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McCuistian C, Lisha NE, Campbell B, Cheng C, Le J, Guydish J. Reducing tobacco use in substance use treatment: The California tobacco free initiative. Addict Behav 2024; 155:108025. [PMID: 38593596 DOI: 10.1016/j.addbeh.2024.108025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2024] [Revised: 03/12/2024] [Accepted: 03/29/2024] [Indexed: 04/11/2024]
Abstract
BACKGROUND People in substance use disorder (SUD) treatment have a smoking prevalence that is five times higher than the national average. California funded the Tobacco Free for Recovery Initiative, designed to support programs in implementing tobacco-free grounds and increasing smoking cessation services. In the first cohort of the initiative (2018-2020) client smoking prevalence decreased from 54.2% to 26.6%. The current study examined whether similar findings would be replicated with a later cohort of programs (2020-2022). METHOD Cross-sectional survey data were collected from clients in 11 residential SUD treatment programs at baseline (n = 185) and at post intervention (n = 227). Multivariate logistic regression assessed change over time in smoking prevalence, tobacco use behaviors, and receipt of cessation services across the two timepoints. RESULTS Client smoking prevalence decreased from 60.3 % to 40.5 % (Adjusted Odds Ratio [AOR] = 0.46, 95 % CI = 0.27, 0.78; p = 0.004). Current smokers and those who quit while in treatment reported an increase in nicotine replacement therapy (NRT)/pharmacotherapy from baseline to post intervention (31.9 % vs 45.6 %; AOR = 2.22, 95 % CI = 1.08, 4.58; p = 0.031). CONCLUSIONS Like the first cohort, the Tobacco Free for Recovery initiative was associated with decreased client smoking prevalence and an increase in NRT/pharmacotherapy. These findings strengthen the evidence that similar initiatives may be effective in reducing smoking prevalence among people in SUD treatment.
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Affiliation(s)
- Caravella McCuistian
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco 1001 Potrero Ave, San Francisco, CA 94110, United States.
| | - Nadra E Lisha
- Division of General Internal Medicine, School of Medicine University of California, San Francisco 530 Parnassus Ave, San Francisco, CA 94143, United States
| | - Barbara Campbell
- Division of General Internal Medicine & Geriatrics, Oregon Health and Science University 3181 SW Sam Jackson Park Road, Portland, OR 97239-3098, United States
| | - Christine Cheng
- Smoking Cessation Leadership Center, University of California, San Francisco 490 Illinois Street, 9216, San Francisco, CA 94158, United States
| | - Jennifer Le
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco 1001 Potrero Ave, San Francisco, CA 94110, United States
| | - Joseph Guydish
- Philip R. Lee Institute for Health Policy Studies, University of California San Francisco, 490 Illinois St., Floor 7, San Francisco, CA 94158, United States
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Segrin C, Jiao J, Cooper RA. Social Isolation Mediates the Effects of Negative Emotionality and Resilience on Drinking to Cope and Drinking Alone. Subst Use Misuse 2024; 59:1860-1869. [PMID: 39060223 DOI: 10.1080/10826084.2024.2383615] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/28/2024]
Abstract
Objective: The purpose of this research was to test an extension of the incentive motivation model of alcohol by examining effects of personality traits on drinking motives and contexts, as mediated by social isolation. Methods: Participants were 1269 adults who resided in the United States (n = 618) or United Kingdom (n = 651) and completed an online questionnaire measuring the traits of negative emotionality and resilience, along with social isolation, drinking motives (coping, social) and drinking contexts (alone, at a party, at a bar/club). Six months later, 70% of the participants returned to complete a similar online questionnaire. Results: Path analysis was used to test the hypothesized models and revealed that negative emotionality had a prospective indirect effect on drinking to cope and drinking alone through increased social isolation over the 6-month period of observation. In contrast, the trait of resilience had a prospective indirect effect on reductions in the drinking to cope motive and reductions in drinking alone, through decreased social isolation. Conclusion: The findings suggest that personality traits that contribute to social isolation may be risk factors for dysfunctional drinking motives and contexts.
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Affiliation(s)
- Chris Segrin
- Department of Communication, University of Arizona, Tucson, Arizona, USA
| | - Jian Jiao
- Faculty of Humanities and Arts, Macau University of Science and Technology, Macau, China
| | - R Amanda Cooper
- Department of Communication, University of Connecticut, Storrs, CT, USA
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O'Leary C, Ralphs R, Stevenson J, Smith A, Harrison J, Kiss Z, Armitage H. The effectiveness of abstinence-based and harm reduction-based interventions in reducing problematic substance use in adults who are experiencing homelessness in high income countries: A systematic review and meta-analysis: A systematic review. CAMPBELL SYSTEMATIC REVIEWS 2024; 20:e1396. [PMID: 38645303 PMCID: PMC11032639 DOI: 10.1002/cl2.1396] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 04/23/2024]
Abstract
Background Homelessness is a traumatic experience, and can have a devastating effect on those experiencing it. People who are homeless often face significant barriers when accessing public services, and have often experienced adverse childhood events, extreme social disadvantage, physical, emotional and sexual abuse, neglect, low self-esteem, poor physical and mental health, and much lower life expectancy compared to the general population. Rates of problematic substance use are disproportionately high, with many using drugs and alcohol to deal with the stress of living on the street, to keep warm, or to block out memories of previous abuse or trauma. Substance dependency can also create barriers to successful transition to stable housing. Objectives To understand the effectiveness of different substance use interventions for adults experiencing homelessness. Search Methods The primary source of studies for was the 4th edition of the Homelessness Effectiveness Studies Evidence and Gaps Maps (EGM). Searches for the EGM were completed in September 2021. Other potential studies were identified through a call for grey evidence, hand-searching key journals, and unpacking relevant systematic reviews. Selection Criteria Eligible studies were impact evaluations that involved some comparison group. We included studies that tested the effectiveness of substance use interventions, and measured substance use outcomes, for adults experiencing homelessness in high income countries. Data Collection and Analysis Descriptive characteristics and statistical information in included studies were coded and checked by at least two members of the review team. Studies selected for the review were assessed for confidence in the findings. Standardised effect sizes were calculated and, if a study did not provide sufficient raw data for the calculation of an effect size, author(s) were contacted to obtain these data. We used random-effects meta-analysis and robust-variance estimation procedures to synthesise effect sizes. If a study included multiple effects, we carried out a critical assessment to determine (even if only theoretically) whether the effects are likely to be dependent. Where dependent effects were identified, we used robust variance estimation to determine whether we can account for these. Where effect sizes were converted from a binary to continuous measure (or vice versa), we undertook a sensitivity analysis by running an additional analysis with these studies omitted. We also assessed the sensitivity of results to inclusion of non-randomised studies and studies classified as low confidence in findings. All included an assessment of statistical heterogeneity. Finally, we undertook analysis to assess whether publication bias was likely to be a factor in our findings. For those studies that we were unable to include in meta-analysis, we have provided a narrative synthesis of the study and its findings. Main Results We included 48 individual papers covering 34 unique studies. The studies covered 15, 255 participants, with all but one of the studies being from the United States and Canada. Most papers were rated as low confidence (n = 25, or 52%). By far the most common reason for studies being rated as low confidence was high rates of attrition and/or differential attrition of study participants, that fell below the What Works Clearinghouse liberal attrition standard. Eleven of the included studies were rated as medium confidence and 12 studies as high confidence. The interventions included in our analysis were more effective in reducing substance use than treatment as usual, with an overall effect size of -0.11 SD (95% confidence interval [CI], -0.27, 0.05). There was substantial heterogeneity across studies, and the results were sensitive to the removal of low confidence studies (-0.21 SD, 95% CI [-0.59, 0.17] - 6 studies, 17 effect sizes), the removal of quasi-experimental studies (-0.14 SD, 95% CI [-0.30, 0.02] - 14 studies, 41 effect sizes) and the removal of studies where an effect size had been converted from a binary to a continuous outcome (-0.08 SD, 95% CI [-0.31, 0.15] - 10 studies, 31 effect sizes). This suggests that the findings are sensitive to the inclusion of lower quality studies, although unusually the average effect increases when we removed low confidence studies. The average effect for abstinence-based interventions compared to treatment-as-usual (TAU) service provision was -0.28 SD (95% CI, -0.65, 0.09) (6 studies, 15 effect sizes), and for harm reduction interventions compared to a TAU service provision is close to 0 at 0.03 SD (95% CI, -0.08, 0.14) (9 studies, 30 effect sizes). The confidence intervals for both estimates are wide and crossing zero. For both, the comparison groups are primarily abstinence-based, with the exception of two studies where the comparison group condition was unclear. We found that both Assertative Community Treatment and Intensive Case Management were no better than treatment as usual, with average effect on substance use of 0.03 SD, 95% CI [-0.07, 0.13] and -0.47 SD, 95% CI [-0.72, -0.21] 0.05 SD, 95% CI [-0.28, 0.39] respectively. These findings are consistent with wider research, and it is important to note that we only examined the effect on substance use outcomes (these interventions can be effective in terms of other outcomes). We found that CM interventions can be effective in reducing substance use compared to treatment as usual, with an average effect of -0.47 SD, 95% CI (-0.72, -0.21). All of these results need to be considered in light of the quality of the underlying evidence. There were six further interventions where we undertook narrative synthesis. These syntheses suggest that Group Work, Harm Reduction Psychotherapy, and Therapeutic Communities are effective in reducing substance use, with mixed results found for Motivational Interviewing and Talking Therapies (including Cognitive Behavioural Therapy). The narrative synthesis suggested that Residential Rehabilitation was no better than treatment as usual in terms of reducing substance use for our population of interest. Authors' Conclusions Although our analysis of harm reduction versus treatment as usual, abstinence versus treatment as usual, and harm reduction versus abstinence suggests that these different approaches make little real difference to the outcomes achieved in comparison to treatment as usual. The findings suggest that some individual interventions are more effective than others. The overall low quality of the primary studies suggests that further primary impact research could be beneficial.
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Affiliation(s)
| | - Rob Ralphs
- Manchester Metropolitan UniversityManchesterUK
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Moore J, Castro Y, DiNitto D, Hernandez M, Velasquez M. Sociodemographic and treatment-related determinants of recent substance use among adults with comorbid substance misuse and psychotic disorders discharged from substance use treatment. JOURNAL OF SUBSTANCE USE AND ADDICTION TREATMENT 2024; 161:209349. [PMID: 38494053 DOI: 10.1016/j.josat.2024.209349] [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: 10/16/2023] [Revised: 02/04/2024] [Accepted: 02/21/2024] [Indexed: 03/19/2024]
Abstract
INTRODUCTION Rates of alcohol and illicit substance use are higher among persons with psychotic disorders relative to the general population. The adverse health and psychological effects of substance use behaviors disproportionately impact persons with psychotic disorders. Prior research has shown that persons with psychotic disorders experience increased difficulty in reducing substance use behaviors, and interventions targeting substance use behavior change among this population have demonstrated limited effectiveness. One reason for this is that little is known about the factors that influence substance use and behavior change among this population. To address these disparities, the present study investigated sociodemographic and treatment-related factors of substance use recurrence among persons with psychotic disorders who received substance use treatment services. METHODS Data came from the 2015-2018 Treatment Episode Dataset-Discharges (TEDS-D). TEDS-D collects annual data on adolescent and adult discharges from state-certified substance use treatment centers in the United States. The study conducted all analyses with a subsample of 1956 adult discharges with a psychotic disorder who received services from an outpatient substance use treatment center for at least one month. χ2 tests of independence and multivariable logistic regression analyses were used to examine associations of sociodemographic and treatment-related characteristics with substance use recurrence while in treatment (α < 0.05 analyses). The study presents results from multivariable logistic regression models as adjusted odds ratios (AORs) with 95 % confidence intervals (CI). RESULTS Those who were age 50 or older, were referred to treatment by the criminal justice system, and attended substance use self-help groups had lower odds of substance use recurrence while in treatment. Sex, educational attainment, employment status, living situation, type of substance use, and treatment history were not significantly associated with substance use recurrence. CONCLUSIONS In designing treatment services, providers should consider whether focusing on sociodemographic, including cultural, factors can affect more positive substance use behavior change and other desired treatment outcomes among those with psychotic disorders and comorbid substance misuse. Further study is needed to identify these factors among specific subpopulations of those with psychotic disorders and substance misuse.
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Affiliation(s)
- John Moore
- Florida State University, College of Social Work, 296 Champions Way, Tallahassee, FL 32304, United States of America.
| | - Yessenia Castro
- Steve Hicks School of Social Work, The University of Texas at Austin, 1925 San Jacinto Blvd, Austin, TX 78712, United States of America
| | - Diana DiNitto
- Steve Hicks School of Social Work, The University of Texas at Austin, 1925 San Jacinto Blvd, Austin, TX 78712, United States of America
| | - Mercedes Hernandez
- Steve Hicks School of Social Work, The University of Texas at Austin, 1925 San Jacinto Blvd, Austin, TX 78712, United States of America
| | - Mary Velasquez
- Steve Hicks School of Social Work, The University of Texas at Austin, 1925 San Jacinto Blvd, Austin, TX 78712, United States of America
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Blondé J, Falomir-Pichastor JM, Desrichard O. Unveiling the psychological mechanisms of mutual help groups for addiction recovery: The role of social identity factors. BRITISH JOURNAL OF SOCIAL PSYCHOLOGY 2024. [PMID: 38809032 DOI: 10.1111/bjso.12771] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Revised: 04/08/2024] [Accepted: 05/10/2024] [Indexed: 05/30/2024]
Abstract
The effectiveness of mutual help groups (MHGs) in promoting addiction recovery has been widely acknowledged. However, the psychological mechanisms underlying the impact of MHGs remain somewhat uncertain. Drawing on a social identity perspective, this study investigated a sequential mediation model in which social support is posited as a driving factor that enhances abstinence maintenance through group identification, recovery identity, and self-efficacy. A sample of 820 smokers, participating in a 6-month collective smoking cessation programme which included access to an online help group, completed measures of social support, group identification, smoker/ex-smoker identity, and self-efficacy at the programme's outset. Smoking abstinence was assessed 6 and 9 months later. The findings supported the proposed model, indicating that social support was positively associated with MHG identification, which, in turn, was related to a stronger recovery identity. Subsequently, recovery identity was associated with increased self-efficacy, and indirectly, with smoking abstinence at both measurement times. Additional analyses testing alternative mediation models further supported the validity of the proposed model. These findings suggest that social identity factors play significant roles in accounting for the effectiveness of MHGs for addiction recovery.
