Self-efficacy and substance abuse: assessment using a brief phone interview

Social support and depressive symptoms: exploring stigma and self-efficacy in a moderated mediation model

BACKGROUND

Although some psychological processes, such as stigma and self-efficacy, affect the complicated relationship between social support and depressive symptoms, few studies explored a similar psychological mechanism among individuals with substance use disorders (SUDs). Hence, this research investigates the mediating effects of stigma and the moderating effects of self-efficacy among the psychological mechanism that social support affects depressive symptoms.

METHODS

The study included 1040 Chinese participants with SUDs and completed a series of self-report questionnaires. R software was used to organize and clean up data sets and analyze mediation and moderation effects.

RESULTS

The result showed that stigma partially mediated depressive symptoms, while self-efficacy moderated this relationship. More specifically, less social support increased depression symptoms by bringing about higher stigma. Besides, subjects with higher self-efficacy are less susceptible to stigma and therefore have mild depressive symptoms. Furthermore, clinical and theoretical implications are discussed in our study.

CONCLUSIONS

Chinese SUDs patients' depressive symptoms were indirectly affected by perceived social support via stigma and less affected by stigma with improved self-efficacy. The theoretical and practical implications of these results are discussed.

The Roles of Attachment Style, Self-Efficacy, and Impulsivity on the Prediction of Attitudes toward Substance Use in Male Adolescents

The aim of this study was to examine the role of attachment styles, self-efficacy, and impulsivity on the prediction of attitudes toward substance abuse among male adolescents. Participants were 199 male adolescents from Najafabad City, Isfahan province, Iran. A demographic questionnaire, the Attachment Style Measure (ASM), the General Self-Efficacy Scale (GSES), the Barratt Impulsiveness Scale (BIS), and the Attitude toward Substance Use Scale (ASUS) were used in this study. Analysis showed that avoidance and ambivalent attachment patterns and impulsiveness were significantly positively correlated with attitudes toward substance use. On the other hand, secure attachment style and self-efficacy were significantly negatively associated with attitudes toward substance use. Findings showed that attachment styles, self-efficacy, and impulsiveness account for 58% of the variance in attitudes toward substance use among these adolescents. This study confirmed the predictive role of attachment styles, self-efficacy, and impulsivity in the prediction of the attitudes toward substance use in male adolescents.

Associations between insecurity and stress among Chinese university students: The mediating effects of hope and self-efficacy

BACKGROUND

In the context of the pandemic, exploration on the association between insecurity and stress among university students is limited. The current study aims to investigate the parallel mediation role of hope and self-efficacy in the relationship between insecurity and stress among university students during the COVID-19 pandemic.

METHODS

We employed a cross-sectional research design in a university by distributing questionnaires online. 5286 participants were recruited (mean age = 19.65; SD = 1.13). Items were from the Security Questionnaire, Depression Anxiety and Stress Scale-21, and the Positive Psychology Capital (Psycap) Questionnaire (PPQ). Parallel mediation analysis was performed using PROCESS macro in SPSS.

RESULTS

The results indicate that insecurity predicted students' stress positively and that students with high-level perceived insecurity are more likely to perceive stress. Moreover, hope and self-efficacy mediated the relationship between insecurity and stress, indicating that hope and self-efficacy could buffer the negative effects of insecurity on stress.

LIMITATIONS

This study examines the mediating model between insecurity and stress among Chinese university students. The generalizability of the findings in other regions remains to be explored. Additionally, the roles of other positive self-beliefs including optimism and resilience in relieving stress can be further explored in future research.

CONCLUSIONS

This research provides direct evidence of insecurity effects on stress among university students, enriching relevant theories in the field of stress. Moreover, this research suggests that enhancing positive self-beliefs such as hope, and self-efficacy helps to relieve students' stress during COVID-19.

