Cognitive Behaviour Therapy for Schizophrenia in Patients with Mild to Moderate Substance Misuse Problems

Rates of substance misuse are high among patients with schizophrenia. Cognitive therapies have been developed separately for both problems but little is known about outcome for this group of dual diagnosed patients. Data from a major trial of cognitive behaviour therapy for psychosis was therefore sub‐analysed to determine whether this therapy is effective in those with schizophrenia and mild to moderate substance misuse. During the original study patients received a brief cognitive behaviour therapy‐based intervention for schizophrenia delivered by trained and supervised nurses. The control group received care as usual. The outcome measures included: total psychopathology using the Comprehensive Psychopathological Rating Scale (CPRS) and Health of the Nation Outcome Scale (HoNOS), change in schizophrenic positive symptoms using Schizophrenia Change Scale (SCR), anxiety using the Brief Scale for Anxiety (BAS), depression using the Montgomery‐Asberg Depression Rating Scale (MADRS) and insight using the Assessment of Insight Scale, at baseline and end of therapy. In the original study, patients who received cognitive behaviour therapy showed improvement in overall symptomatology (p = 0.01), insight (p = 0.00) and depression (p = 0.00) compared with the control group. In the present sub‐analysis, no interaction was found between treatment group and presence or absence of substance misuse. There was a reduction in substance misuse after treatment in both the cognitive behaviour therapy and control groups but this did not differ between them. It appears that mild to moderate degrees of substance misuse did not change the outcome of cognitive behaviour therapy for psychosis in this sub‐analysis.     

Reasons for Entering Treatment Reported by Initially Treatment-Resistant Patients with Substance Use Disorders

Many individuals with substance use disorders are resistant to entering formal treatment, despite the negative consequences that plague their own lives and the lives of concerned significant others (CSOs). Community Reinforcement and Family Training (CRAFT) has been developed as an effective strategy for helping family members who are concerned about the alcohol/drug use of a loved one who refuses to seek treatment. The present study explored reasons and feelings that played a part in these resistant individuals' (identified patients [IPs]) decision to begin treatment. Written statements and feelings of 36 initially treatment-refusing IPs, who were engaged into treatment via their CRAFT-trained CSOs, were examined upon entering treatment. Self-report forms assessed three complementary domains about entering treatment: (1) feelings about coming for treatment, (2) important reasons for entering treatment, and (3) reasons for entering treatment narratives. It was shown that the occurrences of self-reported positive emotions and statements that expressed a positive wish for change outweighed negative feelings and statements. Although conceivably these CRAFT-exposed IPs may have provided different responses than other treatment-seeking populations, the current study's strong IP reports of positive feelings, reasons, and narrative statements regarding treatment entry nonetheless address potential concerns that treatment-refusing IPs might only enter treatment if felt coerced by family members and while experiencing salient negative feelings overall.     

Anxiety and Drinking: Are Personal Beliefs Regarding Control and Unpredictability Relevant?

Abstract

Anxiety and drinking problems are fairly common, and it is important to know what factors affect these issues. Previous studies document that control beliefs are associated with anxiety and drinking. Unpredictability beliefs correlate with anxiety, yet whether they relate to drinking is unknown. The present study explored these relationships in a sample of adults (N?=?150; 40.0% female; M?=?34.4?years old) and in a sample of college students (N?=?182; 74.7% female; M?=?18.9 years old). Among adults, unpredictability beliefs correlated with anxiety and control beliefs, but not drinking. Similarly, control beliefs correlated with anxiety but not drinking. Furthermore, anxiety and drinking were uncorrelated. Among undergraduates, unpredictability and control beliefs predicted anxiety, whereas unpredictability (pertaining to the self and others) and internality predicted frequency of drinking. Personal unpredictability beliefs emerged as having the strongest association with anxiety across both samples. Future research and treatment should take into account unpredictability beliefs when addressing anxiety problems.     

Aggression in Toddlers: Associations With Parenting and Marital Relations

This study examined the relation among parenting factors, marital relations, and toddler aggression. A structured questionnaire was administered to both parents of 254 2-year-olds. The authors used correlation and hierarchical multiple regression analyses to assess the extent to which certain personality traits, drug use, parenting style, and marital conflicts were related to the toddlers' aggressive behavior. Results showed that the maternal child-rearing and parental aggression domains had a direct effect on toddler aggression. The domain of maternal child rearing also served as a mediator for the domains of marital relations, paternal child rearing, parental aggression, and parental drug use. The findings indicated that maternal child-rearing practices, personality attributes, and drug use were more important than paternal attributes in relation to toddler aggression. Implications for prevention among families at risk are discussed.     