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Arruda T, Sinko L, Regier P, Tufanoglu A, Curtin A, Teitelman A, Ayaz H, Cronholm P, Childress AR. Exploring Social Impairment in Those with Opioid Use Disorder: Linking Impulsivity, Childhood Trauma, and the Prefrontal Cortex. RESEARCH SQUARE 2024:rs.3.rs-4202009. [PMID: 38659778 PMCID: PMC11042419 DOI: 10.21203/rs.3.rs-4202009/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/26/2024]
Abstract
Background Challenges with social functioning, which is a hallmark of opioid use disorder (OUD), are a drawback in treatment adherence and maintenance. Yet, little research has explored the underlying mechanisms of this impairment. Impulsivity, a known risk factor for OUD, and corresponding neural alterations may be at the center of this issue. Childhood adversity, which has been linked to both impulsivity and poorer treatment outcomes, could also affect this relationship. This study aims to understand the relationship between impulsivity and social functioning in those recovering from OUD. Differences in the prefrontal cortex will be analyzed, as well as potential moderating effects of childhood trauma. Methods Participants with (N = 16) and without (N = 19) social impairment completed a survey (e.g., social functioning, Barrat's Impulsivity Scale, Adverse Childhood Experiences (ACEs) and cognitive tasks while undergoing neuroimaging. Functional near infrared spectroscopy (fNIRS), a modern, portable, wearable and low-cost neuroimaging technology, was used to measure prefrontal cortex activity during a behavioral inhibition task (Go/No-Go task). Results Those who social functioning survey scores indicated social impairment (n = 16) scored significantly higher on impulsivity scale (t(33)= -3.4, p < 0.01) and reported more depressive symptoms (t(33) = -2.8, p < 0.01) than those reporting no social impairment (n = 19). Social functioning was negatively correlated with impulsivity (r=-0.7, p < 0.001), such that increased impulsivity corresponded to decreased social functioning. Childhood trauma emerged as a moderator of this relationship, but only when controlling for the effects of depression, B=-0.11, p = 0.023. Although both groups had comparable Go/No-Go task performance, the socially impaired group displayed greater activation in the dorsolateral (F(1,100.8) = 7.89, p < 0.01), ventrolateral (F(1,88.8) = 7.33, p < 0.01), and ventromedial (F(1,95.6) = 7.56, p < 0.01) prefrontal cortex during impulse control. Conclusion In addition to being more impulsive, individuals with social impairment exhibited differential activation in the prefrontal cortex when controlling responses. Furthermore, the impact of impulsivity on social functioning varies depending on ACEs demonstrating that it must be considered in treatment approaches. These findings have implications for addressing social needs and impulsivity of those in recovery, highlighting the importance of a more personalized, integrative, and trauma-informed approach to intervention.
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Daros AR, Guimond TH, Yager C, Palermo EH, Wilks CR, Quilty LC. Feasibility, Acceptability, and Potential Efficacy of a Self-Guided Internet-Delivered Dialectical Behavior Therapy Intervention for Substance Use Disorders: Randomized Controlled Trial. JMIR Ment Health 2024; 11:e50399. [PMID: 38227362 PMCID: PMC10828941 DOI: 10.2196/50399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2023] [Revised: 11/02/2023] [Accepted: 11/24/2023] [Indexed: 01/17/2024] Open
Abstract
BACKGROUND People with alcohol and substance use disorders (SUDs) often have underlying difficulties in regulating emotions. Although dialectical behavioral therapy is effective for SUDs, it is often difficult to access. Self-guided, internet-delivered dialectical behavioral therapy (iDBT) allows for expanded availability, but few studies have rigorously evaluated it in individuals with SUDs. OBJECTIVE This study examines the feasibility, acceptability, and potential efficacy of an iDBT intervention in treatment-seeking adults with SUDs. We hypothesized that iDBT would be feasible, credible, acceptable, and engaging to people with SUDs. We also hypothesized that the immediate versus delayed iDBT group would show comparatively greater improvements and that both groups would show significant improvements over time. METHODS A 12-week, single-blinded, parallel-arm, randomized controlled trial was implemented, with assessments at baseline and at 4 (acute), 8, and 12 weeks (follow-up). A total of 72 community adults aged 18 to 64 years were randomized. The immediate group (n=38) received access to iDBT at baseline, and the delayed group (n=34) received access after 4 weeks. The intervention (Pocket Skills 2.0) was a self-guided iDBT via a website, with immediate access to all content, additional text and email reminders, and additional support meetings as requested. Our primary outcome was substance dependence, with secondary outcomes pertaining to feasibility, clinical outcomes, functional disability, and emotion dysregulation, among other measures. All outcomes were assessed using self-report questionnaires. RESULTS iDBT was perceived as a credible and acceptable treatment. In terms of feasibility, 94% (68/72) of the participants started iDBT, 13% (9/68) were early dropouts, 35% (24/68) used it for the recommended 8 days in the first month, and 50% (34/68) were still active 4 weeks later. On average, the participants used iDBT for 2 hours and 24 minutes across 10 separate days. In the acute period, no greater benefit was found for the immediate group on substance dependence, although we did find lower depression (b=-2.46; P=.02) and anxiety (b=-2.22; P=.02). At follow-up, there were greater benefits in terms of reduced alcohol (b=-2.00; P=.02) and nonalcoholic substance (b=-3.74; P=.01) consumption in the immediate access group. Both groups demonstrated improvements in substance dependence in the acute (b=-1.73; P<.001) and follow-up period (b=-2.09; P<.001). At follow-up, both groups reported reduced depression, anxiety, suicidal behaviors, emotional dysregulation, and functional disability. CONCLUSIONS iDBT is a feasible and acceptable intervention for patients with SUDs, although methods for improving engagement are warranted. Although results did not support efficacy for the primary outcome at 4 weeks, findings support reductions in substance dependence and other mental health concerns at 12 weeks. Notwithstanding the limitations of this study, the results suggest the potential value of iDBT in the treatment of SUDs and other mental health conditions. TRIAL REGISTRATION ClinicalTrials.gov NCT05094440; https://clinicaltrials.gov/show/NCT05094440.
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Affiliation(s)
- Alexander R Daros
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Timothy H Guimond
- Addictions Division, Centre for Addiction and Mental Health, Toronto, ON, Canada
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Christina Yager
- Addictions Division, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Emma H Palermo
- Penn Center for Mental Health, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States
| | - Chelsey R Wilks
- Department of Psychological Science, University of Missouri-St Louis, St. Louis, MO, United States
| | - Lena C Quilty
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
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Mohammadi M, Vahedian-Sharoodi M, Joghatei Z, Esmaily H, Tehrani H. Educational intervention based on health action model to promote safe behavior of hospital service workers. BMC Health Serv Res 2023; 23:1296. [PMID: 38001435 PMCID: PMC10668369 DOI: 10.1186/s12913-023-10267-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Accepted: 11/01/2023] [Indexed: 11/26/2023] Open
Abstract
BACKGROUND Hospitals are considered to be one of the most hazardous environments to work in, and their service workers are exposed to many serious risks. So The purpose of this study was to investigate the effect of educational intervention based on the Health Action Model to promote the safe behavior of hospital service workers. METHODS In this quasi-experimental study, 45 workers in each of the control and experimental groups participated. Demographic information and data related to Health Action Model constructs were collected through a questionnaire and a checklist, immediately and three months after the intervention. Cronbach's alpha coefficients were used to confirm the properties of the tools. Educational intervention accompanied was applied in the form of four training classes. The data were analyzed using SPSS 20 software. RESULTS Before the intervention, there was no significant difference between the two groups in terms of demographics and the study's main variables. results showed significant changes in mean scores of safe behavior, Attitude, norms, belief, intention, knowledge in the experimental group three months after the intervention (P < 0.001). CONCLUSIONS The research results show that Health Action Model educational intervention can change workers' awareness, attitudes, norms, beliefs, and intentions toward unsafe behavior and improve their safety performance. TRIAL REGISTRATION IRCTID: IRCT20160619028529N7.
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Affiliation(s)
- Maryam Mohammadi
- Social Determinants of Health Research Center, Mashhah University of Medical Sciences, Mashhad, Iran
- Department of Health Education and Health Promotion, School of Health, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mohammad Vahedian-Sharoodi
- Social Determinants of Health Research Center, Mashhah University of Medical Sciences, Mashhad, Iran
- Department of Health Education and Health Promotion, School of Health, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Zahra Joghatei
- Student Research Committee, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Habibullah Esmaily
- Social Determinants of Health Research Center, Mashhah University of Medical Sciences, Mashhad, Iran
- Department of Biostatistics, School of Health, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Hadi Tehrani
- Social Determinants of Health Research Center, Mashhah University of Medical Sciences, Mashhad, Iran.
- Department of Health Education and Health Promotion, School of Health, Mashhad University of Medical Sciences, Mashhad, Iran.
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Castro SA, Infurna FJ, Lemery-Chalfant K, Waldron VR, Zautra E. Are Daily Well-Being and Emotional Reactivity to Stressors Modifiable in Midlife?: Evidence from a Randomized Controlled Trial of an Online Social Intelligence Training Program. PREVENTION SCIENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR PREVENTION RESEARCH 2023; 24:841-851. [PMID: 36870019 PMCID: PMC9984754 DOI: 10.1007/s11121-023-01492-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/10/2023] [Indexed: 03/05/2023]
Abstract
The complex set of challenges that middle-aged adults encounter emphasizes a need for mental health interventions that promote resilience and positive outcomes. The present study evaluated whether an online, self-guided social intelligence training (SIT) program (8 h) improved midlife adults' daily well-being and emotion regulation in the context of their own naturalistic everyday environment. A randomized controlled trial was conducted with 230 midlife adults allocated into either a SIT program or an attentional control (AC) condition that focused on healthy lifestyle education. Intent-to-treat analyses examined two bursts of 14-day daily surveys that participants completed pre- and post-treatment. Multilevel models evaluated pre-to post-treatment changes in mean positive and negative affect, as well as daily emotional reactivity to stressors and responsiveness to uplifts. Compared to the AC group, those in the SIT program reported improvements (i.e., decreases) in mean negative affect, positive emotional reactivity to daily stressors (i.e., smaller decreases in positive affect on stressor days), and negative emotional responsiveness to uplifts (i.e., lower negative affect on days without uplifts). Our discussion considers potential mechanisms underlying these improvements, highlights downstream effects on midlife functioning, and elaborates on how online delivery of the SIT program increases its potential for positive outcomes across adulthood. ClinicalTrials.gov Identifier: NCT03824353.
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Affiliation(s)
- Saul A Castro
- Department of Psychology, Arizona State University, Box 871104, Tempe, AZ, 85287, USA.
- Social Intelligence Institute, Phoenix, USA.
| | - Frank J Infurna
- Department of Psychology, Arizona State University, Box 871104, Tempe, AZ, 85287, USA
| | | | - Vincent R Waldron
- Department of Psychology, Arizona State University, Box 871104, Tempe, AZ, 85287, USA
| | - Eva Zautra
- Social Intelligence Institute, Phoenix, USA
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Amini F, Vaziri S, Amini Z. The Effect of Healthy Mental Lifestyle Package On Sleep Quality, Mental Health, and Lifestyle of Substance Users. Adv Biomed Res 2023; 12:166. [PMID: 37564450 PMCID: PMC10410435 DOI: 10.4103/abr.abr_186_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2022] [Revised: 08/06/2022] [Accepted: 08/30/2022] [Indexed: 08/12/2023] Open
Abstract
Background The aim of this study was to assess the effect of a training package based on the lived experience of substance abusers on sleep problems and mental health. Materials and Methods The current study was performed on 70 subjects equally distributed into two groups of control and intervention, Data collection tools included the Pittsburgh Sleep Quality Index (PSQI), the General Health Questionnaire (GHQ), and the Basic Adlerian Scales for Interpersonal Success-Adult Form (BASIS-A) Inventory. Data analysis was administered using the independent t-test, paired t-test, and MANCOVA. Statistical significance was considered when the P value < 0.05. Results A total of 70 subjects participated in this study; 7 (10.6%) were females and 59 (89.4%) were males, with a mean age of 36.29 ± 8.588 years. The total score of PSQI was 12.48 (±4.206) and 13.16 (±3.397) for control and intervention groups, respectively, and declined to 12.33 (±4.442) and 9.56 (±4.45) after the intervention. The intervention resulted in an improved score for scales of belonging, going along, taking charge, harshness, being liked by all, and striving for perfection. Whereas the total score of the GHQ is reduced for both groups, that in the intervention group showed a higher decrease, which was also statistically significant. Conclusion The developed training package successfully improved participants' sleep quality, mental health, and lifestyle.
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Affiliation(s)
- Fahimeh Amini
- Department of Educational Sciences, Faculty of Humanities, Islamic Azad University, Yazd Branch, Yazd, Iran
| | - Saeed Vaziri
- Department of Educational Sciences, Faculty of Humanities, Islamic Azad University, Yazd Branch, Yazd, Iran
| | - Zahra Amini
- Department of Community and Family Medicine, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
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Service Providers’ Perceptions of Substitute Addictions in the Western Cape, South Africa. JOURNAL OF DRUG ISSUES 2023. [DOI: 10.1177/00220426231159550] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/02/2023]
Abstract
Globally little is known regarding substance use service providers’ perceptions of substitute behaviours and this significant gap could hinder service provision and recovery outcomes. Semi-structured focus group discussions (including 22 service providers across five sites) were conducted in residential treatment facilities in the Western Cape, South Africa. Service providers recognised substances (e.g. cigarettes and caffeine) and behaviours (e.g. gambling, eating, love, sex, shopping, exercise, and gaming) as potential substitutes. Identified substitute motives included managing cravings; self-medication; filling the experiential void of the primary substance, and time-spending. Concurrent behaviours and addictions were believed to be a key mechanism underlying substitution however, service providers did not uniformly screen for co-occurring behavioural addictions. Substitute behaviours were primarily considered a pathway to relapse and service providers emphasised prevention, detection and family education. To suitably intervene, screening for co-occurring behaviours should be an integral part of the assessment of those presenting for substance use treatment.
