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Caro-Cañizares I, López Carpintero N, Carmona-Camacho R. The Elephant in the Room: A Systematic Review of the Application and Effects of Psychological Treatments for Pregnant Women with Dual Pathology (Mental Health and Substance-Related Disorders). INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:392. [PMID: 38673305 PMCID: PMC11050033 DOI: 10.3390/ijerph21040392] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/16/2024] [Revised: 03/14/2024] [Accepted: 03/22/2024] [Indexed: 04/28/2024]
Abstract
PURPOSE Maternal mental health and substance use, referred to as dual pathology, represent significant concerns associated with adverse pregnancy and birth outcomes, a prevalence higher than commonly anticipated. Nonetheless, a notable dearth exists ofevidence-based treatment protocols tailored for pregnant women with dual pathology. METHODS A systematic review, adhering to the PRISMA methodology, was conducted. RESULTS Out of the 57 identified papers deemed potentially relevant, only 2were ultimately included. Given the limited number of studies assessing the efficacy of psychological interventions utilizing randomized controlled trials (RCTs) for both mental health and substance misuse, and considering the diverse objectives and measures employed, definitive conclusions regarding the effectiveness of psychological interventions in this domain prove challenging. CONCLUSIONS Maternal mental health appears to be the proverbial "elephant in the room". The development of specialized and integrated interventions stands as an imperative to effectively address this pressing issue. As elucidated in the present review, these interventions ought to be grounded in empirical evidence. Furthermore, it is essential that such interventions undergo rigorous evaluation through RCTs to ascertain their efficacy levels. Ultimately, the provision of these interventions by psychology/psychiatric professionals, both within clinical practice and the RCTs themselves, is recommended to facilitate the generalizability of the results to specialized settings.
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Affiliation(s)
- Irene Caro-Cañizares
- Facultad de Ciencias de la Salud y la Educación, Universidad a Distancia de Madrid, UDIMA, 28400 Collado Villalba, Spain
| | - Nayara López Carpintero
- Departamento de Obstetricia y Ginecología, Hospital Universitario del Tajo, 28300 Aranjuez, Spain
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Reid N, Schölin L, Erng MN, Montag A, Hanson J, Smith L. Preconception interventions to reduce the risk of alcohol-exposed pregnancies: A systematic review. Alcohol Clin Exp Res 2021; 45:2414-2429. [PMID: 34590331 DOI: 10.1111/acer.14725] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Revised: 08/31/2021] [Accepted: 09/23/2021] [Indexed: 12/28/2022]
Abstract
BACKGROUND The preconception period provides a unique opportunity to optimize the health of women and children. High rates of alcohol use and unintended pregnancies are common across many Western societies, and alcohol-exposed pregnancies (AEPs) are a possible unintended outcome. The aim of the current study was to evaluate preconception interventions for the prevention of AEPs. METHODS A systematic search of four electronic databases (PubMed, Embase, CINAHL, and PsycINFO) was undertaken for relevant peer-reviewed articles published from 1970 onward. Studies were included if they enrolled women and/or their support networks during the preconception period. RESULTS Nineteen studies met the inclusion criteria. The majority of studies (n = 14) evaluated CHOICES-based interventions, which incorporate motivational interviewing approaches to change alcohol and/or contraceptive behavior. The other five interventions included a range of different approaches and modes of delivery. The majority of interventions were successful in reducing AEP risk. Changes in AEP risk were more often driven by changes in contraceptive behavior, although some approaches led to changes in both alcohol and contraceptive behavior. CONCLUSIONS The review indicated that many interventions were efficacious at reducing AEP risk during the preconception period through preventing unplanned pregnancy. The effectiveness estimated from these clinical trials may be greater than that seen in interventions when implemented in practice where there is a lack of blinding and greater attrition of participants during follow-up. Further research investigating the real-world effectiveness of these intervention approaches implemented across a wide range of clinical settings would be beneficial.
