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Nadkarni A, Bhatia U, Velleman R, Orford J, Velleman G, Church S, Sawal S, Pednekar S. Supporting addictions affected families effectively (SAFE): a mixed methods exploratory study of the 5-step method delivered in Goa, India, by lay counsellors. DRUGS-EDUCATION PREVENTION AND POLICY 2017. [DOI: 10.1080/09687637.2017.1394983] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Abhijit Nadkarni
- Department of Population Health, London School of Hygiene and Tropical Medicine, London, UK
- Addictions Research Group, Sangath, Goa, India
| | | | - Richard Velleman
- Addictions Research Group, Sangath, Goa, India
- Mental Health Research and Development Unit, University of Bath, Bath, UK
| | - Jim Orford
- School of Psychology, University of Birmingham, Birmingham, UK
| | | | - Sydney Church
- Addictions Research Group, Sangath, Goa, India
- School of Oriental and African Studies, London, UK
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Rane A, Church S, Bhatia U, Orford J, Velleman R, Nadkarni A. Psychosocial interventions for addiction-affected families in Low and Middle Income Countries: A systematic review. Addict Behav 2017; 74:1-8. [PMID: 28554034 DOI: 10.1016/j.addbeh.2017.05.015] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2016] [Revised: 05/05/2017] [Accepted: 05/15/2017] [Indexed: 11/16/2022]
Abstract
AIM To review the literature on psychosocial interventions for addiction affected family members in Low and Middle Income Countries (LMIC). METHODS A systematic review with a detailed search strategy focussing on psychosocial interventions directed towards people affected by addiction without any gender, year or language specifications was conducted. Identified titles and abstracts were screened; where needed full papers retrieved, and then independently reviewed. Data was extracted based on the aims of the study, to describe the modalities, acceptability, feasibility and effectiveness of the interventions. RESULTS Four papers met our selection criteria. They were published between 2003 and 2014; the total sample size was 137 participants, and two studies were from Mexico and one each from Vietnam and Malaysia. The predominantly female participants comprised of parents, spouses and siblings. The common components of all the interventions included providing information regarding addiction, teaching coping skills, and providing support. Though preliminary these small studies suggests a positive effect on affected family members (AFM). There was lowering of psychological and physical distress, along with a better understanding of addictive behaviour. The interventions led to better coping; with improvements in self-esteem and assertive behaviour. The interventions, mostly delivered in group settings, were largely acceptable. CONCLUSIONS The limited evidence does suggest positive benefits to AFMs. The scope of research needs to be extended to other addictions, and family members other than spouse and female relatives. Indigenous and locally adapted interventions are needed to address this issue keeping in mind the limited resources of LMIC. This is a field indeed in its infancy and this under recognised and under-served group needs urgent attention of researchers and policy makers.
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Affiliation(s)
- Anil Rane
- Institute of Psychiatry and Human Behaviour, Goa, India.
| | - Sydney Church
- School of Oriental and African Studies, UK; Addictions Research Group, Sangath, Goa, India
| | | | - Jim Orford
- School of Psychology, University of Birmingham, UK
| | - Richard Velleman
- Addictions Research Group, Sangath, Goa, India; University of Bath, Bath, UK
| | - Abhijit Nadkarni
- Addictions Research Group, Sangath, Goa, India; South London & Maudsley NHS Foundation Trust, London, UK
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A Unique Model for Adolescent Addiction Treatment: A Description of the Alberta Adolescent Recovery Centre. ADDICTIVE DISORDERS & THEIR TREATMENT 2017. [DOI: 10.1097/adt.0000000000000110] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Denomme WJ, Benhanoh O. Helping concerned family members of individuals with substance use and concurrent disorders: An evaluation of a family member-oriented treatment program. J Subst Abuse Treat 2017; 79:34-45. [PMID: 28673525 DOI: 10.1016/j.jsat.2017.05.012] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2016] [Revised: 05/05/2017] [Accepted: 05/19/2017] [Indexed: 01/09/2023]
Abstract
There is a growing body of research demonstrating that families of individuals with substance use and concurrent disorders (SUCD) experience a wide range of biopsychosocial problems that significantly impedes their quality of life and health. However, there has been a relative lack of treatment programs primarily focused on improving the well-being and quality of life of these family members. The current study assessed the efficacy of such a program at reducing stress, increasing perceived social support from family and friends, and increasing general, dyadic, and self-rated family functioning within these concerned family members. A sample of 125 family members of individuals with SUCDs was recruited, of which 97 participated in the treatment program and 28 were used as the comparison group. Results indicated that the treatment program significantly reduced stress, increased perceived social support from family and friends, and increased general, dyadic and self-rated family functioning. A perceived personal benefits questionnaire demonstrated that participants had a better understanding of SUCDs, better coping capabilities in regard to emotional difficulties, adopted stronger coping methods, participated in more leisure activities, and improved their relationship with the individual with a SUCD. The results of the current study further demonstrate the need to implement more of these family-member oriented psycho-educational treatment programs.
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Affiliation(s)
- William James Denomme
- University of Ontario Institute of Technology, Faculty of Social Science and Humanities, 2000 Simcoe Street North, Oshawa, ON L1H 7K4, Canada.
| | - Orry Benhanoh
- Royal Ottawa Mental Health Centre, 1145 Carling Ave, Ottawa, ON K1Z 7K4, Canada.
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Browning S, Magor-Blatch LE. A turning point for problematic alcohol users: can relationship adjustment predict desistance? JOURNAL OF SUBSTANCE USE 2017. [DOI: 10.3109/14659891.2016.1150527] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Watson J, Toner P, Day E, Back D, Brady LM, Fairhurst C, Renwick C, Templeton L, Akhtar S, Lloyd C, Li J, Cocks K, Ambegaokar S, Parrott S, McArdle P, Gilvarry E, Copello A. Youth social behaviour and network therapy (Y-SBNT): adaptation of a family and social network intervention for young people who misuse alcohol and drugs – a randomised controlled feasibility trial. Health Technol Assess 2017; 21:1-260. [DOI: 10.3310/hta21150] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
BackgroundFamily interventions appear to be effective at treating young people’s substance misuse. However, implementation of family approaches in UK services is low. This study aimed to demonstrate the feasibility of recruiting young people to an intervention based on an adaptation of adult social behaviour and network therapy. It also sought to involve young people with experience of using substance misuse services in the research process.ObjectivesTo demonstrate the feasibility of recruiting young people to family and social network therapy and to explore ways in which young people with experience of using substance misuse services could be involved in a study of this nature.DesignA pragmatic, two-armed, randomised controlled open feasibility trial.SettingTwo UK-based treatment services for young people with substance use problems, with recruitment taking place from May to November 2014.ParticipantsYoung people aged 12–18 years, newly referred and accepted for structured interventions for drug and/or alcohol problems.InterventionsA remote, web-based computer randomisation system allocated young people to adapted youth social behaviour and network therapy (Y-SBNT) or treatment as usual (TAU). Y-SBNT participants were intended to receive up to six 50-minute sessions over a maximum of 12 weeks. TAU participants continued to receive usual care delivered by their service.Main outcome measuresFeasibility was measured by recruitment rates, retention in treatment and follow-up completion rates. The main clinical outcome was the proportion of days on which the main problem substance was used in the preceding 90-day period as captured by the Timeline Follow-Back interview at 3 and 12 months.ResultsIn total, 53 young people were randomised (Y-SBNT,n = 26; TAU,n = 27) against a target of 60 (88.3%). Forty-two young people attended at least one treatment session [Y-SBNT 22/26 (84.6%); TAU 20/27 (74.1%)]; follow-up rates were 77.4% at month 3 and 73.6% at month 12. Data for nine young people were missing at both months 3 and 12, so the main clinical outcome analysis was based on 24 young people (92.3%) in the Y-SBNT group and 20 young people (74.1%) in the TAU group. At month 12, the average proportion of days that the main problem substance was used in the preceding 90 days was higher in the Y-SBNT group than in the TAU group (0.54 vs. 0.41; adjusted mean difference 0.13, 95% confidence interval –0.12 to 0.39;p = 0.30). No adverse events were reported. Seventeen young people with experience of substance misuse services were actively involved throughout the study. They informed key elements of the intervention and research process, ensuring that the intervention was acceptable and relevant to our target groups; contributing to the design of key trial documents, ideas for a new model of public involvement and this report. Two parents were also involved.ConclusionsThe adapted intervention could be delivered in young people’s services, and qualitative interviews found that Y-SBNT was acceptable to young people, family members and staff. Engagement of family and network members proved difficult within the intervention and research aspects. The study proved the feasibility of this work in routine services but outcome measurement based on narrow substance use variables may be limited and may fail to capture other important changes in wider areas of functioning for young people. Validation of the EuroQol-5 Dimensions for young people aged 12–18 years should be considered and flexible models for involvement of young people in research are required to achieve inclusive representation throughout all aspects of the research process. Although recommendation of a full trial of the Y-SBNT intervention compared with TAU is not supported, this study can inform future intervention development and UK research within routine addiction services.Trial registrationCurrent Controlled Trials ISRCTN93446265.FundingThis project was funded by the National Institute for Health Research (NIHR) Health Technology Assessment programme and will be published in full inHealth Technology Assessment; Vol. 21, No. 15. See the NIHR Journals Library website for further project information.