Fear Versus Humor: The Impact of Sensation Seeking on Physiological,Cognitive, and Emotional Responses to Antialcohol Abuse Messages

This study investigates the differences in physiological, cognitive, and emotional responses to existing emotional antialcohol abuse advertisements (fear vs. humor appeal) between high and low sensation seekers. A 2 (Message Type) × 2 (Sensation-Seeking Tendency) × 4 (Message Repetition) mixed-model experiment with repeated measures was conducted with 71 college students. The results, based on self-reports, indicated that fear messages generated more interest and perceived danger of excessive drinking regardless of sensation-seeking tendency, whereas humorous messages were rated as more likeable than fear messages, and the difference was bigger among low sensation seekers than among high sensation seekers. One interesting finding was that for both fear and humor appeals, low sensation seekers showed greater emotional responses (greater corrugators activities and greater zygomatic activities) than high sensation seekers overall. The implications of the current study as well as suggestions for future study were discussed.     

Time use of Hellene 3rd and 4th graders during a school day

Using data from the time diaries of 164 Hellene 3rd and 4th graders interviewed in their homes in March 2007, individual differences in time-use patterns were investigated. The participants rested for 9 hours 10 minutes, and spent 57.0%, 21.7%, and 5.0% of their waking time on school-related activities (attending school, learning languages, doing homework), leisure activities (such as playing and watching TV), and other activities, respectively. Pupils from rural areas rested longer; more boys engaged in play and sports; more girls and more pupils from higher SES families engaged in dance. Overall, the time spent on school-related activities is higher than the times spent on other activities. Regarding leisure, girls spent the most time watching TV, while boys spent the most time watching TV and playing. In line with previous literature, the time schedule of Hellene pupils is directed towards knowledge acquisition, rather than cognitive or socio-emotional development.     

Juror Perceptions in a Rape Trial: Examining the Complainant's Ingestion of Chemical Substances Prior to Sexual Assault

This study examined the impact of a rape complainant's willingness to ingest a chemical substance and the type of ingested substance on the decisions of 229 mock jurors. Jurors were influenced by the type of substance used by the complainant, the complainant's willingness to use a substance, and rape myths. The complainant's ingestion of alcohol (compared to gamma-hydroxybutrate [GHB] and marijuana) led to the highest guilt ratings for the defendant. The complainant who willingly ingested a substance was viewed as less credible and more to blame for the rape compared to one who unwillingly used a substance. The complainant was perceived as the most credible when she unwillingly ingested GHB or marijuana. Jurors high in rape myth acceptance gave lower ratings of guilt to the defendant compared to jurors with lower rape myth acceptance. Overall, the results highlight several juror and case factors that might bias jurors in actual rape trials.     

Posttraumatic Stress Symptoms,Aggression, and Substance Use Coping among Young Adults

This study examined how the symptom clusters of posttraumatic stress disorder (PTSD) were related to substance use and self-reported aggression in a college sample. There were 358 participants (ages 18–24) who completed surveys to assess PTSD symptoms, substance use as coping, and aggression. Hierarchical regressions tested for the effects of PTSD symptoms (total symptoms as well as cluster symptoms) on self-reported aggression, along with the main and interaction effects of substance use coping on these relationships. The hyperarousal cluster of PTSD was the only group of symptoms significantly related to aggression. There was an interaction between avoidance symptoms and substance use coping on aggression such that under conditions of high substance use coping, aggression increased regardless of avoidance symptoms; however, the relationship between avoidance and aggression was stronger under conditions of low substance use coping, with greater aggression as avoidance symptoms and low substance use coping increased.     

Linking Childhood Maltreatment to Substance Use in College Students: The Mediating Role of Self-Worth Contingencies

This study investigated the link between childhood maltreatment and substance use, focusing on examining contingencies of self-worth (CSWs) as mediators among college students (N?=?513). Structural equation modeling indicated that childhood sexual abuse among females was related to lower God's love CSW, which in turn was related to higher levels of cigarette, marijuana, and other illicit drug use, supporting the mediational role of God's love CSW. Correlational analyses demonstrated that, for both male and female students, external contingency of appearance was related to higher substance use, whereas internal contingencies of God's love and virtue were related to lower substance use. The findings highlight the protective role of internal CSWs in substance use among females with childhood sexual abuse.     

Impact of Abuse History on Adolescent African American Women's Current HIV/STD-Associated Behaviors and Psychosocial Mediators of HIV/STD Risk

This study examined if relationship power, sex refusal self-efficacy, or fear of condom negotiation mediated the relationship between abuse history and consistent condom use (CCU) among African American female adolescents (N?=?593). Participants with an abuse history (58%) were less likely to report CCU. Women with an abuse history reported less relationship power and self-efficacy for refusing sex and more fear of condom negotiation, none of which independently or jointly mediated the association between abuse and CCU. Notably, history of abuse was associated with CCU across mediator models despite inclusion of psychosocial mediators. This study demonstrates the importance of understanding adolescents' condom use behaviors within the context of their life experiences, especially past abuse history.