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Affiliation(s)
- Natasha Reid
- Child Health Research Centre, University of Queensland, Brisbane, Queensland, Australia
| | - Lisa Schölin
- Centre for Pesticide Suicide Prevention, University of Edinburgh, Edinburgh, UK
| | - May Na Erng
- Child Health Research Centre, University of Queensland, Brisbane, Queensland, Australia
| | - Annika Montag
- Department of Pediatrics, University of California San Diego, La Jolla, California, USA
| | - Jessica Hanson
- Department of Applied Health Sciences, University of Minnesota Duluth, Duluth, Minnesota, USA
| | - Lesley Smith
- Faculty of Health Sciences, Institute of Clinical Applied Health Research, University of Hull, Hull, Yorkshire, UK
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Kriengtuntiwong T, Zaw YH, Taneepanichskul N. Brain-Derived Neurotrophic Factor (BDNF) Depression and Subjective Sleep Quality in the First Trimester of Pregnancy Among Migrant Workers in Thailand. J Multidiscip Healthc 2021; 14:2549-2556. [PMID: 34552333 PMCID: PMC8450157 DOI: 10.2147/jmdh.s322355] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Accepted: 09/03/2021] [Indexed: 12/26/2022] Open
Abstract
Introduction Brain-derived neurotrophic factor (BDNF) influences neurodevelopment during pregnancy. Maternal sleep quality and depression are suggested to influence BDNF levels. The objective of this study was to assess the association between depression, sleep quality, and BDNF levels among Myanmar migrant pregnancies. Methods A cross-sectional study was conducted at Krathum Baen Hospital, Samut Sakhon province, from June to October 2018. A total of 108 first-trimester women were recruited into our study. Maternal blood was collected to analyze BDNF. Depression levels were assessed using the Patient Health Questionnaire (PHQ-9) instrument. The Pittsburgh Sleep Quality Index (PSQI) questionnaire was applied to evaluate subjective sleep quality. Because BDNF was skewed, binary logistic regression was analyzed. Results We found that 28.7% of pregnant women reported poor sleep quality, and 33.4% were classified as having mild to moderate depression. After adjusting for covariate variables, pregnant women with depression had higher BDNF levels than those without depression (OR = 2.972, 95% CI = [1.111, 7.949], p = 0.030). Pregnant women with poor sleep quality had lower BDNF levels than those who had good sleep quality (OR = 0.359, 95% CI = [0.132, 0.972], p = 0.044). Discussion The results suggested that BDNF might be an alternative tool to assess sleep quality in pregnant women.
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Affiliation(s)
- Thuvachit Kriengtuntiwong
- College of Public Health Science, Chulalongkorn University, Bangkok, Thailand.,Department of Mental Health, Srithanya Hospital, Nonthaburi, Thailand
| | - Ye Htet Zaw
- Defense Services Medical Academy, Yangon, Myanmar
| | - Nutta Taneepanichskul
- College of Public Health Science, Chulalongkorn University, Bangkok, Thailand.,HAUS IAQ Research Unit, Department of Pediatrics, Faculty of Medicine, Chulalongkorn University, King Chulalongkorn Memorial Hospital, Bangkok, Thailand
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Dai W, Palmer R, Sunderrajan A, Durantini M, Sánchez F, Glasman LR, Chen FX, Albarracín D. More behavioral recommendations produce more change: A meta-analysis of efficacy of multibehavior recommendations to reduce nonmedical substance use. PSYCHOLOGY OF ADDICTIVE BEHAVIORS 2020; 34:709-725. [PMID: 32309956 PMCID: PMC7572872 DOI: 10.1037/adb0000586] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Death and morbidity associated with substance use have risen continuously over the last few decades, increasing the need for rigorous examination of promising programs. Interventions attempting to change multiple behaviors have been designed to address interconnected problems such as use of both alcohol and drugs. This meta-analysis aimed to examine the efficacy of multibehavior interventions to curb nonmedical substance use in relation to the theoretical relation among different substance use behaviors. Specifically, our synthesis aimed to estimate the optimal number of recommendations for intervention efficacy and evaluate the impact of different combinations of recommendations on intervention efficacy. A synthesis of multibehavior interventions addressing nonmedical substance use was conducted to measure behavioral changes between the pretest and the follow-up. These changes were then compared across different numbers of recommendations. Sixty-nine reports and 233 effect sizes (k of conditions = 155, n = 28,295) were included. A positive linear relation was found between the number of targeted behaviors and intervention efficacy, which was stronger for drug use than alcohol use. Furthermore, recommendations on drug use worked better when paired with recommendations targeting other behaviors, whereas recommendations on alcohol use worked more independently. Lastly, multibehavior interventions were especially efficacious when delivered by experts. Overall, our synthesis indicated that targeting multiple substances is beneficial for changing drug use outcomes, but less so for alcohol use outcomes. Therefore, in the current substance use epidemic, innovative multibehavior programs appear to hold promise, especially to combat nonmedical drug use. (PsycInfo Database Record (c) 2020 APA, all rights reserved).
