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Hodgkin D, Garnick DW, Horgan CM, Busch AB, Stewart MT, Reif S. Is it feasible to pay specialty substance use disorder treatment programs based on patient outcomes? Drug Alcohol Depend 2020; 206:107735. [PMID: 31790980 PMCID: PMC6941579 DOI: 10.1016/j.drugalcdep.2019.107735] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2019] [Revised: 11/06/2019] [Accepted: 11/09/2019] [Indexed: 01/19/2023]
Abstract
BACKGROUND Some US payers are starting to vary payment to providers depending on patient outcomes, but this approach is rarely used in substance use disorder (SUD) treatment. PURPOSE We examine the feasibility of applying a pay-for-outcomes approach to SUD treatment. METHODS We reviewed several relevant literatures: (1) economic theory papers that describe the conditions under which pay-for-outcomes is feasible in principle; (2) description of the key outcomes expected from SUD treatment, and the measures of these outcomes that are available in administrative data systems; and (3) reports on actual experiences of paying SUD treatment providers based on patient outcomes. RESULTS The economics literature notes that when patient outcomes are strongly influenced by factors beyond provider control and when risk adjustment performs poorly, pay-for-outcomes will increase provider financial risk. This is relevant to SUD treatment. The literature on SUD outcome measurement shows disagreement on whether to include broader outcomes beyond abstinence from substance use. Good measures are available for some of these broader constructs, but the need for risk adjustment still brings many challenges. Results from two past payment experiments in SUD treatment reinforce some of the concerns raised in the more conceptual literature. CONCLUSION There are special challenges in applying pay-for-outcomes to SUD treatment, not all of which could be overcome by developing better measures. For SUD treatment it may be necessary to define outcomes more broadly than for general medical care, and to continue conditioning a sizeable portion of payment on process measures.
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Affiliation(s)
- Dominic Hodgkin
- Institute for Behavioral Health, Heller School for Social Policy and Management, Brandeis University, USA.
| | - Deborah W Garnick
- Institute for Behavioral Health, Heller School for Social Policy and Management, Brandeis University, USA
| | - Constance M Horgan
- Institute for Behavioral Health, Heller School for Social Policy and Management, Brandeis University, USA
| | - Alisa B Busch
- McLean Hospital, and the Department of Health Care Policy, Harvard Medical School, USA
| | - Maureen T Stewart
- Institute for Behavioral Health, Heller School for Social Policy and Management, Brandeis University, USA
| | - Sharon Reif
- Institute for Behavioral Health, Heller School for Social Policy and Management, Brandeis University, USA
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102
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O'Grady MA, Lincourt P, Hussain S, Gilmer E, Neighbors CJ. An instrument for assessing progress in substance use disorder treatment: a pilot study of initial reliability and factor structure of the Treatment Progress Assessment-8. J Addict Dis 2019; 38:49-54. [PMID: 31870228 DOI: 10.1080/10550887.2019.1695512] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
New instruments are needed to assist substance use disorder (SUD) clinics in monitoring client treatment progress. This paper describes the development of an 8-item monitoring tool and results from a pilot to understand the tool's structure and reliability. 393 clients completed the tool upon treatment entry. A factor analysis resulted in a 2-factor solution: SUD symptoms and treatment progress. Multiple regression analyses showed that clients in inpatient detoxification had lower scores than those in less intensive levels of care. Acceptable internal consistency reliability was found. This study shows promise for the tool and sets the stage for future validation work.
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Affiliation(s)
- Megan A O'Grady
- Division of Health Services Research, Center on Addiction, New York, USA
| | - Patricia Lincourt
- Addiction Treatment and Recovery, New York State Office of Alcoholism and Substance Abuse Services, New York, USA
| | - Shazia Hussain
- Practice Innovation and Care Management, New York State Office of Alcoholism and Substance Abuse Services, New York, USA
| | - Evan Gilmer
- Division of Health Services Research, Center on Addiction, New York, USA
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103
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Rampure R, Inbaraj LR, Elizabeth CG, Norman G. Factors Contributing to Alcohol Relapse in a Rural Population: Lessons from a Camp-Based De-Addiction Model from Rural Karnataka. Indian J Community Med 2019; 44:307-312. [PMID: 31802790 PMCID: PMC6881896 DOI: 10.4103/ijcm.ijcm_321_18] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Context: Alcohol consumption is the third largest risk factor for disease and disability in developing countries. Globally, 4% of all deaths are related to alcohol consumption every year. De-addiction measures and rehabilitation strategies can sometimes be challenging in rural population as there is a potential for a higher rate of relapse due to socio-cultural barriers such as unemployment, limited entrainment activities, and peer pressure during social events. Methodology: A cross-sectional study was conducted to determine the factors contributing to relapse in Bengaluru rural district. A total of 112 participants were interviewed, after attending de-addiction camp, using a semi-structured questionnaire containing instruments such as Penn Alcohol Craving Scale, self-efficacy scale, interpersonal support evaluation list, and presumptive stressful life events scale. Bivariate and multivariate logistic regression was done to determine the factors associated with relapse. Results: The relapse rate was 55.4% among the study participants. Education, self-efficacy, social support, and craving were associated with relapse in the bivariate analysis (P < 0.05). In multiple logistic regression model, craving (odds ratio [OR] – 1.8, confidence interval [CI]: 1.2–2.5), good interpersonal tangible support (OR – 0.09, CI: 0.01–0.5), and desirable life events (OR – 0.03, CI: 0.02–0.6) in the past were associated with relapse. Conclusion: Relapse rate was 55.4% among the study participants which is comparable to the findings of the other long-term studies. Increased craving, low-self-efficacy, and poor social support were associated with relapse hence need to be addressed in follow-up counseling sessions.
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Affiliation(s)
- Rahul Rampure
- Department of Family Medicine, Rural Development Trust Hospital, Anantapur, Andhra Pradesh, India
| | - Leeberk Raja Inbaraj
- Department of Family Medicine and Community Health, Bangalore Baptist Hospital, Bangalore, Karnataka, India
| | - Carolin George Elizabeth
- Department of Family Medicine and Community Health, Bangalore Baptist Hospital, Bangalore, Karnataka, India
| | - Gift Norman
- Department of Family Medicine and Community Health, Bangalore Baptist Hospital, Bangalore, Karnataka, India
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104
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Tong KK, Chen JH, Wu AMS. Application of Health Belief Model to Practice of Responsible Gambling. J Gambl Stud 2019; 35:1047-1062. [PMID: 31254140 DOI: 10.1007/s10899-019-09871-y] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Responsible gambling (RG) strategies seem to be effective only to some people and it is unclear why some gamblers are more likely to adhere to RG practices (e.g., self-exclusion and setting limits). The current study investigated whether cognitive factors, including RG awareness and Health Belief Model (HBM) factors (i.e., perceived susceptibility, perceived severity, perceived benefit, perceived barrier, cue to action, and self-efficacy), accounted for individual differences in adherence to ten common RG practices. Eight hundred and ninety-six community-dwelling adults were recruited to participate in a telephone poll in Macao, China, in November 2016. We found that only 56.1% of the respondents had heard of RG, and there was a positive relation between RG awareness and RG practices. Moreover, HBM factors were also shown to explain one's adherence to RG practices in general but the effectiveness of HBM factors varied across RG practices. The findings provided practical implications that there is a need to target different cognitive beliefs for promoting different RG practices in designing intervention.
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Affiliation(s)
- Kwok-Kit Tong
- Department of Psychology, Faculty of Social Sciences, University of Macau, Avenida da Universidade, Taipa, Macau, China
| | - Juliet Honglei Chen
- Department of Psychology, Faculty of Social Sciences, University of Macau, Avenida da Universidade, Taipa, Macau, China
| | - Anise M S Wu
- Department of Psychology, Faculty of Social Sciences, University of Macau, Avenida da Universidade, Taipa, Macau, China.
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105
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Zhang W, Liu Z, Zhou X, Zhou L. Resilience among stroke survivors: A cohort study of the first 6 months. J Adv Nurs 2019; 76:504-513. [PMID: 31651047 DOI: 10.1111/jan.14247] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2019] [Revised: 09/19/2019] [Accepted: 10/22/2019] [Indexed: 11/28/2022]
Abstract
AIMS To explore (a) resilience among patients over the first 6 months following a first ischaemic stroke; (b) factors associated with resilience at hospitalization, 1, 3, and 6 months postdischarge; (c) baseline predictors of resilience at 6 months postdischarge. DESIGN a cohort study. METHODS From February 2017-January 2018, 217 patients presenting at two hospitals with a first ischaemic stroke were recruited. Their resilience, medical coping styles, general self-efficacy, functional independency, socio-demographic, and clinical data were assessed while they were still in hospital (baseline) and at 1, 3, and 6 months after discharge. RESULTS Resilience among stroke patients decreased significantly 1 month after hospital discharge and remained stable. Predictors of resilience were as follows: self-efficacy and resignation at baseline; number of children, functional independency, general self-efficacy, and resignation at 1 month; and religion, resignation, self-efficacy, confrontation at 3 months and 6 months. The baseline factors that predicted resilience at 6 months were income level, religion, stroke severity at discharge, self-efficacy, and resignation. CONCLUSION Stroke survivors experienced a significant decrease in resilience from hospitalization until 1-month postdischarge. Factors contributing to resilience after a stroke varied across time. Self-efficacy and coping styles were particularly important and contributed to long-term resilience. IMPACT Understanding resilience among stroke survivors is needed to inform the development of interventions to enhance the psychological recovery of survivors. The levels of resilience among stroke survivors were low compared with those in the normal older population. Nurses should provide greater psychological support during hospitalization to stroke survivors and especially to those with lower income, higher stroke severity at discharge, no religion, lower self-efficacy, or who use resignation as a coping strategy as those survivors may have lower resilience 6 months later. Future studies are needed to test interventions designed to change or modify stroke survivors' coping styles and promote self-efficacy, thereby enhancing higher resilience.
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Affiliation(s)
- Wei Zhang
- Nursing School, Second Military Medical University, Shanghai, China
| | - Zhihui Liu
- Assisted Reproductive Department, Shanghai First Maternity and Infant Hospital, Shanghai, China
| | - Xuan Zhou
- Nursing School, Second Military Medical University, Shanghai, China
| | - Lanshu Zhou
- Department of Clinical Nursing, Nursing School, Second Military Medical University, Shanghai, China
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106
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Hallgren KA, Epstein EE, McCrady BS. Changes in Hypothesized Mechanisms of Change Before and After Initiating Abstinence in Cognitive-Behavioral Therapy for Women With Alcohol Use Disorder. Behav Ther 2019; 50:1030-1041. [PMID: 31735239 PMCID: PMC6866668 DOI: 10.1016/j.beth.2019.01.009] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2018] [Revised: 01/11/2019] [Accepted: 01/30/2019] [Indexed: 12/01/2022]
Abstract
Abstinence self-efficacy, coping skills, and therapeutic alliance are hypothesized mechanisms of behavioral change (MOBCs) in cognitive-behavioral therapy (CBT) for alcohol use disorder (AUD). However, little is known about when these hypothesized MOBCs change during treatment or in relation to the initiation of abstinence from alcohol, which the current study investigated. Patient-reported abstinence self-efficacy, drinking-related coping skills, and therapeutic alliance were measured at every session throughout a 12-session clinical trial that previously showed equivalent drinking reductions in female-specific individual- and group-based CBT for AUD. Participants (N = 121 women) were classified into subgroups based on whether and when they first initiated 14 days of continuous abstinence from alcohol during treatment. Interrupted time-series analyses evaluated the magnitude and timing of change in MOBC variables in relation to the initiation of abstinence. All three MOBC measures showed gradual improvements throughout treatment (within-subjects d = 0.03 to 0.09 change per week). Participants who initiated abstinence during treatment experienced additional sudden improvements in abstinence self-efficacy (d = 0.47) and coping skills (d = 0.27), but not therapeutic alliance (d = -0.02), the same week they initiated abstinence. Participants who were already abstinent when treatment started maintained higher abstinence self-efficacy and coping skills, but not therapeutic alliance, throughout treatment compared to participants who never initiated abstinence. Initiating abstinence may help facilitate improvements in abstinence self-efficacy and drinking-related coping skills. Clinicians may help patients anticipate when and how much these variables are expected to improve during treatment and encourage initiation of abstinence to potentially help facilitate improvements in abstinence self-efficacy and coping skills.
