[Substance use disorders as a cause and consequence of childhood abuse. Basic research, therapy and prevention in the BMBF-funded CANSAS-Network]

Assessment of characteristics and exposure to vulnerable factors for drug use among male illicit drug users in Sri Lanka: A multicenter cross-sectional study

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Methodology:

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Clinical Outcomes of Severe Forms of Early Social Stress

Early social stress, particularly severe but nevertheless frequent forms such as abuse and neglect, are among the major risk factors for the development of mental disorders. However, we only have very limited knowledge of the psychobiological disease mechanisms underlying the influence of early life stress and stress-related disorders during this vulnerable phase of life. Early stress can have long-lasting adverse effects on the brain and other somatic systems, e.g. through influences on brain development. In adulthood, the prior experience of abuse or neglect can result in complex clinical profiles. Besides conditions such as mood and anxiety disorders as well as posttraumatic stress disorder, substance use disorders (SUD) are among the most prevalent sequelae of early social stress. Current social stress further influences the development and maintenance of these disorders, e.g., by increasing the risk of relapses. In this chapter, we will first give an overview of currently used methods to assess the phenomenology and pathophysiology of stress-related disorders and then focus on the phenomenological and neurobiological background of the interaction between early social stress and SUD. We will give an overview of important insights from neuroimaging studies and will also highlight recent findings from studies using digital tools such as ecological momentary assessment or virtual reality to capture the influence of early social stress as well as current social stress in everyday life of persons with SUD.

[Treatment of mentally ill parents-Strengthen awareness for children]

To raise awareness that families with a mentally ill parent face special challenges and the correct handling of it, need to be considered more in health care. The simple question "how are you as a parent and your children?" is often not asked but this question is important so as not to endanger the healing process, to identify the need for assistance and to break the potential vicious circle for children. Awareness of the problem in the psychiatry of adults can support the care of affected persons and their children.

Den Genderkäfig verlassen – Beachtung von Genderaspekten in der Behandlung männlicher Substanzabhängigkeit

Männer dominieren im Konsum und der Abhängigkeit von Alkohol und illegalen Drogen. Ein Bezug zur Lebenssituation von Männern und deren Art ihre Männlichkeit zu konstruieren, wird jedoch in der Suchttherapie, -forschung und Therapieausbildung selten gezogen. Die männliche Geschlechtsrolle stellt heute eine größere Pluralität zur Verfügung. Sie basiert jedoch weiterhin grundsätzlich auf traditionellen Elementen von Stärke und Invulnerabilität. Ein Diskurs unter Männern über die Gefahren und Entwicklungsmöglichkeiten von männlichem Verhalten hat nicht wirklich begonnen. Stattdessen wächst global eher eine Rückentwicklung hin zu starren Frauen- und Männerbildern. Männer sterben jedoch nach wie vor früher als Frauen, häufig an Suizid und sind z. B. deutlich häufiger inhaftiert. Dieser Artikel fokussiert die enge Beziehung von Männern zur Substanzabhängigkeit und appelliert für eine gendersensible Beachtung männlicher Geschlechtsrollenaspekte in der Suchttherapie. Als Beispiele für ein mögliches Vorgehen wird auf ein Manual zum Thema und eine kürzlich erschienene Videoreihe verwiesen.

[Process analysis of weekly self- and external assessments of adolescents with substance abuse disorder during long-term psychotherapy]

Process analysis of weekly self- and external assessments of adolescents with substance abuse disorder during long-term psychotherapy Abstract.

OBJECTIVE

Little is known about the course of emotional and motivational states in young patients with substance use disorder (SUD) during long-term treatment.

METHOD

We collected weekly self-reports from N = 42 adolescents, resulting in 853 questionnaires. Additionally, 708 observations were obtained from their key carers. Principal component analysis (PCA) was used to explore the dimensional structure of the questionnaires. Multi-level models were applied to test for group differences and time series models to evaluate dependencies on the person level.

RESULTS

PCA yielded four factors: negative mental state, appreciation of the setting, motivation, and addiction dynamics. Correlations between self- and (unidimensional) carer-reports were low to moderate, but differential on the individual level. Scores of all four scales decreased during the course of treatment. The level of appreciation during the initial phase was the only significant predictor for drop-outs of treatment later on: in drop-outs, appreciation decreased, whereas it increased in completers.

CONCLUSION

Appreciation was the most important predictive factor for a regular therapy ending in SUD, whereas motivation showed fluctuations typical for adolescence. Addiction dynamics were of lesser relevance than commonly expected. Therefore, programs in long-term SUD treatment should focus more on improving appreciation than on issues of addiction itself.