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12
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De Salis HF, Martin R, Mansoor Z, Newton-Howes G, Bell E. A realist review of residential treatment for adults with substance use disorder. Drug Alcohol Rev 2023; 42:827-842. [PMID: 36747370 DOI: 10.1111/dar.13615] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Revised: 12/15/2022] [Accepted: 12/30/2022] [Indexed: 02/08/2023]
Abstract
ISSUES Completion of residential treatment for substance use disorder (SUD) relates to improvements in substance use and mental health. Findings from systematic reviews have been equivocal about which interventions work best for clients. There has been limited attention to the theories that explain the effectiveness of residential treatment. APPROACH We conducted a realist review of the literature to identify program theories that would explain successful and unsuccessful outcomes from residential treatment for SUD. The unit of analysis was context-mechanism-outcome (CMO). Inclusion criteria were studies of residential treatment of more than 30 days for adults with SUD. Pharmacological studies were excluded. KEY FINDINGS We identified 24 studies from 5748 screened. The studies were from settings comprising Indigenous programs, faith-based programs, psycho-social interventions and therapeutic communities and were conducted in North America, Scandinavia, Continental Europe and Australasia. We chose six CMO configurations as the best explanations for outcomes from residential treatment. Theories that best explained the mechanisms of change were the need to belong, meaning in life, and self-determination theory. IMPLICATIONS Previous research has noted similar outcomes from different residential treatment interventions, but has not been able to explain these similarities. In contrast, our findings suggest that the outcomes can be explained by causal mechanisms that apply across all programs, regardless of the philosophy of treatment. CONCLUSION We identified six CMO configurations whose mechanisms of change could be explained by three overarching theories-the need to belong, meaning in life and self-determination theory. The findings apply across ethnicities and genders.
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Affiliation(s)
- Henry F De Salis
- Department of Psychological Medicine, University of Otago, Wellington, New Zealand
| | - Rachelle Martin
- Rehabilitation Teaching and Research Unit, Department of Medicine, University of Otago, Wellington, New Zealand.,Burwood Academy Trust, Burwood Hospital, Christchurch, New Zealand
| | - Zara Mansoor
- Department of Psychological Medicine, University of Otago, Wellington, New Zealand
| | - Giles Newton-Howes
- Department of Psychological Medicine, University of Otago, Wellington, New Zealand
| | - Elliot Bell
- Department of Psychological Medicine, University of Otago, Wellington, New Zealand.,Rehabilitation Teaching and Research Unit, Department of Medicine, University of Otago, Wellington, New Zealand
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13
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Wood EE, Liang Y, Moon TJ, Wasserman AM, Lamb RJ, Roache JD, Hill-Kapturczak N, Dougherty DM. Reduced alcohol use increases drink-refusal self-efficacy: Evidence from a contingency management study for DWI arrestees. Drug Alcohol Depend 2023; 242:109706. [PMID: 36493503 PMCID: PMC9784176 DOI: 10.1016/j.drugalcdep.2022.109706] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2022] [Revised: 11/14/2022] [Accepted: 11/15/2022] [Indexed: 11/21/2022]
Abstract
BACKGROUND Several therapies and interventions to reduce drinking first target drink-refusal self-efficacy (DRSE) to influence drinking behavior. While higher self-efficacy scores are correlated with better outcomes, it is unclear that increased self-efficacy is the causative step leading to improved outcomes. Instead, this correlation may result from reduced drinking that increased self-efficacy. The current study sought to understand how changes in drinking behavior can influence DRSE. METHODS Data were from 211 driving while intoxicated (DWI) arrestees participating in an 8-week contingency management (CM) study to reduce drinking. Some of participants were mandated by the courts to wear transdermal alcohol monitoring devices (Mandated group) and some were not mandated (Non Mandated group). All wore a transdermal alcohol monitor during the 8-week study and were randomized to CM or a Control condition stratified by the mandate group. Participants completed weekly assessments of DRSE. Group-based trajectory-modeling identified three drinking behavior trajectory groups. RESULTS While there were no differences in baseline DRSE between the three trajectory groups, participants in the low- and moderate-frequency drinking behavior groups significantly increased DRSE across the study. CONCLUSION The present study indicates that being able to maintain abstinence or reduce heavy drinking may increase DRSE.
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Affiliation(s)
- Erin E Wood
- Department of Psychiatry and Behavioral Sciences, The University of Texas Health Science Center at San Antonio, 7703 Floyd Curl Drive, San Antonio, TX, 78229, USA.
| | - Yuanyuan Liang
- Department of Epidemiology and Public Health, University of Maryland School of Medicine, University of Maryland, Baltimore, 660 W. Redwood Street, Baltimore, MD 21201, USA
| | - Tae-Joon Moon
- Department of Psychiatry and Behavioral Sciences, The University of Texas Health Science Center at San Antonio, 7703 Floyd Curl Drive, San Antonio, TX, 78229, USA
| | - Alexander M Wasserman
- Department of Psychology, Ohio State University, Lazenby Hall 226, 1835 Neil Avenue, Columbus, OH 43210, USA
| | - R J Lamb
- Department of Psychiatry and Behavioral Sciences, The University of Texas Health Science Center at San Antonio, 7703 Floyd Curl Drive, San Antonio, TX, 78229, USA
| | - John D Roache
- Department of Psychiatry and Behavioral Sciences, The University of Texas Health Science Center at San Antonio, 7703 Floyd Curl Drive, San Antonio, TX, 78229, USA
| | - Nathalie Hill-Kapturczak
- Department of Psychiatry and Behavioral Sciences, The University of Texas Health Science Center at San Antonio, 7703 Floyd Curl Drive, San Antonio, TX, 78229, USA
| | - Donald M Dougherty
- Department of Psychology, University of North Texas, 1155 Union Circle #311280, Denton, TX 76203, USA
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14
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Hubbard NA, Miller KB, Aloi J, Bajaj S, Wakabayashi KT, Blair RJR. Evaluating instrumental learning and striatal-cortical functional connectivity in adolescent alcohol and cannabis use. Addict Biol 2023; 28:e13258. [PMID: 36577718 PMCID: PMC10173870 DOI: 10.1111/adb.13258] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Revised: 11/03/2022] [Accepted: 11/08/2022] [Indexed: 12/03/2022]
Abstract
Adolescence is a vulnerable time for the acquisition of substance use disorders, potentially relating to ongoing development of neural circuits supporting instrumental learning. Striatal-cortical circuits undergo dynamic changes during instrumental learning and are implicated in contemporary addiction theory. Human studies have not yet investigated these dynamic changes in relation to adolescent substance use. Here, functional magnetic resonance imaging was used while 135 adolescents without (AUD-CUDLow ) and with significant alcohol (AUDHigh ) or cannabis use disorder symptoms (CUDHigh ) performed an instrumental learning task. We assessed how cumulative experience with instrumental cues altered cue selection preferences and functional connectivity strength between reward-sensitive striatal and cortical regions. Adolescents in AUDHigh and CUDHigh groups were slower in learning to select optimal instrumental cues relative to AUD-CUDLow adolescents. The relatively fast learning observed for AUD-CUDLow adolescents coincided with stronger functional connectivity between striatal and frontoparietal regions during early relative to later periods of task experience, whereas the slower learning for the CUDHigh group coincided with the opposite pattern. The AUDHigh group not only exhibited slower learning but also produced more instrumental choice errors relative to AUD-CUDLow adolescents. For the AUDHigh group, Bayesian analyses evidenced moderate support for no experience-related changes in striatal-frontoparietal connectivity strength during the task. Findings suggest that adolescent cannabis use is related to slowed instrumental learning and delays in peak functional connectivity strength between the striatal-frontoparietal regions that support this learning, whereas adolescent alcohol use may be more closely linked to broader impairments in instrumental learning and a general depression of the neural circuits supporting it.
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Affiliation(s)
- NA Hubbard
- Department of Psychology, University of Nebraska-Lincoln, Lincoln, NE
| | - KB Miller
- Department of Psychology, University of Nebraska-Lincoln, Lincoln, NE
| | - J Aloi
- Department of Psychiatry, Indiana University School of Medicine, Indianapolis, IN
| | - S Bajaj
- Center for Neurobehavioral Research in Children, Boys Town National Research Hospital, Boys Town, NE
| | - KT Wakabayashi
- Department of Psychology, University of Nebraska-Lincoln, Lincoln, NE
| | - RJR Blair
- Child and Adolescent Mental Health Centre, Mental Health Services, Capital Region of Denmark, Copenhagen, Denmark
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15
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Gourlan M, Ricupero S, Carayol M, Cousson-Gélie F. Efficacy of theory-based interventions aimed at reducing binge drinking in adolescents: A systematic review and meta-analysis of randomised controlled trials. Soc Sci Med 2023; 317:115571. [PMID: 36455407 DOI: 10.1016/j.socscimed.2022.115571] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Revised: 11/09/2022] [Accepted: 11/21/2022] [Indexed: 11/23/2022]
Abstract
BACKGROUND AND AIMS Binge drinking is a widespread practice among adolescents worldwide and is associated with various harmful consequences. Theory-based interventions are a promising approach to prevent this drinking behaviour in this population. The aim of the present review was to determine: (1) the characteristics of theory-based interventions targeting binge drinking in adolescents, (2) the impact of such interventions on binge drinking, and (3) the quality of theoretical implementation. METHODS For this systematic review, randomised controlled trials were eligible for inclusion if the binge drinking-targeting intervention was based at least on one theoretical framework, and if the population's mean age was between 10 and 18 years. Two authors extracted relevant data. A meta-analysis was conducted to evaluate the effect of interventions on binge drinking. Effect sizes were calculated with the Hedges's g. Binge drinking was measured as a continuous or dichotomous outcome. The quality of theoretical implementation of interventions was measured using an existing "theory coding scheme". RESULTS Sixteen studies were identified. Ten were based on a single theory, and six on a combination of theories. The number and type of behaviour change techniques used in each intervention varied greatly. Theory-based interventions led to a small but significant decrease in binge drinking (Hedges's g = 0.10; 95% confidence interval = 0.04, 0.16). The quality of theoretical implementation was globally low, and the reciprocal link between behaviour change techniques and theoretical constructs was unclear for most studies. CONCLUSIONS Theory-based interventions have a small but significant beneficial impact on decreasing binge drinking in adolescents. Future research should try to be more effective in matching theoretical determinants of behaviour with the content of the intervention.
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Affiliation(s)
- Mathieu Gourlan
- Epidaure-Prevention Department of the Montpellier Cancer Institute, France; Univ. Paul Valéry Montpellier 3 -EPSYLON EA 4556, F34000, Montpellier, France.
| | - Sarah Ricupero
- Epidaure-Prevention Department of the Montpellier Cancer Institute, France; Univ. Paul Valéry Montpellier 3 -EPSYLON EA 4556, F34000, Montpellier, France
| | - Marion Carayol
- Epidaure-Prevention Department of the Montpellier Cancer Institute, France; Univ. Paul Valéry Montpellier 3 -EPSYLON EA 4556, F34000, Montpellier, France; IAPS Laboratory "Impact of Physical Activity on Health", University of Toulon, France
| | - Florence Cousson-Gélie
- Epidaure-Prevention Department of the Montpellier Cancer Institute, France; Univ. Paul Valéry Montpellier 3 -EPSYLON EA 4556, F34000, Montpellier, France
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16
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Fathian-Dastgerdi Z, Eslami AA, Ghofranipour F, Mostafavi F. Effects of a community-based substance use prevention program in Iranian adolescents (SUPPIA)-using social cognitive theory. JOURNAL OF SUBSTANCE USE 2022. [DOI: 10.1080/14659891.2022.2157772] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Affiliation(s)
- Zohreh Fathian-Dastgerdi
- Department of Health Education & Promotion, School of Health, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Ahmad-Ali Eslami
- Department of Health Education & Promotion, School of Health, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Fazlolah Ghofranipour
- Health Education Department, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
| | - Firoozeh Mostafavi
- Department of Health Education & Promotion, School of Health, Isfahan University of Medical Sciences, Isfahan, Iran
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17
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Frone MR, Casey Chosewood L, Osborne JC, Howard JJ. Workplace Supported Recovery from Substance Use Disorders: Defining the Construct, Developing a Model, and Proposing an Agenda for Future Research. OCCUPATIONAL HEALTH SCIENCE 2022; 6:475-511. [PMID: 37206918 PMCID: PMC10193449 DOI: 10.1007/s41542-022-00123-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Revised: 07/13/2022] [Accepted: 07/20/2022] [Indexed: 05/21/2023]
Abstract
Substance use disorders (SUDs) represent a critical public and occupational health issue. Therefore, understanding the process of SUD recovery has become an issue of growing importance among substance use and recovery professionals. Nonetheless, despite the acknowledged importance of employment for SUD recovery, little conceptual or empirical work exists on how the workplace might support or undermine SUD recovery. In this article, we address this limitation in several ways. First, to promote a better understanding of SUD recovery for occupational health researchers, we provide a brief overview of the nature of a SUD, prior definitions of SUD recovery, and general themes associated with the recovery process. Second, we develop a working definition of workplace supported recovery. Third, we present a heuristic conceptual model showing how the workplace might impact the SUD recovery process. Fourth, using this model and research from the substance use and occupational health literatures, we develop a series of general research propositions. These propositions highlight broad directions requiring more detailed conceptualization and empirical research to understand better how work conditions may support or undermine the process of employee SUD recovery. Our overarching goal is to motivate innovative conceptualization and research on workplace supported recovery from SUDs. Such research may inform the development and evaluation of workplace interventions and policies supporting SUD recovery and highlight the benefits of workplace supported SUD recovery for employees, employers, and communities. Research on this issue may allow occupational health researchers to impact a significant societal and occupational health issue.