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Affiliation(s)
- Judith Watson
- York Trials Unit, Department of Health Sciences, University of York, York, UK
| | - Paul Toner
- Department of Health Sciences, University of York, York, UK
| | - Ed Day
- Addictions Department, Institute of Psychiatry, London, UK
- Birmingham and Solihull Mental Health NHS Foundation Trust, Birmingham, UK
| | - Donna Back
- Birmingham and Solihull Mental Health NHS Foundation Trust, Birmingham, UK
- School of Psychology, University of Birmingham, Birmingham, UK
| | | | - Caroline Fairhurst
- York Trials Unit, Department of Health Sciences, University of York, York, UK
| | | | | | - Shabana Akhtar
- Birmingham and Solihull Mental Health NHS Foundation Trust, Birmingham, UK
- School of Psychology, University of Birmingham, Birmingham, UK
| | - Charlie Lloyd
- Department of Health Sciences, University of York, York, UK
| | - Jinshuo Li
- Department of Health Sciences, University of York, York, UK
| | - Kim Cocks
- York Trials Unit, Department of Health Sciences, University of York, York, UK
| | | | - Steve Parrott
- Department of Health Sciences, University of York, York, UK
| | - Paul McArdle
- Northumberland, Tyne and Wear NHS Foundation Trust, Newcastle upon Tyne, UK
| | - Eilish Gilvarry
- North of Tyne Community Children and Young People’s Services, Northgate Hospital, Morpeth, UK
| | - Alex Copello
- Birmingham and Solihull Mental Health NHS Foundation Trust, Birmingham, UK
- School of Psychology, University of Birmingham, Birmingham, UK
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Hojjat SK, Rezaei M, Hatami SE, Kohestani M, Norozi Khalili M. The Effectiveness of Group Family Training About the Principles of Harm Reduction Approach on Marital Satisfaction of Spouses of Patients Under Methadone Maintenance Treatment. JOURNAL OF SEX & MARITAL THERAPY 2017; 43:68-77. [PMID: 26743023 DOI: 10.1080/0092623x.2015.1114548] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
One of the most important problems in treatment of drug dependence is the cooperation of the patient's family. Many families do not look at drug dependence as a chronic and relapsing disorder and expect a quick and definite recovery of the disease. These families, including wives, are unfamiliar with the concept of harm reduction as a realistic approach. The aim of this study was to educate the spouses of patients undergoing methadone maintenance treatment (MMT) on the different aspects of harm reduction approach and assess the impact of this training on marital satisfaction and relapse rate. This study was a pretest-posttest study with control group. The sample consisted of 50 MMT patients and their wives in private methadone maintenance treatment clinics in the city of Bojnurd, located in the northeastern region of Iran. The experimental group received eight group training sessions run by a psychiatrist. The content of the training sessions was based on harm reduction programs for families of patients with high-risk behaviors. Two groups are compared in terms of marital satisfaction and relapse rate. A paired t test was used to compare changes before and after the training. The results of this study showed that harm reduction education and efforts for changing wives' views toward MMT are effective in increasing their marital satisfaction. However, the conducted training showed no effect on relapse rate in the six-month follow-up. Regarding the fact that this type of training has not been paid enough attention in the national protocol, the proposed training program of this research can be considered in MMT clinics.
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Affiliation(s)
- Seyed Kaveh Hojjat
- a Addiction and Behavioral Sciences Research Center, North Khorasan University of Medical Sciences , Bojnurd , Iran
| | - Mahdi Rezaei
- a Addiction and Behavioral Sciences Research Center, North Khorasan University of Medical Sciences , Bojnurd , Iran
| | - Seyed Esmaeil Hatami
- a Addiction and Behavioral Sciences Research Center, North Khorasan University of Medical Sciences , Bojnurd , Iran
| | - Mina Kohestani
- b MA of Family Counseling, Islamic Azad University-Ghuchan , Ghuchan , Iran
| | - Mina Norozi Khalili
- c Department of Community Medicine , North Khorasan University of Medical Sciences , Bojnurd , Iran
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McPherson C, Boyne H, Willis R. The Role of Family in Residential Treatment Patient Retention. Int J Ment Health Addict 2016. [DOI: 10.1007/s11469-016-9712-0] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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van Boekel LC, Brouwers EPM, van Weeghel J, Garretsen HFL. Experienced and anticipated discrimination reported by individuals in treatment for substance use disorders within the Netherlands. HEALTH & SOCIAL CARE IN THE COMMUNITY 2016; 24:e23-e33. [PMID: 26417904 DOI: 10.1111/hsc.12279] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 06/30/2015] [Indexed: 06/05/2023]
Abstract
Experiences and expectations of discrimination (anticipated discrimination) may delay treatment seeking among people with substance use disorders. In addition, experienced and anticipated discrimination can be a barrier to successful recovery and rehabilitation. The aim of this study was to study the level of experienced and anticipated (the expectation to be rejected) discrimination among individuals in treatment for substance use disorders as well as the association between both concepts of discrimination. In addition, the association of experienced and anticipated discrimination with clinical and social characteristics was investigated. A cross-sectional survey among individuals in treatment for substance use disorders in the Netherlands was carried out in 2012. Individuals in treatment (N = 186) completed a self-reported questionnaire about experienced and anticipated discrimination. Descriptive statistics and chi-squared analyses were performed to investigate the level of experienced and anticipated discrimination and the association between both concepts. Linear regression analyses were used to investigate the association with clinical and social characteristics, such as occupational status and type of treatment. Individuals in treatment for substance use disorders reported high levels of experienced and anticipated discrimination. Respondents experienced most discrimination in family ties, intimate relationships and friendships. Experienced and anticipated discrimination were both positively correlated. Having complex substance use problems and a longer history of substance use problems was related to higher levels of experienced discrimination. In conclusion, experienced and anticipated discrimination were highly prevalent among individuals in treatment for substance use disorders. Attention in addiction treatment for adequate coping with discrimination may be needed in order to achieve successful social participation and rehabilitation of these individuals.
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Affiliation(s)
- Leonieke C van Boekel
- Department Tranzo, Tilburg School of Social and Behavioral Sciences, Tilburg University, Tilburg, the Netherlands
| | - Evelien P M Brouwers
- Department Tranzo, Tilburg School of Social and Behavioral Sciences, Tilburg University, Tilburg, the Netherlands
| | - Jaap van Weeghel
- Department Tranzo, Tilburg School of Social and Behavioral Sciences, Tilburg University, Tilburg, the Netherlands
- Phrenos Centre of Expertise, Utrecht, the Netherlands
- Parnassia Group, Dijk en Duin Mental Health Center, Castricum, the Netherlands
| | - Henk F L Garretsen
- Department Tranzo, Tilburg School of Social and Behavioral Sciences, Tilburg University, Tilburg, the Netherlands
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Bischof G, Iwen J, Freyer-Adam J, Rumpf HJ. Efficacy of the Community Reinforcement and Family Training for concerned significant others of treatment-refusing individuals with alcohol dependence: A randomized controlled trial. Drug Alcohol Depend 2016; 163:179-85. [PMID: 27141840 DOI: 10.1016/j.drugalcdep.2016.04.015] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2015] [Revised: 03/23/2016] [Accepted: 04/13/2016] [Indexed: 11/17/2022]
Abstract
BACKGROUND The Community Reinforcement and Family Training (CRAFT) is a promising approach for Concerned Significant Others (CSOs) of alcohol-dependent individuals (ADI) that aims to engage treatment-refusing patients in alcohol treatment and to improve CSO functioning. To date, only two randomized controlled trials (RCTs) of CRAFT-based treatment for CSOs of ADI are available, both conducted in the U.S. For the first time, this study analyses the efficacy of CRAFT in a sample of CSOs outside of the U.S. METHODS Participants were recruited through the treatment system (general practitioners, psychotherapists, addiction counselling services) and through media solicitation. After brief screening, 94CSOs were randomly allocated to an immediate intervention condition (II) or a wait list condition (WL) that received the CRAFT intervention after 3 months. Data for the follow-up assessments at 3 and 6 months was provided by 78CSOs (II N=42; WL N=36). In addition, a follow-up assessment (f-u) was conducted after 12 months (Response rate 92%). RESULTS At 3-month f-u, II revealed significant higher ADI engagement rates (40.5%) compared to WL (13.9%); after WL received the CRAFT intervention, engagement rates did not differ between both groups at 6- and 12-month f-u. CSOs in both groups reported significant improvements in terms of mental health and family cohesion after having received the intervention, i.e. II at 3-months f-u and WL at 6-month f-u. CONCLUSIONS Data show that CRAFT is effective for treating CSOs of alcohol dependent individuals in terms of treatment engagement and improvement of CSOs mental health and family cohesion.