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Affiliation(s)
- Kevin A. Hallgren
- Behavioral Research in Technology and Engineering (BRiTE Center) and Department of Psychiatry and Behavioral Sciences, University of Washington. 1959 NE Pacific Street, Box 356560, Seattle, WA 98195, United States,
| | - Elizabeth E. Epstein
- Department of Psychiatry, Addiction Division, University of Massachusetts Medical School. Biotech One, 365 Plantation Street, Worcester, Massachusetts 01605, United States,
| | - Barbara S. McCrady
- Department of Psychology and Center on Alcoholism, Substance Abuse, and Addictions, University of New Mexico. UNM CASAA, 2650 Yale Blvd. SE, Albuquerque, NM 87106, United States,
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107
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Noyes ET, Levine JA, Schlauch RC, Crane CA, Connors GJ, Maisto SA, Dearing RL. Impact of Pretreatment Change on Mechanism of Behavior Change Research: An Applied Example Using Alcohol Abstinence Self-Efficacy. J Stud Alcohol Drugs 2019; 79:223-228. [PMID: 29553349 DOI: 10.15288/jsad.2018.79.223] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE With the growing recognition that, for some, significant changes in drinking occur before the first treatment session (i.e., pretreatment change), researchers have called for the careful assessment of when change occurs and its potential impact on mechanism of behavior change (MOBC) research. Using a commonly hypothesized MOBC variable, alcohol abstinence self-efficacy, the primary aim of this study was to examine the effect of pretreatment change on the study of MOBCs. METHOD Sixty-three individuals diagnosed with alcohol dependence were recruited to participate in a 12-week cognitive-behavioral treatment. Participants completed weekly assessments of self-efficacy and drinking behaviors. RESULTS Multilevel time-lagged regression models indicated that pretreatment change significantly moderated the effect of self-efficacy on the number of drinking days, such that among those higher on pretreatment change, higher self-efficacy ratings predicted lower rates of drinking days in the week until the next treatment session. In contrast, pretreatment change did not moderate the effect of self-efficacy on the rate of heavy drinking days. CONCLUSIONS Results from the current study add to a small but growing body of research highlighting the importance of pretreatment change when studying MOBCs. Further, these results provide important insights into the conditions in which self-efficacy may play an important role in treatment outcomes.
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Affiliation(s)
- Emily T Noyes
- Department of Psychology, University of South Florida, Tampa, Florida
| | - Jacob A Levine
- Department of Psychology, University of South Florida, Tampa, Florida
| | - Robert C Schlauch
- Department of Psychology, University of South Florida, Tampa, Florida
| | - Cory A Crane
- Biomedical Sciences Department, Rochester Institute of Technology, Rochester, New York
| | - Gerard J Connors
- Research Institute on Addictions, University at Buffalo, Buffalo, New York
| | - Stephen A Maisto
- Department of Psychology, Syracuse University, Syracuse, New York
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108
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Sabarinah. Use of Drug Treatment and Rehabilitation Services in Indonesia: Findings of the 2014 National Narcotic Survey. Asia Pac J Public Health 2019; 31:548-558. [PMID: 31516020 DOI: 10.1177/1010539519872343] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
This study was conducted to identify factors associated with the utilization of treatment and rehabilitation services by drug abusers. Around 14.7% of drug abusers self-reported as having used treatment and rehabilitation services at any point in their lifetime (90.8% male and 9.2% female). The dependent variable of having "ever used" the services was positively associated with receiving support of family and friends, knowing of an existing treatment and rehabilitation program, having ever been involved in an outreach program activity, experiencing self-treatment, and having a positive perception of the efficacy of the program. Among the 10 cities examined, the findings showed unequal utilization of treatment and rehabilitation services, implying the need to better monitor the use of the services and to develop a community-based treatment that both enables drug abusers to confront barriers to the utilization of treatment and rehabilitation services and also reintegrates drug abusers to the community.
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Affiliation(s)
- Sabarinah
- Universitas Indonesia, Depok, West Java, Indonesia
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109
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Citlik Saritas S, Erci B. Psychometric evaluation of the Drug Avoidance Self-Efficacy Scale. JOURNAL OF SUBSTANCE USE 2019. [DOI: 10.1080/14659891.2019.1604843] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
| | - Behice Erci
- Public Health Nursing Department, Inonu University Faculty of Nursing, Malatya, Turkey
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110
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Davis AK, Arterberry BJ. Passion for Marijuana Use Mediates the Relations between Refusal Self-Efficacy and Marijuana Use and Associated Consequences. J Psychoactive Drugs 2019; 51:343-350. [PMID: 30947640 PMCID: PMC6764850 DOI: 10.1080/02791072.2019.1596334] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2018] [Accepted: 02/01/2019] [Indexed: 01/11/2023]
Abstract
Marijuana (MJ) refusal self-efficacy and obsessive/harmonious passion for MJ use are associated with use and related consequences but have not been examined simultaneously. We examined the relation among obsessive/harmonious passion for MJ use, refusal self-efficacy, frequency of use, and related consequences in an online community sample (n = 524; mean age = 23.78; 87.5% male). A path analysis revealed that, while controlling for the relationship between MJ use and consequences, lower refusal self-efficacy was related to greater obsessive passion and to greater harmonious passion, and was associated with more consequences but not with MJ use. Greater obsessive passion was associated with greater MJ use frequency and consequences, and greater harmonious passion was related to greater MJ use frequency and fewer consequences. Obsessive passion mediated the relation between lower refusal self-efficacy and greater MJ use and more consequences, and harmonious passion mediated the relation between lower refusal self-efficacy and consequences. Passion mediates the relationships between refusal self-efficacy and MJ use and consequences, with obsessive passion being the stronger mediator. Passion could be a relevant target in interventions aimed at changing a person's MJ use.
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Affiliation(s)
- Alan K Davis
- Behavioral Pharmacology Research Unit, Department of Psychiatry, Johns Hopkins School of Medicine , Baltimore , MD , USA
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111
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Surratt HL, Otachi JK, Williams T, Gulley J, Lockard AS, Rains R. Motivation to Change and Treatment Participation Among Syringe Service Program Utilizers in Rural Kentucky. J Rural Health 2019; 36:224-233. [PMID: 31415716 DOI: 10.1111/jrh.12388] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2019] [Revised: 06/21/2019] [Accepted: 07/16/2019] [Indexed: 12/27/2022]
Abstract
PURPOSE Kentucky experiences a disproportionate burden of substance use disorder (SUD), particularly in rural areas of the state. Multiple factors increase vulnerability to SUD and limit access to services in rural communities. However, the recent implementation and expansion of syringe service programs (SSPs) in rural Kentucky may provide a leverage point to reach at-risk people who inject drugs (PWID). METHODS Data were collected as part of an ongoing NIDA-funded study designed to examine uptake of SSPs among PWID in Appalachian Kentucky. Using Respondent Driven Sampling (RDS), the study enrolled a sample of 186 PWID SSP attenders across 3 rural Appalachian Kentucky counties and conducted face-to-face interviews regarding health behaviors, injecting practices, SSP utilization, and treatment services. Using logistic regression analyses, we examined consistent SSP use, as well as importance and confidence to reduce substance use as predictors of current treatment participation. FINDINGS For the prior 6 months, 44.6% of the sample reported consistent SSP use. Consistent use of SSPs was associated with treatment participation in the unadjusted logistic regression models. Significant predictors of treatment participation in the adjusted model included high confidence to reduce substance use, and not reporting primary methamphetamine injection. CONCLUSIONS Rurally located SSPs may play an important role in supporting confidence and motivation to change substance use behaviors among PWID impacted by SUD. SSPs may be critical venues for integration and expansion of prevention, health promotion, and treatment linkage services for this underserved population.
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Affiliation(s)
- Hilary L Surratt
- Center for Health Services Research, College of Medicine, University of Kentucky, Lexington, Kentucky
| | - Janet K Otachi
- Center for Health Services Research, College of Medicine, University of Kentucky, Lexington, Kentucky
| | - Timothy Williams
- Center for Health Services Research, College of Medicine, University of Kentucky, Lexington, Kentucky
| | | | | | - Rebecca Rains
- Knox County Health Department, Barbourville, Kentucky
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112
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Tormohlen KN, Tobin KE, Davey-Rothwell MA, Latkin C. Low overdose responding self-efficacy among adults who report lifetime opioid use. Drug Alcohol Depend 2019; 201:142-146. [PMID: 31212214 PMCID: PMC6699739 DOI: 10.1016/j.drugalcdep.2019.03.028] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2018] [Revised: 03/14/2019] [Accepted: 03/21/2019] [Indexed: 11/24/2022]
Abstract
BACKGROUND Evaluations of overdose response programs suggest effectiveness in preventing overdose-related death and individual willingness to respond to an overdose. However, knowledge of and confidence in performing response behaviors is necessary for individuals to intervene. This study assessed overdose responding self-efficacy among adults who reported lifetime opioid use. METHODS Data come from a cross-sectional survey, part of a randomized controlled trial designed for adults living with hepatitis C. Participants were 18 years old or older, and reported lifetime opioid use. Overdose responding self-efficacy was assessed by perceived knowledge and/or need for additional training to have confidence responding to an overdose. Univariate statistics were calculated for overdose responding self-efficacy, and individual characteristics and experiences. Adjusted logistic regression was used to identify variables associated with low overdose responding self-efficacy. RESULTS Of the 424 participants, 67.2% reported low overdose responding self-efficacy. Sixty percent witnessed and 30.4% experienced an overdose in the past year. Witnessing an overdose in the past year, experience with naloxone training, and receiving and using naloxone were associated with high overdose responding self-efficacy. While, apprehension with particular response behaviors (e.g. rescue breathing) was associated with low overdose responding self-efficacy. CONCLUSIONS A large proportion of adults who reported lifetime opioid use did not feel confident or knowledgeable responding to an overdose. This could be influenced by overdose exposure, specific response behaviors, and response trainings.
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Affiliation(s)
- Kayla N Tormohlen
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, 624 N. Broadway, Room 888, Baltimore, MD 21205, USA.
| | - Karin E Tobin
- Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, 2213 McElderry Street, 2nd Floor, Baltimore, MD 21205, USA.
| | - Melissa A Davey-Rothwell
- Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, 2213 McElderry Street, 2nd Floor, Baltimore, MD 21205, USA.
| | - Carl Latkin
- Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, 624 N. Broadway, Room 737, Baltimore, MD 21205, USA.
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113
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Moggi F. Commentary on Kirouac & Witkiewitz (2019): A clinical perspective of non-consumption outcomes. Addiction 2019; 114:1093-1094. [PMID: 31074071 DOI: 10.1111/add.14624] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2019] [Accepted: 03/13/2019] [Indexed: 11/29/2022]
Affiliation(s)
- Franz Moggi
- University Hospital of Psychiatry, Clinical Psychology Service and Addiction Research Group, University of Bern, Bern, Switzerland
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114
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Carter AK, Breen LJ, Beilby JM. Self-efficacy beliefs: Experiences of adults who stutter. JOURNAL OF FLUENCY DISORDERS 2019; 60:11-25. [PMID: 30953951 DOI: 10.1016/j.jfludis.2019.03.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/25/2019] [Revised: 03/18/2019] [Accepted: 03/27/2019] [Indexed: 06/09/2023]
Abstract
PURPOSE Childhood-onset stuttering is a complex and multifaceted disorder. Intervention for adults who stutter has historically addressed speech fluency more so than psychosocial aspects of the disorder, including the nature of the individual's self-efficacy beliefs concerning their confidence in their capacity to enact change. Self-efficacy is an important construct related to quality of life, resilience, and maintenance of treatment gains for adults who stutter. The purpose of this qualitative study is to explore the nature of the self-efficacy beliefs expressed by adults who stutter in order to inform efficacious and holistic intervention for these individuals. METHOD Semi-structured interviews were conducted with 29 adults who stutter to describe their experiences as a person who stutters and elucidate the nature of their self-efficacy beliefs. RESULTS Thematic analysis identified several major themes that provided novel insight into the complex nature of the self-efficacy beliefs experienced by adults who stutter: speaker experiences shaped communicative confidence, there was a conflict between communication and fluency, stuttering was viewed as more than fluency, and individual perspectives shaped communicative confidence, as did the pervading influence of self. The notion that fluency and confidence are inextricably linked was evident within and across each major theme. CONCLUSION These preliminary findings provide further support for a multidimensional approach to the treatment of adults who stutter. Findings will be used to inform a novel integrated fluency and psychosocial intervention for adults who stutter that addresses fluency and self-efficacy concurrently, with a view of engendering durable improvements in speech fluency and communicative confidence.