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Affiliation(s)
- Michael R. Frone
- Department of Psychology, University at Buffalo, The State University of New York, Buffalo, NY, United States
| | - L. Casey Chosewood
- Office of the Director, Office for Total Worker Health®, Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health, Atlanta, GA, United States
| | - Jamie C. Osborne
- Office of the Director, Office for Policy, Planning and Evaluation, Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health, Atlanta, GA, United States
| | - John J. Howard
- Office of the Director, Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health, Washington, DC, United States
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18
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Majer JM, Jason LA, Bobak TJ. Understanding recovery Capital in relation to categorical 12-Step involvement and abstinence social support. ADDICTION RESEARCH & THEORY 2022; 30:207-212. [PMID: 36275074 PMCID: PMC9585994 DOI: 10.1080/16066359.2021.1999935] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Revised: 10/24/2021] [Accepted: 10/26/2021] [Indexed: 05/28/2023]
Abstract
Background Although recovery capital represents various resources for persons recovering from substance use disorders, measures of this construct examine components that might not necessarily reflect the recovery goals of individuals who base their recovery through involvement in 12-step groups such as Alcoholics Anonymous (AA) and Narcotics Anonymous (NA). It is not clear whether 12-step involvement is related to recovery capital, particularly among individuals living in recovery homes who utilize social networks of recovering peers for their recovery. Thus, categorical involvement in a set of 12-step activities was examined in relation to recovery capital and abstinence social support. Methods Differences in terms of general (recovery capital scores, retention rates) and abstinence-specific (abstinence social support) resources were examined in relation to recovery home residents who were (n = 395) and were not (n = 232) categorically involved in their 12-step recovery. Results Residents with categorical 12-step involvement reported significantly higher levels of recovery capital and abstinence social support, and there was no significant difference observed in retention rates between residents who were/were not categorically involved in 12-step groups. Conclusions Findings suggest community resources such as recovery homes and categorical involvement in 12-step groups are important recovery capital components that help individuals who use a 12-step approach to their recovery. Recovery capital among those involved with 12-step fellowships such as AA and NA should be assessed by examining abstinence-specific components such as representative involvement in 12-step groups and social support that is abstinence-specific.
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Affiliation(s)
- John M. Majer
- Social and Behavioral Sciences Department, Harry S. Truman College, Chicago, IL, USA
| | - Leonard A. Jason
- Center for Community Research, DePaul University, Chicago, IL, USA
| | - Ted J. Bobak
- Center for Community Research, DePaul University, Chicago, IL, USA
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19
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Massey SH, Pool LR, Estabrook R, Level RA, Shisler S, Stacks AM, Neiderhiser JM, Espy KA, Wakschlag LS, Eiden RD, Allen NB. Within-person decline in pregnancy smoking is observable prior to pregnancy awareness: Evidence across two independent observational cohorts. Addict Biol 2022; 27:e13245. [PMID: 36301213 PMCID: PMC9939010 DOI: 10.1111/adb.13245] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Revised: 09/22/2022] [Accepted: 09/29/2022] [Indexed: 01/24/2023]
Abstract
Decreased consumption of nicotine and other drugs during pregnancy appears to be a cross-species phenomenon from which mechanism(s) capable of interrupting addictive processes could be elucidated. Whether pregnancy influences smoking behaviour independent of women's knowledge of the pregnancy, however, has not been considered. Using repeated measures analysis of variance (ANOVA), we estimated within-person change in mean cigarettes/day smoked across the estimated date of conception but prior to individually reported dates of pregnancy recognition using longitudinal smoking data from two independent observational cohorts, the Growing Up Healthy (GUH, n = 271) and Midwest Infant Development Studies (MIDS, n = 145). Participants smoked an average of half a pack/day in the month immediately before conception (M (SD) = 12(8.1) and 9.5(6.7) cigarettes/day in GUH and MIDS, respectively). We observed within-person declines in smoking after conception, both before (MGUH = -0.9; 95% CI -1.6, -0.2; p = 0.01; MMIDS = -1.1; 95% CI -1.9, -0.3; p = 0.01) and after (MGUH = -4.8; 95% CI -5.5, -4.1; p < 0.001; MMIDS = -3.3; 95% CI -4.4, -2.5; p < 0.001) women were aware of having conceived, even when women who had quit and women who were planning to conceive were excluded from analyses. Pregnancy may interrupt smoking-related processes via mechanisms not previously considered. Plausible candidates and directions for future research are discussed.
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Affiliation(s)
- Suena H. Massey
- Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
- Institute for Innovations in Developmental Sciences, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
- Deparment of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Lindsay R. Pool
- Institute for Innovations in Developmental Sciences, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
- Deparment of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Ryne Estabrook
- Department of Psychology, University of Illinois at Chicago, Chicago, Illinois, USA
| | - Rachel A. Level
- Department of Psychology, The Pennsylvania State University, University Park, Pennsylvania, USA
| | - Shannon Shisler
- Research Institute on Addictions, University at Buffalo, Buffalo, New York, USA
| | - Ann M. Stacks
- Merrill Palmer Skillman Institute, Wayne State University, Detroit, Michigan, USA
| | - Jenae M. Neiderhiser
- Department of Psychology, The Pennsylvania State University, University Park, Pennsylvania, USA
| | - Kimberly A. Espy
- Department of Neuroscience, Developmental and Regenerative Biology; Department of Psychiatry and Behavioral Science, Long School of Medicine, University of Texas at San Antonio, San Antonio, Texas, USA
| | - Lauren S. Wakschlag
- Institute for Innovations in Developmental Sciences, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Rina D. Eiden
- Department of Psychology, The Pennsylvania State University, University Park, Pennsylvania, USA
| | - Norrina B. Allen
- Institute for Innovations in Developmental Sciences, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
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20
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Wnuk M. The mechanism underlying the relationship between the spiritual struggles and life satisfaction of Polish codependent individuals participating in Al-Anon – pilot study. JOURNAL OF SPIRITUALITY IN MENTAL HEALTH 2022. [DOI: 10.1080/19349637.2022.2124141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Affiliation(s)
- Marcin Wnuk
- Department of Work and Organizational Psychology, Adam Mickiewicz University, Poznań, Poland
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21
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Elison-Davies S, Newsome J, Jones A, Davies G, Ward J. Associations between psychosocial risk factors, and changes in substance dependence and psychosocial functioning, during engagement with digital cognitive behavioral therapy for methamphetamine use: use of 'Breaking Free from Substance Abuse' by incarcerated people during the COVID-19 pandemic. HEALTH & JUSTICE 2022; 10:28. [PMID: 36070026 PMCID: PMC9449936 DOI: 10.1186/s40352-022-00190-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Accepted: 07/30/2022] [Indexed: 06/04/2023]
Abstract
BACKGROUND Methamphetamine use can be associated with involvement with correctional services and incarceration. Traditionally, treatments for methamphetamine use have been delivered in-person - however, lockdowns initiated during the COVID-19 pandemic significantly reduced access to such in-person support in prisons. Therefore, in May 2020 a digital cognitive-behavioral therapy (CBT) program for substance use disorders - 'Breaking Free from Substance Abuse' - was made available across prisons in Ohio in order to meet this treatment gap. This represents the first time this digital CBT intervention has been made widely available to incarcerated people residing in prisons or jails in the United States (US). This was a within-subjects study using data from 2187 Ohio prison residents who engaged with this digital CBT program to address their methamphetamine use. RESULTS Participants reported multiple psychosocial risk factors, including moderate to severe substance dependence, depression and anxiety; interpersonal conflict; aggressive behavior; paranoia; and difficulties with work, education and accommodation. Significant reductions in substance dependence, depression/anxiety and biopsychosocial impairment, and improvements in quality of life, were identified in the sample. Risk factors were associated with less positive outcomes, specifically interpersonal conflict and poor mental health. Completion of specific components of the program were associated with more positive outcomes - a dose response was also identified. CONCLUSIONS Digital CBT can be delivered in secure US correctional settings and may help to fill unmet needs for in-person treatment. Specifically, this digital CBT program may support incarcerated individuals to address methamphetamine use, with outcomes being associated with psychosocial risk factors and program engagement.
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Affiliation(s)
| | | | - Andrew Jones
- Division of Population Health, Health Services Research and Primary Care, University of Manchester, Manchester, UK
| | - Glyn Davies
- LifeWorks, Manchester Science Park, Manchester, UK
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22
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O'Leary C, Ralphs R, Stevenson J, Smith A, Harrison J, Kiss Z. PROTOCOL: The effectiveness of abstinence-based and harm reduction-based interventions in reducing problematic substance use in adults who are experiencing severe and multiple disadvantage homelessness: A systematic review and meta-analysis. CAMPBELL SYSTEMATIC REVIEWS 2022; 18:e1246. [PMID: 36909874 PMCID: PMC9261927 DOI: 10.1002/cl2.1246] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/18/2023]
Abstract
Background Homelessness is a major social and public health concern. It is a traumatic experience, and can have a devastating effect on those experiencing it. People who are homeless often face significant barriers when accessing public services, and those experiencing more visible and extreme forms of homelessness have often faced adverse childhood events, extreme social disadvantage, physical, emotional and sexual abuse, neglect, low self-esteem, poor physical and mental health, and much lower life expectancy compared to the general population. Problematic substance use is disproportionately high amongst people experiencing homelessness, with many using drugs and alcohol to deal with the stress of living on the street, to keep warm, or to block out memories of previous abuse or trauma. Drug overdose is a major cause of death for people experiencing street homelessness. Substance dependency can also create barriers to successful transition to stable housing. There is ongoing policy interest in the effectiveness of different interventions that aim to stop, reduce or prevent problematic substance use, and there is specific interest in the relative effectiveness of interventions that adopt harm reduction or abstinence-based approaches. Objectives The objective of this review is to understand the effectiveness of different substance use interventions. The review will consider the effectiveness of harm reduction-based interventions, and abstinence-based interventions, for adults experiencing homelessness. The focus of the review is on high-income countries. Search Methods The primary source of studies for potential inclusion in this review is the Homelessness Effectiveness Studies Evidence and Gaps Maps (EGM). The first of these was published in 2018, with updates published in 2019 and 2020. A further update is due to be published in the summer of 2022. It is this update that provides the final list of studies from which this review will draw. The search for this update (EGM 4th edition) was completed in September 2021. Other potential studies will be identified through a call for grey evidence and hand-searching key journals. Selection Criteria Eligible studies will be impact evaluations with designs at levels, 3, 4 and 5 of the Maryland Scientific Methods scale. This therefore includes all studies categorised as either 'Randomised Controlled Trials' or 'nonexperimental designs with a comparison group' from the studies which form the basis of the Homelessness Effectiveness Studies Evidence and Gap Maps (EGM) created by CHI and the Campbell Collaboration. We are interested in studies that examine the effect of interventions on substance use outcomes. Studies to be excluded are those with designs at levels 1 and 2 of the Maryland Scientific Methods scale, for example, studies without a control or comparison group, 'before vs. after' designs (without an untreated comparison group), and cross-sectional regressions. Data Collection and Analysis Descriptive characteristics and statistical information in included studies will be coded and checked by at least two members of the review team. Studies selected for the review will be assessed for confidence in the findings using a critical appraisal tool for determining confidence in primary studies. Standardised effect sizes will be calculated and, if a study does not provide sufficient raw data for the calculation of an effect size, we will attempt to contact the author(s) to obtain this data. We will aim to use random-effects meta-analysis and robust-variance estimation procedures to synthesise effect sizes. If a study includes multiple effects, we will carry out a critical assessment to determine (even if only theoretically) whether the effects are likely to be dependent. Where we suspect dependent effects, we will determine whether we can account for these by robust variance estimation. We will explore the moderating influence of participant and study characteristics, such as gender, race, substances targeted and length of follow-up. Where effect sizes are converted from a binary to continuous measure (or vice versa), we will undertake a sensitivity analysis to investigate the effect of the inclusion of studies with a converted effect size in the meta-analysis by running an additional analysis with these studies omitted. We will also assess the sensitivity of results to inclusion of non-randomised studies and studies classified as low confidence in findings. All analyses will include an assessment of statistical heterogeneity. Finally, we will undertake analysis to assess whether publication bias is likely to be a factor in our findings.
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Affiliation(s)
- Chris O'Leary
- Policy Evaluation and Research UnitManchester Metropolitan UniversityManchesterUK
| | - Rob Ralphs
- Substance Use and Associated Behaviours Research UnitManchester Metropolitan UniversityManchesterUK
| | | | - Andrew Smith
- Policy Evaluation and Research UnitManchester Metropolitan UniversityManchesterUK
| | - Jordan Harrison
- Policy Evaluation and Research UnitManchester Metropolitan UniversityManchesterUK
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Individual Paths to Recovery from Substance Use Disorder (SUD): What Are the Implications of the Emerging Recovery Evidence Base for Addiction Psychiatry and Practice? Psychiatr Clin North Am 2022; 45:547-556. [PMID: 36055738 DOI: 10.1016/j.psc.2022.04.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Although the research base around 12-step effectiveness has been grown markedly in recent years, there has also been growth in the broader evidence base around recovery models, and this article reviews three key components: the transition to a social model of recovery; the emergence of a metric of recovery progress, recovery capital focused on building strengths; and multiple pathways to recovery, involving mutual aid groups, recovery community organizations, and access to jobs, friends, and housing. We conclude with an overview of the practical implications for addiction treatment and sustaining the gains made in specialist treatment services.
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24
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Rodgers RF, Fischer LE, Laveway K, Laws K, Bui E. Fear of fatness and desire for thinness as distinct experiences: A qualitative exploration. Int J Eat Disord 2022; 55:530-540. [PMID: 35150010 DOI: 10.1002/eat.23689] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2021] [Revised: 01/27/2022] [Accepted: 01/28/2022] [Indexed: 01/18/2023]
Abstract
OBJECTIVE The pursuit of thinness and fear of gaining weight have been found to play an important role in eating disorder symptomatology. While these dimensions have typically been considered conjointly, emerging evidence suggests they may be distinct dimensions. The aim of this study was to explore the subjective experiences of fear of fatness and drive for thinness in young women with body image concerns. METHOD Young women endorsing weight concerns (N = 29, mean age = 20.86, SD = 2.70 years) were interviewed and asked to describe an experience of fear of fat and drive for thinness, respectively. RESULTS Qualitative analysis was conducted and identified four themes: (1) precipitating events; (2) physiological, emotional, cognitive, and proprioceptive experiences; (3) coping strategies; and (4) sociocultural influences. While similarities emerged, the experiences of fear of fatness, and of drive for thinness also evidenced clear differences situating the former in the context of fear-based avoidance patterns, and the latter in approach-based reward models. DISCUSSION These findings provide additional support for the usefulness of considering fear of fat and drive for thinness as distinct constructs. Further research examining the contributions of each of these constructs to eating pathology is warranted.
