Dual diagnosis: Clinical issues in the treatment of substance abuse,and affective,personality, and psychotic disorders

Co-morbidity of alcohol and substance with the spectrum of other psychiatric diagnoses is examined with specific emphasis on diagnostic indicators for anxiety and mood disorders. Diagnostic issues for the chemically dependent person are examined with the context of borderline personality disorder, schizophrenia and other psychiatric disorders. Clinical research related to the dually-diagnosed patient is explored     

A test of the four-factor model of impulsivity-related traits

In a recent article, Whiteside and Lynam [Person. Indiv. Diff. 30 (2001) 669] proposed a new model for understanding personality pathways to impulsive behavior. Their UPPS model maintains that there are four personality dimensions that are related differentially to impulsive behaviors: urgency, sensation seeking, (lack of) premeditation, and (lack of) perseverance. The purpose of the current study was to provide validation for this model and to test some of the specific hypotheses offered by Whiteside and Lynam. The sample used in this study consisted of 481 individuals who completed mailed surveys at age 20 and an in-depth laboratory protocol at age 21. Zero-order correlations and multiple regression analyses were used to examine the relations between the four personality traits and various forms of externalizing behaviors, several types of internalizing psychopathology, and intelligence. Results revealed that the four traits were differentially related to various behaviors and forms of psychopathology consistent with many of Whiteside and Lynam's predictions. Therefore, the UPPS model does appear to offer a novel and useful way of understanding behaviors and forms of psychopathology considered to be characterized by some form of impulsivity.     

Multinational efforts in substance abuse prevention

This article is a review of the world-wide efforts of clinicians and researchers in the area of diagnosis, treatment, and prevention of multiple substance abuse. Represented are studies in cross-cultural prevention research and substance abuse which address the new and burgeoning area of clinical prevention research from a multidisciplinary perspective. The article also discusses the theory and methods in prevention in New York City, Israel, Italy, Spain, and in Cali, Columbia. The authors hope that this information will result in greater recognition for the need to understand effective measures of drug prevention, and to develop new research directions which shall enrich and enhance our present state of knowledge in substance abuse prevention programming.     

Dual diagnosis: Clinical issues in substance abuse treatment

Dual diagnosis within the context of alcohol and substance abuse has become the focus of considerable interest, particularly when related to anxiety and depression. Depressive symptomatology is frequently associated with substance abuse and chemical dependency and numerous studies report a high concordance with these diagnostic entities and major affective disorder (Galanter,Casteneda, & Ferman, 1988). Depressive symptoms are also related to post treatment of alcohol and substance abuse with reported occurrences of 75 percent occurring with patients who have experienced relapse (Biedermann, Newcome, & Sprich, 1991).     

Prevention education and substance abuse treatment

Relapse prevention is influenced by a number of variables including stress and negative mood states, motivation and commitment to abstinence, social support, physiological factors, withdrawal symptoms, and a repertoire of cognitive and behavioral strategies utilized in responding to the relapse process. Diverse theoretical approaches have emphasized conditioning models as well as information processing, cognitive and affective components of treatment, cognitive and behavioral coping responses, and a variety of other procedures. Outcome studies related to treatment have failed to consistently support the effectiveness of several of these components. To overcomes this, the authors advocate a single subject design in the study of these approaches. This article emphasizes the role of relapse prevention, and training and education in facilitating long-term abstinence, particularly with those intervention methods that are based on social learning theory and cognitive-behavioral models.     

Developmental Trajectories of Religious Service Attendance: Predictors of Nicotine Dependence and Alcohol Dependence/Abuse in Early Midlife

Journal of Religion and Health - This longitudinal study assesses the associations between developmental trajectories of religious service attendance from mean age 14 to mean age 43 and nicotine...     

Examining antisocial behavior through the lens of the five factor model of personality

The current study attempts to provide greater precision in understanding how personality is related to antisocial behavior. Specifically, we examined the relations between the facets (subordinate traits) from three domains (superordinate dimensions): Neuroticism, Agreeableness, and Conscientiousness, of the Five Factor Model and five outcome variables: stability of conduct problems, variety of conduct problems, onset of conduct problems, aggression, and antisocial personality disorder symptoms. These relations were examined in a community sample of 481 individuals. These three personality dimensions were chosen for exploration due to their consistent relations, at the domain level, with antisocial behaviors. The results from this study suggest that the facets from the dimension of Agreeableness are the most consistently related to all five outcomes. However, the facets from all three domains made significant contributions. Overall, three personality traits stood out as being the strongest and most consistent predictors: low straightforwardness, low compliance, and low deliberation. Implications for prevention and intervention are discussed. Aggr. Behav. 29:497–514, 2003. © 2003 Wiley‐Liss, Inc.     

Commentary on Reconceptualizing Personality Disorder Categories Using Trait Dimensions

The present study examined Widiger and Lynam's (1998) hypothesis that psychopathy can be represented using the Five-Factor Model (FFM) of personality. Participants in the study consisted of 481 21-22-year-old men and women who are part of an ongoing longitudinal study. Psychopathy was assessed by the degree of similarity between an individual's NEO-PI-R and an expert-generated FFM psychopathy prototype. The expert-based prototype supported the account of Widiger and Lynam (1998), as did the correlations between the NEO-PI-R Psychopathy Resemblance Index (PRI) and the individual personality dimensions. The PRI was also related in predicted ways to measures of antisocial behavior, drug use, and psychopathology. The results support the contention that psychopathy can be understood as an extreme variant of common dimensions of personality, and underscore the utility of a dimensional model of personality disorders.     

Women,sex, and HIV: social and contextual factors,meta-analysis of published interventions,and implications for practice and research

This article is focused on examining social and contextual factors related to HIV-risk behavior for women. Specifically, this article has three main purposes: to review the literature on selected social and contextual factors that contribute to the risk for the heterosexual transmission of HIV and AIDS, to review and conduct a meta-analysis of HIV-prevention interventions targeting adult heterosexual populations, and to suggest future directions for HIV-prevention intervention research and practice. Results suggest that the HIV-prevention interventions reviewed for this article had little impact on sexual risk behavior, that social and contextual factors are often minimally addressed, and that there was a large gap between research and the practice of HIV-prevention intervention.     

Alcohol and Substance Use Disorders: Algorithms and Critical Pathways for Healthcare Delivery

Contemporary health care delivery is being driven by a changing health care market environments as well as by the availability of enhanced models of service delivery. Providers are using clinical algorithms and critical pathways to standardize clinical care and improve clinical services to patients. The article highlights the application of contemporary clinical models and demonstrates their utility in the context of substance use and abuse disorders. Clinical algorithms and critical pathways are advanced as guidelines in diagnostic and therapeutic processes for the delivery of quality health care to patients. Specific recommendations for the development and implementation of such initiatives are discussed in detail.