Gender Differences in Problem Drinking and Depression: Different “Vulnerabilities?”

This study examines the relationship between stressors and resources and the functioning of a sample of 515 men and women who had a drinking problem. At a one-year follow-up, both women and men had improved on three functioning measures: alcohol consumption, days intoxicated, and depression. There were no gender differences at Time 2 on alcohol consumption, but men had more days intoxicated and women had more symptoms of depression. The impact of stressors and resources varied by life domain, functioning criterion, and gender. Although the predictors varied, the amount of variance in depression accounted for was the same for women and men. The most striking gender difference was the stronger impact of friendships for women on all aspects of functioning. This study provides support for reconsideration of the stress vulnerability of women and men.     

Historical misrepresentation in science: The case of fetal alcohol syndrome

The history of the fetal alcohol syndrome (FAS) provides a microcosm in which to explore the larger ramifications of historical citations in biomedical publications. Though some historical references such as Biblical writings may hint at a rudimentary understanding of the relationship between maternal drinking and fetal development, no definitive case can be made for an understanding of FAS dating back hundreds of years. Authors who claim an impressive history for FAS misrepresent that history. The modern history of FAS raises a question concerning citations of original discoveries. The first paper describing ethanol-induced damage to the fetus appeared in 1968 yet most researchers cite one of two papers from 1973. Both ancient citations and modern references to original discoveries pose difficult questions for the scientist. Both dilemmas may be solved by a better reading of the literature and a more judicious wording when writing about history. This work was supported in part by Grant # AA10681 to SNP.     

A scale to assess the restrictiveness of educational settings

The placement of students into educational settings is perhaps one of the most debated issues in special education, particularly for students with emotional and behavioral disorders (EBD). A primary consideration in this decision is the restrictiveness of the setting, yet no scale to assess restrictiveness of educational settings exists. We undertook two surveys that asked respondents to rate the restrictiveness of 18 educational placements. The first survey was sent to a national panel of experts, the second survey was sent to supervisors of programs for students with EBD. The results of the surveys led to the development of theScale to Assess Restrictiveness of Educational Settings. This scale is designed to provide a measure of restrictiveness of educational settings that can provide data to evaluate student progress and program outcomes.     

Analogue drinking assessment: Sensation seeking and gender

This study assessed the relationship between sensation seeking measured as a trait variable and drinking behaviors observed unobtrusively in the laboratory. It was hypothesized that high-sensation-seeking subjects would consume more alcohol than low sensation seekers and experience greater enhancement of positive moods and body sensations associated with intoxication. Thirty female and 31 male subjects divided into high- and low-sensation-seeking subgroups participated in an ad libitum drinking situation with the manifest task of taste rating three types of vodka (actually 95% alcohol) or tonic. Dependent variables included beverage consumption, positive/negative mood states, body sensations, breath estimates of blood alcohol levels, and self-rated level of intoxication. All subjects reported feeling the effects of alcohol. Contrary to predictions, high-sensation-seeking subjects neither consumed more alcohol than their low-sensation-seeking counterparts nor drank more alcohol than tonic, Paradoxically, low-sensation-seeking women displayed significantly greater alcohol intake and intoxication than all other groups. Possible explanations for findings were considered as well as the necessity for multimethod assessments of both predictor (i.e., sensation seeking) and criterion (i.e., alcohol consumption) variables across time and situations.This research was supported by Grant Award AA04042-03 from the National Institute on Alcohol Abuse and Alcoholism to the first and third authors. Special Appreciation is expressed to Anne T. Patsiokas, Susan W. Altman, Victoria Molony-Sinnott, and Pamela J. Thompson for their invaluable assistance in collecting and analyzing the data.     

Culturally grounded strategies for suicide and alcohol risk prevention delivered by rural Alaska Native communities: A dynamic wait-listed design evaluation of the Qungasvik intervention

We examined the effectiveness of the Qungasvik (Tools for Life) intervention in enhancing protective factors as a universal suicide and alcohol prevention strategy for young people ages 12−18 living in highly affected rural Alaska Native communities. Four communities were assigned to immediate intervention or to a dynamic wait list. Outcomes were analyzed for 239 young people at four time points over two years of community intervention. Outcomes assessed two ultimate variable protective factors buffering suicide and alcohol risk, and three intermediate variable protective factors at the individual, family, and community level. Dose dependent intervention effects were associated with growth in ultimate but not intermediate variables. This evaluation of the Qungasvik intervention provides support for the effectiveness of its Indigenous strategies for suicide and alcohol misuse prevention in this rural Alaska Native setting. Though findings did not provide support for a theory of change where growth in ultimate variables is occasioned through effects on intermediate variables, research designs focused on young people who enter intervention at lower levels of preexisting protection hold promise for better understanding of intervention change processes. The Qungasvik intervention is responsive to an acute public health need for effective rural Alaska Native suicide and alcohol risk prevention strategies.     

