Giving meaning to illness: An investigation of self-defining memories in patients with relapsing-remitting multiple sclerosis patients

Multiple sclerosis (MS) patients are often unable to adequately fulfill their established roles due to physical disabilities and cognitive changes, making this chronic illness particularly threatening to personal identity. Twenty-five MS patients and 25 healthy controls were asked to recall five self-defining memories (SDM). Overall characteristics of SDM did not differ between patients and controls; MS patients displayed preserved capacity to draw meaning upon past events. Moreover, almost two-thirds of MS patients mentioned at least one illness related SDM and about 25% of patients’ SDM referred to MS. These memories were experienced as more negative and associated with more tension than other SDM but led toward more positive emotion and less negative emotion over time; they were also more central and more integrated to the personal identity. We concluded that self-challenging events due to MS may trigger both cognitive and emotional processes enabling the integration of illness in patients’ self-representations.     

The Drinking Expectancy Questionnaire: A revised measure of alcohol-related beliefs

Alcohol-related expectancies have been recently proposed as potentially important determinants of drinking behavior. This study describes the development of a New Zealand measure of such beliefs, the Drinking Expectancy Questionnaire (DEQ). Items selected through interviews, literature review, and the modification of other relevant questionnaires were piloted on 333 drinkers in a community sample and 275 college students. Factor analyses of both samples revealed nine alcohol reinforcement domains relating to assertiveness, affective change, sexual enhancement, social enhancement, relaxation, cognitive impairment, dependence, carelessness, and aggression. The potential clinical and research possibilities using this revised expectancy measure are briefly discussed, along with the scale's strength and weaknesses.The financial assistance of the Alcoholic Liquor Advisory Council of New Zealand in conducting this study is gratefully acknowledged.     

Effects of family therapy for substance abuse: A systematic review of recent research

One of the most serious psychosocial problems worldwide is substance abuse because of its repercussions not only on the physical and psychological health of the abuser but also on their relational functioning. Among the well-established therapeutic approaches for the treatment of substance abuse is family therapy, which, in addition to influencing personal variables, promotes changes in family dynamics. The main objective of this study is to review the scientific literature published from 2010 to the present on the efficacy and effectiveness shown by family-based treatment approaches for substance use problems both in adolescent and adult samples. In addition, the effect on secondary variables such as family functioning and behavioral problems is evaluated. The empirical evidence accumulated in the last decade and reviewed in the present study indicates that the incorporation of family members in the treatment of substance abuse produces benefits by diminishing consumption and improving family functioning. Limitations of this study and of the research reviewed are discussed and directions for future research are provided.     

Centering culture in the treatment of opioid use disorder with American Indian and Alaska Native Communities: Contributions from a National Collaborative Board

American Indian/Alaska Native (AI/AN) communities are disproportionally impacted by the opioid overdose epidemic. There remains a dearth of research evaluating methods for effectively implementing treatments for opioid use disorder (OUD) within these communities. We describe proceedings from a 2-day Collaborative Board (CB) meeting tasked with developing an implementation intervention for AI/AN clinical programs to improve the delivery of medications to treat OUD (MOUD). The CB was comprised of Elders, cultural leaders, providers, individuals with lived experience with OUD, and researchers from over 25 communities, organizations, and academic institutions. Conversations were audio-recorded, transcribed, and coded by two academic researchers with interpretation oversight provided by the CB. These proceedings provided a foundation for ongoing CB work and a frame for developing the program-level implementation intervention using a strength-based and holistic model of OUD recovery and wellbeing. Topics of discussion posed to the CB included engagement and recovery strategies, integration of extended family traditions, and addressing stigma and building trust with providers and clients. Integration of traditional healing practices, ceremonies, and other cultural practices was recommended. The importance of centering AI/AN culture and involving family were highlighted as priorities for the intervention.     

Reframing caring for parents who struggle with substance-use disorders

Nancy Suchman and the colleagues she influenced have produced ground-breaking and attitude-challenging work in understanding how parenting and substance use come together. Dr Suchman and her colleagues make the claim that there is nothing about a substance-use disorder that precludes effective and sensitive caring for children especially with interventions that focus on the parent–child relationship. Suchman's legacy is to highlight how substance use as an illness pulls individuals away from important, caring relationships and limits their giving themselves to those relationships. Restoring the salience of caring relationships and of the individual's ability to care may be as impactful on their substance use as a strict focus on the reduction of drug use and achieving abstinence.     

L’approche existentielle dans l’accompagnement de personnes au chômage en perte de repères : les processus de construction du sens de la vie et du travail (études de cas)

The guidance design for unemployed people in changing career must increasingly take into account their existential concerns about career meaning. The literature about life and work meaning has highlighted the multifactorial complexity of meaning definition and determinants of meaning. This fact does not facilitate their use in counselling design. Bernaud et al. (2020) “Guidance for life and work meaning” device takes into account this problem; it offers many thinking prospects that organize meaning questioning in order to help people who loosed professional and personal markers. By analyzing an application of this device with the multiple cases method, our article examines how a meaning guidance helps unemployed people in giving a new direction of their career. The study of five cases with chronologic analysis unities shows how various meaning dimensions help people to clarify, to enrich and to transform their initial problematic during accompaniment and how they progress with different rhythms to major personal and vocational decisions.     

A rich palette of Bible use: A theoretical and empirical contribution from the context of Protestant Christian primary schools in the Netherlands

The aim of this study is to gain empirical knowledge about how the Bible functions in the context of Protestant Christian primary schools in the Netherlands. It presents the results of an empirical explorative and qualitative study on the perceptions of teachers and school administrators (directors and internal supervisors) on the goals of Bible use in Protestant primary education, as well as the roles of teachers and pupils, and how these can be understood in terms of religious pedagogical models and theories. Five small focus group interviews with teachers and six interviews with school administrators revealed a variety of goals teachers hold regarding Bible use in education and a variety of divisions of teacher–learner roles in this regard. The findings also show some particular characteristics when compared with secondary schools.     

The factor structure of the Multiple Affect Adjective Check List-Revised (MAACL-R): Some statistical considerations

In response to Zuckerman's comments on my factor analyses of the MAACL-R, I focus on the statistical issues of the cutoff criterion for factor loadings and the evidence for the discriminant validity of the five-factor solution. Based upon the conclusions I draw in these two areas, I recommend that researchers either (a) use the two factor solution to the MAACL-R represented in the summary scores of Dysphoria and Positive Affect + Sensation Seeking or (b) include all MAACL-R scales in their studies and analyze their data to determine whether it is statistically appropriate to report results from a single scale (A, D, H, PA, or SS) rather than from the summary scores.     

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.