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Anastasiadou D, Sepulveda AR, Sánchez JC, Parks M, Álvarez T, Graell M. Family Functioning and Quality of Life among Families in Eating Disorders: A Comparison with Substance-related Disorders and Healthy Controls. EUROPEAN EATING DISORDERS REVIEW 2016; 24:294-303. [DOI: 10.1002/erv.2440] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2015] [Revised: 01/12/2016] [Accepted: 01/18/2016] [Indexed: 11/12/2022]
Affiliation(s)
- Dimitra Anastasiadou
- Department of Biological and Health Psychology, Faculty of Psychology; Autonomous University of Madrid; Madrid Spain
| | - Ana R. Sepulveda
- Department of Biological and Health Psychology, Faculty of Psychology; Autonomous University of Madrid; Madrid Spain
| | | | - Melissa Parks
- Department of Biological and Health Psychology, Faculty of Psychology; Autonomous University of Madrid; Madrid Spain
| | - Tamara Álvarez
- Department of Biological and Health Psychology, Faculty of Psychology; Autonomous University of Madrid; Madrid Spain
| | - Montserrat Graell
- Eating Disorders Program, Child and Adolescence Psychiatry Department; Niño Jesus University Hospital, CIBERSAM; Madrid Spain
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Cartwright L. Respite and repair: how mothers of incarcerated long-term problematic drug users make prison work for them. JOURNAL OF SUBSTANCE USE 2016. [DOI: 10.3109/14659891.2015.1052106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Magnusson K, Nilsson A, Hellner Gumpert C, Andersson G, Carlbring P. Internet-delivered cognitive-behavioural therapy for concerned significant others of people with problem gambling: study protocol for a randomised wait-list controlled trial. BMJ Open 2015; 5:e008724. [PMID: 26656017 PMCID: PMC4680021 DOI: 10.1136/bmjopen-2015-008724] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2015] [Revised: 10/12/2015] [Accepted: 11/04/2015] [Indexed: 11/18/2022] Open
Abstract
INTRODUCTION About 2.3% of the adult population in Sweden are considered to suffer from problem gambling, and it is estimated that only 5% of those seek treatment. Problem gambling can have devastating effects on the economy, health and relationship, both for the individual who gambles and their concerned significant other (CSO). No empirically supported treatment exists for the CSOs of people with problem gambling. Consequently, the aim of this study is to develop and evaluate a programme aimed at CSOs of treatment-refusing problem gamblers. The programme will be based on principles from cognitive behavioural therapy (CBT) and motivational interviewing. To benefit as many CSOs as possible, the programme will be delivered via the internet with therapist support via encrypted email and short weekly conversations via telephone. METHODS AND ANALYSIS This will be a randomised wait-list controlled internet-delivered treatment trial. A CBT programme for the CSOs of people with problem gambling will be developed and evaluated. The participants will work through nine modules over 10 weeks in a secure online environment, and receive support via secure emails and over the telephone. A total of 150 CSOs over 18 years of age will be included. Measures will be taken at baseline and at 3, 6 and 12 months. Primary outcomes concern gambling-related harm. Secondary outcomes include the treatment entry of the individual who gambles, the CSO's levels of depression, anxiety, as well as relationship satisfaction and quality of life. ETHICS AND DISSEMINATION The protocol has been approved by the regional ethics board of Stockholm, Sweden. This study will add to the body of knowledge on how to protect CSOs from gambling-related harm, and how to motivate treatment-refusing individuals to seek professional help for problem gambling. TRIAL REGISTRATION NUMBER NCT02250586.
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Affiliation(s)
- Kristoffer Magnusson
- Department of Clinical Neuroscience, Stockholm Center for Psychiatry Research and Education, Karolinska Institutet, Stockholm, Sweden
| | - Anders Nilsson
- Department of Clinical Neuroscience, Stockholm Center for Psychiatry Research and Education, Karolinska Institutet, Stockholm, Sweden
| | - Clara Hellner Gumpert
- Department of Clinical Neuroscience, Stockholm Center for Psychiatry Research and Education, Karolinska Institutet, Stockholm, Sweden
| | - Gerhard Andersson
- Department of Clinical Neuroscience, Stockholm Center for Psychiatry Research and Education, Karolinska Institutet, Stockholm, Sweden
- Department of Behavioral Sciences and Learning, Linköping University, Linköping, Sweden
| | - Per Carlbring
- Department of Psychology, Stockholm University, Stockholm, Sweden
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Gethin A, Trimingham T, Chang T, Farrell M, Ross J. Coping with problematic drug use in the family: An evaluation of the Stepping Stones program. Drug Alcohol Rev 2015; 35:470-6. [PMID: 26365113 DOI: 10.1111/dar.12327] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2015] [Accepted: 07/16/2015] [Indexed: 11/29/2022]
Abstract
INTRODUCTION AND AIMS Problematic substance use by an individual is often highly destructive to their family, creating emotional turmoil and destroying healthy family functioning. The aim of this study was to evaluate the impact of participation in the Stepping Stones family support program on the coping capacity of family members affected by another's substance use. DESIGN AND METHODS A pre and post study of the Stepping Stones intervention for families was conducted, involving 108 participants recruited from March 2013 to March 2014. RESULTS Significant improvement in coping across all domains was observed post course and at follow up on both outcome measures (Coping Questionnaire and the Family Drug Support Questionnaire). Improvements for participants were either increased or sustained at 3 months follow up. Participants recorded high satisfaction ratings. DISCUSSION AND CONCLUSIONS The findings from this study demonstrate that participation in the Stepping Stones program assists family members to cope better with problematic substance use of a family member, as indicated by reductions in negative coping strategies, such as over-engagement, making excuses for the drug user or hopelessly tolerating the problem, and improvements in positive coping strategies such as self-care and engagement with their own activities and interests. [Gethin A, Trimingham T, Chang T, Farrell M, Ross J. Coping with problematic drug use in the family: An evaluation of the Stepping Stones program. Drug Alcohol Rev 2016;35:470-476].
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Affiliation(s)
- Anni Gethin
- Argyle Research and Training, Hazelbrook, Australia
| | | | - Theo Chang
- Family Drug Support, Blue Mountains, Australia
| | - Michael Farrell
- National Drug and Alcohol Research Centre, University of New South Wales, Sydney, Australia
| | - Joanne Ross
- National Drug and Alcohol Research Centre, University of New South Wales, Sydney, Australia
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Adams PJ. Switching to a Social Approach to Addiction: Implications for Theory and Practice. Int J Ment Health Addict 2015. [DOI: 10.1007/s11469-015-9588-4] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Baker R, Orton E, Tata LJ, Kendrick D. Risk factors for long-bone fractures in children up to 5 years of age: a nested case-control study. Arch Dis Child 2015; 100:432-7. [PMID: 25398446 PMCID: PMC4413839 DOI: 10.1136/archdischild-2013-305715] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2013] [Accepted: 10/24/2014] [Indexed: 11/03/2022]
Abstract
AIM To investigate risk factors for first long-bone fractures in children up to 5 years old in order to provide evidence about which families could benefit from injury prevention interventions. METHODS Population-based matched nested case-control study using The Health Improvement Network, a UK primary care research database, 1988-2004. Maternal, household and child risk factors for injury were assessed among 2456 children with long-bone fractures (cases). 23,661 controls were matched to cases on general practice. Adjusted ORs and 95% CIs were estimated using conditional logistic regression. RESULTS Fractures of long-bones were independently associated with younger maternal age and higher birth order, with children who were the fourth-born in the family, or later, having a threefold greater odds of fracture compared to first-born children (adjusted OR 3.12, 95% CI 2.08 to 4.68). Children over the age of 1 year had a fourfold (13-24 months, adjusted OR 4.09 95% CI 3.51 to 4.76) to fivefold (37+ months, adjusted OR 4.88 95% CI 4.21 to 5.66) increase in the odds of a long-bone fracture compared to children aged 0-12 months. Children in families with a history of maternal alcohol misuse had a raised odds of long-bone fracture (adjusted OR 2.33, 95% CI 1.13 to 4.82) compared to those with no documented history. CONCLUSIONS Risk factors for long-bone fractures in children less than 5 years old included age above 1 year, increasing birth order, younger maternal age and maternal alcohol misuse. These risk factors should be used to prioritise families and communities for injury prevention interventions.