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Affiliation(s)
- Wenhao Dai
- Department of Psychology, University of Illinois, Urbana-Champaign
| | - Ryan Palmer
- Department of Psychology, University of Illinois, Urbana-Champaign
| | | | - Marta Durantini
- Department of Psychology, University of Illinois, Urbana-Champaign
| | - Flor Sánchez
- Departamento de Psicología Social, Universidad Autónoma de Madrid
| | - Laura R. Glasman
- Department of Psychiatry and Behavioral Medicine, Medical College of Wisconsin
| | - Fan Xuan Chen
- Department of Psychology, University of Illinois, Urbana-Champaign
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5
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Depressive symptoms as a moderator of college student response to computerized alcohol intervention. J Subst Abuse Treat 2020; 115:108038. [PMID: 32600626 DOI: 10.1016/j.jsat.2020.108038] [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: 11/02/2019] [Revised: 04/28/2020] [Accepted: 05/14/2020] [Indexed: 12/17/2022]
Abstract
BACKGROUND Personalized normative alcohol feedback (PNF) is associated with decreased alcohol use among young adults. However, limited research has examined the influence of depressive symptoms on PNF efficacy. This study examined symptoms of depression as a moderator of college student response to a computerized PNF intervention for alcohol use. METHODS College students (N = 212, 59% female) who reported drinking in a typical week completed baseline and one-month assessments as part of a previously published intervention trial. We randomized participants to alcohol PNF (n = 153) or assessment only (n = 59). We used regression models to examine the interaction between PNF and symptoms of depression on alcohol outcomes at one-month follow-up. RESULTS One in four participants screened positive for clinically significant symptoms of depression. Depressive symptoms did not moderate intervention effects on drinking quantity. However, PNF was only associated with reduced frequency of heavy episodic drinking and lower probability of any alcohol-related consequence in the context of mild to moderate (not minimal) symptoms of depression. CONCLUSIONS PNF is more effective than assessment alone in reducing drinking quantity, regardless of symptoms of depression. However, it may only be more effective in decreasing frequency of heavy episodic drinking and the probability of alcohol-related consequences among those experiencing mild to moderate (as opposed to minimal) symptoms of depression. Alcohol intervention trials should assess symptoms of depression and consider them in data analysis.
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Deutsch AR. The Importance of Intimate Partner Violence in Within-Relationship and Between-Person Risk for Alcohol-Exposed Pregnancy. Alcohol Clin Exp Res 2019; 43:679-689. [PMID: 30698820 DOI: 10.1111/acer.13968] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2018] [Accepted: 01/21/2019] [Indexed: 11/29/2022]
Abstract
BACKGROUND Preconceptual prevention programs geared toward reducing alcohol-exposed pregnancy (AEP) typically emphasize behavioral change of alcohol use and birth control exclusively, but rarely consider other important AEP predictors that may affect behavioral change. Intimate partner violence (IPV) substantially relates to AEP and to AEP predictors; however, few studies have tested if IPV is a unique indicator of prospective AEP risk, as both a main effect and a contextual influence on alcohol use or birth control. METHODS Using Waves II and III of the National Longitudinal Study of Adolescent to Adult Health, multilevel logistic regression models were estimated, in which IPV and birth control (both within-person and between-person) and adolescent alcohol use (between-person only) were examined as unique predictors of AEP compared to both nonpregnancy and non-AEP (nAEP) outcomes over up to 5 sexual relationships. Interactions between within-person and between-person IPV, and birth control or alcohol use were also tested. RESULTS Within-person and between-person IPV significantly related to higher odds of AEP compared to nonpregnancy and nAEP. Adolescent alcohol use had similarly increased odds for AEP when compared to nonpregnancy or nAEP outcomes. Only between-person birth control use related to higher odds for AEP compared to nonpregnancy and nAEP. Between-person IPV also moderated adolescent alcohol use on odds of AEP, such that infrequent adolescent drinkers had higher odds of AEP compared to nonpregnancy or nAEP if they experienced IPV over their relationships. CONCLUSIONS IPV is a substantial predictor for AEP as both a direct influence within relationships (within-person) and between individuals (between-person). Intervention and prevention programs focused on reducing AEP may benefit from including IPV-specific curricula.