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Affiliation(s)
- Rachel F Rodgers
- APPEAR, Department of Applied Psychology, Northeastern University, Boston, Massachusetts, USA.,Department of Psychiatric Emergency & Acute Care, Lapeyronie Hospital, CHRU Montpellier, Montpellier, France
| | - Laura E Fischer
- APPEAR, Department of Applied Psychology, Northeastern University, Boston, Massachusetts, USA
| | - Katherine Laveway
- APPEAR, Department of Applied Psychology, Northeastern University, Boston, Massachusetts, USA
| | - Kristen Laws
- APPEAR, Department of Applied Psychology, Northeastern University, Boston, Massachusetts, USA
| | - Eric Bui
- Department of Psychiatry, Caen University Hospital & Caen University, Caen, France.,Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts, USA
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25
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Lewis N, Sznitman SR. Too Much Information? Excessive Media Use, Maladaptive Coping, and Increases in Problematic Cannabis Use during the COVID-19 Pandemic. J Psychoactive Drugs 2022; 54:207-216. [PMID: 35109774 DOI: 10.1080/02791072.2022.2031355] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
During a health crisis like the COVID-19 pandemic, the public depends on the media for accurate and up-to-date information. However, frequent use of media for COVID-19-related information may be associated with maladaptive coping, and with increased prevalence of substance use. This study examined indirect associations between the frequency of media use for information about COVID-19 and increases in cannabis use behaviors through maladaptive coping strategies. We use data from an online survey of Israeli adult cannabis users (N = 440), conducted in May of 2020, to test associations between media use frequency for COVID-19 information and three problematic cannabis use behaviors: increased cannabis use, increased use alone, and increased use before midday. Among all respondents, 41% agreed that their cannabis use had increased since the onset of the pandemic. Analyses showed that higher frequency of media use was positively associated with all three indicators of problematic cannabis use, and that associations were partly mediated by maladaptive coping strategies. Higher frequency of media use for information about COVID-19 may be an indicator of difficulty with coping and of increased risk of escalation of cannabis use. These results have implications for assessing and mitigating the risk of coping-motivated cannabis use during a crisis.
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Affiliation(s)
- Nehama Lewis
- Department of Communication, University of Haifa, Haifa, Israel
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26
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Mutschler C, Junaid S, Tellez C, Franco G, Gryspeerdt C, Bushe J. Community-based residential treatment for alcohol and substance use problems: A realist review. HEALTH & SOCIAL CARE IN THE COMMUNITY 2022; 30:e287-e304. [PMID: 35122344 DOI: 10.1111/hsc.13511] [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: 09/16/2020] [Revised: 05/20/2021] [Accepted: 06/25/2021] [Indexed: 06/14/2023]
Abstract
Research and reviews to date suggest that community-based residential treatments for substance use disorders (SUDs) have mixed effectiveness, with some studies finding positive outcomes while others finding no differences between intervention arms, including inpatient, outpatient, and control groups. In order to understand these mixed findings, reviews have underscored the importance of outlining the active treatment components of residential treatment, as well as treatment mechanisms and outcomes. Further, there is very little research on the underlying theories explaining how and for whom residential treatments are effective. The purpose of the present realist synthesis was to address this gap in the literature by exploring how, why, for whom, and in what circumstances, community-based residential treatments are effective. Following the RAMESES Publication Standards, a search was undertaken for articles examining community-based residential treatments in PsycINFO and PubMed from anytime to January 2020. The search generated 28 articles that met inclusion criteria and were extracted for relevant information. Results of the realist synthesis identified six Context-Mechanism-Outcome (CMO) configurations. Contextual factors that generated subsequent mechanisms and outcomes included substance-related problem severity, psychiatric comorbidities, diverse populations, pre-treatment relationships, lack of structure and lack of coping strategies. These CMO configurations provide important information for clinicians, treatment centres and policy makers, including the specific programme components that need to be offered in treatment to facilitate positive treatment outcomes.
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Affiliation(s)
| | - Sana Junaid
- Department of Psychology, Ryerson University, Toronto, ON, Canada
| | - Carmina Tellez
- Department of Psychology, Ryerson University, Toronto, ON, Canada
| | - Giselle Franco
- Department of Psychology, Ryerson University, Toronto, ON, Canada
| | | | - Julianne Bushe
- Department of Psychology, Ryerson University, Toronto, ON, Canada
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27
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Herlinger K, Lingford-Hughes A. Opioid use disorder and the brain: a clinical perspective. Addiction 2022; 117:495-505. [PMID: 34228373 DOI: 10.1111/add.15636] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Revised: 03/16/2021] [Accepted: 06/18/2021] [Indexed: 02/06/2023]
Abstract
Opioid use disorder (OUD) has gained increasing publicity and interest during recent years, with many countries describing problems of epidemic proportions with regard to opioid use and deaths related to opioids. While opioids are not themselves acutely neurotoxic, the chronic relapsing and remitting nature of this disorder means that individuals are often exposed to exogenous opioids for lengthy periods of time (either illicit or prescribed as treatment). We are increasingly characterizing the effect of such long-term opioid exposure on the brain. This narrative review aims to summarize the literature regarding OUD and the brain from a clinical perspective. Alterations of brain structure and function are discussed, as well as neurological and psychiatric disorders in OUD. Finally, we review current and new directions for assessment and treatment.
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Affiliation(s)
- Katherine Herlinger
- MRC Addiction Research Clinical Training Programme, Imperial College London, London, UK
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28
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Majer JM, Jason LA, Bobak TJ. An examination of abstinence social support among recovery home residents with psychiatric comorbidity. Drug Alcohol Depend 2021; 228:108971. [PMID: 34508961 PMCID: PMC8595772 DOI: 10.1016/j.drugalcdep.2021.108971] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Revised: 08/12/2021] [Accepted: 08/14/2021] [Indexed: 10/20/2022]
Abstract
BACKGROUND Although social support is a resource that helps persons in their recovery from substance use disorders, it is not clear whether specific types buffer the effects of stress and optimize outcomes for those with psychiatric comorbidity. This investigation examined two types of social support in relation to lengths of stay to identify mechanisms related to retention among individuals with psychiatric comorbidity living in community-based settings. METHODS Baseline rates of social support (abstinence specific and general types) and stress were examined in relation to follow-up lengths of stay (at four-months and beyond) among individuals (N = 368) with psychiatric comorbidity (n = 90) and no psychiatric comorbidity (n = 278) living in community-based settings (Oxford Houses) in the U.S. The psychiatric severity index of the Addiction Severity Index was used as a proxy measure of psychiatric comorbidity. Moderated mediation analyses were conducted to test the potential mediating effects of abstinence social support and general social support on the relationship between stress and lengths of stay, and whether these were influenced by psychiatric comorbidity. RESULTS A full mediating effect was observed for abstinence social support for residents with psychiatric comorbidity, whereas a partial mediating effect for general social support was observed for all residents. CONCLUSIONS Findings demonstrate qualities of social support have differential effects, substantiating the notion that specific components of social support optimize outcomes for those with psychiatric comorbidity living in recovery homes.
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Affiliation(s)
- John M. Majer
- Social and Behavioral Sciences Department, Harry S. Truman College, 1145 W. Wilson Ave., Chicago, IL 60640 USA
| | - Leonard A. Jason
- Center for Community Research, DePaul University, 990 W. Fullerton Ave., Suite 3100, Chicago, IL 60614 USA
| | - Ted J. Bobak
- Center for Community Research, DePaul University, 990 W. Fullerton Ave., Suite 3100, Chicago, IL 60614 USA
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29
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Kelly PJ, Beck AK, Deane FP, Larance B, Baker AL, Hides L, Manning V, Shakeshaft A, Neale J, Kelly JF, Oldmeadow C, Searles A, Palazzi K, Lawson K, Treloar C, Gray RM, Argent A, McGlaughlin R. Feasibility of a Mobile Health App for Routine Outcome Monitoring and Feedback in SMART Recovery Mutual Support Groups: Stage 1 Mixed Methods Pilot Study. J Med Internet Res 2021; 23:e25217. [PMID: 34612829 PMCID: PMC8529481 DOI: 10.2196/25217] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2020] [Revised: 03/25/2021] [Accepted: 04/25/2021] [Indexed: 01/19/2023] Open
Abstract
Background Mutual support groups are an important source of long-term help for people impacted by addictive behaviors. Routine outcome monitoring (ROM) and feedback are yet to be implemented in these settings. SMART Recovery mutual support groups focus on self-empowerment and use evidence-based techniques (eg, motivational and behavioral strategies). Trained facilitators lead all SMART Recovery groups, providing an opportunity to implement ROM. Objective The aim of this stage 1 pilot study is to explore the feasibility, acceptability, and preliminary outcomes of a novel, purpose-built mobile health ROM and feedback app (SMART Track) in mutual support groups coordinated by SMART Recovery Australia (SRAU) over 8 weeks. Methods SMART Track was developed during phase 1 of this study using participatory design methods and an iterative development process. During phase 2, 72 SRAU group participants were recruited to a nonrandomized, prospective, single-arm trial of the SMART Track app. Four modes of data collection were used: ROM data directly entered by participants into the app; app data analytics captured by Amplitude Analytics (number of visits, number of unique users, visit duration, time of visit, and user retention); baseline, 2-, and 8-week follow-up assessments conducted through telephone; and qualitative telephone interviews with a convenience sample of study participants (20/72, 28%) and facilitators (n=8). Results Of the 72 study participants, 68 (94%) created a SMART Track account, 64 (88%) used SMART Track at least once, and 42 (58%) used the app for more than 5 weeks. During week 1, 83% (60/72) of participants entered ROM data for one or more outcomes, decreasing to 31% (22/72) by the end of 8 weeks. The two main screens designed to provide personal feedback data (Urges screen and Overall Progress screen) were the most frequently visited sections of the app. Qualitative feedback from participants and facilitators supported the acceptability of SMART Track and the need for improved integration into the SRAU groups. Participants reported significant reductions between the baseline and 8- week scores on the Severity of Dependence Scale (mean difference 1.93, SD 3.02; 95% CI 1.12-2.73) and the Kessler Psychological Distress Scale-10 (mean difference 3.96, SD 8.31; 95% CI 1.75-6.17), but no change on the Substance Use Recovery Evaluator (mean difference 0.11, SD 7.97; 95% CI –2.02 to 2.24) was reported. Conclusions Findings support the feasibility, acceptability, and utility of SMART Track. Given that sustained engagement with mobile health apps is notoriously difficult to achieve, our findings are promising. SMART Track offers a potential solution for ROM and personal feedback, particularly for people with substance use disorders who attend mutual support groups. Trial Registration Australian New Zealand Clinical Trials Registry ACTRN12619000686101; https://anzctr.org.au/Trial/Registration/TrialReview.aspx?id=377336 International Registered Report Identifier (IRRID) RR2-10.2196/15113
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Affiliation(s)
- Peter J Kelly
- School of Psychology, Faculty of Arts, Social Sciences and Humanities, University of Wollongong, Wollongong, Australia.,Illawarra Health and Medical Research Institute, University of Wollongong, Wollongong, Australia
| | - Alison K Beck
- School of Psychology, Faculty of Arts, Social Sciences and Humanities, University of Wollongong, Wollongong, Australia
| | - Frank P Deane
- School of Psychology, Faculty of Arts, Social Sciences and Humanities, University of Wollongong, Wollongong, Australia.,Illawarra Health and Medical Research Institute, University of Wollongong, Wollongong, Australia
| | - Briony Larance
- School of Psychology, Faculty of Arts, Social Sciences and Humanities, University of Wollongong, Wollongong, Australia.,Illawarra Health and Medical Research Institute, University of Wollongong, Wollongong, Australia
| | - Amanda L Baker
- School of Medicine and Public Health, University of Newcastle, Newcastle, Australia
| | - Leanne Hides
- Centre for Youth Substance Abuse Research, Lives Lived Well Group, School of Psychology, University of Queensland, Brisbane St Lucia, Australia
| | - Victoria Manning
- Eastern Health Clinical School, Faculty of Medicine, Nursing and Health Sciences, Monash University, Box Hill, Australia
| | - Anthony Shakeshaft
- National Drug and Alcohol Research Centre, University of New South Wales, Sydney, Australia
| | - Joanne Neale
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - John F Kelly
- Harvard Medical School, Harvard University, Boston, MA, United States
| | - Christopher Oldmeadow
- Clinical Research Design, IT and Statistical Support Unit, Hunter Medical Research Institute, New Lambton, Australia
| | - Andrew Searles
- Hunter Medical Research Institute Health Research Economics, Hunter Medical Research Institute, New Lambton, Australia
| | - Kerrin Palazzi
- Clinical Research Design, IT and Statistical Support Unit, Hunter Medical Research Institute, New Lambton, Australia
| | - Kenny Lawson
- Hunter Medical Research Institute Health Research Economics, Hunter Medical Research Institute, New Lambton, Australia
| | - Carla Treloar
- Centre for Social Research in Health, Faculty of Arts and Social Sciences, University of New South Wales, Sydney, Australia
| | - Rebecca M Gray
- Centre for Social Research in Health, Faculty of Arts and Social Sciences, University of New South Wales, Sydney, Australia
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30
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Kaniuka AR, Kelliher Rabon J, Brooks BD, Sirois F, Kleiman E, Hirsch JK. Gratitude and suicide risk among college students: Substantiating the protective benefits of being thankful. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2021; 69:660-667. [PMID: 31944902 DOI: 10.1080/07448481.2019.1705838] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/09/2019] [Revised: 09/28/2019] [Accepted: 12/12/2019] [Indexed: 06/10/2023]
Abstract
Gratitude, or thankfulness for positive aspects of life, is related to psychosocial well-being and decreased psychopathology, and may reduce suicide risk. We explored four potential hypotheses purported to explain the beneficial outcomes of gratitude (schematic, positive affect, broaden-and-build, and coping), hypothesizing that hopelessness (schematic), depression (positive affect), social support (broaden-and-build), and substance use (coping) would mediate the gratitude-suicide linkage. Participants: 913 undergraduate students from a mid-size, southeastern U.S. university. Methods: Respondents completed online self-report questionnaires including the Suicidal Behaviors Questionnaire-Revised, Gratitude Questionnaire, Beck Hopelessness Scale, Beck Depression Inventory, Duke Social Support Index, Alcohol Use Disorders Identification Test, and Drug Abuse Screening Test. Results: Supporting theory and hypotheses, gratitude was related to less suicide risk via beneficial associations with hopelessness, depression, social support, and substance misuse. Conclusions: The linkage between gratitude and suicide risk appears to be predicated on the beneficial association of gratitude to negative mood and interpersonal functioning.