Prognostic Value of Motor Timing in Treatment Outcome in Patients With Alcohol- and/or Cocaine Use Disorder in a Rehabilitation Program

Introduction: Individuals with Substance Use Disorder (SUD) often have cognitive deficits in multiple domains, including motor timing deficits, with recovery times of up to 1 year. Cognitive deficits influence treatment outcomes and abstinence. To our knowledge, timing deficits have not been investigated with regard to treatment outcome and relapse. Methods: This prospective study tested the prognostic value of motor timing in SUD with regard to treatment outcome. The study sample consisted of 74 abstinent in-patients at a private treatment programme for drug/alcohol dependence at the Momentum Mental Healthcare clinic in Somerset West, South Africa, diagnosed with alcohol and/or cocaine dependence. Participants were tested at three points: (i) Within 72 hours of the start of the treatment programme (ii) after completion of the treatment programme at 8 weeks (measure of treatment response) through filling out self-report questionnaires and experimental motor task testing, and (iii) a third visit followed through a telephonic interview at 12-months (measure of relapse). Results: Motor timing alone predicted 27 percent of the variance in alcohol self-efficacy score change, and 25 percent variance in cocaine self-efficacy change scores at treatment completion. Specifically, spatial errors, synchronization errors and inter- response interval errors of a spatial tapping task at baseline predicted self-efficacy in alcohol self-efficacy. Cocaine self-efficacy was predicted by spatial errors and contact times of a spatial tapping task at very high tempi (300 ms) only. The high rate of dropout at 12 months post-treatment did not allow for further analysis of the prognostic value of motor timing on relapse. Conclusions: The results of this investigation show us that motor timing holds prognostic value with regard to treatment outcomes. Motor timing predictors for relapse require further investigation going forward.

Characteristics of Cannabis-Only and Other Drug Users Who Visit the Emergency Department

Emergency department (ED) settings have gained interest as venues for illegal drug misuse prevention and intervention, with researchers and practitioners attempting to capitalize on the intersection of need and opportunity within these settings. This study of 686 adult patients visiting two EDs for various reasons who admitted drug use compared daily cannabis-only users, nondaily cannabis-only users, and other drug users on sociodemographic and drug-related severity outcomes. The three drug use groups did not differ on most sociodemographic factors or medical problem severity scores. Forty-five percent of the sample was identified as having a drug use problem. ED patients who used drugs other than cannabis were at particular risk for high drug use severity indicators and concomitant problems such as psychiatric problems and alcohol use severity. However, 19-29% of cannabis-only users were identified as having problematic drug use. Furthermore, daily cannabis-only users fared less well than nondaily cannabis users with regard to drug use severity indicators and self-efficacy for avoiding drug use. Results may assist emergency medicine providers and medical social workers in matching patients to appropriate intervention. For example, users of drugs other than cannabis (and perhaps heavy, daily cannabis-only users) may need referral to specialty services for further assessment. Enhancement of motivation and self-efficacy beliefs could be an important target of prevention and treatment for cannabis-only users screened in the ED.

Randomized clinical trial of the effects of screening and brief intervention for illicit drug use: the Life Shift/Shift Gears study

Background

Although screening, brief intervention, and referral to treatment (SBIRT) has shown promise for alcohol use, relatively little is known about its effectiveness for adult illicit drug use. This randomized controlled trial assessed the effectiveness of the SBIRT approach for outcomes related to drug use among patients visiting trauma and emergency departments (EDs) at two large, urban hospitals.

Methods

A total of 700 ED patients who admitted using illegal drugs in the past 30 days were recruited, consented, provided baseline measures of substance use and related problems measured with the Addiction Severity Index-Lite (ASI-Lite), and then randomized to the Life Shift SBIRT intervention or to an attention-placebo control group focusing on driving and traffic safety (Shift Gears). Both groups received a level of motivational intervention matched to their condition and risk level by trained paraprofessional health educators. Separate measurement technicians conducted face-to-face follow-ups at 6 months post-intervention and collected hair samples to confirm reports of abstinence from drug use. The primary outcome measure of the study was past 30-day drug abstinence at 6 months post-intervention, as self-reported on the ASI-Lite.

Results

Of 700 participants, 292 (42%) completed follow-up. There were no significant differences in self-reported abstinence (12.5% vs. 12.0% , p = 0.88) for Life Shift and Shift Gears groups, respectively. When results of hair analyses were applied, the abstinence rate was 7 percent for Life Shift and 2 percent for Shift Gears (p = .074). In an analysis in which results were imputed (n = 694), there was no significant difference in the ASI-Lite drug use composite scores (Life Shift +0.005 vs. Shift Gears +0.017, p = 0.12).

Conclusions

In this randomized controlled trial, there was no evidence of effectiveness of SBIRT on the primary drug use outcome.

Trial registration

ClinicalTrials.gov NCT01683227.