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Affiliation(s)
- Arielle R Deutsch
- Population Health, Sanford Research, Sioux Falls, South Dakota.,Pediatrics, School of Medicine, University of South Dakota, Vermillion, South Dakota
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Thibaut F, Chagraoui A, Buckley L, Gressier F, Labad J, Lamy S, Potenza MN, Rondon M, Riecher-Rössler A, Soyka M, Yonkers K, Yonkers K. WFSBP * and IAWMH ** Guidelines for the treatment of alcohol use disorders in pregnant women. World J Biol Psychiatry 2019; 20:17-50. [PMID: 30632868 DOI: 10.1080/15622975.2018.1510185] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
OBJECTIVES These practice guidelines for the treatment of alcohol use disorders during pregnancy were developed by members of the International Task Force of the World Federation of Societies of Biological Psychiatry and the International Association for Women's Mental Health. METHODS We performed a systematic review of all available publications and extracted data from national and international guidelines. The Task Force evaluated the data with respect to the strength of evidence for the efficacy and safety of each medication. RESULTS AND DISCUSSION There is no safe level of alcohol use during pregnancy. Abstinence is recommended. Ideally, women should stop alcohol use when pregnancy is planned and, in any case, as soon as pregnancy is known. Detecting patterns of alcohol maternal drinking should be systematically conducted at first antenatal visit and throughout pregnancy. Brief interventions are recommended in the case of low or moderate risk of alcohol use. Low doses of benzodiazepines, for the shortest duration, may be used to prevent alcohol withdrawal symptoms when high and chronic alcohol intake is stopped and hospitalisation is recommended. Due to the low level of evidence and/or to low benefit/risk ratio, pharmacological treatment for maintenance of abstinence should not be used during pregnancy. At birth, foetal alcohol spectrum disorders must be searched for, and alcohol metabolites should be measured in meconium of neonates in any doubt of foetal alcohol exposure.
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Affiliation(s)
- Florence Thibaut
- a University Hospital Cochin , Faculty of Medicine Paris Descartes, INSERM U 894, Centre Psychiatry and Neurosciences , Paris , France
| | - Abdeslam Chagraoui
- b Neuronal and Neuroendocrine Differentiation and Communication Laboratory , Institute for Research and Innovation in Biomedicine of Normandy (IRIB), Normandie Univ , UNIROUEN, INSERM, U1239, CHU Rouen , Rouen , France ; Department of Medical Biochemistry , Rouen University Hospital , Rouen , France
| | - Leslie Buckley
- c Addiction Services , University Health Network, University of Toronto , Toronto , Canada
| | - Florence Gressier
- d Department of Psychiatry , INSERM UMR1178 CESP, Univ. Paris-Sud , Hôpitaux Universitaires Paris-Sud, Hôpital de Bicêtre , Le Kremlin Bicêtre , France
| | - Javier Labad
- e Department of Mental Health , Parc Tauli Hospital Universitari, I3PT ; Department of Psychiatry and Legal Medicine , Universitat Autonoma de Barcelona, CIBERSAM, Sabadell , Barcelona , Spain
| | - Sandrine Lamy
- f Department of Addictology , Ramsay- General de Santé, SSR Petit Colmoulins , Harfleur , France
| | - Marc N Potenza
- g Neuroscience and Child Study , Yale University School of Medicine , New Haven , CT , USA
| | - Marta Rondon
- h Instituto Nacional Materno Perinatal , Lima , Peru
| | - Anita Riecher-Rössler
- i Center for Gender Research and Early Detection , University of Basel Psychiatric Hospital , Basel , Switzerland
| | - Michael Soyka
- j University of Munich , Munich, and Medicalpark Chiemseeblick, Bernau , Germany
| | - Kim Yonkers
- k Center for Wellbeing of Women and Mothers, Psychiatry, of Epidemiology (Chronic Diseases) and of Obstetrics, Gynecology, and Reproductive Sciences , Yale University , New Haven , CT , USA
| | - Kim Yonkers
- Center for Wellbeing of Women and Mothers, Psychiatry, of Epidemiology (Chronic Diseases) and of Obstetrics, Gynecology, and Reproductive Sciences, Yale University, New Haven, CT, USA
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8
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Depresión en el embarazo. ACTA ACUST UNITED AC 2019; 48:58-65. [DOI: 10.1016/j.rcp.2017.07.003] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2016] [Revised: 02/15/2017] [Accepted: 07/10/2017] [Indexed: 11/19/2022]
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Boniface S, Malet-Lambert I, Coleman R, Deluca P, Donoghue K, Drummond C, Khadjesari Z. The Effect of Brief Interventions for Alcohol Among People with Comorbid Mental Health Conditions: A Systematic Review of Randomized Trials and Narrative Synthesis. Alcohol Alcohol 2018; 53:282-293. [PMID: 29293882 DOI: 10.1093/alcalc/agx111] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2017] [Accepted: 11/30/2017] [Indexed: 11/12/2022] Open