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Affiliation(s)
- Alice K Carter
- School of Occupational Therapy, Social Work, and Speech Pathology, Curtin University, Western Australia, Australia
| | - Lauren J Breen
- School of Psychology, Curtin University, Western Australia, Australia
| | - Janet M Beilby
- School of Occupational Therapy, Social Work, and Speech Pathology, Curtin University, Western Australia, Australia.
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115
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Lebowitz MS. The Implications of Genetic and Other Biological Explanations for Thinking about Mental Disorders. Hastings Cent Rep 2019; 49 Suppl 1:S82-S87. [PMID: 31268569 PMCID: PMC8667266 DOI: 10.1002/hast.1020] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Given the rise of genetic etiological beliefs regarding psychiatric disorders, a growing body of research has focused on trying to elucidate the effects that such explanatory frameworks might be having on how mental disorders are perceived by patients, clinicians, and the general public. Genetic and other biomedical explanations of mental disorders have long been seen as a potential tool in the efforts to destigmatize mental disorders, given the harshness of the widespread negative attitudes about them and the important negative clinical and social impacts of this stigma. The conventional wisdom has appeared to be that because the effects of genes are seen as falling outside individual control, conceiving of mental disorders as caused by genes casts patients as blameless, thereby reducing stigmatization. Indeed, the results of experimental and correlational research have now robustly linked genetic and other biomedical explanations for mental disorders with reductions in the extent to which people are blamed for their psychiatric symptoms. However, research examining the impact of genetic and other biomedical explanations of mental disorders has also suggested that they can have significant downsides. The most consistently observed negative effect of these kinds of explanations is that they can apparently lead to the assumption that mental disorders are unlikely to improve or abate. Genetic and other biomedical explanations of mental disorders can also increase people's confidence in the effectiveness of biomedical treatments (such as pharmacotherapy) but decrease their confidence in the effectiveness of "nonbiomedical" treatments (such as psychotherapy).
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116
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Belanger HG, Vanderploeg RD, Curtiss G, Armistead-Jehle P, Kennedy JE, Tate DF, Eapen BC, Bowles AO, Cooper DB. Self-efficacy predicts response to cognitive rehabilitation in military service members with post-concussive symptoms. Neuropsychol Rehabil 2019; 30:1190-1203. [DOI: 10.1080/09602011.2019.1575245] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- Heather G. Belanger
- Defense and Veterans Brain Injury Center (DVBIC), Special Operations Command (SOCOM), Tampa, FL, USA
- Department of Psychiatry and Behavioral Neurosciences, University of South Florida, Tampa, FL, USA
- Department of Psychology, University of South Florida, Tampa, FL, USA
| | - Rodney D. Vanderploeg
- Department of Psychiatry and Behavioral Neurosciences, University of South Florida, Tampa, FL, USA
- Department of Psychology, University of South Florida, Tampa, FL, USA
| | - Glenn Curtiss
- Department of Psychology, University of South Florida, Tampa, FL, USA
| | | | - Jan E. Kennedy
- Department of Rehabilitation Medicine, Brooke Army Medical Center (BAMC)
| | - David F. Tate
- Missouri Institute of Mental Health and University of Missouri, St Louis, MO, USA
- Department of Neurology, University of Utah School of Medicine, Salt Lake City, UT, USA
| | - Blessen C. Eapen
- Polytrauma Rehabilitation Center, South Texas Veterans Health Care System, San Antonio, TX, USA
- Department of Rehabilitation Medicine, University of Texas Health, San Antonio, TX, USA
| | - Amy O. Bowles
- Department of Rehabilitation Medicine, Brooke Army Medical Center (BAMC)
- Department of Physical Medicine & Rehabilitation, Uniformed Services University of Health Sciences (USUHS), Bethesda, MD, USA
| | - Douglas B. Cooper
- Polytrauma Rehabilitation Center, South Texas Veterans Health Care System, San Antonio, TX, USA
- Defense and Veteran’s Brain Injury Center (DVBIC), South Texas Veterans Health Care System, San Antonio, TX, USA
- Department of Psychiatry, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
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117
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Dawkins JC, Hasking PA, Boyes ME, Greene D, Passchier C. Applying a cognitive-emotional model to nonsuicidal self-injury. Stress Health 2019; 35:39-48. [PMID: 30221443 DOI: 10.1002/smi.2837] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2017] [Revised: 08/14/2018] [Accepted: 09/10/2018] [Indexed: 12/22/2022]
Abstract
The recently proposed cognitive-emotional model of nonsuicidal self-injury (NSSI) draws on emotion regulation models and social cognitive theory to understand the onset, maintenance, and cessation of NSSI. We tested the prediction of the model that the relationship between emotional reactivity and NSSI is moderated by specific cognitions about self-injury (i.e., self-efficacy to resist NSSI, NSSI outcome expectancies), emotion regulation, and rumination. A sample of 647 university students aged 17-25 years (M = 19.92, SD = 1.78) completed self-report measures of the constructs of interest. As expected, we found that emotional reactivity was positively related to NSSI, particularly for people who had weak self-efficacy to resist NSSI. However, emotional reactivity was negatively related to NSSI for people who were more likely to use expressive suppression to regulate emotion. Implications for the theoretical understanding of NSSI are discussed.
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Affiliation(s)
- Jessica C Dawkins
- School of Psychology and Speech Pathology, Curtin University, Bentley, Australia
| | - Penelope A Hasking
- School of Psychology and Speech Pathology, Curtin University, Bentley, Australia
| | - Mark E Boyes
- School of Psychology and Speech Pathology, Curtin University, Bentley, Australia
| | - Danyelle Greene
- School of Psychology and Speech Pathology, Curtin University, Bentley, Australia
| | - Chantelle Passchier
- School of Psychology and Speech Pathology, Curtin University, Bentley, Australia
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118
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Figueroa W, Yomogida K, Mendez J, Bavarian N. Prescription stimulant misuse avoidance self-efficacy: Correlates and moderation by race/ethnicity. J Ethn Subst Abuse 2019; 19:476-489. [PMID: 30638147 DOI: 10.1080/15332640.2018.1542370] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
This study examined whether personality characteristics, attention deficit hyperactivity disorder (ADHD) symptomology, psychological distress, and religiosity were associated with prescription stimulant avoidance self-efficacy and whether these relationships were moderated by race/ethnicity among a probability sample of 1,053 college students. We used regression analyses to examine associations between avoidance self-efficacy and the independent variables of interest, and moderation analyses to identify whether these associations were moderated by race/ethnicity. Inattention, hyperactivity, sensation seeking, and psychological distress were inversely associated with prescription stimulant avoidance self-efficacy, whereas religiosity had a direct association. Moreover, greater inattention was a risk factor for lower self-efficacy among students identifying as White but not for students identifying as Asian. Increased religiosity was a risk factor for students identifying as Latinx, whereas it was a protective factor for students identifying as White. Prevention implications are discussed.
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Affiliation(s)
- Wilma Figueroa
- Health Science Department, California State University, Long Beach, Long Beach, California
| | - Kyle Yomogida
- Health Science Department, California State University, Long Beach, Long Beach, California
| | - Jocelyne Mendez
- Health Science Department, California State University, Long Beach, Long Beach, California
| | - Niloofar Bavarian
- Health Science Department, California State University, Long Beach, Long Beach, California
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119
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Testing the biosocial cognitive model of substance use in cannabis users referred to treatment. Drug Alcohol Depend 2019; 194:216-224. [PMID: 30453107 DOI: 10.1016/j.drugalcdep.2018.09.032] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2018] [Revised: 09/26/2018] [Accepted: 09/26/2018] [Indexed: 01/05/2023]
Abstract
BACKGROUND The bioSocial Cognitive Theory (bSCT) hypothesizes two pathways linking dimensions of impulsivity to substance use. The first predicts that the association between reward sensitivity and substance use is mediated by positive outcome expectancies. The second predicts that the relationship between rash impulsiveness and substance use is mediated by refusal self-efficacy. This model has received empirical support in studies of alcohol use. The present research provides the first application of bSCT to a cannabis treatment population and aims to extend its utility to understanding cannabis use and severity of dependence. DESIGN 273 patients referred for cannabis treatment completed a clinical assessment that contained measures of interest. SETTING A public hospital alcohol and drug clinic. MEASUREMENTS The Sensitivity to Reward Scale, Dysfunctional Impulsivity Scale, Cannabis Expectancy Questionnaire, Cannabis Refusal Self-Efficacy Questionnaire and Severity of Dependence Scale-Cannabis were completed, along with measures of cannabis consumption. FINDINGS The bSCT model provided a good fit to the data for cannabis use and severity of dependence outcomes. The association between reward sensitivity and each cannabis outcome was fully mediated by positive cannabis expectancies and cannabis refusal self-efficacy. The relationship between rash impulsiveness and each cannabis outcome was fully mediated by cannabis refusal self-efficacy. CONCLUSIONS Findings support the application of the bSCT model to cannabis use and dependence severity and highlight the important role of social cognitive mechanisms in understanding the association between impulsivity traits and these outcomes. The differential association of impulsivity traits to social cognition may assist targeted treatment efforts.
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120
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DiBello AM, Miller MB, Carey KB. Self-Efficacy to Limit Drinking Mediates the Association between Attitudes and Alcohol-Related Outcomes. Subst Use Misuse 2019; 54:2400-2408. [PMID: 31434546 PMCID: PMC6883163 DOI: 10.1080/10826084.2019.1653322] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Personal attitudes toward alcohol consumption are reliable predictors of alcohol use and related problems, with emerging work suggesting that one's favorable attitude toward limited drinking (i.e., at levels below the threshold for heavy episodic drinking) is a buffer against alcohol use and binge drinking. However, little work has examined the specific mechanism(s) through which one's personal attitude toward limited drinking is associated with alcohol use and related problems. One such mechanism may be an individual's self-efficacy to limit their alcohol use. The current study aimed to evaluate whether self-efficacy to limit one's alcohol use mediates the association between one's personal attitude toward limited drinking and actual alcohol use and related problems over time. Participants were mandated students (n = 568; 28% female) who violated campus alcohol policy and received a brief motivational intervention. Mediation models were used to test (a) self-efficacy to limit one's alcohol use as a traditional mediator of the attitudes-drinking quantity association and (b) self-efficacy and drinking quantity as serial mediators of the attitudes-alcohol-problems link. Favorable attitudes toward limiting drinking at baseline were positively associated with self-efficacy to limit drinking at 1 month, which was associated with a reduction in drinking quantity at 3 months; this, in turn, was associated with a reduction in alcohol-related problems at 5 months. These findings provide a rationale for incorporating attitudes and self-efficacy in the development and refinement of intervention strategies.
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Affiliation(s)
- Angelo M DiBello
- Center for Alcohol and Addiction Studies, Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, Rhode Island, USA.,Department of Psychology, City University of New York, Brooklyn College, Brooklyn, New York, USA
| | - Mary Beth Miller
- Department of Psychiatry, University of Missouri School of Medicine, Columbia, Missouri, USA
| | - Kate B Carey
- Center for Alcohol and Addiction Studies, Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, Rhode Island, USA
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121
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Personal Factors as Correlates and Predictors of Relapse in Nurses With Impaired Practice. J Addict Nurs 2019; 30:24-31. [DOI: 10.1097/jan.0000000000000262] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
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122
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Sheykhnezhad F, Seyedfatemi N. Effect of group education on self-efficacy and craving tendencies in drug abusers in 5th Azar Drug Abuse Treatment Center of Gorgan. COGENT PSYCHOLOGY 2019. [DOI: 10.1080/23311908.2019.1587818] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
Affiliation(s)
- Fatemeh Sheykhnezhad
- Faculty of Nursing and Midwifery, Golestan University of Medical Sciences, Gorgan, Iran
| | - Naeimeh Seyedfatemi
- Faculty of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran
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123
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Yang C, Zhou Y, Cao Q, Xia M, An J. The Relationship Between Self-Control and Self-Efficacy Among Patients With Substance Use Disorders: Resilience and Self-Esteem as Mediators. Front Psychiatry 2019; 10:388. [PMID: 31249535 PMCID: PMC6582546 DOI: 10.3389/fpsyt.2019.00388] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2018] [Accepted: 05/16/2019] [Indexed: 11/27/2022] Open
Abstract
Background: While substance use disorder is one of the overarching health and social issues that might seriously disrupt individuals' self-control and self-efficacy, most previous studies have been conducted among university students or other groups, and little is known about how the underlying mechanisms between self-control and self-efficacy might impact patients with substance use disorders. Objectives: The purpose of this study is to investigate how resilience and self-esteem mediate the relationships between self-control and self-efficacy among patients with substance use disorders. Methods: We conducted a cross-sectional study of 298 patients with substance use disorder from Shifosi rehab in China. Diagnostic and Statistical Manual of Mental Disorders (5th Edition)-based diagnostic questionnaires were used to collect demographic information and assess addiction severity. The Dual-Modes of Self-Control Scale (DMSC-S) was implemented to measure self-control, while self-esteem was measured using the Self-esteem Scale (SES). The Connor-Davidson Resilience Scale (CD-RISC) was used to measure resilience, and self-efficacy was measured by the regulatory emotional self-efficacy scale (RESE). Results: The correlations between all the dimensions and total scores on the self-control, resilience, self-esteem, and self-efficacy were significantly positive (p < 0.01), indicating that they could predict patients' self-efficacy. Bootstrap testing indicated that resilience and self-esteem fully mediated the relationship between self-control and self-efficacy, relationships between self-control and self-esteem were partially mediated by resilience, and resilience partially mediated the relationship between self-esteem and self-efficacy. Finally, the multiple-group analysis indicated that the relationships among self-control, resilience, self-esteem, and self-efficiency did not differ with respect to gender. Conclusions: The path from self-control through resilience and self-esteem and on to self-efficacy is significant among patients with substance use disorders, suggesting that increasing self-control, resilience, and self-esteem can improve self-efficacy among patients with substance use disorders.