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Affiliation(s)
- Ruth Baker
- Division of Epidemiology and Public Health, Nottingham City Hospital, University of Nottingham, Nottingham, UK
| | - Elizabeth Orton
- Division of Primary Care, University Park, University of Nottingham, Nottingham, UK
| | - Laila J Tata
- Division of Epidemiology and Public Health, Nottingham City Hospital, University of Nottingham, Nottingham, UK
| | - Denise Kendrick
- Division of Primary Care, University Park, University of Nottingham, Nottingham, UK
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Watson J, Back D, Toner P, Lloyd C, Day E, Brady LM, Templeton L, Ambegaokar S, Parrott S, Torgerson D, Cocks K, Gilvarry E, McArdle P, Copello A. A randomised controlled feasibility trial of family and social network intervention for young people who misuse alcohol and drugs: study protocol (Y-SBNT). Pilot Feasibility Stud 2015; 1:8. [PMID: 27965788 PMCID: PMC5154128 DOI: 10.1186/s40814-015-0004-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2014] [Accepted: 02/18/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND A growing body of research has identified family interventions to be effective in treating young people's substance use problems. However, despite this evidence, take-up of family-based approaches in the UK has been low. Key factors for this appear to include the resource-intensive nature of most family interventions which challenges implementation and delivery in many service settings and the cultural adaptation of approaches developed in the USA to a UK setting. This study aims to demonstrate the feasibility of recruiting young people to a specifically developed family- and wider social network-based intervention by testing an adapted version of adult social behaviour and network therapy (SBNT). METHODS A pragmatic, randomised controlled, open feasibility trial delivered in two services for young people in the UK. Potential participants are aged 12-18 years referred for drug or alcohol problems to either service. The main purpose of this study is to demonstrate the feasibility of recruiting young people to a specifically developed family and social network-based intervention. The feasibility and acceptability of this intervention will be measured by recruitment rates, treatment retention, follow-up rates and qualitative interviews. The feasibility of training staff from existing services to deliver this intervention will be explored. Using this opportunity to compare the effectiveness of the intervention against treatment as usual, Timeline Follow-Back interviews will document the proportion of days on which the main problem substance was used in the preceding 90-day period at each assessment point. The economic component will examine the feasibility of conducting a full incremental cost-effectiveness analysis of the two treatments. The study will also explore and develop models of patient and public involvement which support the involvement of young people in a study of this nature. DISCUSSION An earlier phase of work adapted social behaviour and network therapy (adult approach) to produce a purpose-designed youth version supported by a therapy manual and associated resources. This was achieved by consultation with young people with experience of services and professionals working in services for young people. This feasibility trial alongside ongoing consultations with young people will offer a meaningful understanding of processes of delivery and implementation. TRIAL REGISTRATION ISRCTN93446265; Date ISRCTN assigned 31/05/2013.
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Affiliation(s)
- Judith Watson
- Department of Health Sciences, University of York, York, YO10 5DD UK
| | - Donna Back
- School of Psychology, University of Birmingham, Edgbaston, Birmingham, B15 2TT UK
- Birmingham and Solihull Mental Health Foundation Trust, Birmingham, B1 3RB UK
| | - Paul Toner
- Department of Health Sciences, University of York, York, YO10 5DD UK
| | - Charlie Lloyd
- Department of Health Sciences, University of York, York, YO10 5DD UK
| | - Ed Day
- Addictions Department, Institute of Psychiatry, 4 Windsor Walk, London, SE5 8AF UK
- Birmingham and Solihull Mental Health Foundation Trust, Birmingham, B1 3RB UK
| | | | | | | | - Steve Parrott
- Department of Health Sciences, University of York, York, YO10 5DD UK
| | - David Torgerson
- Department of Health Sciences, University of York, York, YO10 5DD UK
| | - Kim Cocks
- Department of Health Sciences, University of York, York, YO10 5DD UK
| | - Eilish Gilvarry
- Northumberland, Tyne and Wear NHS Foundation Trust, Newcastle, UK
| | | | - Alex Copello
- School of Psychology, University of Birmingham, Edgbaston, Birmingham, B15 2TT UK
- Birmingham and Solihull Mental Health Foundation Trust, Birmingham, B1 3RB UK
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Passa I, Giovazolias T. Evaluation of a self-help group for parents of substance addicted offspring: a mixed methods approach. Subst Use Misuse 2015; 50:32-9. [PMID: 25262652 DOI: 10.3109/10826084.2014.957770] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
The effectiveness of the self-help method for parents of substance addicted offsprings, using a mixed-methods approach was assessed in two samples (n = 92 and n = 6) of parents attending self-help groups in a therapy center for dependent individuals in Athens, Greece. The data were analyzed using one-way ANOVA as well as Interpretative Phenomenological Analysis (IPA). Results indicate that the self-help method contributes to the decrease of anxiety, the adoption of effective coping strategies, and the improvement of family dynamics. Study limitations and implications for clinical practice are discussed.
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Affiliation(s)
- Ioanna Passa
- 1Faculty of Early Childhood Education, University of Athens, Athens, Greece
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70
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Abstract
Addiction professionals and the public are recognizing that certain nonsubstance behaviors--such as gambling, Internet use, video-game playing, sex, eating, and shopping--bear resemblance to alcohol and drug dependence. Growing evidence suggests that these behaviors warrant consideration as nonsubstance or "behavioral" addictions and has led to the newly introduced diagnostic category "Substance-Related and Addictive Disorders" in DSM-5. At present, only gambling disorder has been placed in this category, with insufficient data for other proposed behavioral addictions to justify their inclusion. This review summarizes recent advances in our understanding of behavioral addictions, describes treatment considerations, and addresses future directions. Current evidence points to overlaps between behavioral and substance-related addictions in phenomenology, epidemiology, comorbidity, neurobiological mechanisms, genetic contributions, responses to treatments, and prevention efforts. Differences also exist. Recognizing behavioral addictions and developing appropriate diagnostic criteria are important in order to increase awareness of these disorders and to further prevention and treatment strategies.
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71
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Akram Y, Copello A, Moore D. Family-based interventions for substance misuse: a systematic review of systematic reviews--protocol. Syst Rev 2014; 3:90. [PMID: 25128186 PMCID: PMC4150116 DOI: 10.1186/2046-4053-3-90] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2014] [Accepted: 08/05/2014] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Worldwide, there are an estimated 15 million individuals with drug use disorders and over five times as many with alcohol use disorders (WHO 1:2, 2005). Most individuals with substance misuse have families who are affected. Initial scoping searches identified an expanse of broad and disparate studies and reviews on the family interventions for substance misuse. This systematic review of systematic reviews aims to bring together the expanse of research on the effectiveness of family-based interventions in substance misuse.Initial scoping searches identified an expanse of broad and disparate studies and reviews on the family interventions for substance misuse. This systematic review of systematic reviews aims to bring together the expanse of research on the effectiveness of family-based interventions in substance misuse. METHODS Extensive electronic and manual searches will be undertaken. Screening, data extraction and quality assessment will be undertaken by two reviewers with disagreements resolved through discussion.The inclusion criteria will be that the study is a systematically undertaken review, the population is individuals with substance misuse problems and the interventions include a family-focused component. Reviews that focus on prevention rather than treatment will be excluded. The reviews will be assessed for quality and relevance. The evidence from included systematic reviews will be mapped by focus of intervention (promoting engagement of user into treatment/joint involvement in treatment of user/treating family member in own right) for both adults and adolescents for drug and/or alcohol misusers to allow assessment of the density of available evidence. The higher-quality, up-to-date evidence for each domain will be identified and described, and conclusions will be drawn with limitations of the evidence highlighted. DISCUSSION This systematic review of systematic reviews will be an efficient and robust way of looking at the current state of the evidence in the field of family-based interventions for substance misuse. It will evaluate all the available systematic-review-level literature to report on the effectiveness of family-based psychological interventions in improving substance-related outcomes and improving health and wellbeing of substance misusers and/or their families. This will inform future treatment policies and commissioning decisions.In addition, it will identify areas of poor quality, inconsistency and gaps in the evidence base for family-based psychological interventions in substance misuse with respect to secondary evidence in order to inform future research. SYSTEMATIC REVIEW REGISTRATION PROSPERO CRD42014006834.
