by psychological adjustment and beliefs about craving. These data should be taken into account when considering quality of life as a measurement of the effectiveness of a treatment for drug addicts with personality disorders.     

Differential effects of a 5-HT2 receptor blocker on alcohol intake in rats selectively bred for high and low catecholamine responses to stress

The effect of the selective 5-HT2 receptor blocker ritanserin on alcohol consumption was investigated in two strains of rats selectively bred for high and low catecholamine responses to stress. Rats were forced to drink a 5% alcohol solution for 10 days. For the subsequent six days, animals were injected subcutaneously with 2.5 mg/kg/2 ml ritanserin or vehicle only, and both a 5% solution of alcohol and water were presented to the animals. Ritanserin affected neither water nor total fluid intake. Furthermore, no effect of ritanserin on alcohol consumption could be demonstrated in high-responding rats, whereas in low-responding rats a very pronounced ritanserin-induced reduction in alcohol intake was observed. Results are discussed in terms of mediating effects of serotonergic neurons on mesolimbic dopaminergic reward systems related to drug addiction.     

A behavioral approach to substance abuse prevention in the correctional setting: A preliminary report

This study evaluated the effectiveness of a substance abuse program in a correctional institution using social skills training for secondary prevention. Forty-four male inmates with a history of substance use participated in the pilot program. Program topics included drug, alcohol, and substance abuse treatment knowledge and development of anger and stress management skills. A pretest-posttest analysis revealed significant improvement in overall knowledge of program topics and within specific areas. Areas of greatest improvement were drugs and alcohol. Clients and group leaders reported that the program was effective in facilitating attitude and behavior change regarding substance abuse. Results suggest a social competence approach to substance abuse rehabilitation in correctional institutions holds promise for both increasing knowledge and teaching effective skills to resist future substance abuse.     

青少年学生焦虑敏感与睡眠质量的关系及其内在机制

采用中学生、大学生焦虑敏感问卷和匹兹堡睡眠质量指数量表(PSQI),分别对1011名中学生和607名大学生进行调查。结果显示高焦虑敏感学生的PSQI总分显著高于低焦虑敏感学生,焦虑敏感及其三个因子与PSQI的相关都是中效应,焦虑敏感对青少年学生睡眠质量指数具有显著的正向预测作用,焦虑敏感水平越高,其睡眠质量越差。焦虑敏感可能以应激事件和健康问题作为致敏源,以焦虑等负性情绪作为敏感内容,在消极自动认知觉察与思维的介入下,进一步放大对有关负性情绪的感受与体验,从而影响青少年学生的睡眠质量。     

The relationship of depression to health risk behaviors and health perceptions in Korean college students

The purpose of this study was to investigate the relationship of depression to health risk behaviors and health perceptions in Korean college students. The sample consisted of 434 students, ranging in age from 18 to 28 years, who were attending four universities in Korea. Data were collected using the Beck Depression Inventory, the Symptom Pattern Scale, and the Short Form Health Survey. Results indicate that the students were mildly depressed. The prevalence of alcohol consumption during the previous month was 84.6% and for smoking it was 33.6%. The majority of the students reported a low occurrence of symptoms of psychological distress and evaluated their health as either very good or good. The level of depression predicted alcohol consumption, symptom pattern, and physical health. Students who were more depressed reported more symptoms and perceived their health as worse compared with those who were less depressed. The students who were less depressed drank more alcohol. Depression did not predict smoking.     

Risk Factors for Attempting Suicide in Heroin Addicts

In order to examine risk factors for attempting suicide in heroin dependent patients, a group of 527 abstinent opiate dependent patients had a psychiatric interview and completed the Childhood Trauma Questionnaire. Patients who had or had never attempted suicide were compared on putative suicide risk factors. It was found that 207 of the 527 heroin abusers (39.3%) had attempted suicide. Attempters were younger; more were female, reported childhood trauma, a family history of suicidal behavior, a history of aggression, treatment with antidepressant medication, and alcohol and cocaine dependence. Logistic regression revealed that a family history of suicidal behavior, alcohol dependence, cocaine dependence, and treatment with antidepressant medication were significant predictors of attempting suicide. These results suggest that attempting suicide is common among opiate dependent patients and that both distal and proximal risk factors may play a role.     

Adaptation of panic-related psychopathology measures to Russian

The study reports results of adaptation of panic-related psychopathology measures to Russian, including the Anxiety Sensitivity Index (ASI), the Agoraphobic Cognitions Questionnaire (ACQ), and the Mobility Inventory for Agoraphobia (MIA). Psychometric properties (e.g., reliability, factor structure, endorsement) and external validity of the adaptations were evaluated in a representative sample of Moscow residents (N = 390) and Ukrainian undergraduates (N = 492). The adapted ASI was generally equivalent to the original English-language version. The ACQ showed structural equivalency but did not exhibit expected specificity to panic. Finally, the MIA displayed notable structural discrepancies but had external validity comparable to the original.