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Affiliation(s)
- Chunyu Yang
- School of Economics and Management, Changzhou Institute of Technology, Changzhou, China.,School of Social and Behavioral Sciences, Nanjing University, Nanjing, China
| | - You Zhou
- Graduate School of Humanities and Social Sciences, University of Melbourne, Melbourne, VIC, Australia
| | - Qilong Cao
- School of Social and Behavioral Sciences, Nanjing University, Nanjing, China.,Business School, Changzhou University, Changzhou, China
| | - Mengfan Xia
- School of Social and Behavioral Sciences, Nanjing University, Nanjing, China
| | - Jing An
- School of Economics and Management, Changzhou Institute of Technology, Changzhou, China.,School of Social and Behavioral Sciences, Nanjing University, Nanjing, China
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124
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Treatment retention in a specialized alcohol programme after an episode of alcoholic hepatitis: Impact on alcohol relapse. J Psychosom Res 2019; 116:75-82. [PMID: 30654998 DOI: 10.1016/j.jpsychores.2018.11.020] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2018] [Accepted: 11/27/2018] [Indexed: 12/20/2022]
Abstract
AIMS Alcoholic hepatitis (AH) is a life-threatening complication of alcohol use disorder (AUD). Alcohol abstinence is the main predictor of the long-term prognosis of AH. It is unknown whether AUD treatment retention (TR) after an AH episode impacts alcohol relapse and mortality or what baseline factors influence TR. METHODS Design: case-control study; Study population: hospitalized patients (1999-2012) with an episode of biopsy-proven AH were included (n = 120); Assessment: demographic and clinical data, the High-Risk Alcoholism Relapse (HRAR) scale, mortality and alcohol relapse were assessed through clinical records and telephone or personal interviews; Follow-up period: short-term and long-term TRs were assessed at 12 and 24 months, respectively. RESULTS The overall short-term and long-term TRs were 37% and 27.8%, respectively. The severity of liver disease at baseline predicted both short-term and long-term TR (OR 3.7 and 3.3, respectively), whereas HRAR >3 and a history of psychiatric disorders predicted long-term TR (OR 2.9 and 2.6, respectively). Moreover, HRAR >3 (OR 3.0) and previous treatment for AUD (OR 2.9) increased the risk of relapse in the short term. Importantly, receiving alcohol therapy in a centre different from the hospital where the patient was admitted was associated with increased risk of alcohol relapse over the long term (OR 5.4). CONCLUSION Experiencing an alcohol-related life-threatening complication is insufficient motivation to seek treatment for AUD. AUD treatment after an episode of AH is suboptimal, with a low TR rate, high risk of alcohol relapse and poor impact of treatment on alcohol relapse.
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125
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Kapitány-Fövény M, Vagdalt E, Ruttkay Z, Urbán R, Richman MJ, Demetrovics Z. Potential of an Interactive Drug Prevention Mobile Phone App (Once Upon a High): Questionnaire Study Among Students. JMIR Serious Games 2018; 6:e19. [PMID: 30514697 PMCID: PMC6299233 DOI: 10.2196/games.9944] [Citation(s) in RCA: 60] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2018] [Revised: 06/30/2018] [Accepted: 08/07/2018] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND In recent years, drug prevention networks and drug education programs have started using Web-based or mobile phone apps as novel prevention tools, testing their efficacy compared with face-to-face prevention. OBJECTIVE The aim of this study was to assess the potential of an interactive app called Once Upon a High (VoltEgySzer). METHODS The app approaches drug prevention from 6 different aspects, and it addresses youngsters with 6 different modules: (1) interactive comics/cartoons, telling stories of recovery; (2) quiz game; (3) roleplay game; (4) introduction of psychoactive drugs; (5) information on the somatic and psychological effects of psychoactive substances; (6) list of available treatment units, rehabs, and self-support groups in Hungary. Students of 2 vocational schools and 2 high schools filled out a questionnaire at a baseline (T0) and a 2-month follow-up (T1) data collection session. Students of 1 vocational school and 1 high school downloaded the Once Upon a High app (app group), whereas students from the other vocational school and high school did not (nonapp group). The time points of T0 and T1 questionnaires contained demographic variables, items with regard to substance use characteristics for both legal and illegal substances, including novel psychoactive substance, exercise habits, knowledge about psychoactive substances, attitudes toward substance users and validated instruments measuring the severity of tobacco (Fagerström Test for Nicotine Dependence), alcohol (Alcohol Use Disorder Identification Test), cannabis (Cannabis Abuse Screening Test), and synthetic cannabinoid consumption. Beliefs about substance use (Beliefs About Substance Abuse) and perceived self-efficacy (General Perceived Self-Efficacy) were also measured. At T1, members of the app group provided additional evaluation of the app. RESULTS There were 386 students who participated in the T0 session. After dropout, 246 students took part in T1 data collection procedure. Alcohol was the most frequently consumed psychoactive substance (334/364, 91.8% lifetime use), followed by tobacco (252/386, 65.3%, lifetime use) and cannabis (43/323, 13.3% lifetime use). Decreased self-efficacy (beta=-.29, P=.04) and increased daily physical exercise frequencies (beta=.04, P<.001) predicted higher frequencies of past month energy drink consumption, whereas elevated past month alcohol consumption was mainly predicted by a decrease in negative attitudes toward substance users (beta=-.13, P=.04) in the regression models. Once Upon a High was found to be effective only in reducing energy drink consumption (beta=-1.13, P=.04) after controlling for design effect, whereas perceived utility of the app showed correlation with a decreasing alcohol use (rS(44)=.32, P=.03). The roleplay module of the app was found to be the most preferred aspect of the app by the respondents. CONCLUSIONS The Once Upon a High app can be a useful tool to assist preventive intervention programs by increasing knowledge and self-efficacy; however, its efficacy in reducing or preventing substance use needs to be improved and further studied. Additional potential impacts of the app need further testing.
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Affiliation(s)
- Máté Kapitány-Fövény
- Department of Addiction, Semmelweis University Faculty of Health Sciences, Budapest, Hungary
- Drug Outpatient Centre, Nyírő Gyula National Institute of Psychiatry and Addictions, Budapest, Hungary
| | - Eszter Vagdalt
- Budapest Center for Vocational Education and Training in Engineering, Budapest, Hungary
| | - Zsófia Ruttkay
- Creative Technology Lab, Moholy-Nagy University of Art and Design, Budapest, Hungary
| | - Róbert Urbán
- Institute of Psychology, Eötvös Loránd University, Budapest, Hungary
| | - Mara J Richman
- Institute of Psychology, Eötvös Loránd University, Budapest, Hungary
| | - Zsolt Demetrovics
- Institute of Psychology, Eötvös Loránd University, Budapest, Hungary
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126
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Hasking P, Boyes M, Greves S. Self-efficacy and emotionally dysregulated behaviour: An exploratory test of the role of emotion regulatory and behaviour-specific beliefs. Psychiatry Res 2018; 270:335-340. [PMID: 30292086 DOI: 10.1016/j.psychres.2018.09.045] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2018] [Revised: 09/19/2018] [Accepted: 09/19/2018] [Indexed: 10/28/2022]
Abstract
We examined the relationship between self-efficacy and three behaviours that can serve similar affect-regulatory functions (self-injury, risky alcohol use, disordered eating). We proposed that general self-efficacy would be indirectly related to each outcome, operating via emotion regulatory self-efficacy and behaviour-specific self-efficacy. A path analysis confirmed this proposal in a sample of 490 university students, who completed questionnaires assessing the constructs of interest. Emotion regulatory self-efficacy was a salient predictor of self-injury and disordered eating, evidencing both direct and indirect relationships. Self-efficacy to resist each of the behaviours was uniquely related to its target behaviour. We discuss these findings, outlining the implications for a theoretical understanding of emotion-regulatory behaviours, and offer suggestions for prevention and early intervention initiatives.
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Affiliation(s)
- Penelope Hasking
- School of Psychology and Speech Pathology, Curtin University Kent St, Bentley, 6845, Australia.
| | - Mark Boyes
- School of Psychology and Speech Pathology, Curtin University Kent St, Bentley, 6845, Australia.
| | - Stuart Greves
- School of Psychology and Speech Pathology, Curtin University Kent St, Bentley, 6845, Australia.
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127
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Wilson M, Finlay M, Orr M, Barbosa-Leiker C, Sherazi N, Roberts MLA, Layton M, Roll JM. Engagement in online pain self-management improves pain in adults on medication-assisted behavioral treatment for opioid use disorders. Addict Behav 2018; 86:130-137. [PMID: 29731244 DOI: 10.1016/j.addbeh.2018.04.019] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2017] [Revised: 04/03/2018] [Accepted: 04/25/2018] [Indexed: 01/14/2023]
Abstract
INTRODUCTION Persistent pain has been recognized as an important motivator that can lead individuals to misuse opioids. New approaches are needed to test pain treatments that can improve outcomes for people with persistent pain in medication-assisted behavioral treatment for opioid use disorder. This study piloted an online pain self-management program to explore acceptability and treatment effects. METHODS A sample of 60 adults diagnosed with chronic non-cancer pain and receiving medication-assisted behavioral treatment at one of two clinics were randomized into either treatment group with access to an online pain management program or waitlist attention control. Participants received online surveys via email at baseline and post-treatment at week 8. RESULTS The majority of participants (n = 44; 73%) reported that their first use of opioids was in response to a painful event. Those who engaged in the online program had significantly lower pain interference, pain severity, opioid misuse measures, and depressive symptoms after eight weeks while pain self-efficacy was increased. CONCLUSION Our results suggest the online pain self-management program content may be helpful for managing physical and emotional symptoms experienced by individuals with co-occurring pain and opioid use disorders. To improve online engagement, more support is necessary to assist with technology access and completion of online activities.
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128
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Young SY, Kidd M, van Hoof JJM, Seedat S. Prognostic Value of Motor Timing in Treatment Outcome in Patients With Alcohol- and/or Cocaine Use Disorder in a Rehabilitation Program. Front Psychol 2018; 9:1945. [PMID: 30405472 PMCID: PMC6204653 DOI: 10.3389/fpsyg.2018.01945] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2018] [Accepted: 09/20/2018] [Indexed: 01/20/2023] Open
Abstract
Introduction: Individuals with Substance Use Disorder (SUD) often have cognitive deficits in multiple domains, including motor timing deficits, with recovery times of up to 1 year. Cognitive deficits influence treatment outcomes and abstinence. To our knowledge, timing deficits have not been investigated with regard to treatment outcome and relapse. Methods: This prospective study tested the prognostic value of motor timing in SUD with regard to treatment outcome. The study sample consisted of 74 abstinent in-patients at a private treatment programme for drug/alcohol dependence at the Momentum Mental Healthcare clinic in Somerset West, South Africa, diagnosed with alcohol and/or cocaine dependence. Participants were tested at three points: (i) Within 72 hours of the start of the treatment programme (ii) after completion of the treatment programme at 8 weeks (measure of treatment response) through filling out self-report questionnaires and experimental motor task testing, and (iii) a third visit followed through a telephonic interview at 12-months (measure of relapse). Results: Motor timing alone predicted 27 percent of the variance in alcohol self-efficacy score change, and 25 percent variance in cocaine self-efficacy change scores at treatment completion. Specifically, spatial errors, synchronization errors and inter- response interval errors of a spatial tapping task at baseline predicted self-efficacy in alcohol self-efficacy. Cocaine self-efficacy was predicted by spatial errors and contact times of a spatial tapping task at very high tempi (300 ms) only. The high rate of dropout at 12 months post-treatment did not allow for further analysis of the prognostic value of motor timing on relapse. Conclusions: The results of this investigation show us that motor timing holds prognostic value with regard to treatment outcomes. Motor timing predictors for relapse require further investigation going forward.