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Affiliation(s)
- Yasmin Akram
- University of Birmingham, Birmingham B15 2TT, UK.
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72
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Alcohol drinking patterns and differences in alcohol-related harm: a population-based study of the United States. BIOMED RESEARCH INTERNATIONAL 2014; 2014:853410. [PMID: 25057502 PMCID: PMC4095708 DOI: 10.1155/2014/853410] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/21/2014] [Revised: 04/22/2014] [Accepted: 05/14/2014] [Indexed: 11/29/2022]
Abstract
Alcohol use and associated alcohol-related harm (ARH) are a prevalent and important public health problem, with alcohol representing about 4% of the global burden of disease. A discussion of ARH secondary to alcohol consumption necessitates a consideration of the amount of alcohol consumed and the drinking pattern. This study examined the association between alcohol drinking patterns and self-reported ARH. Pearson chi-square test (χ2) and logistic regression analyses were used on data from the National Comorbidity Survey Replication (NCS-R). The NCS-R is a cross-sectional nationally representative sample. Data was obtained by face-to-face interviews from 9282 adults aged ≥18 years in the full sample, and 5,692 respondents in a subsample of the full sample. Results presented as odds ratio (OR) and 95% confidence intervals (95% CI). Alcohol drinking patterns (frequency of drinking, and drinks per occasion) were associated with increased risks of self-reported ARH; binge or “risky” drinking was strongly predictive of ARH than other categories of drinks per occasion or frequency of drinking; and men had significantly higher likelihood of ARH in relation to frequency of drinking and drinks per occasion. Findings provide evidence for public health practitioners to target alcohol prevention strategies at the entire population of drinkers.
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73
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Joolaee S, Fereidooni Z, Seyed Fatemi N, Meshkibaf MH, Mirlashari J. Exploring needs and expectations of spouses of addicted men in Iran: a qualitative study. Glob J Health Sci 2014; 6:132-41. [PMID: 25169001 PMCID: PMC4825508 DOI: 10.5539/gjhs.v6n5p132] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2014] [Accepted: 05/04/2014] [Indexed: 11/30/2022] Open
Abstract
Addiction is one of the majore problems that affect everyone in the society especially the spouses of addicted men who have to face a large number of problems which are the consequences of their husband’s addiction. This qualitative study was conducted to explore the needs and expectations of women who are living with their addicted husband in Iran. Twenty-four spouses of addicted men participated in this study. The participants were interviewed and each interview was analyzed via the content analysis method. The results of this study showed that the women’s difficulties were related to their approach to the treatment, or their husbands’ response to the treatment, financial constraints and emotional and informational needs. Moreover, these Iranian women expected more stringent control by the government on the phenomenon of addiction and drug trafficking with a view of having a drug-free country. The needs and expectations of the wives of addicted men are context-based and should be assessed separately between individuals, families, and communities. In addition to the addicted person, it is vitally important that the health of the family members of drug addicts be taken into account and for whom supportive services be provided.
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Affiliation(s)
- Soodabeh Joolaee
- Associate Professor Center for Nursing Care Research, Nursing and Midwifery School, Iran University of Medical Sciences, Tehran, Iran..
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74
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Hudson CR, Kirby KC, Clements NT, Benishek LA, Nick CE. Social adjustment of women with and without a substance-abusing partner. J Psychoactive Drugs 2014; 46:106-13. [PMID: 25052786 PMCID: PMC4112468 DOI: 10.1080/02791072.2014.880536] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Little normative information is available about the psychosocial functioning of women who have a substance-abusing intimate partner. This study examined whether the social adjustment of women who indicate that they have a substance-abusing partner (n=69) is compromised relative to that of women who indicate that their partner does not abuse substances (n=68). Women with a substance-abusing partner reported compromised social adjustment relative to a comparison sample both overall and in five of six life domains (work, social/leisure, primary relationship, parental, family). Results suggest the potential benefit of expanding the focus of research and treatment to include effects and outcomes for these women and to influence treatment-related policy.
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Affiliation(s)
- Clifton R. Hudson
- Independent Forensic Consultant & Proprietor, Hudson Forensic Psychology, South Charleston, West Virginia
| | - Kimberly C. Kirby
- Director of Behavioral Treatments & Applications Research, Treatment Research Institute, and Research Associate Professor, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Nicolle T. Clements
- Data Analyst, Treatment Research Institute and Assistant Professor, St. Joseph’s University, Philadelphia, Pennsylvania
| | - Lois A. Benishek
- Behavioral Scientist, Treatment Research Institute, Philadelphia, Pennsylvania
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Abstract
Research on drug use often fails to account for drug dealing in most analyses of violence and other systemic risks associated with illegal drugs. The current study examined whether drug dealing, independent of its connection to drug use, increases involvement with delinquent peers, violence, weapons, and other drug-related conflicts. Data were drawn from the first two waves of the Toledo Adolescent Relationships Study ( N = 1,148). Hierarchical linear models were used to investigate changes in these behaviors that resulted from the respondents’ involvement in drug dealing and drug use. Results indicate that involvement in drug dealing, controlling for drug use, increases violence and other systemic risks to a level that drug use alone is not likely to achieve. Findings also show, however, that drug use among dealers may reduce violence and limit contact with delinquent peers.
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76
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Is there more to psychosocial treatments in addiction than brief interventions? Ir J Psychol Med 2014; 31:61-68. [PMID: 30189469 DOI: 10.1017/ipm.2013.44] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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77
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Mugavin J, Livingston M, Laslett AM. Seeking help because of others' drinking. Drug Alcohol Rev 2014; 33:161-8. [PMID: 24423167 DOI: 10.1111/dar.12113] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2013] [Accepted: 12/06/2013] [Indexed: 11/29/2022]
Abstract
INTRODUCTION AND AIMS Many individuals contact and are assisted by community and emergency services because of someone else's drinking. Previous studies have focused on family members accessing services, such as Alcoholics Anonymous due to significant others' drinking; however, little is known about service use in the broad community. This paper aims to estimate the prevalence of contacting the police and seeking help from health services because of others' drinking and to compare the profiles of individuals seeking services with those who did not contact a service. DESIGN AND METHODS A total of 2649 adult Australians were surveyed about their experience of harm from others' drinking, including use of emergency and community services. RESULTS In the 12 months prior to the survey, 13% of respondents had contacted the police and 5% had sought help from a health-related service. Using logistic regression, being older and having a secondary school education were associated with a decreased likelihood of contacting police because of others' drinking, whereas residing in a non-metropolitan location was positively associated with using health-related services. Having a partner was negatively associated with use of health-related services. The extent of self-reported harm from others' drinking was the only factor associated with use of both police and health-related services. DISCUSSION AND CONCLUSION Results suggest differences in the profile of respondents who call the police and those who seek health-related services due to others' drinking. This supports the need for tailored services to support and address the needs of people experiencing harm from others' drinking.
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Affiliation(s)
- Janette Mugavin
- Centre for Alcohol Policy Research, Turning Point, Melbourne, Australia
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78
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Reisner SL, Gamarel KE, Nemoto T, Operario D. Dyadic effects of gender minority stressors in substance use behaviors among transgender women and their non-transgender male partners. PSYCHOLOGY OF SEXUAL ORIENTATION AND GENDER DIVERSITY 2014; 1:63-71. [PMID: 25642440 DOI: 10.1037/0000013] [Citation(s) in RCA: 57] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Despite evidence that interpersonal processes shape health behaviors, research concerning the dyadic effects of gender minority stressors on substance use behaviors of transgender people is scarce. The objective of this study was to use dyadic analysis to examine whether transgender discrimination was associated with substance use among transgender women and their male partners. METHODS Transgender women and their male partners (N=191 couples; N=382 individuals) completed questionnaires. Participants' mean age was 37.1; 79.1% were racial/ethnic minority; 61.3% earned <$500 per-month. The mean relationship duration was 37.9 months. Actor-Partner Interdependence Models were used to examine the associations between transgender-related discrimination and past 30-day non-marijuana illicit drug use adjusting for age, relationship length, financial hardship, and depressive distress among partners in these dyads. RESULTS Illicit drug use was reported by 31.4% of transgender women and 25.1% of their male partners. Perceived transgender discrimination was independently associated with increased odds of illicit drug use for transgender women (actor effect) but not for their male partners. Financial hardship statistically predicted drug use for both partners (actor effects). There were no partner effects for financial hardship on drug use. Overall, 34.5% of dyads had discrepant substance use. Discrimination scores of male partners differentiated dyads who reported discrepant substance use. DISCUSSION Gender minority stressors are critical to understanding substance use among transgender women and their male partners. Integrating socioeconomic status into gender minority stress frameworks is essential. Results have implications for substance use prevention and treatment, including the need to incorporate gender minority stressors into interventions.