Primary Care Treatment Integrating Motivation and Exposure for PTSD Symptoms and Hazardous Alcohol Use: A Case Series

Symptoms of posttraumatic stress disorder (PTSD) and hazardous alcohol use are highly comorbid. Research on integrated interventions to address PTSD symptoms and hazardous alcohol use concurrently has demonstrated efficacy, yet integrated treatments are underutilized. Both patient (e.g., stigma, scheduling/logistics) and clinician (e.g., concern about symptom exacerbation and/or treatment dropout) barriers may impede utilization of integrated interventions among those with comorbid PTSD symptoms and hazardous alcohol use. Primary care behavioral health models (PCBH), in which embedded behavioral health providers deliver treatment to individuals with mild or moderate behavioral health symptoms in primary care, may help address treatment barriers by offering accessible behavioral health interventions in a destigmatizing setting. This paper presents two case examples from a randomized controlled trial testing the efficacy of an integrated intervention for PTSD symptoms and hazardous alcohol use developed for and delivered in primary care. Outcome data and session-by-session content for two participants are included, along with discussion of barriers encountered during the course of treatment. Clinician-suggested strategies for navigating barriers to facilitate utilization of integrated interventions for PTSD symptoms and hazardous alcohol use are also discussed.     

“In my own comfort zone”: Clients' experiences of relational aspects of online therapy for alcohol problems

Background

Therapists and counsellors increasingly use online video applications to offer treatment in place of face-to-face delivery. In the alcohol treatment sector, this offers a range of potential benefits for treatment providers. However, the impact of working remotely via video on the therapeutic relationship remains unclear and under-researched.

Aims

This study aimed to explore how alcohol treatment clients make sense of the relational aspects of therapy delivered remotely, and to examine how the use of remote therapy might disrupt existing ideas around the therapeutic relationship.

Methodology

This study utilised a qualitative design using thematic analysis, with 15 participant interviews with adult service users from a single treatment provider. All participants had previously undertaken at least four 1-h online therapy sessions.

Findings

The themes that were identified highlighted the significance of the participants' own homes as the site of therapy, with emphasis on the comfort of the home, and the presence of family members and pets. Participants stressed the importance of viewing the face of the therapist, the establishment of a therapeutic bond and specific therapist qualities. Participants also reflected on issues around denial and avoidance associated with self-image and identity.

Discussion

There are nuanced and potentially unforeseen consequences of undertaking therapy for alcohol problems via video, relating to the significance of the therapy environment and relationship between client and therapist. This may include issues of shame, denial and avoidance, which are of particular significance for clients experiencing difficulties associated with alcohol.     

Aggressive disposition,alcohol, and aggression

This study investigated the effect of aggressive disposition on intoxicated and non-intoxicated aggressive behavior. Prior aggressiveness was measured with a structured questionnaire. Based on a bipartite split of scores, 28 subjects were assigned to the high aggressor group, and 29 to the low aggressor group. Subjects in both disposition groups were then randomly assigned to either a drunk or sober condition, and participated in a competitive reaction time task involving the administering and receiving of electric shocks to/from a fictitious opponent under conditions of high and low provocation. Aggression was defined as shock level intensity delivered to the sham opponent. When highly provoked, sober high aggressors were significantly more aggressive than low aggressors, thus validating the measure of aggressive disposition. When intoxicated, highly provoked individuals in both the high and low aggressive disposition groups attained equal levels of aggression. It was low aggressors who responded to escalated provocation with a significant increase in aggression responding when intoxicated. These results lend support to the notion that a pharmacological effect of alcohol can increase aggressive behaviour. Aggr. Behav. 23:11–18, 1997. © 1997 Wiley-Liss, Inc.     

Adolescent gambling and drug use

In this study, 4516 adolescents (aged 11–16 years) completed a questionnaire examining the relationship between underage National Lottery gambling, underage scratchcard gambling, cigarette smoking, drinking alcohol and drug use. It was found that these behaviours were closely linked. Adolescent gamblers reported that they were significantly more likely to drink alcohol (particularly ‘alcopops’), smoke tobacco and take drugs compared to non-gamblers. © 1998 John Wiley & Sons, Ltd.     

Predictors of Placement Outcomes in Treatment Foster Care: Implications for Foster Parent Selection and Service Delivery

Treatment foster care (TFC) is a normalizing environment in which to treat those children whose particular needs are not addressed in traditional foster care and for whom an institutional setting is a restrictive and unnecessary alternative. However, when the foster care placements of these emotionally and behaviorally disturbed children fail, as they often do, the children are shifted from one home to another without the opportunity to experience permanence or emotional attachment, resulting in poor adjustment to foster care. Placement stability, which depends in part upon effective matching of foster children with potential foster families, is critical for achieving positive outcomes in TFC. Yet, there is a dearth of information to guide placement agencies in making decisions about matching foster children with families. Moreover, once a successful match has been made, it is equally vital that service delivery be of high quality so that permanence is maintained. We review research on the predictors of positive outcomes in foster care, focusing on studies involving emotionally or behaviorally disturbed children, and provide recommendations for selecting foster parents and for ensuring high quality foster care services and placement stability.