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Affiliation(s)
- Susanne Yvette Young
- Department of Psychiatry, Faculty of Medicine and Health Sciences, Stellenbosch University, Stellenbosch, South Africa
| | - Martin Kidd
- Centre for Statistical Consultation, Statistics and Actuarial Sciences, Stellenbosch University, Stellenbosch, South Africa
| | - Jacques J M van Hoof
- Department of Psychiatry, Radboud University Medical Centre, Nijmegen, Netherlands
| | - Soraya Seedat
- Department of Psychiatry, Faculty of Medicine and Health Sciences, Stellenbosch University, Stellenbosch, South Africa
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129
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Law KH, Dimmock J, Guelfi KJ, Nguyen T, Gucciardi D, Jackson B. Stress, Depressive Symptoms, and Maternal Self-Efficacy in First-Time Mothers: Modelling and Predicting Change across the First Six Months of Motherhood. Appl Psychol Health Well Being 2018; 11:126-147. [PMID: 30345730 DOI: 10.1111/aphw.12147] [Citation(s) in RCA: 41] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
BACKGROUND First-time mothers commonly experience stress and depressive symptoms in the postpartum period. Maternal self-efficacy has been shown to be an important protective factor against these experiences; however, research on the dynamic nature of stress, depressive symptoms, and maternal self-efficacy is limited. The aim of this study was to document changes in these psychological factors among first-time mothers, and determine how early maternal self-efficacy perceptions may predict change in stress and depressive symptoms over the first 6 months postpartum. METHODS Sixty first-time Australian mothers were recruited during their third trimester of pregnancy. Participants completed a baseline survey during the third trimester of pregnancy (M = 32.87 weeks, SD = 2.62 weeks), and subsequently reported stress, depressive symptoms, and maternal self-efficacy every 3 weeks postpartum for 6 months. Latent growth curve modelling was used to estimate participants' change over time for stress and depressive symptoms. RESULTS First-time mothers' stress and depressive symptoms peaked, and maternal self-efficacy was weakest, at 3 weeks postpartum. Maternal self-efficacy at 3 weeks postpartum was a significant (negative) predictor of 3-week levels of, and also (positively) predicted later reductions in, stress. CONCLUSION Future interventions aimed at bolstering early maternal self-efficacy may protect against postpartum stress for first-time mothers.
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Affiliation(s)
| | | | | | - Thinh Nguyen
- The University of Western Australia, Australia
- Peel and Rockingham Kwinana Mental Health Service, Australia
| | | | - Ben Jackson
- The University of Western Australia, Australia
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130
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Morris DH, Davis AK, Lauritsen KJ, Rieth CM, Silvestri MM, Winters JJ, Chermack ST. Substance use consequences, mental health problems, and readiness to change among Veterans seeking substance use treatment. J Subst Abuse Treat 2018; 94:113-121. [PMID: 30243411 DOI: 10.1016/j.jsat.2018.08.005] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2017] [Revised: 08/13/2018] [Accepted: 08/14/2018] [Indexed: 01/07/2023]
Abstract
Individuals seeking substance use treatment who have one or more co-occurring mental health problems tend to have lower treatment engagement, higher rates of attrition, and poorer treatment outcomes. Readiness to change (RTC) is an integral construct in the recovery process, with higher RTC associated with improved treatment outcomes. However, the impact of psychiatric symptoms on RTC is not fully understood, especially among specialty subpopulations, such as military Veterans. Therefore, the aim of the present study was to examine the associations of mental health problems with RTC in a sample of Veterans initiating outpatient substance use treatment. The present sample was comprised of 278 Veterans (12% women, Mage = 48.22, SD = 14.06) who completed self-report intake measures assessing past month substance use frequency, substance-related consequences, symptoms of insomnia, depression, and anxiety, and importance and confidence to change one's substance use. Four separate canonical correlation analyses focusing on RTC alcohol, opioid, cannabis, and nicotine use were conducted. Veterans' inclusion in each analysis was not mutually exclusive. Results indicated that greater depression, anxiety, consequences, and frequency of alcohol use corresponded with greater importance to change alcohol use. Likewise, greater depression, anxiety, and insomnia symptoms along with frequency of use and consequences related to greater importance and confidence to change one's opioid use. In contrast, greater anxiety, depression, insomnia, and frequency of use were associated with less confidence in one's ability to change cannabis use. None of these variables were related to one's RTC nicotine use. Findings highlight the importance of assessing mental health problems at outset of substance use treatment, as they may be an indication of RTC and could be used as a catalyst to advance Veterans forward in the process of behavior change.
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Affiliation(s)
- David H Morris
- Veterans Affairs Ann Arbor Healthcare System, 2215 Fuller Road, Ann Arbor, MI 48105, USA; Department of Psychiatry, University of Michigan Addiction Center, 4250 Plymouth Road, Ann Arbor, MI 48109, USA.
| | - Alan K Davis
- Department of Psychiatry, University of Michigan Addiction Center, 4250 Plymouth Road, Ann Arbor, MI 48109, USA; Behavioral Pharmacology Research Unit, Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, 5510 Nathan Shock Drive, Baltimore, MD 21224, USA
| | - Kirstin J Lauritsen
- Veterans Affairs Ann Arbor Healthcare System, 2215 Fuller Road, Ann Arbor, MI 48105, USA
| | - C Martin Rieth
- Veterans Affairs Ann Arbor Healthcare System, 2215 Fuller Road, Ann Arbor, MI 48105, USA
| | - Mark M Silvestri
- Cincinnati Veterans Affairs Medical Center, 3200 Vine Street, Cincinnati, OH 45220, USA
| | - Jamie J Winters
- Veterans Affairs Ann Arbor Healthcare System, 2215 Fuller Road, Ann Arbor, MI 48105, USA; Department of Psychiatry, University of Michigan Addiction Center, 4250 Plymouth Road, Ann Arbor, MI 48109, USA
| | - Stephen T Chermack
- Veterans Affairs Ann Arbor Healthcare System, 2215 Fuller Road, Ann Arbor, MI 48105, USA; Department of Psychiatry, University of Michigan Addiction Center, 4250 Plymouth Road, Ann Arbor, MI 48109, USA
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131
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Factors related to methamphetamine relapse risk among clients in the substance rehabilitation center of National Narcotics Board in West Java, Indonesia. JOURNAL OF HEALTH RESEARCH 2018. [DOI: 10.1108/jhr-05-2018-035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Purpose
This purpose of this paper is to describe methamphetamine relapse risk, examine the relationship between factors in the dynamic model of relapse and methamphetamine relapse risk.
Design/methodology/approach
A total of 165 clients from the Substance Rehabilitation Center of National Narcotics Board in West Java, Indonesia were recruited. The research instruments included a demographic characteristic questionnaire and eight different tests: Drug Taking Confidence Questionnaire; Stimulant Effect Expectancy Questionnaire; Stage of Change Readiness and Treatment Eagerness Scale version 8.0 for Drug; Coping Strategies Inventory Short Form; Positive Affect and Negative Affect Schedule; Desire for Speed Questionnaire; Social Support Questionnaire; and the Stimulant Relapse Risk Scale. Descriptive statistics were used to analyze the data. Pearson’s product moment correlation was used to test the relationship among variables.
Findings
Clients (63 percent) were at a moderate level of methamphetamine relapse risk (mean=56.33, SD=10.54). Outcome expectancy, positive emotional state, negative emotional state and craving were positive and had a significant correlation with relapse risk (r=0.261, r=0.380, r=0.370, r=0.509, p<0.01, respectively). Self-efficacy was negative and had a significant correlation with relapse risk (r=−0.316, p<0.01). Motivation, coping and social support had no correlation with relapse risk.
Originality/value
Two-thirds of the clients in a rehabilitation center have a tendency to relapse following treatment. Nursing intervention for early detection of methamphetamine relapse risk during treatment by using standardized instruments should be implemented.
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Litt MD, Kadden RM, Tennen H. Treatment response and non-response in CBT and Network Support for alcohol disorders: targeted mechanisms and common factors. Addiction 2018; 113:1407-1417. [PMID: 29575339 PMCID: PMC6043382 DOI: 10.1111/add.14224] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2017] [Revised: 09/19/2017] [Accepted: 03/12/2018] [Indexed: 11/28/2022]
Abstract
AIMS To determine whether mechanisms of drinking behavior change that are targeted by specific treatments mediate the effects of Packaged Cognitive Behavior Therapy (PCBT) and Network Support (NS) on abstinence rates throughout 27 months. DESIGN Secondary analysis of data from two Network Support Project randomized clinical trials, in which participants were assigned to either a case management control treatment (control) or NS treatment in trial 1, or to PCBT or NS treatment in trial 2. SETTING An out-patient substance abuse treatment site at a university medical center in the United States. PARTICIPANTS A total of 249 men and 154 women (n = 403) with alcohol use disorder. MEASUREMENTS The primary outcome was membership in a treatment responder class determined by growth mixture modeling (GMM) of monthly proportion days abstinent (PDA) to 27 months. Key predictors of responder class membership included network change variables, and changes in coping scores and self-efficacy. FINDINGS GMM analyses indicated that a three-class solution provided the best fit to the data: a treatment responder class comprising almost 55% of patients, a late relapsing class that showed post-treatment gains followed by a return to baseline drinking (12.7% of patients) and a non-responder class (32% of patients). Analyses indicated that treatment effects on responder class membership were moderated by baseline drinking (P < 0.001). PCBT effects were mediated by changes in coping scores (P < 0.05). NS treatment effects were also mediated by coping change, as well as by increases in self-efficacy and in number of abstinent friends (P < 0.05). CONCLUSIONS Long-term success in Packaged Cognitive Behavior Therapy and Network Support treatments for alcohol use disorder appears to be mediated by both general mechanisms (developing coping skills and self-efficacy) and treatment-targeted mechanisms (developing network strategies that emphasize social support and avoiding friends who drink).
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133
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Nyamathi AM, Salem BE, Ekstrand M, Yadav K, Le Y, Oleskowicz T, Shin SS. Correlates of Treatment Readiness among Formerly Incarcerated Homeless Women. CRIMINAL JUSTICE AND BEHAVIOR 2018; 45:969-983. [PMID: 30555191 PMCID: PMC6289200 DOI: 10.1177/0093854818771111] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Treatment readiness is a key predictor of drug treatment completion, rearrest, and recidivism during community reentry; however, limited data exists among homeless, female ex-offenders (HFOs). The purpose of this study was to present baseline data from a randomized controlled trial of 130 HFOs who had been released from jail or prison. Over half (60.8%) of HFOs had a treatment readiness score of ≥ 40 (n = 79, μ = 40.2, SD = 8.72). Bivariate analyses revealed that methamphetamine use, psychological well-being, and high emotional support were positively associated with treatment readiness. On the other hand, depressive symptomology and depression/anxiety scores were negatively associated with the treatment readiness score. Multiple linear regression revealed that depressive symptomology was negatively associated with treatment readiness (β = -0.377; p = .001). Further analyses revealed that the effect of emotional support on treatment readiness was mediated by depressive symptomatology.
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134
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Bluma L. The role of spirituality in alcohol abstinence self-efficacy amongst alcoholics anonymous members. DRUGS AND ALCOHOL TODAY 2018. [DOI: 10.1108/dat-09-2017-0049] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose
Previous research indicates that Alcoholics Anonymous (AA) can play an effective role in alcohol use disorder recovery (Kelly, Stout, Magill, Tonigan and Pagano, 2011). Acceptance of a “Higher Power” and experiencing a “spiritual awakening” are essential components of AA recovery programme (Alcoholics Anonymous World Service, 2014). The purpose of this paper is to identify if there are high associations in levels of spirituality and alcohol abstinence self-efficacy (AASE) measures amongst AA members.