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Affiliation(s)
- Sari L Reisner
- Department of Epidemiology, Harvard School of Public Health, Boston, MA ; The Fenway Institute, Fenway Health, Boston, MA
| | - Kristi E Gamarel
- Basic & Applied Social Psychology, Graduate Center at the City University of New York, New York City, NY
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79
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Characteristics and treatment interests among individuals with substance use disorders and a history of past six-month violence: findings from an emergency department study. Addict Behav 2014; 39:265-72. [PMID: 24148140 DOI: 10.1016/j.addbeh.2013.10.004] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2013] [Revised: 09/08/2013] [Accepted: 10/01/2013] [Indexed: 11/22/2022]
Abstract
The study examined clinical characteristics and treatment interests of individuals identified to have substance use disorders (SUDs) in an urban emergency department (ED) who reported past six-month history of violence or victimization. Specifically, participants were 1441 ED patients enrolled in a randomized controlled trial of interventions designed to link those with SUDs to treatment. To examine factors related to violence type, four groups based on participants' reports of violence toward others were created: no violence (46.8%), partner violence only (17.3%), non-partner violence only (20.2%), and both partner and non-partner violence (15.7%). Four groups based on participants' reports of victimization were also created: no violence (42.1%), victimization from partner only (18.7%), victimization from non-partner only (20.2%), and both partner and non-partner victimization (17.7%). Separate multinomial logistic regression analyses were conducted to examine which variables distinguished the violence and victimization groups from those reporting no violence or victimization. For violence toward others, demographic variables, alcohol and cocaine disorders, and rating treatment for psychological problems were higher for violence groups, with some differences depending on the type of violence. For victimization, demographic variables, having an alcohol disorder, and rating treatment for family/social problems were higher for violence groups, also with some differences depending on the type of violence. Findings from the present study could be useful for designing effective brief interventions and services for ED settings.
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80
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Abstract
O envolvimento da família no tratamento tem sido apontado como preditor de sucesso terapêutico da dependência química. Nesse sentido, foi realizada uma investigação qualitativa, utilizando o estudo de caso de dependente químico e sua família, atendidos por instituição de saúde, para identificação da dinâmica relacional estabelecida nestes contextos. Para a coleta de dados foram utilizados entrevistas, genograma e registros de grupos de familiares. A análise dos dados se deu a partir da compreensão sistêmica da família. O estudo realizado aponta a necessidade de compreensão da dependência química como fenômeno que pode ser influenciado pela dinâmica familiar reforçando aspectos de seu funcionamento para a manutenção do sintoma. Tratar a disfuncionalidade familiar pode constituir-se um fator de proteção ao uso de drogas e prevenção à recaída.
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81
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Chen G, Elisha E, Timor U, Ronel N. Parents' perceptions of their adolescent sons' recovery in a therapeutic community for addicted clients. INTERNATIONAL JOURNAL OF OFFENDER THERAPY AND COMPARATIVE CRIMINOLOGY 2013; 57:1417-1436. [PMID: 22992657 DOI: 10.1177/0306624x12460226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
A qualitative phenomenological study of parents of addicted male adolescents who were residents of a Jewish therapeutic community (TC) describes and interprets the parents' perceptions of the recovery process. Deep, semistructured interviews with 14 parents provided the data. The parents' perceptions were clustered into three main themes of meaning: (a) the process of change, (b) the experiences of family members in the course of the son's recovery process, and (c) the parents' perception of the treatment at Retorno. According to the parents, the admission of their sons into the TC brought notable relief to the family life, which enabled the whole family to begin a recovery process. The findings support the positive criminology perspective that emphasizes the disintegration-integration vector as significant in the recovery process. Recommendations for intervention planning are provided.
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82
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Ahmedani BK, Kubiak SP, Kessler RC, de Graaf R, Alonso J, Bruffaerts R, Zarkov Z, Viana MC, Huang YQ, Hu C, Posada-Villa JA, Lepine JP, Angermeyer MC, de Girolamo G, Karam AN, Medina-Mora ME, Gureje O, Ferry F, Sagar R, Anthony JC. Embarrassment when illness strikes a close relative: a World Mental Health Survey Consortium Multi-Site Study. Psychol Med 2013; 43:2191-2202. [PMID: 23298443 PMCID: PMC4013530 DOI: 10.1017/s003329171200298x] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND In this global study we sought to estimate the degree to which a family member might feel embarrassed when a close relative is suffering from an alcohol, drug, or mental health condition (ADMC) versus a general medical condition (GMC). To date, most studies have considered embarrassment and stigma in society and internalized by the afflicted individual but have not assessed family embarrassment in a large-scale study. METHOD In 16 sites of the World Mental Health Surveys (WMHS), standardized assessments were completed including items on family embarrassment. Site matching was used to constrain local socially shared determinants of stigma-related feelings, enabling a conditional logistic regression model that estimates the embarrassment close relatives may hold in relation to family members affected by an ADMC, a GMC, or both conditions. RESULTS There was a statistically robust association such that subgroups with an ADMC-affected relative were more likely to feel embarrassed compared to subgroups with a relative affected by a GMC (p<0.001), even with covariate adjustments for age and sex. CONCLUSIONS . The pattern of evidence from this research is consistent with conceptual models for interventions that target individual- and family-level stigma-related feelings of embarrassment as possible obstacles to effective early intervention and treatment for an ADMC. Macro-level interventions are under way but micro-level interventions may also be required among family members, along with care for each person with an ADMC.
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Affiliation(s)
- B K Ahmedani
- Center for Health Policy and Health Services Research, Henry Ford Health System, Detroit, MI 48202, USA.
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83
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Day E, Copello A, Karia M, Roche J, Grewal P, George S, Haque S, Chohan G. Social network support for individuals receiving opiate substitution treatment and its association with treatment progress. Eur Addict Res 2013; 19:211-21. [PMID: 23391965 DOI: 10.1159/000343827] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2012] [Accepted: 09/27/2012] [Indexed: 11/19/2022]
Abstract
BACKGROUND/AIMS Social networks have been hypothesized to protect people from the harmful effects of stress, but may also provide dysfunctional role models and provide cues associated with drug use. This study describes the range, type and level of social support available to patients engaged in UK opiate substitution treatment (OST) programmes, and explores the association between network factors and continued use of illicit heroin. METHODS A cross-sectional survey of a randomly selected sample of OST patients (n = 118) utilised measures of current substance use and social network structure and support. RESULTS More than half of the participants had used heroin in the previous month, and most described networks that were both supportive and positive about treatment. Multivariate analysis showed that the substance use involvement of network members was higher in those patients still using heroin, even when other treatment factors were controlled for. CONCLUSION There was a strong association between ongoing contact with other drug users and continued use of illicit heroin in this treatment sample. Whilst there is potential for the involvement of social networks in treatment, future research needs to ascertain the exact nature of the relationship between social support and drug use.
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Affiliation(s)
- Ed Day
- Department of Psychiatry, University of Birmingham, Birmingham B15 2FG, UK.
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84
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Orr LC, Barbour RS, Elliott L. Carer involvement with drug services: a qualitative study. Health Expect 2012; 16:e60-72. [PMID: 23216899 PMCID: PMC3883094 DOI: 10.1111/hex.12033] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/02/2012] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Empirical research suggests that involving carers brings benefits to families and services. Consequently, drug-related policy and guidance has increasingly encouraged drug services to involve carers at all levels of service provision. OBJECTIVE To explore the purpose and scope of carer involvement with adult drug services in North-east Scotland. DESIGN, SETTING AND PARTICIPANTS A total of 82 participants (20 informal carers, 43 service providers and 19 policy makers) were purposively selected to take part in a qualitative study. Eight focus groups and 32 interviews were conducted between 2007 and 2008. FINDINGS Three themes were identified through thematic coding: 'Current levels of involvement', 'Use of the term carer' and 'Opportunities for change?' Carer involvement was described as limited, unplanned and unstructured, and consisted largely of information and advice, practical and emotional support, and signposting of services. Although use of the term 'carer' was contested within and across the groups, caring in a drug context was considered the 'same but different' from caring in other contexts. Carers remained sceptical that services actually wanted to involve them in supporting their relative or to offer carers support in their own right. Many service providers and policy makers regarded carer involvement as an aspiration. CONCLUSION Encouraging carers, service providers and policy makers to reach a shared understanding of caring in a drug context may help translation of policy into practice. However, there is also a fundamental need for drug services to widen the level and type of involvement activities on offer to carers.