Abstract
Aims To review the evidence on the effect of brief interventions (BIs) for alcohol among adults with risky alcohol consumption and comorbid mental health conditions. Methods A systematic review of randomized controlled trials (RCTs) published before May 2016 was undertaken and reported according to PRISMA guidelines. The findings were combined in a narrative synthesis. The risk of bias was assessed for included trials. Results Seventeen RCTs were included in the review and narrative synthesis: 11 in common mental health problems, and 6 in severe mental illness. There was considerable heterogeneity in study populations, BI delivery mode and intensity, outcome measures and risk of bias. Where BI was compared with a minimally active control, BI was associated with a significant reduction in alcohol consumption in four out of nine RCTs in common mental disorders and two out of five RCTs in severe mental illness. Where BI was compared with active comparator groups (such as motivational interviewing or cognitive behavioural therapy), findings were also mixed. Differences in the findings may be partly due to differences in study design, such as the intensity of BI and possibly the risk of bias. Conclusions Overall, the evidence is mixed regarding the effects of alcohol BI in participants with comorbid mental health conditions. Future well-designed research is required to answer this question more definitively.
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Affiliation(s)
- Sadie Boniface
- Addictions Department, Institute of Psychiatry, Psychology & Neuroscience, King's College London, Addiction Sciences Building PO 48, 16 De Crespigny Park, London SE5 8AF, UK
| | - Isabella Malet-Lambert
- Addictions Department, Institute of Psychiatry, Psychology & Neuroscience, King's College London, Addiction Sciences Building PO 48, 16 De Crespigny Park, London SE5 8AF, UK
| | - Rachel Coleman
- Addictions Department, Institute of Psychiatry, Psychology & Neuroscience, King's College London, Addiction Sciences Building PO 48, 16 De Crespigny Park, London SE5 8AF, UK
| | - Paolo Deluca
- Addictions Department, Institute of Psychiatry, Psychology & Neuroscience, King's College London, Addiction Sciences Building PO 48, 16 De Crespigny Park, London SE5 8AF, UK
| | - Kim Donoghue
- Addictions Department, Institute of Psychiatry, Psychology & Neuroscience, King's College London, Addiction Sciences Building PO 48, 16 De Crespigny Park, London SE5 8AF, UK
| | - Colin Drummond
- Addictions Department, Institute of Psychiatry, Psychology & Neuroscience, King's College London, Addiction Sciences Building PO 48, 16 De Crespigny Park, London SE5 8AF, UK.,South London and Maudsley NHS Foundation Trust, Monks Orchard Road, Beckenham BR3 3BX, UK
| | - Zarnie Khadjesari
- Centre for Implementation Science, Health Service and Population Research Department, Centre for Implementation Science, Institute of Psychiatry, Psychology & Neuroscience, King's College London, 16 De Crespigny Park, London SE5 8AF, UK
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Poole N, Schmidt RA, Green C, Hemsing N. Prevention of Fetal Alcohol Spectrum Disorder: Current Canadian Efforts and Analysis of Gaps. SUBSTANCE ABUSE-RESEARCH AND TREATMENT 2016; 10:1-11. [PMID: 27199560 PMCID: PMC4861006 DOI: 10.4137/sart.s34545] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/04/2016] [Revised: 03/13/2016] [Accepted: 03/15/2016] [Indexed: 12/04/2022]
Abstract
Effective prevention of risky alcohol use in pregnancy involves much more than providing information about the risk of potential birth defects and developmental disabilities in children. To categorize the breadth of possible initiatives, Canadian experts have identified a four-part framework for fetal alcohol spectrum disorder (FASD) prevention: Level 1, public awareness and broad health promotion; Level 2, conversations about alcohol with women of childbearing age and their partners; Level 3, specialized support for pregnant women; and Level 4, postpartum support for new mothers. In order to describe the level of services across Canada, 50 Canadian service providers, civil servants, and researchers working in the area of FASD prevention were involved in an online Delphi survey process to create a snapshot of current FASD prevention efforts, identify gaps, and provide ideas on how to close these gaps to improve FASD prevention. Promising Canadian practices and key areas for future action are described. Overall, Canadian FASD prevention programming reflects evidence-based practices; however, there are many opportunities to improve scope and availability of these initiatives.