Design/methodology/approach
Self-reported measures were collected from members of AA of their spiritual and religious beliefs and their everyday experiences of alcohol abstinence. Demographic information of participant’s ethnical background, age and length of AA membership was also obtained.
Findings
The analysis revealed high levels of spirituality amongst participants with a mean of 70.14 (2dp). There was no difference in participant high or low spiritual beliefs and their attitude towards alcohol abstinence. The frequency measures of spiritual activities showed that 73.7 per cent of participants engage in private spiritual or religious activities more than once a week.
Originality/value
Overall the study supports previously conduced researches in the field of spirituality and AASE amongst AA members when considering other variables associated with sustained sobriety. The implications of the results of this study are discussed and suggestions have been made for further investigation.
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135
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Ko S, Park W. Effects of quantitative electroencephalography based neurofeedback training on autonomous regulations in patients with alcohol use disorder. Asian Nurs Res (Korean Soc Nurs Sci) 2018; 12:S1976-1317(18)30042-2. [PMID: 29870808 DOI: 10.1016/j.anr.2018.05.003] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2018] [Revised: 05/28/2018] [Accepted: 05/29/2018] [Indexed: 12/14/2022] Open
Abstract
PURPOSE The study investigated whether neurofeedback training can normalize the excessive high-beta and low alpha waves indicative of hyperarousal, and subsequently improve autonomous regulation based on the self-determination theory in alcohol use disorders. METHODS A nonequivalent control group pretest-posttest design was used. Data were collected using self-report questionnaires from 36 Korean inpatients who met the Alcohol Use Disorder Identification Test in Korea criteria. Data were collected from quantitative electroencephalography to assess alpha (8-12 Hz) and high-beta (21-30 Hz) waves for hyperarousal. The questionnaires included Basic Psychological Need Satisfaction scales that assessed autonomy, competence, and relatedness, and the Alcohol Abstinence Self-Efficacy Scale and Treatment Self-Regulation Questionnaire. The experimental group underwent 10 sessions of neurofeedback training over four weeks. Data were analyzed using the chi-squared, Mann-Whitney U, and Wilcoxon signed-rank tests. RESULTS In the experimental group, the alpha wave was increased in 15 of 19 sites and high-beta waves were decreased in 15 of 19 sites, but this difference was not significant. However, high-beta waves were increased in 15 of 19 sites in the control group, with seven sites (Fz, Cz, Pz, Fp2, F4, C4, and P4) showing significant increases. The experimental group showed a significant increase in basic psychological need satisfaction, alcohol abstinence self-efficacy, and self-regulation compared with the control group. CONCLUSIONS Neurofeedback training is recommended for improving autonomous regulation in alcohol use disorder as a nursing intervention. However, for significantly attenuating hyperarousal through brain wave correction, it may be necessary to increase the number of neurofeedback sessions.
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Affiliation(s)
- Sangjin Ko
- College of Nursing the Research Institute of Nursing Science, Kyungpook National University, Daegu, South Korea
| | - Wanju Park
- College of Nursing the Research Institute of Nursing Science, Kyungpook National University, Daegu, South Korea.
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Patton K, Connor JP, Rundle-Thiele S, Dietrich T, Young RM, Gullo MJ. Measuring adolescent drinking-refusal self-efficacy: Development and validation of the Drinking Refusal Self-Efficacy Questionnaire-Shortened Adolescent version (DRSEQ-SRA). Addict Behav 2018; 81:70-77. [PMID: 29432915 DOI: 10.1016/j.addbeh.2018.02.007] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2017] [Revised: 01/15/2018] [Accepted: 02/04/2018] [Indexed: 02/03/2023]
Abstract
BACKGROUND This study aimed to develop and validate a shortened version of the Drinking Refusal Self-Efficacy Questionnaire-Revised Adolescent version (DRSEQ-RA) using a large sample of adolescents. METHODS Secondary school students (N = 2609, M = 14.52 years, SD = 0.94) completed the DRSEQ-RA (consisting of subscales: Social Pressure; Opportunistic; Emotional Relief) and the Alcohol Use Disorders Identification Test (AUDIT). These data were analysed using non-parametric item response theory (NIRT) including Mokken scalability coefficients, and confirmatory factor analysis. RESULTS Social Pressure subscale items were better able to distinguish between adolescents with lower or higher levels of drinking refusal self-efficacy, while the Opportunistic and Emotional Relief subscale items were able to distinguish adolescents with low drinking-refusal self-efficacy. The DRSEQ-RA was reduced from 19-items to a 9-item scale and retained the original three-factor structure. The reduced scale was named the Drinking Refusal Self-Efficacy Questionnaire-Shortened Revised Adolescent version (DRSEQ-SRA). The DRSEQ-RA and the DRSEQ-SRA have almost identical psychometric properties. They both demonstrated good fit to the data, each explained 18% of the variance in alcohol consumption, Adj. R2 = 0.18, p < .001 respectively. The DRSEQ-RA and the DRSEQ-SRA also have excellent scale and subscale internal reliability (αs = 0.92-0.99). CONCLUSIONS The DRSEQ-SRA is a short, 9-item, measure of adolescent drinking-refusal self-efficacy which demonstrates both reliability and validity. A significant advantage is brevity. The DRSEQ-SRA may be a valuable tool for identifying risk of adolescent drinking and prevention/treatment planning in settings where survey administration time is critical.
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Affiliation(s)
- Kiri Patton
- Centre for Youth Substance Abuse Research, Faculty of Health and Behavioural Sciences, The University of Queensland, Brisbane, QLD, Australia; School of Psychology, Faculty of Health and Behavioural Sciences, The University of Queensland, Brisbane, QLD, Australia.
| | - Jason P Connor
- Centre for Youth Substance Abuse Research, Faculty of Health and Behavioural Sciences, The University of Queensland, Brisbane, QLD, Australia; Discipline of Psychiatry, Faculty of Medicine, The University of Queensland, Brisbane, QLD, Australia
| | - Sharyn Rundle-Thiele
- Social Marketing @ Griffith, Griffith Business School, Griffith University, Nathan, QLD, Australia
| | - Timo Dietrich
- Centre for Youth Substance Abuse Research, Faculty of Health and Behavioural Sciences, The University of Queensland, Brisbane, QLD, Australia; Social Marketing @ Griffith, Griffith Business School, Griffith University, Nathan, QLD, Australia; Department of Marketing, Griffith Business School, Griffith University, Nathan, QLD, Australia
| | - Ross McD Young
- Institute of Health and Biomedical Innovation, Queensland University of Technology, Kelvin Grove, QLD, Australia; Faculty of Health, Queensland University of Technology, Kelvin Grove, QLD, Australia
| | - Matthew J Gullo
- Centre for Youth Substance Abuse Research, Faculty of Health and Behavioural Sciences, The University of Queensland, Brisbane, QLD, Australia
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137
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Li L, Hien NT, Liang LJ, Lin C, Lan CW, Lee SJ, Tuan NA, Tuan LA, Thanh DC, Ha NTT. Efficacy of Communication Training of Community Health Workers on Service Delivery to People Who Inject Drugs in Vietnam: A Clustered Randomized Trial. Am J Public Health 2018; 108:791-798. [PMID: 29672144 DOI: 10.2105/ajph.2018.304350] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVES To evaluate the efficacy of an intervention targeted to commune health workers (CHWs) who deliver services to people who inject drugs (PWID) in Vietnam. METHODS From 2014 to 2016, we conducted a cluster randomized controlled trial of 300 CHWs and 900 PWID in 60 communes in 2 provinces of Vietnam. Intervention CHWs participated in training sessions to enhance their communication skills. Trained CHWs were asked to deliver individual sessions to PWID. We assessed the outcomes at baseline and at 3-, 6-, 9-, and 12-month follow-ups. RESULTS Intervention CHWs showed greater improvement in provider-client interactions than did control CHWs at all follow-ups (range of difference = 3.33-5.18; P < .001). Intervention CHWs showed greater reduction in negative attitudes toward PWID at the 12-month follow-up (mean ±SD = 1.75 ±0.50; P < .001). PWID in the intervention group exhibited greater improvement in drug avoidance than did those in the control group from the 6-month follow-up on (range of difference = 1.21-1.65; P < .001). We observed no intervention effect on heroin use as measured by urinalysis. CONCLUSIONS This intervention targeting CHWs could lead to desired outcomes for both CHWs and PWID. ClinicalTrials.gov: NCT0213092.1.
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Affiliation(s)
- Li Li
- Li Li, Li-Jung Liang, Chunqing Lin, Chiao-Wen Lan, and Sung-Jae Lee are with the Semel Institute for Neuroscience and Human Behavior, Center for Community Health, University of California, Los Angeles. Nguyen Tran Hien, Nguyen Anh Tuan, Le Anh Tuan, Duong Cong Thanh, and Nguyen Thi Thanh Ha are with the HIV/AIDS Department, National Institute of Hygiene and Epidemiology, Hanoi, Vietnam
| | - Nguyen Tran Hien
- Li Li, Li-Jung Liang, Chunqing Lin, Chiao-Wen Lan, and Sung-Jae Lee are with the Semel Institute for Neuroscience and Human Behavior, Center for Community Health, University of California, Los Angeles. Nguyen Tran Hien, Nguyen Anh Tuan, Le Anh Tuan, Duong Cong Thanh, and Nguyen Thi Thanh Ha are with the HIV/AIDS Department, National Institute of Hygiene and Epidemiology, Hanoi, Vietnam
| | - Li-Jung Liang
- Li Li, Li-Jung Liang, Chunqing Lin, Chiao-Wen Lan, and Sung-Jae Lee are with the Semel Institute for Neuroscience and Human Behavior, Center for Community Health, University of California, Los Angeles. Nguyen Tran Hien, Nguyen Anh Tuan, Le Anh Tuan, Duong Cong Thanh, and Nguyen Thi Thanh Ha are with the HIV/AIDS Department, National Institute of Hygiene and Epidemiology, Hanoi, Vietnam
| | - Chunqing Lin
- Li Li, Li-Jung Liang, Chunqing Lin, Chiao-Wen Lan, and Sung-Jae Lee are with the Semel Institute for Neuroscience and Human Behavior, Center for Community Health, University of California, Los Angeles. Nguyen Tran Hien, Nguyen Anh Tuan, Le Anh Tuan, Duong Cong Thanh, and Nguyen Thi Thanh Ha are with the HIV/AIDS Department, National Institute of Hygiene and Epidemiology, Hanoi, Vietnam
| | - Chiao-Wen Lan
- Li Li, Li-Jung Liang, Chunqing Lin, Chiao-Wen Lan, and Sung-Jae Lee are with the Semel Institute for Neuroscience and Human Behavior, Center for Community Health, University of California, Los Angeles. Nguyen Tran Hien, Nguyen Anh Tuan, Le Anh Tuan, Duong Cong Thanh, and Nguyen Thi Thanh Ha are with the HIV/AIDS Department, National Institute of Hygiene and Epidemiology, Hanoi, Vietnam
| | - Sung-Jae Lee
- Li Li, Li-Jung Liang, Chunqing Lin, Chiao-Wen Lan, and Sung-Jae Lee are with the Semel Institute for Neuroscience and Human Behavior, Center for Community Health, University of California, Los Angeles. Nguyen Tran Hien, Nguyen Anh Tuan, Le Anh Tuan, Duong Cong Thanh, and Nguyen Thi Thanh Ha are with the HIV/AIDS Department, National Institute of Hygiene and Epidemiology, Hanoi, Vietnam
| | - Nguyen Anh Tuan
- Li Li, Li-Jung Liang, Chunqing Lin, Chiao-Wen Lan, and Sung-Jae Lee are with the Semel Institute for Neuroscience and Human Behavior, Center for Community Health, University of California, Los Angeles. Nguyen Tran Hien, Nguyen Anh Tuan, Le Anh Tuan, Duong Cong Thanh, and Nguyen Thi Thanh Ha are with the HIV/AIDS Department, National Institute of Hygiene and Epidemiology, Hanoi, Vietnam
| | - Le Anh Tuan
- Li Li, Li-Jung Liang, Chunqing Lin, Chiao-Wen Lan, and Sung-Jae Lee are with the Semel Institute for Neuroscience and Human Behavior, Center for Community Health, University of California, Los Angeles. Nguyen Tran Hien, Nguyen Anh Tuan, Le Anh Tuan, Duong Cong Thanh, and Nguyen Thi Thanh Ha are with the HIV/AIDS Department, National Institute of Hygiene and Epidemiology, Hanoi, Vietnam
| | - Duong Cong Thanh
- Li Li, Li-Jung Liang, Chunqing Lin, Chiao-Wen Lan, and Sung-Jae Lee are with the Semel Institute for Neuroscience and Human Behavior, Center for Community Health, University of California, Los Angeles. Nguyen Tran Hien, Nguyen Anh Tuan, Le Anh Tuan, Duong Cong Thanh, and Nguyen Thi Thanh Ha are with the HIV/AIDS Department, National Institute of Hygiene and Epidemiology, Hanoi, Vietnam
| | - Nguyen Thi Thanh Ha
- Li Li, Li-Jung Liang, Chunqing Lin, Chiao-Wen Lan, and Sung-Jae Lee are with the Semel Institute for Neuroscience and Human Behavior, Center for Community Health, University of California, Los Angeles. Nguyen Tran Hien, Nguyen Anh Tuan, Le Anh Tuan, Duong Cong Thanh, and Nguyen Thi Thanh Ha are with the HIV/AIDS Department, National Institute of Hygiene and Epidemiology, Hanoi, Vietnam
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138
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Brooks AT, Krumlauf M, Beck KH, Fryer CS, Yang L, Ramchandani VA, Wallen GR. A Mixed Methods Examination of Sleep Throughout the Alcohol Recovery Process Grounded in the Social Cognitive Theory: The Role of Self-Efficacy and Craving. HEALTH EDUCATION & BEHAVIOR 2018; 46:126-136. [DOI: 10.1177/1090198118757820] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Sleep disturbances can accompany alcohol use disorders during various phases of the disease. This analysis utilized a mixed methods approach to assess whether sleep-related beliefs and/or behavior of individuals who are alcohol dependent were associated with sleep quality both pre- and postdischarge from a clinical research facility providing inpatient alcohol rehabilitation treatment. Individuals with higher self-efficacy for sleep (SE-S) reported better sleep quality at both time points. Individuals with fewer dysfunctional beliefs about sleep had poorer sleep quality at both time points. Individuals with higher unhealthy sleep-related safety behaviors had poorer sleep quality at both time points. In a linear regression model, only the difference in SE-S scores from pre- to postdischarge (β = −.396, p = .01) and the postdischarge Penn Alcohol Craving Score (β = .283, p = .019) significantly predicted the change in sleep quality. Thus, those whose SE-S scores increased and those with lower postdischarge craving scores were more likely to experience a decrease on Pittsburgh Sleep Quality Index scores from pre- to postdischarge even after controlling for covariates. References to behavior or personal factors were often discussed during the qualitative interviews in tandem with the environment. Participants reported both (1) self-medicating anxiety with alcohol and (2) self-medicating the inability to fall asleep with alcohol. Given the success of behavioral sleep interventions in various populations and the unique potential contributions of mixed methods approaches to examine sleep and alcohol use, assessing sleep-related cognitions and behaviors of individuals with severe alcohol use disorders may be important in understanding sleep quality and subsequent relapse.