Self-efficacy for cocaine abstinence: pretreatment correlates and relationship to outcomes

Little research has been conducted on the relationship of self-efficacy at treatment entry to individual differences or to treatment outcome for patients with cocaine dependence. Those relationships were examined in 163 cocaine-dependent patients in a residential treatment program using two measures of self-efficacy administered in the first week of treatment: beliefs about success in quitting in general and confidence about not using in 11 cocaine-specific high-risk situations. The most robust correlates of self-efficacy were greater desire to stop using and lower urge to use in high-risk situations. Age, depressive symptoms, cognitive functioning, recent substance use, and past success with quitting also correlated with self-efficacy. Both measures of self-efficacy predicted quantity and frequency of cocaine use and abstinence at 3 but not 6 months after treatment after controlling pretreatment cocaine use. Results suggest that treatments should target self-efficacy in cocaine-dependent patients.

Screening, assessment, and management of depression in VA primary care clinics. The Behavioral Health Laboratory

OBJECTIVES

The purpose of this project was to assess the utility and feasibility of a telephone-based systematic clinical assessment service, the Behavioral Health Laboratory (BHL), in the context of primary care. The BHL is a clinical service that provides primary care providers with an assessment and a summary of mental health and substance abuse (MH/SA) symptoms and provides treatment decision support, including triage to specialty MH/SA services. The BHL was implemented to assist in the evaluation of patients who screened positively for depression at an annual clinical appointment or who were identified through routine care.

METHODS

Results from systematic screening of primary care patients were extracted during a period of 6 months prior to implementation of the BHL and after implementation of the BHL. Descriptive results of the 580 evaluations conducted during this time were available.

RESULTS

Results suggest an association between the implementation of the BHL and an increase in the proportion of patients screened for depression in primary care. In addition, there was an increase in the proportion of patients who screened positively (2.8% vs 7.0%). The BHL was successful in providing a comprehensive assessment for 78% of those referred. Significant co-occurring mental illness and substance misuse were found among those assessed.

CONCLUSIONS

Introducing the BHL into primary care was associated with an apparent change in clinical practice in primary care at the Philadelphia VA Medical Center. Not only were more patients identified, the broad-based approach of the BHL identified significant comorbidity with alcohol misuse, illicit drugs, and suicidal ideation, symptoms likely to have been missed in routine clinical practice. The BHL offers a practical, low-cost method of assessment, monitoring, and treatment planning for patients identified in primary care with MH/SA needs.

Adolescents' smoking behavior and its relationships with psychological constructs based on transtheoretical model: a cross-sectional survey

BACKGROUND

Korean adolescents' smoking is currently being considered as a crucial factor determining the health status of adolescents and an important public health and social issue.

OBJECTIVES

The purpose of the study was to test the applicability of the Transtheoretical model to gain an understanding of smoking behavior change.

METHODS

A total of 706 adolescents who participated in the smoking cessation programs administered by the Korea Quit Smoking Association or Korean Association of Smoking & Health in 2003 were recruited. Four Korean-version questionnaires were used to identify the stages of smoking behavior and psychological attributes: Stage of Smoking Behavior Change Scale, Processes of Change Scale for Smoking, Decision Balance Scale for Smoking, and Self-efficacy Scale to avoid smoking.

RESULTS

Korean adolescents' smoking behavior was differed according to gender. In addition, the findings revealed that behavioral and cognitive processes of change, self-efficacy, and positives differed across the stages of smoking behavior, and that psychological constructs of the transtheoretical model had a statistically significant impact on smoking behavior change.

CONCLUSIONS

This research could spawn the development of theory-based and empirically supported smoking cessation intervention strategies and programs directed toward adolescents in the health care and nursing areas.

Examining interrelationships between abstinence and coping self-efficacy in cocaine-dependent outpatients

Initial abstinence and self-efficacy predict treatment outcome in cocaine-dependent outpatients. Associations between abstinence and coping self-efficacy were examined among cocaine-dependent outpatients (N=126). Abstinence was verified by urinalysis. Coping self-efficacy was measured using a modified Situational Confidence Questionnaire (SCQ). The modified SCQ had good validity and reliability, and scores increased during treatment. In bivariate analyses, early abstinence and SCQ scores each predicted subsequent abstinence and confidence during treatment and posttreatment follow-up. Based on structural equation modeling, early confidence was a significant predictor of later confidence but not of later abstinence, whereas early abstinence was a significant predictor of later abstinence and confidence. Results suggest a unidirectional relationship wherein prior abstinence predicts subsequent abstinence and confidence.