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Affiliation(s)
- Andrea R Kaniuka
- Department of Public Health Sciences, University of North Carolina at Charlotte, Charlotte, USA
| | | | - Byron D Brooks
- Department of Psychology, East Tennessee State University, Johnson City, USA
| | - Fuschia Sirois
- Department of Psychology, University of Sheffield, United Kingdom of Great Britain and Northern Ireland
| | - Evan Kleiman
- Department of Psychology, Rutgers University, New Brunswick, USA
| | - Jameson K Hirsch
- Department of Psychology, East Tennessee State University, Johnson City, USA
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31
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Na PJ, Norman SB, Nichter B, Hill ML, Rosen MI, Petrakis IL, Pietrzak RH. Prevalence, risk and protective factors of alcohol use disorder during the COVID-19 pandemic in U.S. military veterans. Drug Alcohol Depend 2021; 225:108818. [PMID: 34171825 PMCID: PMC9758576 DOI: 10.1016/j.drugalcdep.2021.108818] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Revised: 04/02/2021] [Accepted: 04/27/2021] [Indexed: 02/07/2023]
Abstract
BACKGROUND There have been reports of increased alcohol consumption during the COVID-19 pandemic in the general population. However, little is known about the impact of the pandemic on the prevalence of alcohol use disorder (AUD), especially in high-risk samples such as U.S. military veterans. METHODS Data were analyzed from the 2019-2020 National Health and Resilience in Veterans Study, which surveyed a nationally representative, prospective cohort of 3078 U.S. veterans. Pre-pandemic and 1-year peri-pandemic risk and protective factors associated with incident and chronic probable AUD were examined. RESULTS A total of 6.9 % (n = 183) of veterans were classified as chronic probable AUD, 3.2 % (n = 85) as remitted from AUD, and 2.7 % (n = 71) as incident probable AUD during the pandemic; the prevalence of probable AUD in the full sample remained stable -10.1 % pre-pandemic and 9.6 % peri-pandemic. Younger age, greater pre-pandemic alcohol use severity, and COVID-related stressors were associated with incident AUD during the pandemic, whereas higher pre-pandemic household income was associated with lower risk of this outcome. Younger age, combat experience, lifetime substance use disorder, greater drug use severity, lower dispositional optimism, and more COVID-related worries and social restriction stress were associated with higher risk of chronic AUD. CONCLUSIONS Nearly 1-in-10 US veterans screened positive for AUD 1-year into the pandemic; however, the pre- and 1-year peri-pandemic prevalence of probable AUD remained stable. Veterans who are younger, have served in combat roles, endorse more COVID-related stressors, and have fewer socioeconomic resources may be at higher risk for AUD during the pandemic.
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Affiliation(s)
- Peter J Na
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA.
| | - Sonya B Norman
- National Center for PTSD, White River Junction, VT, USA; VA San Diego Healthcare System, San Diego, CA, USA; Department of Psychiatry, University of California, San Diego, CA, USA; VA Center of Excellence for Stress and Mental Health, San Diego, CA, USA
| | - Brandon Nichter
- Department of Psychiatry, University of California, San Diego, CA, USA
| | - Melanie L Hill
- VA San Diego Healthcare System, San Diego, CA, USA; Department of Psychiatry, University of California, San Diego, CA, USA
| | - Marc I Rosen
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA; VA Connecticut Healthcare System, West Haven, CT, USA
| | - Ismene L Petrakis
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA; VA Connecticut Healthcare System, West Haven, CT, USA
| | - Robert H Pietrzak
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA; National Center for PTSD, VA Connecticut Healthcare System, West Haven, CT, USA; Department of Social and Behavioral Sciences, Yale School of Public Health, New Haven, CT, USA
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McGee-Vincent P, Juhasz K, Jamison AL, Avery TJ, Owen JE, Jaworski BK, Blonigen DM. Mobile Mental Health Apps from the National Center for PTSD: Digital Self-Management Tools for Co-Occurring Disorders. J Dual Diagn 2021; 17:181-192. [PMID: 34152258 DOI: 10.1080/15504263.2021.1939919] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
Mobile mental health apps can help bridge gaps in access to care for those with substance use disorders and dual diagnoses. The authors describe a portfolio of free, publicly available mobile mental health apps developed by the National Center for PTSD. The authors also demonstrate how this suite of primarily non-substance use disorder-specific mobile mental health apps may support the active ingredients of substance use disorder treatment or be used for self-management of substance use disorder and related issues. The potential advantages of these apps, as well as limitations and considerations for future app development, are discussed.
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Affiliation(s)
- Pearl McGee-Vincent
- National Center for PTSD, Dissemination and Training Division, VA Palo Alto Health Care System, Menlo Park, California, USA
| | - Katherine Juhasz
- National Center for PTSD, Dissemination and Training Division, VA Palo Alto Health Care System, Menlo Park, California, USA
| | - Andrea L Jamison
- National Center for PTSD, Dissemination and Training Division, VA Palo Alto Health Care System, Menlo Park, California, USA
| | - Timothy J Avery
- National Center for PTSD, Dissemination and Training Division, VA Palo Alto Health Care System, Menlo Park, California, USA
| | - Jason E Owen
- National Center for PTSD, Dissemination and Training Division, VA Palo Alto Health Care System, Menlo Park, California, USA
| | - Beth K Jaworski
- National Center for PTSD, Dissemination and Training Division, VA Palo Alto Health Care System, Menlo Park, California, USA
| | - Daniel M Blonigen
- HSR&D Center for Innovation to Implementation, VA Palo Alto Health Care System; Menlo Park, California, USA.,Department of Psychiatry & Behavioral Sciences, Stanford University School of Medicine, Stanford, California, USA
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33
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Overlapping Mechanisms of Recovery Between Professional Psychotherapies and Alcoholics Anonymous. J Addict Med 2021; 14:367-375. [PMID: 32058337 DOI: 10.1097/adm.0000000000000601] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Much research over the past 25 years has focused on elucidating the mechanisms by which Alcoholics Anonymous (AA) affects behavioral change in its participants. In addition to research on the spiritual mechanisms for which AA is best known in the popular conception, research on mechanisms of recovery (MOR) has predominantly supported social, cognitive, and affective mechanisms that are also present in many professional psychotherapies. AIM This paper compares and contrasts the theorized MOR of AA with those found in several common professional psychotherapies to illustrate analogous elements. METHODS Literature review, summary, and synthesis of studies examining the MOR of both AA and common psychotherapies including analytic/dynamic therapies, cognitive-behavioral therapies, and acceptance and mindfulness-based therapies. RESULTS There exists a significant overlap in theorized MOR of AA and mainstream, professional psychotherapies. Mechanisms with the greatest overlap include those mobilizing stress and coping theory, behavioral choice theory, and social learning theory, while mechanisms more unique to AA compared to professional psychotherapies mobilize social control theory to a greater degree. CONCLUSIONS In caring for patients with addiction, practicing clinicians will find it useful to be aware of overlapping analogous elements found in the AA program and professional psychotherapies and how they can complement one another.
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34
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Dobber J, Snaterse M, Latour C, Peters R, Ter Riet G, Scholte Op Reimer W, de Haan L, van Meijel B. Active Ingredients and Mechanisms of Change in Motivational Interviewing for Smoking Cessation in Patients With Coronary Artery Disease: A Mixed Methods Study. Front Psychol 2021; 12:599203. [PMID: 34239470 PMCID: PMC8258345 DOI: 10.3389/fpsyg.2021.599203] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Accepted: 05/18/2021] [Indexed: 11/16/2022] Open
Abstract
Background: For patients with coronary artery disease (CAD), smoking is an important risk factor for the recurrence of a cardiovascular event. Motivational interviewing (MI) may increase the motivation of the smokers to stop smoking. Data on MI for smoking cessation in patients with CAD are limited, and the active ingredients and working mechanisms of MI in smoking cessation are largely unknown. Therefore, this study was designed to explore active ingredients and working mechanisms of MI for smoking cessation in smokers with CAD, shortly after a cardiovascular event. Methods: We conducted a qualitative multiple case study of 24 patients with CAD who participated in a randomized trial on lifestyle change. One hundred and nine audio-recorded MI sessions were coded with a combination of the sequential code for observing process exchanges (SCOPE) and the motivational interviewing skill code (MISC). The analysis of the cases consisted of three phases: single case analysis, cross-case analysis, and cross-case synthesis. In a quantitative sequential analysis, we calculated the transition probabilities between the use of MI techniques by the coaches and the subsequent patient statements concerning smoking cessation. Results: In 12 cases, we observed ingredients that appeared to activate the mechanisms of change. Active ingredients were compositions of behaviors of the coaches (e.g., supporting self-efficacy and supporting autonomy) and patient reactions (e.g., in-depth self-exploration and change talk), interacting over large parts of an MI session. The composition of active ingredients differed among cases, as the patient process and the MI-coaching strategy differed. Particularly, change talk and self-efficacy appeared to stimulate the mechanisms of change “arguing oneself into change” and “increasing self-efficacy/confidence.” Conclusion: Harnessing active ingredients that target the mechanisms of change “increasing self-efficacy” and “arguing oneself into change” is a good MI strategy for smoking cessation, because it addresses the ambivalence of a patient toward his/her ability to quit, while, after the actual cessation, maintaining the feeling of urgency to persist in not smoking in the patient.
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Affiliation(s)
- Jos Dobber
- Faculty of Health, Center of Expertise Urban Vitality, Amsterdam University of Applied Sciences, Amsterdam, Netherlands
| | - Marjolein Snaterse
- Faculty of Health, Center of Expertise Urban Vitality, Amsterdam University of Applied Sciences, Amsterdam, Netherlands
| | - Corine Latour
- Faculty of Health, Center of Expertise Urban Vitality, Amsterdam University of Applied Sciences, Amsterdam, Netherlands
| | - Ron Peters
- Amsterdam University Medical Centers, Department of Cardiology, University of Amsterdam, Amsterdam, Netherlands
| | - Gerben Ter Riet
- Faculty of Health, Center of Expertise Urban Vitality, Amsterdam University of Applied Sciences, Amsterdam, Netherlands.,Amsterdam University Medical Centers, Department of Cardiology, University of Amsterdam, Amsterdam, Netherlands
| | - Wilma Scholte Op Reimer
- Faculty of Health, Center of Expertise Urban Vitality, Amsterdam University of Applied Sciences, Amsterdam, Netherlands.,Amsterdam University Medical Centers, Department of Cardiology, University of Amsterdam, Amsterdam, Netherlands
| | - Lieuwe de Haan
- Amsterdam University Medical Centers, Department of Psychiatry, University of Amsterdam, Amsterdam, Netherlands
| | - Berno van Meijel
- Inholland University of Applied Sciences, Amsterdam, Netherlands.,Amsterdam University Medical Centers, Department of Psychiatry, VU Medical Center, Public Health Research Institute (APH), Amsterdam, Netherlands.,Parnassia Psychiatric Institute, The Hague, Netherlands
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Beck AK, Kelly PJ, Deane FP, Baker AL, Hides L, Manning V, Shakeshaft A, Neale J, Kelly JF, Gray RM, Argent A, McGlaughlin R, Chao R, Martini M. Developing a mHealth Routine Outcome Monitoring and Feedback App ("SMART Track") to Support Self-Management of Addictive Behaviours. Front Psychiatry 2021; 12:677637. [PMID: 34220583 PMCID: PMC8249767 DOI: 10.3389/fpsyt.2021.677637] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Accepted: 05/03/2021] [Indexed: 11/13/2022] Open
Abstract
Background: Routine outcome monitoring (ROM) has been implemented across a range of addiction treatment services, settings and organisations. Mutual support groups are a notable exception. Innovative solutions are needed. SMART Track is a purpose built smartphone app designed to capture ROM data and provide tailored feedback to adults attending Australian SMART Recovery groups for addictive behaviour(s). Objective: Details regarding the formative stage of app development is essential, but often neglected. Improved consideration of the end-user is vital for curtailing app attrition and enhancing engagement. This paper provides a pragmatic example of how principles embedded in published frameworks can be operationalised to address these priorities during the design and development of the SMART Track app. Methods: Three published frameworks for creating digital health technologies ("Person-Based Approach," "BIT" Model and IDEAS framework) were integrated and applied across two stages of research to inform the development, design and content of SMART Track. These frameworks were chosen to ensure that SMART Track was informed by the needs and preferences of the end-user ("Person-Based"); best practise recommendations for mHealth development ("BIT" Model) and a collaborative, iterative development process between the multi-disciplinary research team, app developers and end-users (IDEAS framework). Results: Stage one of the research process generated in-depth knowledge to inform app development, including a comprehensive set of aims (clinical, research/organisation, and usage); clear articulation of the target behaviour (self-monitoring of recovery related behaviours and experiences); relevant theory (self-determination and social control); appropriate behavioural strategies (e.g., behaviour change taxonomy and process motivators) and key factors that may influence engagement (e.g., transparency, relevance and trust). These findings were synthesised into guiding principles that were applied during stage two in an iterative approach to app design, content and development. Conclusions: This paper contributes new knowledge on important person-centred and theoretical considerations that underpin a novel ROM and feedback app for people with addictive behaviour(s). Although person-centred design and best-practise recommendations were employed, further research is needed to determine whether this leads to improved usage outcomes. Clinical Trial Registration: Pilot Trial: http://anzctr.org.au/Trial/Registration/TrialReview.aspx?id=377336.