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Affiliation(s)
- Linda C Orr
- School of Nursing and Midwifery, University of Dundee, Dundee, UK.
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85
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Benishek LA, Carter M, Clements NT, Allen C, Salber KE, Dugosh KL, Kirby KC. Psychometric assessment of a self-administered version of the Significant Other Survey. PSYCHOLOGY OF ADDICTIVE BEHAVIORS 2012; 26:986-93. [PMID: 23067309 DOI: 10.1037/a0030378] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
While there are a number of general measures that assess interpersonal and psychological distress experienced by individuals who are in a close relationship with a substance abusing adult, until recently the field has lacked a psychometrically sound, self-administered multidimensional measure explicitly designed to measure the problems of non-substance-abusing adults who are concerned about a substance using loved one. This study examined the psychometric properties of a 54-item, self-administered (SA) version of the Significant Other Survey (SOS), a measure designed to address this gap. The SOS-SA assesses problems across seven problem domains (emotional, relationship, family, financial, physical violence, legal, health). Coefficient alpha estimates (N = 168) were good to excellent for five of the domains, the test-retest reliability (N = 83) across a 7-day time frame was fair to excellent for all seven domains. Similar reliability coefficients were identified regardless of whether the item queried about the problem frequency or perceived severity. There was preliminary support for the construct and discriminant validity of the SOS-SA. The SOS-SA appears to be a promising instrument given that it is brief, requires no specialized training to administer, and has good psychometric properties.
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Affiliation(s)
- Lois A Benishek
- Treatment Research Institute, Philadelphia, PA 19106-3475, USA.
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86
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Contractor LFM, Celedonia KL, Cruz M, Douaihy A, Kogan JN, Marin R, Stein BD. Mental health services for children of substance abusing parents: voices from the community. Community Ment Health J 2012; 48:22-8. [PMID: 21107692 DOI: 10.1007/s10597-010-9357-6] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2009] [Accepted: 10/06/2010] [Indexed: 11/26/2022]
Abstract
This qualitative study explores how to improve services for children of parents with Substance Use Disorders (SUD) with unmet mental health needs. Focus groups were conducted with parents and caregivers to identify perceived barriers to services, including: (1) attitudes and beliefs about mental health care, (2) inadequacies in mental health services, (3) children's ambivalence about treatment, and (4) parental disagreement and lack of involvement. Peer support, afterschool activities, and family counseling were identified as potential improvements. This information can serve as a foundation and guide to develop services for the underserved population of children and adolescents of substance abusing parents.
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87
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Lee CE, Christie MM, Copello A, Kellett S. Barriers and enablers to implementation of family-based work in alcohol services: A qualitative study of alcohol worker perceptions. DRUGS: EDUCATION, PREVENTION AND POLICY 2012. [DOI: 10.3109/09687637.2011.644599] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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88
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Hussaarts P, Roozen HG, Meyers RJ, van de Wetering BJ, McCrady BS. Problem Areas Reported by Substance Abusing Individuals and Their Concerned Significant Others. Am J Addict 2011; 21:38-46. [DOI: 10.1111/j.1521-0391.2011.00187.x] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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89
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Jackson LA, Dykeman M, Gahagan J, Karabanow J, Parker J. Challenges and opportunities to integrating family members of injection drug users into harm reduction efforts within the Atlantic Canadian context. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2011; 22:385-92. [PMID: 21742479 DOI: 10.1016/j.drugpo.2011.05.011] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2011] [Revised: 05/06/2011] [Accepted: 05/17/2011] [Indexed: 11/18/2022]
Abstract
BACKGROUND This paper explores injection drug users' (IDUs) relationships with non-drug using family members in order to understand the potential opportunities for, and challenges to, having these family members provide harm reduction services (e.g., clean syringes). METHODS The qualitative data for this paper were drawn from a larger study of IDUs' relationships with key individuals in their lives (e.g., friends, family members). Interviews were conducted with 115 IDUs from across Atlantic Canada living in both urban and rural areas. RESULTS IDUs report that their relationships with family members are variable and dynamic, often changing over time. IDUs and family members engage in a variety of strategies to protect themselves from the multiple harms associated with drug use. Several strategies of self-protection (e.g., discontinuing all contact) are antithetical to the provision of harm reduction supports by family members. However, other strategies are based on continued contact, providing a potential opportunity for the integration of harm reduction approaches. Some family members not only have contact but provide supports (e.g., emotional support, housing) thus potentially facilitating the integration of harm reduction. In a few instances, family members already provide harm reduction supports (e.g., safe space to use). CONCLUSIONS Conceptualizing addictions as a health and social justice issue, and providing appropriate interventions, may reduce some of the harms experienced by users and family members thus encouraging sustained relationships and greater integration of harm reduction approaches into the relationship. Targeted education to family members about harm reduction may also further encourage their involvement in such efforts. Likewise, supporting family members who are already providing harm reduction supports will likely assist in the scaling-up of harm reduction efforts.
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Affiliation(s)
- Lois A Jackson
- School of Health and Human Performance, Faculty of Health Professions, Dalhousie University, 1459 Oxford Street, Halifax, Nova Scotia, Canada B3H 4R2.
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90
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Gunzerath L, Hewitt BG, Li TK, Warren KR. Alcohol research: past, present, and future. Ann N Y Acad Sci 2010; 1216:1-23. [PMID: 21182533 DOI: 10.1111/j.1749-6632.2010.05832.x] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Created forty years ago, the National Institute on Alcohol Abuse and Alcoholism (NIAAA) has played a major role in the great strides made in the understanding, treatment, prevention, and public acceptance of alcohol-use disorders. Throughout most of U.S. history "habitual drunkenness" was viewed as a problem of moral degeneracy or character flaw inherent in the individual. However, the wealth of scientific evidence amassed throughout NIAAA's history has established alcoholism as a medical condition, that is, as a disease for which affected individuals should feel no shame or be treated with disdain. We look at the developments in alcohol epidemiology, typology, etiology, prevention, and treatment research over the past 40 years. We also discuss how NIAAA addresses alcohol disorders from a life-course framework, affecting all stages of the lifespan, from fetus through child, adolescent, and young adult, to midlife/senior adult, with each stage involving different risks, consequences, prevention efforts, and treatment strategies.
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Affiliation(s)
- Lorraine Gunzerath
- National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Rockville, Maryland 20892, USA.
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91
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Iwen J, Bischof G, Reinhardt S, Grothues J, Hapke U, John U, Freyer-Adam J, Rumpf HJ. The impact of having a loved one with alcohol consumption-related problems on subjective health status and health-risk behaviors in a general hospital sample. Subst Use Misuse 2010; 45:2470-80. [PMID: 20536354 DOI: 10.3109/10826084.2010.487233] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Consecutively admitted inpatients of a general hospital in Northern Germany (N = 2903) completed a standardized screening questionnaire in 2005-2006 containing questions about alcohol consumption-related problems in loved ones, their own alcohol consumption, and other health-related aspects. Almost 26.2% reported having a loved one with alcohol consumption-related problems. The proportions of smokers and those who screened positively for at-risk consumption or alcohol abuse were significantly higher in those patients; they were significantly younger and reported worse overall states of health and emotional health. Since those patients showed a high risk of numerous health problems, psychological interventions were implemented. The study's limitation noted.
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Affiliation(s)
- Julia Iwen
- Department of Psychiatry and Psychotherapy, University of Luebeck, Ratzeburger Allee, Luebeck, Germany.