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Affiliation(s)
- Alyssa T. Brooks
- National Institutes of Health Clinical Center, Bethesda, MD, USA
| | - Michael Krumlauf
- National Institutes of Health Clinical Center, Bethesda, MD, USA
| | - Kenneth H. Beck
- University of Maryland School of Public Health, College Park, MD, USA
| | - Craig S. Fryer
- University of Maryland School of Public Health, College Park, MD, USA
| | - Li Yang
- National Institutes of Health Clinical Center, Bethesda, MD, USA
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Moeini B, Hazavehei SMM, Shahrabadi R, Faradmal J, Ahmadpanah M, Dashti S, Barati M, Mehri A. The effectiveness of cognitive–behavioral stress-management training on the readiness for substance use treatment in Iran. JOURNAL OF SUBSTANCE USE 2018. [DOI: 10.1080/14659891.2018.1436597] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Babak Moeini
- Social Determinants of Health Research Center & Department of Public Health, School of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Seyed Mohammad Mehdi Hazavehei
- Research Center for Health Sciences and Department of Health, School of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Reza Shahrabadi
- Department of Health Education & Promotion, Sabzevar University of Medical Sciences, Sabzevar, Iran
| | - Javad Faradmal
- Modeling of Noncommunicable Disease Research Center & Department of Vital Statistics, School of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Mohammad Ahmadpanah
- Research Center for Behavioral Disorders and Substance Abuse, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Saeed Dashti
- Department of Health Education & Promotion, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Majid Barati
- Social Determinants of Health Research Center & Department of Public Health, School of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Ali Mehri
- Department of Health Education & Promotion, Sabzevar University of Medical Sciences, Sabzevar, Iran
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Wilson M, Gogulski HY, Cuttler C, Bigand TL, Oluwoye O, Barbosa-Leiker C, Roberts MA. Cannabis use moderates the relationship between pain and negative affect in adults with opioid use disorder. Addict Behav 2018; 77:225-231. [PMID: 29078148 DOI: 10.1016/j.addbeh.2017.10.012] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2017] [Revised: 10/11/2017] [Accepted: 10/16/2017] [Indexed: 01/11/2023]
Abstract
INTRODUCTION Adults in Medication-Assisted Treatment (MAT) for opioid addiction are at risk for substance use relapse and opioid overdose. They often have high rates of cannabis use and comorbid symptoms of pain, depression, and anxiety. Low levels of self-efficacy (confidence that one can self-manage symptoms) are linked to higher symptom burdens and increased substance use. The effects of cannabis use on symptom management among adults with MAT are currently unclear. Therefore, the primary purpose of this study is to examine whether cannabis use moderates the relationships between pain and negative affect (i.e., depression and anxiety) and whether self-efficacy influences these interactions. METHODS A total of 150 adults receiving MAT and attending one of two opioid treatment program clinics were administered a survey containing measures of pain, depression, anxiety, self-efficacy, and cannabis use. RESULTS Cannabis use frequency moderated the relationships between pain and depression as well as pain and anxiety. Specifically, as cannabis use frequency increased, the positive relationships between pain and depression and pain and anxiety grew stronger. However, cannabis use was no longer a significant moderator after controlling for self-efficacy. CONCLUSIONS Results suggest that cannabis use strengthens, rather than weakens, the relationships between pain and depression and pain and anxiety. These effects appear to be driven by decreased self-efficacy in cannabis users. It is important to understand how self-efficacy can be improved through symptom self-management interventions and whether self-efficacy can improve distressing symptoms for people in MAT.
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141
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A biosocial cognitive model of cannabis use in emerging adulthood. Addict Behav 2018; 76:229-235. [PMID: 28863315 DOI: 10.1016/j.addbeh.2017.08.011] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2017] [Revised: 08/10/2017] [Accepted: 08/16/2017] [Indexed: 11/24/2022]
Abstract
OBJECTIVES The aim of this study was to test a new theoretical model of cannabis use incorporating biologically-based personality traits and social cognition. This biosocial cognitive theory (bSCT) has robust support in alcohol studies, but has not been applied to cannabis. The model proposes two pathways linking dimensions of impulsivity to cannabis use. The first predicts that the association between Reward Sensitivity (SR) and cannabis use is mediated by positive outcome expectancies. The second predicts that the relationship between Rash Impulsiveness (RI) and cannabis use is mediated by cannabis refusal self-efficacy. An extended version of this model was also tested and included a third pathway linking Punishment Sensitivity (SP) to cannabis use via higher negative outcome expectancies. METHOD Participants were 252 18-to-21-year-olds who completed questionnaires assessing cannabis use, personality and social cognition. Theoretical models were tested using structural equation modeling. RESULTS The bSCT model provided a good fit to the data (CFI=0.95; RMSEA=0.07; SRMR=0.06). Positive cannabis expectancies and refusal self-efficacy partially mediated the association between SR and cannabis use (p<0.05). Cannabis refusal self-efficacy fully mediated the relationship between RI and cannabis use (p<0.05). The addition of a third SP pathway did not improve model fit. CONCLUSIONS Consistent with alcohol studies, the association between impulsivity and cannabis use is largely mediated by social cognition. The bSCT may provide novel insights to inform prevention and treatment of problematic cannabis use.
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Hetelekides EM, Tyskiewicz AJ, Prince MA, Collins RL. The Indirect Effects of Self-Efficacy on Cannabis Use via Cannabis Protective Strategies: A Preliminary Study. ACTA ACUST UNITED AC 2018; 1:66-76. [PMID: 34327312 PMCID: PMC8318200 DOI: 10.26828/cannabis.2018.02.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Cannabis use has more than doubled in the past decade and nearly three of 10 users develop a cannabis use disorder. The increase in users, combined with the ongoing changes in the medical, legal and social status of cannabis, has contributed to interest in the antecedents of cannabis use. In the current preliminary study, we gathered information from a community sample (N = 54) of regular cannabis using young adults. Assessments included perceived self-efficacy for reducing intake or abstaining (SE-R/A), use of cannabis protective strategies (CPS), and average quantity of cannabis use per day. We systematically explored which specific CPS were most strongly associated with self-efficacy and cannabis use. Three clinically relevant subgroups of CPS emerged from this analysis: strategies strongly associated with only self-efficacy, only cannabis use, and both variables. We hypothesized that self-efficacy would be associated with less cannabis use via use of CPS. Among specific CPS examined, "Use a little and then wait to see how you feel before using more" had the strongest association with self-efficacy while "Avoid methods of using cannabis that can make you more intoxicated than you would like" had the strongest negative association with cannabis use. We observed a significant indirect relationship from self-efficacy to cannabis use through use of CPS. Our findings suggest that use of CPS is a potential mechanism by which cannabis users reduce use, and a more proximal antecedent of cannabis use than personal confidence in one's ability to stop using. These preliminary findings highlight the value of studying individual strategies. They also may have implications for promoting use of cannabis protective strategies when treating those with cannabis use problems.
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Affiliation(s)
| | | | - Mark A Prince
- Department of Psychology, Colorado State University, Fort Collins, CO, USA
| | - R Lorraine Collins
- Research Institute on Addictions, University at Buffalo, Buffalo, NY, USA.,Department of Community Health and Health Behavior, University at Buffalo, Buffalo, NY, USA
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143
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Noujaim D, Fortinsky RH, Barry LC. The Relationship Between Emotional Support and Health-Related Self-Efficacy in Older Prisoners. J Aging Health 2017; 31:439-462. [PMID: 29254413 DOI: 10.1177/0898264317733363] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Objective: To determine whether emotional support, and proportion of emotional support provided by specific sources (e.g., family, other prisoners, clinicians), is associated with health-related self-efficacy among older prisoners. Method: Cross-sectional study of 140 older prisoners age ≥50 with chronic medical illness who completed face-to-face interviews. Logistic regression, controlling for demographic, incarceration, and clinical/behavioral factors evaluated the association between emotional support, operationalized as a score and as a proportion of total emotional support from specific sources, and health-related self-efficacy. Results: Higher emotional support scores, and greater proportion of support from clinicians, were associated with lower likelihood of poor health-related self-efficacy. Those with >50% of their emotional support coming from other prisoners had higher likelihood of poor self-efficacy. Discussion: Among older prisoners with chronic illness, higher emotional support, particularly from clinicians, is associated with lower likelihood of poor self-efficacy; relying on other prisoners for emotional support is associated with poor health-related self-efficacy.
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Affiliation(s)
| | | | - Lisa C Barry
- University of Connecticut Health Center, Farmington, USA
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144
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Altamirano J, López-Pelayo H, Michelena J, Jones PD, Ortega L, Ginès P, Caballería J, Gual A, Bataller R, Lligoña A. Alcohol abstinence in patients surviving an episode of alcoholic hepatitis: Prediction and impact on long-term survival. Hepatology 2017. [PMID: 28646515 DOI: 10.1002/hep.29338] [Citation(s) in RCA: 101] [Impact Index Per Article: 14.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
UNLABELLED Alcoholic hepatitis (AH) is the most severe form of alcoholic liver disease. Most studies have focused on short-term prognosis, whereas factors associated with long-term survival are largely unknown. The aims of our study were to (1) determine the impact of complete abstinence from alcohol on long-term survival and (2) identify prognostic factors at admission capable of predicting abstinence during long-term follow-up in patients with AH. One hundred forty-two patients with biopsy-proven AH that survived the first episode were included. Demographic, psychiatric, and biochemical variables at admission and drinking status during follow-up were obtained. Cox regression, logistic regression, and classification and regression trees (CART) analyses were used for statistical analysis. Overall mortality was 38% with a median follow-up of 55 months. During follow-up, complete abstinence was reported in 39% and was associated with better long-term survival (hazard ratio, 0.53; P = 0.03). After adjustment for baseline prognostic scoring systems (Model for End-Stage Liver Disease and age, bilirubin, international normalized ratio, creatinine scores), complete abstinence was independently associated with survival (P < 0.05). Age and lack of past alcoholism treatments were independently associated with complete abstinence (P < 0.001 and P = 0.02, respectively) during follow-up. CART analysis generated a simple and practical algorithm based on the combination of past alcoholism treatments and age. Using CART analysis, we stratified 2 subgroups of patients with high (65%) and low (26%-29%) rates of complete abstinence after an episode of AH. CONCLUSION Complete abstinence after an episode of AH positively impacts long-term survival. The combination of 2 variables easily obtained at admission might be useful to predict long-term abstinence after an episode of AH. Strategies aimed at promoting alcohol abstinence in these patients are necessary. (Hepatology 2017;66:1842-1853).