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Affiliation(s)
- Alison K. Beck
- Faculty of the Arts, Social Sciences and Humanities, School of Psychology, University of Wollongong, Wollongong, NSW, Australia
| | - Peter J. Kelly
- Faculty of the Arts, Social Sciences and Humanities, School of Psychology, University of Wollongong, Wollongong, NSW, Australia
- Illawarra Health and Medical Research Institute, University of Wollongong, Wollongong, NSW, Australia
| | - Frank P. Deane
- Faculty of the Arts, Social Sciences and Humanities, School of Psychology, University of Wollongong, Wollongong, NSW, Australia
- Illawarra Health and Medical Research Institute, University of Wollongong, Wollongong, NSW, Australia
| | - Amanda L. Baker
- School of Medicine and Public Health, University of Newcastle, Callaghan, NSW, Australia
| | - Leanne Hides
- Centre for Youth Substance Abuse Research, Lives Lived Well Group, School of Psychology, University of Queensland, St Lucia, QLD, Australia
| | - Victoria Manning
- Eastern Health Clinical School, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, VIC, Australia
| | - Anthony Shakeshaft
- National Drug and Alcohol Research Centre, University of New South Wales, Randwick, NSW, Australia
| | - Joanne Neale
- Addictions Department, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom
| | - John F. Kelly
- Harvard Medical School, Harvard University, Boston, MA, United States
| | - Rebecca M. Gray
- Centre for Social Research in Health, Faculty of Arts and Social Sciences, UNSW Sydney, Sydney, NSW, Australia
| | | | | | - Ryan Chao
- GHO, Customer Experience Agency, Sydney, NSW, Australia
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Jason LA, Guerrero M, Salomon-Amend M, Stevens E, Light JM, Stoolmiller M. Context Matters: Home-level But Not Individual-Level Recovery Social Capital Predicts Residents' Relapse. AMERICAN JOURNAL OF COMMUNITY PSYCHOLOGY 2021; 67:392-404. [PMID: 33296504 PMCID: PMC9149681 DOI: 10.1002/ajcp.12481] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
The purpose of this study is to contribute to the literature on the prediction of substance use relapse, using sophisticated systems' approaches to individuals and their contexts. In the current study of 42 recovery homes, we investigated the construct of social capital from the perspective of both recovery home residents and the house level. A confirmatory factor analysis found a latent recovery factor (including elements of recovery capital, comprising resources such as wages, self-efficacy, stress, self-esteem, quality of life, hope, sense of community, and social support) at both the individual and the recovery house level. Next, using longitudinal data from homes, an individual's probability of relapse was found to be related to house rather than individual-level latent recovery scores. In other words, an individual's probability of relapse was primarily related to the average of the "recoveries" of his or her recovery home peers, and not of his or her own personal "recovery" status. The finding that resident relapse is based primarily upon the total recovery capital available in the homes highlights the importance of the social environment for recovery.
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Farmer AY, Wang Y, Peterson NA, Borys S, Hallcom DK. Social Isolation Profiles and Older Adult Substance Use: A Latent Profile Analysis. J Gerontol B Psychol Sci Soc Sci 2021; 77:919-929. [PMID: 33959768 DOI: 10.1093/geronb/gbab078] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVES The aim of this study was to determine substance use among older adults based upon their social isolation and loneliness profiles. METHODS Data were derived from the New Jersey Older Adult Survey on Drug Use and Health (OASDUH). Latent profile Analysis (LPA) was used to determine the profiles of older adults (N = 801) based on five dimensions of social isolation and loneliness. Logistic and generalized ordered logistic regressions were conducted to assess the relationship between the latent profiles and substance use. RESULTS LPA identified five social isolation/loneliness profiles. The "connected and active" group had the lowest odds of cigarette use. The "alone but not lonely" group had the highest odds of cigarette use, alcohol use, and high-risk drinking. The "alone and lonely" group had the highest odds of non-medical drug use. DISCUSSION In working with older adults who are using substances, it is important to inquire about their social isolation and loneliness. Cognitive behavioral therapy for the "alone and lonely" group may be beneficial, as it has been deemed effective in reducing loneliness and enhancing social network.
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Affiliation(s)
- Antoinette Y Farmer
- The State University of New Jersey, School of Social Work, Faculty Affiliate, Center for Prevention Science, Faculty Affiliate, Center for Violence Against Women and Children, 536 George Street, Room 114, New Brunswick, New Jersey
| | - Yuqi Wang
- The State University of New Jersey, School of Social Work, Faculty Affiliate, Center for Prevention Science, Faculty Affiliate, Center for Violence Against Women and Children, 536 George Street, Room 114, New Brunswick, New Jersey
| | - N Andrew Peterson
- The State University of New Jersey, School of Social Work, Faculty Affiliate, Center for Prevention Science, Faculty Affiliate, Center for Violence Against Women and Children, 536 George Street, Room 114, New Brunswick, New Jersey
| | - Suzanne Borys
- Assistant Division Director, Office of Planning, Research, Evaluation, and Prevention, Division of Mental Health and Addiction Services, 120 South Stockton Street, P.O, Box 362, Trenton, New Jersey
| | - Donald K Hallcom
- Director of Prevention and Early Intervention, New Jersey Department of Health, Division of Mental Health and Addiction Services, 120 South Stockton Street, PO Box 362, Trenton, NJ
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Aloi J, Crum KI, Blair KS, Zhang R, Bashford-Largo J, Bajaj S, Schwartz A, Carollo E, Hwang S, Leiker E, Filbey FM, Averbeck BB, Dobbertin M, Blair RJR. Individual associations of adolescent alcohol use disorder versus cannabis use disorder symptoms in neural prediction error signaling and the response to novelty. Dev Cogn Neurosci 2021; 48:100944. [PMID: 33773241 PMCID: PMC8024914 DOI: 10.1016/j.dcn.2021.100944] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2020] [Revised: 03/13/2021] [Accepted: 03/14/2021] [Indexed: 12/20/2022] Open
Abstract
Two of the most commonly used illegal substances by adolescents are alcohol and cannabis. Alcohol use disorder (AUD) and cannabis use disorder (CUD) are associated with poorer decision-making in adolescents. In adolescents, level of AUD symptomatology has been negatively associated with striatal reward responsivity. However, little work has explored the relationship with striatal reward prediction error (RPE) representation and the extent to which any augmentation of RPE by novel stimuli is impacted. One-hundred fifty-one adolescents participated in the Novelty Task while undergoing functional magnetic resonance imaging (fMRI). In this task, participants learn to choose novel or non-novel stimuli to gain monetary reward. Level of AUD symptomatology was negatively associated with both optimal decision-making and BOLD response modulation by RPE within striatum and regions of prefrontal cortex. The neural alterations in RPE representation were particularly pronounced when participants were exploring novel stimuli. Level of CUD symptomatology moderated the relationship between novelty propensity and RPE representation within inferior parietal lobule and dorsomedial prefrontal cortex. These data expand on an emerging literature investigating individual associations of AUD symptomatology levels versus CUD symptomatology levels and RPE representation during reinforcement processing and provide insight on the role of neuro-computational processes underlying reinforcement learning/decision-making in adolescents.
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Affiliation(s)
- Joseph Aloi
- Center for Neurobehavioral Research in Children, Boys Town National Research Hospital, Boys Town, NE, United States; College of Medicine, University of Nebraska Medical Center, Omaha, NE, United States; Department of Psychiatry, Indiana University School of Medicine, Indianapolis, IN, United States.
| | - Kathleen I Crum
- Department of Psychiatry, Indiana University School of Medicine, Indianapolis, IN, United States; Adolescent Behavioral Health Research Program, Indiana University School of Medicine, Indianapolis, IN, United States; Department of Neuroscience, Medical University of South Carolina, Charleston, SC, United States
| | - Karina S Blair
- Center for Neurobehavioral Research in Children, Boys Town National Research Hospital, Boys Town, NE, United States
| | - Ru Zhang
- Center for Neurobehavioral Research in Children, Boys Town National Research Hospital, Boys Town, NE, United States
| | - Johannah Bashford-Largo
- Center for Neurobehavioral Research in Children, Boys Town National Research Hospital, Boys Town, NE, United States
| | - Sahil Bajaj
- Center for Neurobehavioral Research in Children, Boys Town National Research Hospital, Boys Town, NE, United States
| | - Amanda Schwartz
- Center for Neurobehavioral Research in Children, Boys Town National Research Hospital, Boys Town, NE, United States
| | - Erin Carollo
- Center for Neurobehavioral Research in Children, Boys Town National Research Hospital, Boys Town, NE, United States
| | - Soonjo Hwang
- Department of Psychiatry, University of Nebraska Medical Center, Omaha, NE, United States
| | - Emily Leiker
- Department of Psychiatry, University of Pittsburgh Medical Center, Pittsburgh, PA, United States
| | - Francesca M Filbey
- Center for BrainHealth, School of Behavioral and Brain Sciences, University of Texas at Dallas, Dallas, TX, United States
| | - Bruno B Averbeck
- Section on Learning and Decision Making, Laboratory of Neuropsychology, National Institute of Mental Health, Bethesda, MD, United States
| | - Matthew Dobbertin
- Center for Neurobehavioral Research in Children, Boys Town National Research Hospital, Boys Town, NE, United States
| | - R James R Blair
- Center for Neurobehavioral Research in Children, Boys Town National Research Hospital, Boys Town, NE, United States
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Herlinger K, Lingford-Hughes A. Addressing unmet needs in opiate dependence: supporting detoxification and advances in relapse prevention. BJPSYCH ADVANCES 2021. [DOI: 10.1192/bja.2020.98] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
SUMMARY
Despite record-breaking numbers of opiate related deaths in the UK in 2019, pharmacological management of opiate dependence has evolved little since the advent of methadone in 1965. Along with harm minimisation and psychosocial interventions, the mainstay of pharmacological treatment remains opioid substitution therapy (OST) using methadone or buprenorphine, with many patients receiving OST for many years. Even with these treatments, opiate users continue to face mortality risks 12 times higher than the general population, and emerging evidence suggests that individuals who remain on long-term OST present with a range of physical and cognitive impairments. Therefore, with a growing ageing opiate dependent population who would benefit from detoxification from OST, this article provides an overview of the current state of opiate dependence in clinical practice, explores the reasons why availability and acceptability of detoxification pathways are declining, and discusses emerging pharmacological therapies that could provide benefit in relapse prevention.
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Jason LA, Guerrero M, Salomon-Amend M, Lynch G, Stevens E, Light JM, Stoolmiller M. Advice seeking and loaning of money related to relapse in recovery homes. JOURNAL OF COMMUNITY & APPLIED SOCIAL PSYCHOLOGY 2021; 31:39-52. [PMID: 34113065 PMCID: PMC8186298 DOI: 10.1002/casp.2486] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2020] [Accepted: 07/23/2020] [Indexed: 11/12/2022]
Abstract
Recovery homes help individuals who have completed substance use treatment programs re-integrate back into the community. However, it is unclear what factors determine who will succeed in these settings and how these factors may be reinforced or undermined by the social interactions and social networks between residents living in the Oxford House recovery homes. In an effort to better understand these factors, the current study evaluated (a) the extent to which the density of social networks (i.e., friendship, willingness to loan money, and advice-seeking relationships) is associated with social capital (i.e., sense of community, quality of life, hopefulness, self-efficacy), and (b) whether the density of social networks predicts relapse over time. Among the findings, willingness to loan money was positively associated with all four individual-level social capital variables, suggesting that availability of instrumental resources may be important to ongoing recovery. To test whether these house-level social network factors then support recovery, a survival analysis was conducted, finding associations between relapse risk and the network densities over a 28-month span. In particular, more dense advice-seeking networks were associated with higher rates of relapse, suggesting that the advice-seeking might represent a sign of organisational house problems, with many residents unsure of issues related to their recovery. In contrast, more dense loaning networks were associated with less relapse, so willingness to lend money could be measuring a willingness to help those in need. The implications of these findings are discussed.
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Affiliation(s)
- Leonard A. Jason
- Center for Community Research, DePaul University, Chicago, Illinois
| | - Mayra Guerrero
- Center for Community Research, DePaul University, Chicago, Illinois
| | | | - Gabrielle Lynch
- Center for Community Research, DePaul University, Chicago, Illinois
| | - Ed Stevens
- Center for Community Research, DePaul University, Chicago, Illinois
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Xu S, Park M, Kang UG, Choi JS, Koo JW. Problematic Use of Alcohol and Online Gaming as Coping Strategies During the COVID-19 Pandemic: A Mini Review. Front Psychiatry 2021; 12:685964. [PMID: 34194349 PMCID: PMC8236582 DOI: 10.3389/fpsyt.2021.685964] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Accepted: 05/17/2021] [Indexed: 12/14/2022] Open
Abstract
The COVID-19 (coronavirus disease 2019) pandemic has dramatically changed our daily lives and activities, including those originally intended to serve for leisure and pleasure. Drinking and online gaming became coping behaviors used to rescue ourselves from the stress and restricted lifestyle during the COVID-19 pandemic. However, frequent drinking and gaming can result in the pathological consequences of addiction. Those affected use the stimuli not to obtain pleasure, but rather to avoid the displeasure induced by stress and previous use, often unsuccessfully. This review aims to provide an overview of recent longitudinal cohort studies on alcohol and gaming use during the COVID-19 pandemic, as well as to analyze how the pandemic has affected alcohol and gaming use. There was a substantial risk of alcohol and online gaming overuse during the lockdown, which may depend on the pandemic's duration or overuse patterns. Previous studies have shown that increased alcohol consumption and online gaming are associated with heightened stress and anxiety levels caused by social isolation/quarantine. Over time, frequent or excessive alcohol consumption and gaming could lead to an increased risk of more serious mental health problems. Every effort should be made to mitigate mental health problems and ensure adequate adaptation to these exceptional circumstances. Therefore, it would be helpful to encourage physical activity, social interaction, and collaboration to facilitate psychological and physical health.