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92
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Copello A, Templeton L, Powell J. The impact of addiction on the family: Estimates of prevalence and costs. DRUGS-EDUCATION PREVENTION AND POLICY 2010. [DOI: 10.3109/09687637.2010.514798] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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93
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Copello A, Templeton L, Orford J, Velleman R. The 5-Step Method: Principles and practice. DRUGS-EDUCATION PREVENTION AND POLICY 2010. [DOI: 10.3109/09687637.2010.515186] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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94
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Arcidiacono C, Velleman R, Procentese F, Berti P, Albanesi C, Sommantico M, Copello A. Italian families living with relatives with alcohol or drugs problems. DRUGS-EDUCATION PREVENTION AND POLICY 2010. [DOI: 10.3109/09687630902824262] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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95
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Affiliation(s)
- Alex Copello
- School of Psychology, The University of Birmingham and Consultant Clinical Psychologist Addictions Programme, Birmingham and Solihull Mental Health Foundation Trust, Birmingham, UK.
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96
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Rhodes T, Bernays S, Houmoller K. Parents who use drugs: Accounting for damage and its limitation. Soc Sci Med 2010; 71:1489-97. [DOI: 10.1016/j.socscimed.2010.07.028] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2010] [Revised: 06/09/2010] [Accepted: 07/21/2010] [Indexed: 10/19/2022]
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97
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Heinrichs N, Cronrath AL, Degen M, Snyder DK. The link between child emotional and behavioral problems and couple functioning. ACTA ACUST UNITED AC 2010. [DOI: 10.1080/19424620.2010.569366] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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98
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Flynn B. Using systemic reflective practice to treat couples and families with alcohol problems. J Psychiatr Ment Health Nurs 2010; 17:583-93. [PMID: 20712681 DOI: 10.1111/j.1365-2850.2010.01574.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
In the UK, an adult with a drinking problem is generally treated from an individual perspective with minimal involvement of carers and relatives. In response to this gap in service provision, a systemic reflecting intervention was introduced to assist couples and families experiencing alcohol-related difficulties. The article documents the background and development of this initiative. Findings from evaluation and clinical outcome studies are reviewed and demonstrate how the use of the approach proved to be effective in facilitating positive change both in drinking and family behaviour. In conclusion, the paper explores the implications of how systemic reflective practice with family groups may be extended and be usefully used in wider addiction, diverse mental and general health-care settings.
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Affiliation(s)
- B Flynn
- Mt Zeehan Unit, St Martins Hospital, Canterbury, UK.
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99
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Ronel N, Haimoff-Ayali R. Risk and resilience: the family experience of adolescents with an addicted parent. INTERNATIONAL JOURNAL OF OFFENDER THERAPY AND COMPARATIVE CRIMINOLOGY 2010; 54:448-472. [PMID: 19270268 DOI: 10.1177/0306624x09332314] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
The family relationships of adolescents brought up by an addicted parent were studied in a qualitative research. The authors interviewed 19 adolescents, all of whom had a parent either actively addicted to drugs or else recovering addicts. The participants were assigned to one of two groups based on the degree to which they maintained normative lives or descended into addiction. It was found that the relative strength of the adolescents within the triad of forces (mother, father, self) had great significance for their development. Younger siblings awakened a desire to protect them from a life of addiction. The extended family was also found to have a potential to influence, in keeping with the significance the young people attributed to these relatives. The results indicate a definition, the first of its kind, of subjective risk and protective factors representing subjective perceptions of the reality of the lives of the participants.
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100
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Pompili M, Serafini G, Innamorati M, Dominici G, Ferracuti S, Kotzalidis GD, Serra G, Girardi P, Janiri L, Tatarelli R, Sher L, Lester D. Suicidal behavior and alcohol abuse. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2010; 7:1392-431. [PMID: 20617037 PMCID: PMC2872355 DOI: 10.3390/ijerph7041392] [Citation(s) in RCA: 227] [Impact Index Per Article: 16.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/19/2010] [Revised: 03/15/2010] [Accepted: 03/19/2010] [Indexed: 12/22/2022]
Abstract
Suicide is an escalating public health problem, and alcohol use has consistently been implicated in the precipitation of suicidal behavior. Alcohol abuse may lead to suicidality through disinhibition, impulsiveness and impaired judgment, but it may also be used as a means to ease the distress associated with committing an act of suicide. We reviewed evidence of the relationship between alcohol use and suicide through a search of MedLine and PsychInfo electronic databases. Multiple genetically-related intermediate phenotypes might influence the relationship between alcohol and suicide. Psychiatric disorders, including psychosis, mood disorders and anxiety disorders, as well as susceptibility to stress, might increase the risk of suicidal behavior, but may also have reciprocal influences with alcohol drinking patterns. Increased suicide risk may be heralded by social withdrawal, breakdown of social bonds, and social marginalization, which are common outcomes of untreated alcohol abuse and dependence. People with alcohol dependence or depression should be screened for other psychiatric symptoms and for suicidality. Programs for suicide prevention must take into account drinking habits and should reinforce healthy behavioral patterns.
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Affiliation(s)
- Maurizio Pompili
- Department of Neuroscience, Mental Health and Sensory Functions, Suicide Prevention Center, Sant’Andrea Hospital, Sapienza University of Rome, Rome 00189, Italy; E-Mails:
(G.S.);
(M.I.);
(G.D.);
(S.F.);
(G.D.K.);
(G.S.);
(P.G.);
(R.T.)
- McLean Hospital, Harvard Medical School, Belmont, MA 02478, USA
- Author to whom correspondence should be addressed; E-Mail:
or
; Tel. +39-06 33775675; Fax +39-0633775342
| | - Gianluca Serafini
- Department of Neuroscience, Mental Health and Sensory Functions, Suicide Prevention Center, Sant’Andrea Hospital, Sapienza University of Rome, Rome 00189, Italy; E-Mails:
(G.S.);
(M.I.);
(G.D.);
(S.F.);
(G.D.K.);
(G.S.);
(P.G.);
(R.T.)
| | - Marco Innamorati
- Department of Neuroscience, Mental Health and Sensory Functions, Suicide Prevention Center, Sant’Andrea Hospital, Sapienza University of Rome, Rome 00189, Italy; E-Mails:
(G.S.);
(M.I.);
(G.D.);
(S.F.);
(G.D.K.);
(G.S.);
(P.G.);
(R.T.)
| | - Giovanni Dominici
- Department of Neuroscience, Mental Health and Sensory Functions, Suicide Prevention Center, Sant’Andrea Hospital, Sapienza University of Rome, Rome 00189, Italy; E-Mails:
(G.S.);
(M.I.);
(G.D.);
(S.F.);
(G.D.K.);
(G.S.);
(P.G.);
(R.T.)
| | - Stefano Ferracuti
- Department of Neuroscience, Mental Health and Sensory Functions, Suicide Prevention Center, Sant’Andrea Hospital, Sapienza University of Rome, Rome 00189, Italy; E-Mails:
(G.S.);
(M.I.);
(G.D.);
(S.F.);
(G.D.K.);
(G.S.);
(P.G.);
(R.T.)
| | - Giorgio D. Kotzalidis
- Department of Neuroscience, Mental Health and Sensory Functions, Suicide Prevention Center, Sant’Andrea Hospital, Sapienza University of Rome, Rome 00189, Italy; E-Mails:
(G.S.);
(M.I.);
(G.D.);
(S.F.);
(G.D.K.);
(G.S.);
(P.G.);
(R.T.)
| | - Giulia Serra
- Department of Neuroscience, Mental Health and Sensory Functions, Suicide Prevention Center, Sant’Andrea Hospital, Sapienza University of Rome, Rome 00189, Italy; E-Mails:
(G.S.);
(M.I.);
(G.D.);
(S.F.);
(G.D.K.);
(G.S.);
(P.G.);
(R.T.)
| | - Paolo Girardi
- Department of Neuroscience, Mental Health and Sensory Functions, Suicide Prevention Center, Sant’Andrea Hospital, Sapienza University of Rome, Rome 00189, Italy; E-Mails:
(G.S.);
(M.I.);
(G.D.);
(S.F.);
(G.D.K.);
(G.S.);
(P.G.);
(R.T.)
| | - Luigi Janiri
- Department of Psychiatry, Catholic University Medical School, Largo F. Vito 1, Rome 00168, Italy; E-Mail:
| | - Roberto Tatarelli
- Department of Neuroscience, Mental Health and Sensory Functions, Suicide Prevention Center, Sant’Andrea Hospital, Sapienza University of Rome, Rome 00189, Italy; E-Mails:
(G.S.);
(M.I.);
(G.D.);
(S.F.);
(G.D.K.);
(G.S.);
(P.G.);
(R.T.)
| | - Leo Sher
- Department of Psychiatry, Columbia University, New York, NY 10032, USA; E-Mail:
| | - David Lester
- The Richard Stockton College of New Jersey, Pomona, NJ 08240-0195, USA; E-Mail:
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