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Affiliation(s)
- Nancy Poole
- British Columbia Centre of Excellence for Women's Health, Vancouver, BC, Canada
| | - Rose A Schmidt
- British Columbia Centre of Excellence for Women's Health, Vancouver, BC, Canada
| | - Courtney Green
- The Society of Obstetricians and Gynaecologists of Canada, Ottawa, ON, Canada
| | - Natalie Hemsing
- British Columbia Centre of Excellence for Women's Health, Vancouver, BC, Canada
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Geisner IM, Varvil-Weld L, Mittmann AJ, Mallett K, Turrisi R. Brief web-based intervention for college students with comorbid risky alcohol use and depressed mood: does it work and for whom? Addict Behav 2015; 42:36-43. [PMID: 25462652 DOI: 10.1016/j.addbeh.2014.10.030] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2014] [Revised: 08/02/2014] [Accepted: 10/24/2014] [Indexed: 10/24/2022]
Abstract
UNLABELLED College is a time of increased risk for problematic alcohol use and depressed mood. The comorbidity of these conditions is well documented, but is less well understood, with few interventions designed to prevent or reduce the related consequences. The current study evaluated a web-based personalized intervention for students (N=311) who reported an AUDIT score of 8 or more, a BDI-II score of 14 or more, and reported drinking four (women) or five (men) or more drinks on at least one occasion in the past month. METHOD Invited participants were randomly selected from all enrolled undergraduates at a large, public, Pacific Northwestern University. Participants completed a screening and baseline assessment, and those who met study eligibility criteria were randomized to one of four conditions (alcohol only, depressed mood only, integrated, and referral-only control). Follow-up occurred one-month post-intervention. RESULTS While no main effects for the interventions were found, there were moderation effects, such that students in the alcohol only and integrated conditions who had lower levels of depressed mood or alcohol-related problems at baseline showed greater reductions in alcohol-related problems at follow-up compared to students in the control condition. Implications for interventions are discussed.
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12
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Merrill JE, Reid AE, Carey MP, Carey KB. Gender and depression moderate response to brief motivational intervention for alcohol misuse among college students. J Consult Clin Psychol 2014; 82:984-92. [PMID: 24865872 DOI: 10.1037/a0037039] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
OBJECTIVE Brief motivational interventions (BMIs) effectively reduce problematic drinking in college students. However, not all students benefit, and little is known about the subgroups of students for whom BMIs are most effective. In the present study, we examined 2 factors that may influence BMI efficacy: gender and depression. METHOD We reanalyzed data from a clinical trial in which heavy drinking students (N = 330; 65% female) were randomized to a BMI (n = 165) or an assessment only control (n = 165). Depression was assessed at baseline; past-month typical drinks per week, heavy drinking frequency, and consequences were assessed at baseline and 1 month. Three- and 2-way interactions among intervention condition (BMI vs. control), gender (male vs. female), and depression (low vs. high) were tested. RESULTS We observed 3-way interaction effects on 2 outcomes: (a) typical drinks per week and (b) frequency of heavy drinking at 1 month. Relative to controls and adjusting for baseline drinking, low-depression women reduced their drinking more after a BMI whereas high-depression women did not show differential improvement. In contrast, high-depression men showed significant reductions in weekly drinks following the BMI whereas low-depression men did not show differential improvement. In addition, higher levels of depression were associated with higher levels of consequences at follow-up across conditions. CONCLUSIONS BMIs are indicated for heavy drinking, depressed men, consistent with recommendations for implementing screening and brief intervention in mental health settings. However, BMIs may need to be refined to enhance their efficacy for depressed women.
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Affiliation(s)
| | - Allecia E Reid
- Center for Alcohol and Addiction Studies, Brown University
| | - Michael P Carey
- Department of Behavioral and Social Sciences, Brown University
| | - Kate B Carey
- Center for Alcohol and Addiction Studies, Brown University
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