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Affiliation(s)
- Shijie Xu
- Medical Research Center, Hainan Cancer Hospital, Haikou, China.,Institute of Human Behavioral Medicine, Medical Research Center, Seoul National University, Seoul, South Korea.,Biomedical Research Institute, Seoul National University Hospital, Seoul, South Korea
| | - Minkyung Park
- Department of Psychiatry, SMG-SNU Boramae Medical Center, Seoul, South Korea
| | - Ung Gu Kang
- Institute of Human Behavioral Medicine, Medical Research Center, Seoul National University, Seoul, South Korea.,Department of Psychiatry and Behavioral Science, Seoul National University College of Medicine, Seoul, South Korea
| | - Jung-Seok Choi
- Department of Psychiatry, SMG-SNU Boramae Medical Center, Seoul, South Korea.,Department of Psychiatry and Behavioral Science, Seoul National University College of Medicine, Seoul, South Korea
| | - Ja Wook Koo
- Emotion, Cognition and Behavior Research Group, Korea Brain Research Institute, Daegu, South Korea.,Department of Brain and Cognitive Sciences, Daegu Gyeongbuk Institute of Science and Technology, Daegu, South Korea
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Gonçalves PD, Moura HF, do Amaral RA, Castaldelli-Maia JM, Malbergier A. Alcohol Use and COVID-19: Can we Predict the Impact of the Pandemic on Alcohol Use Based on the Previous Crises in the 21st Century? A Brief Review. Front Psychiatry 2020; 11:581113. [PMID: 33391048 PMCID: PMC7775307 DOI: 10.3389/fpsyt.2020.581113] [Citation(s) in RCA: 46] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Accepted: 11/23/2020] [Indexed: 01/23/2023] Open
Abstract
The enormous health and economic challenges precipitated by the 2019 coronavirus disease (COVID-19) pandemic are comparable or even greater than those associated with previous historical world crises. Alcohol use, especially drinking to cope with stress, is a concern, as an increase in its sales has been reported in some countries during the quarantine. This study aims to provide a better understanding of what to expect in terms of alcohol consumption, risk factors for excessive use, and its potential consequences during this pandemic based on previous experiences. We investigated how traumatic events related to alcohol consumption. Studies on mass traumatic events (i.e., terrorism as 9/11), epidemic outbreaks (i.e., severe acute respiratory syndrome [SARS] in 2003), economic crises (such as 2008's Great Recession), and COVID-19 were selected. The main keywords used to select the studies were alcohol use, drinking patterns, alcohol use disorders, and alcohol-related consequences. Previous studies reported increases in alcohol use associated with those events mediated, at least partially, by anxiety and depressive symptoms, and posttraumatic stress disorder (PTSD). Being male, young, and single also seems to be associated with a higher vulnerability to develop risky drinking behavior after those tragic events. The discussion of previous risk and protective factors can contribute to elaborate more specific public health policies to mitigate the impact of the current pandemic on people's mental health, especially alcohol-related problems.
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Affiliation(s)
- Priscila Dib Gonçalves
- Department of Psychiatry, Medical School of University of São Paulo (USP), São Paulo, Brazil
| | - Helena Ferreira Moura
- Department of Psychiatry, Universidade Federal do Rio Grande do Sul (UFRGS), Faculty of Medicine, Porto Alegre, Brazil
| | | | - João Maurício Castaldelli-Maia
- Department of Psychiatry, Medical School of University of São Paulo (USP), São Paulo, Brazil
- Department of Neuroscience, ABC Health University Center, Santo André, Brazil
| | - André Malbergier
- Department of Psychiatry, Medical School of University of São Paulo (USP), São Paulo, Brazil
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Knapp KS, Bunce SC, Brick TR, Deneke E, Cleveland HH. Daily associations among craving, affect, and social interactions in the lives of patients during residential opioid use disorder treatment. PSYCHOLOGY OF ADDICTIVE BEHAVIORS 2020; 35:609-620. [PMID: 33090811 DOI: 10.1037/adb0000612] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
OBJECTIVE This study captured the interrelationships among craving, negative affect, and positive and negative social exchanges in the daily lives of patients in residential treatment for opioid use disorders (OUDs). METHOD Participants were 73 patients (77% male), age 19 to 61 (Mage = 30.10, SDage = 10.13) in residential treatment for OUD. Participants completed a smartphone-based survey 4 times per day for 12 consecutive days that measured positive and negative social exchanges (Test of Negative Social Exchange), negative affect (PA-NA scales), and craving (frequency and intensity). Within-person, day-level associations among daily positive and negative social exchanges, negative affect, and craving were examined using multilevel modeling. RESULTS Daily negative social exchanges (M = 1.44, SD = 2.27) were much less frequent than positive social exchanges (M = 6.59, SD = 4.00) during residential treatment. Whereas negative social exchanges had a direct association with same-day craving (β = 0.08; 95% CI = 0.01, 0.16, ΔR2 = 0.01), positive social exchanges related to craving indirectly via moderation of the within-person negative affect-craving link (β = -0.01; 95% CI = -0.01, -0.001, ΔR2 = 0.002). Positive social exchanges decoupled the same-day linkage between negative affect and craving on days when individuals had at least four more positive social exchanges than usual. CONCLUSIONS These results indicate that both negative affect and negative social exchanges are uniquely related to craving on a daily basis, and that extra positive social interactions can reduce the intraindividual coupling of negative affect and craving during residential treatment for OUD. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
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Guerrero M, Jason LA. Social Network Cohesion among Veterans Living in Recovery Homes. MILITARY BEHAVIORAL HEALTH 2020; 9:55-68. [PMID: 34109074 PMCID: PMC8184014 DOI: 10.1080/21635781.2020.1796859] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Recovery homes for individuals with substance use disorders (SUD) called Oxford House (OH) have been shown to improve the prospects of a successful recovery across different sub-populations, and these homes may be particularly beneficial for veterans in recovery. An estimated 18% of OH residents are veterans; however, not much is known about their experiences living in these homes. Participants included 85 veterans and non-veterans living in 13 OHs located in different regions of the United States. Using social network analysis and multi-level modeling, we investigated whether the social networks of veterans residing with other veterans were more cohesive compared to veterans living with only non-veterans. Results indicated that veterans residing with other veterans had stronger relationships with other OH residents compared to veterans that reside with all non-veterans. The implications for theory and practice are discussed. Further research is needed to determine if greater social network cohesion leads to better recovery outcomes for veterans.
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Affiliation(s)
- Mayra Guerrero
- Center for Community Research, DePaul University, Chicago, IL
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45
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Yang Y, Perkins DR, Stearns AE. “I Started to Feel Better now”: Qualitative Findings from Client Narratives on Early Recovery in Inpatient Substance Use Treatment. Int J Ment Health Addict 2020. [DOI: 10.1007/s11469-019-00107-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
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Criminal recidivism among justice-involved veterans following substance use disorder residential treatment. Addict Behav 2020; 106:106357. [PMID: 32120199 DOI: 10.1016/j.addbeh.2020.106357] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2019] [Revised: 02/13/2020] [Accepted: 02/13/2020] [Indexed: 01/18/2023]
Abstract
Veterans in treatment for substance use disorders (SUD) often report past criminal offending. However, the rate of criminal recidivism in this population is unknown. Further, prior research in veterans has not examined personality factors as predictors of recidivism, despite the prominence of such factors in leading models of recidivism risk management. We examined these issues in a secondary data analysis of 197 military veterans with a history of criminal offending who were enrolled in an SUD residential treatment program. Participants were interviewed using several measurement instruments at treatment entry, one month into treatment, treatment discharge, and 12 months post-discharge. Most veterans (94%) had a history of multiple charges, and 53% had recent involvement in the criminal justice system at the time of treatment entry. In the 12 months post-discharge, 22% reported reoffending. In addition, 30% of patients who had been recently involved in the criminal justice system at treatment entry reoffended during follow-up. Higher friend relationship quality (OR = 2.32, 95% CI [1.03, 5.21]) at treatment entry and higher staff ratings of patients' relationship quality with other residents during treatment (OR = 2.76, 95% CI [1.40, 5.41]) predicted lower odds of recidivism post-discharge. After accounting for these factors, smaller reductions during treatment in the personality trait of Negative Emotionality predicted an increased risk for criminal recidivism post-discharge (OR = 1.13, 95% CI [1.01, 1.26]). Results support augmenting the curriculum of SUD programs for veterans with services aimed at reducing risk for criminal recidivism, with a focus on interventions that directly target patients' social support networks and tendencies towards negative emotionality.
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Jason LA, Stevens E, Kassanits J, Reilly A, Bobak T, Guerrero M, Doogan NJ. Recovery homes: A social network analysis of Oxford Houses for Native Americans. J Ethn Subst Abuse 2020; 19:174-189. [PMID: 30183538 PMCID: PMC6401329 DOI: 10.1080/15332640.2018.1489748] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
Social network data were collected among residents of an Oxford House (OH) recovery home, which was located on Suquamish Tribal territory. Data were collected on the social connections of eight male residents (including four Native Americans and four non-Native Americans) using a social network instrument. A number of social network relationship types were examined, including friendship, trust, and mentorship. Social network data assessed included diameter, reciprocity, the average path length, cohesion, density, transitivity, and centrality. Findings indicated that the OH provided residents a well-integrated network with multiple sources of friendship, trust, and mentors. This is of importance as recovery from substance abuse is facilitated when recovering individuals are provided stable and well-functioning networks that foster social support, access to resources, and mentorship.
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Affiliation(s)
| | - Ed Stevens
- DePaul University, Chicago, Illinois, USA
| | | | | | - Ted Bobak
- DePaul University, Chicago, Illinois, USA
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Dobber J, Latour C, van Meijel B, Ter Riet G, Barkhof E, Peters R, Scholte Op Reimer W, de Haan L. Active Ingredients and Mechanisms of Change in Motivational Interviewing for Medication Adherence. A Mixed Methods Study of Patient-Therapist Interaction in Patients With Schizophrenia. Front Psychiatry 2020; 11:78. [PMID: 32265746 PMCID: PMC7105777 DOI: 10.3389/fpsyt.2020.00078] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2019] [Accepted: 01/31/2020] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Trials studying Motivational Interviewing (MI) to improve medication adherence in patients with schizophrenia showed mixed results. Moreover, it is unknown which active MI-ingredients are associated with mechanisms of change in patients with schizophrenia. To enhance the effect of MI for patients with schizophrenia, we studied MI's active ingredients and its working mechanisms. METHODS First, based on MI literature, we developed a model of potential active ingredients and mechanisms of change of MI in patients with schizophrenia. We used this model in a qualitative multiple case study to analyze the application of the active ingredients and the occurrence of mechanisms of change. We studied the cases of fourteen patients with schizophrenia who participated in a study on the effect of MI on medication adherence. Second, we used the Generalized Sequential Querier (GSEQ 5.1) to perform a sequential analysis of the MI-conversations aiming to assess the transitional probabilities between therapist use of MI-techniques and subsequent patient reactions in terms of change talk and sustain talk. RESULTS We found the therapist factor "a trusting relationship and empathy" important to enable sufficient depth in the conversation to allow for the opportunity of triggering mechanisms of change. The most important conversational techniques we observed that shape the hypothesized active ingredients are reflections and questions addressing medication adherent behavior or intentions, which approximately 70% of the time was followed by "patient change talk". Surprisingly, sequential MI-consistent therapist behavior like "affirmation" and "emphasizing control" was only about 6% of the time followed by patient change talk. If the active ingredients were embedded in more comprehensive MI-strategies they had more impact on the mechanisms of change. CONCLUSIONS Mechanisms of change mostly occurred after an interaction of active ingredients contributed by both therapist and patient. Our model of active ingredients and mechanisms of change enabled us to see "MI at work" in the MI-sessions under study, and this model may help practitioners to shape their MI-strategies to a potentially more effective MI.
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Affiliation(s)
- Jos Dobber
- ACHIEVE Centre of Applied Research, Faculty of Health, Amsterdam University of Applied Sciences, Amsterdam, Netherlands
| | - Corine Latour
- ACHIEVE Centre of Applied Research, Faculty of Health, Amsterdam University of Applied Sciences, Amsterdam, Netherlands
| | - Berno van Meijel
- Research Group Mental Health Nursing, Inholland University of Applied Sciences, Amsterdam, Netherlands.,Department of Psychiatry, Amsterdam UMC (VUmc), Amsterdam Public Health Research Institute, Amsterdam, Netherlands.,Parnassia Academy, Parnassia Psychiatric Institute, The Hague, Netherlands
| | - Gerben Ter Riet
- Department of General Practice, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands
| | | | - Ron Peters
- Department of Cardiology, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands
| | - Wilma Scholte Op Reimer
- ACHIEVE Centre of Applied Research, Faculty of Health, Amsterdam University of Applied Sciences, Amsterdam, Netherlands.,Department of Cardiology, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands
| | - Lieuwe de Haan
- Department of Psychiatry, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands
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Dekkers A, De Ruysscher C, Vanderplasschen W. Perspectives of cocaine users on addiction recovery: a qualitative study following a CRA + vouchers programme. DRUGS: EDUCATION, PREVENTION AND POLICY 2019. [DOI: 10.1080/09687637.2019.1687647] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Affiliation(s)
- Anne Dekkers
- Department of Special Needs Education, Ghent University, Ghent, Belgium
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50
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Haviv N, Hasisi B. Prison Addiction Program and the Role of Integrative Treatment and Program Completion on Recidivism. INTERNATIONAL JOURNAL OF OFFENDER THERAPY AND COMPARATIVE CRIMINOLOGY 2019; 63:2741-2770. [PMID: 31510830 DOI: 10.1177/0306624x19871650] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
This study examines whether there is variability between the effects of three different drug rehabilitation programs operating in the Israeli Prison Service (IPS) on completers' recidivism. By performing comparative analysis, this study attempts to address the problem of assessing the role of participants' motivation. The study uses a rich administrative data obtained from the IPS system to develop a propensity score matching (PSM) approach where the treatment groups consist of only those who completed the programs, and the comparison groups consist of drug-addicted prisoners who have not taken part in any drug rehabilitation program. After matching, prisoners in the treatment and comparison groups are found to be similar on all known characteristics. Findings show that the only rehabilitation program that promised significant and positive outcomes for its completers was the more comprehensive one operating at Hermon Prison. Prisoners who completed the treatment were incarcerated and arrested less than their comparison group. The "golden strategy" for rehabilitating drug-using prisoners, then, will be twofold. The program should be based on the promising components of rehabilitation, that is, cognitive behavioral therapy, therapeutic community, long duration, intensity, and positive social climate. The program should also succeed in retaining its participants through completion.
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Affiliation(s)
- Noam Haviv
- The Hebrew University of Jerusalem, Israel
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