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Affiliation(s)
- José Altamirano
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Hugo López-Pelayo
- Grup Recerca Addiccions Clinic (GRAC-GRE) Psychiatry Department, Neurosciences Institute, Hospital Clínic of Barcelona, Red de Trastornos Adictivos (RTA), Barcelona, Spain
| | - Javier Michelena
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Patricia D Jones
- Division of Gastroenterology and Hepatology, University of Miami Miller School of Medicine, Miami, FL
| | - Lluisa Ortega
- Grup Recerca Addiccions Clinic (GRAC-GRE) Psychiatry Department, Neurosciences Institute, Hospital Clínic of Barcelona, Red de Trastornos Adictivos (RTA), Barcelona, Spain
| | - Pere Ginès
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain.,Liver Unit, CIBER de Enfermedades Hepáticas y Digestivas (CIBERehd), Institució Catalana de Recerca i Estudis Avançats (ICREA), Universitat de Barcelona, Barcelona, Spain
| | - Juan Caballería
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain.,Liver Unit, CIBER de Enfermedades Hepáticas y Digestivas (CIBERehd), Institució Catalana de Recerca i Estudis Avançats (ICREA), Universitat de Barcelona, Barcelona, Spain
| | - Antoni Gual
- Grup Recerca Addiccions Clinic (GRAC-GRE) Psychiatry Department, Neurosciences Institute, Hospital Clínic of Barcelona, Red de Trastornos Adictivos (RTA), Barcelona, Spain
| | - Ramón Bataller
- Division of Gastroenterology and Hepatology, Departments of Medicine and Nutrition, University of North Carolina at Chapel Hill, Chapel Hill, NC.,Pittsburgh Liver Research Center, Division of Gastroenterology, Hepatology and Nutrition, University of Pittsburgh Liver Center, Pittsburgh, PA
| | - Anna Lligoña
- Grup Recerca Addiccions Clinic (GRAC-GRE) Psychiatry Department, Neurosciences Institute, Hospital Clínic of Barcelona, Red de Trastornos Adictivos (RTA), Barcelona, Spain
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145
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Abstract
BACKGROUND Addictions are highly stigmatized and increasingly construed as biomedical diseases caused by genes, partly to reduce stigma by deflecting blame. However, genetic explanations may have negative effects, which have been understudied in the context of addiction. How the effects of genetic explanations might differ for substance addictions versus behavioral addictions is also unknown. AIMS This study examined the impact of genetic explanations for addiction on measures of treatment expectancies, blame, and perceived agency and self-control, as well as whether these varied depending on whether the addiction was to a substance or a behavior. METHODS Participants read about a person ('Charlie') with either alcohol use disorder or gambling disorder, receiving either a genetic or nongenetic explanation of Charlie's problem. They rated how much they blamed Charlie for his disorder, his likelihood of benefitting from medication or psychotherapy, and how much agency and self-control they ascribed to him. RESULTS Compared to the nongenetic explanation, the genetic explanation reduced blame and increased confidence in the effectiveness of pharmacotherapy. However, it also decreased the expected effectiveness of psychotherapy and reduced ascriptions of agency and self-control. CONCLUSION Genetic explanations for addiction appear to be a 'double-edged sword', with beneficial effects that come at a cost.
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Affiliation(s)
- Matthew S Lebowitz
- Center for Research on Ethical, Legal and Social Implications of Psychiatric, Neurologic and Behavioral Genetics, New York, NY, USA Psychiatric Institute and Department of Psychiatry, Columbia University, New York, NY, USA
| | - Paul S Appelbaum
- Center for Research on Ethical, Legal and Social Implications of Psychiatric, Neurologic and Behavioral Genetics, New York, NY, USA Psychiatric Institute and Department of Psychiatry, Columbia University, New York, NY, USA
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146
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Blevins CE, Rapoport MA, Battle CL, Stein MD, Abrantes AM. Changes in Coping, Autonomous Motivation, and Beliefs about Exercise among Women in Early Recovery from Alcohol Participating in a Lifestyle Physical Activity Intervention. Ment Health Phys Act 2017; 13:137-142. [PMID: 29358975 PMCID: PMC5774644 DOI: 10.1016/j.mhpa.2017.09.009] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Women are particularly likely to drink alcohol for the purpose of coping with or alleviating negative affect. Engaging in physical activity has been posited as a potentially effective alternate coping strategy during early recovery for managing mood and cravings. Utilizing exercise to cope may be associated with more adaptive coping strategies in general. Additionally, an intrinsic (autonomous) motivational style and positive beliefs about exercise are associated with long-term adherence to physical activity. The current study evaluates changes in coping strategies, autonomous motivation, and beliefs about exercise among women engaged in a physical activity intervention during early recovery (N=20; mean age=39.53). General coping strategies, motivational style, and beliefs about exercise were examined before and after engaging in the 12-week intervention which aimed to help women utilize physical activity as a means to cope with negative affect and alcohol craving. We found that, by the end of the intervention, participants significantly increased utilization of adaptive coping strategies such as the use of emotional support from others. Additionally, participants increased autonomous motivation over time. There were no significant changes in beliefs about exercise. Changes in beliefs about benefits of exercise, autonomous motivation, and adaptive coping were related to use of exercise to cope. However, even though these changes were associated with how women in the intervention used exercise, they were not associated with exercising more. Results from this open pilot suggest that women in early recovery from alcohol who increase physical activity - specifically as a means to cope with negative affect and craving - also demonstrate other wider coping strategies, more positive beliefs, and autonomous motivation.
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Affiliation(s)
- Claire E. Blevins
- Butler Hospital, Providence, RI, USA
- Alpert Medical School of Brown University, Providence, RI, USA
| | | | - Cynthia L. Battle
- Butler Hospital, Providence, RI, USA
- Alpert Medical School of Brown University, Providence, RI, USA
| | - Michael D. Stein
- Butler Hospital, Providence, RI, USA
- Alpert Medical School of Brown University, Providence, RI, USA
- Boston University, Boston, MA, USA
| | - Ana M. Abrantes
- Butler Hospital, Providence, RI, USA
- Alpert Medical School of Brown University, Providence, RI, USA
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147
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Kenney SR, Bailey GL, Anderson BJ, Stein MD. Heroin refusal self-efficacy and preference for medication-assisted treatment after inpatient detoxification. Addict Behav 2017; 73:124-128. [PMID: 28505487 DOI: 10.1016/j.addbeh.2017.05.009] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2017] [Revised: 05/02/2017] [Accepted: 05/08/2017] [Indexed: 11/27/2022]
Abstract
OBJECTIVE An individual's self-efficacy to refuse using heroin in high-risk situations is believed to minimize the likelihood for relapse. However, among individuals completing inpatient heroin detoxification, perceived refusal self-efficacy may also reduce one's perceived need for medication-assisted treatment (MAT), an effective and recommended treatment for opioid use disorder. In the current study, we examined the relationship between heroin refusal self-efficacy and preference for MAT following inpatient detoxification. METHOD Participants (N=397) were interviewed at the start of brief inpatient opioid detoxification. Multiple logistic regression was used to estimate the adjusted association of background characteristics, depressed mood, and perceived heroin refusal self-efficacy with preference for MAT. RESULTS Controlling for other covariates, depressed mood and lower perceived refusal self-efficacy were associated with a significantly greater likelihood of expressing preference for MAT (versus no MAT). CONCLUSIONS Perceived ability to refuse heroin after leaving detox is inversely associated with a heroin user's desire for MAT. An effective continuum of care model may benefit from greater attention to patient's perceived refusal self-efficacy during detoxification which may impact preference for MAT and long-term recovery.
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Affiliation(s)
- Shannon R Kenney
- Behavioral Medicine Department, Butler Hospital, Providence, RI 02906, United States; Warren Alpert Medical School of Brown University, Providence, RI 02912, United States.
| | - Genie L Bailey
- Warren Alpert Medical School of Brown University, Providence, RI 02912, United States; Stanley Street Treatment and Resources, Inc., Fall River, MA 02720, United States
| | - Bradley J Anderson
- Behavioral Medicine Department, Butler Hospital, Providence, RI 02906, United States
| | - Michael D Stein
- Behavioral Medicine Department, Butler Hospital, Providence, RI 02906, United States; Boston University School of Public Health, Boston, MA 02118, United States
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148
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O’Sullivan D, Xiao Y, Watts JR. Recovery Capital and Quality of Life in Stable Recovery From Addiction. REHABILITATION COUNSELING BULLETIN 2017. [DOI: 10.1177/0034355217730395] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Quality of life is becoming an increasingly important outcome measure in both relapse prevention research and rehabilitation counseling research. Recovery capital is a collection of the people and resources believed to contribute to long-term recovery from addiction. Recovery capital indicators were assessed along with quality of life in a national sample of peer support participants in stable recovery ( n = 76) to determine which recovery capital indicators relate to quality of life at this stage. Results reveal that relapse history, refusal self-efficacy, and self-stigma significantly explained about 23% of quality of life in our sample. A discussion of recovery stages and recovery capital is included, as well as implications for rehabilitation counseling practice and research.
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Affiliation(s)
| | - Yi Xiao
- The Pennsylvania State University, University Park, USA
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149
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Tsuei SHT, Clair V, Mutiso V, Musau A, Tele A, Frank E, Ndetei D. Factors Influencing Lay and Professional Health Workers’ Self-efficacy in Identification and Intervention for Alcohol, Tobacco, and Other Substance Use Disorders in Kenya. Int J Ment Health Addict 2017. [DOI: 10.1007/s11469-017-9775-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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150
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Tsuei SHT, Clair V, Mutiso V, Musau A, Tele A, Frank E, Ndetei D. FACTORS INFLUENCING LAY AND PROFESSIONAL HEALTH WORKERS' SELF-EFFICACY IN IDENTIFICATION AND INTERVENTION FOR ALCOHOL, TOBACCO, AND OTHER SUBSTANCE USE DISORDERS IN KENYA. Int J Ment Health Addict 2017; 15:766-781. [PMID: 31558889 PMCID: PMC6761831] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/10/2023] Open
Abstract
The global burden of substance use disorders (SUDs), including alcohol and tobacco, disproportionately affect low- and middle-income countries (LMICs), considering their rising disease burden and low service capacity. Nested within a Kenyan training program, this study explores factors associated with healthcare providers' self-efficacy to treat SUD. Surveys of 206 healthcare workers were used to perform regression and sensitivity analysis assessing various factors association with self-efficacy. Self-efficacy for SUD was lower in those practicing in public facilities and perceiving a need for alcohol use disorder (AUD) training; while higher self-efficacy correlated with a higher proportion of patients with AUD in one's setting, access to mental health worker support, cannabis use at a moderate risk level, and belief that AUD is manageable in outpatient settings. Increasing awareness about SUD prevalence, identification, and treatment skills could improve the self-efficacy of LMICs' health care providers and therefore the willingness to implement more services for patients with SUDs.
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Affiliation(s)
- Sian Hsiang-Te Tsuei
- School of Population and Public Health, University of British Columbia, Vancouver, Canada
| | - Veronic Clair
- School of Population and Public Health, University of British Columbia, Vancouver, Canada
- Africa Mental Health Foundation, Nairobi, Kenya
| | | | | | - Albert Tele
- Africa Mental Health Foundation, Nairobi, Kenya
| | - Erica Frank
- School of Population and Public Health, University of British Columbia, Vancouver, Canada
| | - David Ndetei
- Africa Mental Health Foundation, Nairobi, Kenya
- Department of Psychiatry, University of Nairobi, Nairobi, Kenya
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