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Kaufman CC, Vujanovic AA, Murphy JG, Rosmarin DH. The association between PTSD symptom clusters and religion/spirituality with alcohol use among first responders. J Psychiatr Res 2024; 176:304-310. [PMID: 38905763 DOI: 10.1016/j.jpsychires.2024.06.015] [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: 12/05/2023] [Revised: 04/23/2024] [Accepted: 06/08/2024] [Indexed: 06/23/2024]
Abstract
Alcohol misuse and posttraumatic stress disorder (PTSD) co-occur at high rates among first responders (e.g., law enforcement, firefighters, paramedics), underscoring the need to better understand these relations to inform intervention efforts. Identifying malleable processes relevant to the association between PTSD and alcohol among first responders could inform tailored interventions. An example of such a malleable process is spirituality. As such, the current study examined the unique relationships between PTSD symptom clusters and alcohol misuse, while also accounting for the role of select demographics and religion/spirituality, in a sample of first responders. A national online sample of first responders (N = 320) completed measures of PTSD symptomology, alcohol misuse, religion/spirituality and demographics. Hierarchical linear regression analyses revealed that PTSD Intrusion (Cluster B) symptom severity was associated with greater alcohol misuse and PTSD Avoidance (Cluster C) was associated with lower alcohol misuse. Additionally, positive and negative spiritual coping were also associated with alcohol misuse. In the context of similar research among military samples, findings suggest potentially unique associations between PTSD symptom clusters and alcohol misuse among first responders. Additionally, findings highlight the potentially protective role of religion/spirituality in this population. Future research should explore nuanced relationships between PTSD symptom clusters and alcohol misuse as well as the salience of spirituality/religion in this unique population.
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Affiliation(s)
- Caroline C Kaufman
- Department of Psychiatry, Harvard Medical School, USA; Spirituality and Mental Health Program, McLean Hospital, USA.
| | - Anka A Vujanovic
- Department of Psychological & Brain Sciences, Texas A&M University, USA
| | | | - David H Rosmarin
- Department of Psychiatry, Harvard Medical School, USA; Spirituality and Mental Health Program, McLean Hospital, USA
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Votaw VR, Van ES, Kuhlemeier A, Tuchman FR, Witkiewitz K. Association Between Religious Salience and Past-Year Substance Use by Sexual Identity and Sex Among Adults in the United States. LGBT Health 2024; 11:326-333. [PMID: 38011329 DOI: 10.1089/lgbt.2023.0080] [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] [Indexed: 11/29/2023] Open
Abstract
Purpose: We examined if associations between religious salience and substance use outcomes differed by sexual identity and sex in a nationally representative sample of adults in the United States. Methods: Using data from the 2019 National Survey on Drug Use and Health (N = 41,216 adults), logistic regression models tested whether sexual identity and sex moderated the associations between religious salience (agreement on the importance of religious beliefs) and past-year alcohol and drug use and use disorders. Results: Religious salience reduced risk of alcohol use disorder, drug use, and drug use disorder for heterosexual, but not lesbian, gay, and bisexual (LGB), individuals. Three-way interactions indicated that religious salience was more protective against alcohol use and drug use and use disorder for bisexual men than bisexual women. Conclusions: Heterosexism common in dominant religious institutions in the United States might hamper the protective effect of religiosity on substance use for LGB individuals.
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Affiliation(s)
- Victoria R Votaw
- Department of Psychology, University of New Mexico, Albuquerque, New Mexico, USA
- Center on Alcohol, Substance use, And Addictions, University of New Mexico, Albuquerque, New Mexico, USA
| | - Ethan S Van
- Department of Psychology, University of New Mexico, Albuquerque, New Mexico, USA
| | - Alena Kuhlemeier
- Center on Alcohol, Substance use, And Addictions, University of New Mexico, Albuquerque, New Mexico, USA
| | - Felicia R Tuchman
- Department of Psychology, University of New Mexico, Albuquerque, New Mexico, USA
| | - Katie Witkiewitz
- Department of Psychology, University of New Mexico, Albuquerque, New Mexico, USA
- Center on Alcohol, Substance use, And Addictions, University of New Mexico, Albuquerque, New Mexico, USA
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Vitorino LM, Tostes JG, Ferreira JCL, de Oliveira LAG, Possetti JG, Silva MT, Guimarães MVC, Alckmin-Carvalho F, Lucchetti G. Association between religiosity/spirituality and substance use among homeless individuals. Int J Soc Psychiatry 2024; 70:330-339. [PMID: 37982408 DOI: 10.1177/00207640231211495] [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: 11/21/2023]
Abstract
BACKGROUND Alcohol and illicit drug use are prevalent among homeless people. Religiosity and spirituality (RS) have been widely associated with lower consumption of substances. However, evidence of this relationship among homeless people is still scarce. AIMS To evaluate the associations between RS and alcohol and illicit drug consumption among homeless people in a large Brazilian urban center. METHOD This cross-sectional study was carried out in São Paulo city, Brazil. Aspects such as spirituality (FACIT-Sp12), religiosity (DUREL), spiritual-religious coping (Brief-RCOPE), and self-report questions concerning the current substance use (alcohol and illicit substances) were evaluated. Adjusted logistic regression models were used to assess the impact of RS beliefs on alcohol and illicit drug consumption. RESULTS A total of 456 homeless people were included, of an average age of 44.5 (SD = 12.6) years. More than half of the participants consumed alcohol (55.7%) weekly and 34.2% used illicit drugs weekly. Adjusted logistic regression models identified that aspects of RS were associated with lower likelihood factors for alcohol and illicit drug use; conversely, negative spiritual religious coping (SRC) strategies were associated with a higher likelihood to use both. CONCLUSION The prevalence of alcohol and illicit drug use among participants was high. RS and positive SRC were important protective factors for lower consumption of these substances. Conversely, negative SRC strategies were associated with risk factors.
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Hassan AN, Agabani Z, Ahmed F, Shapiro B, Le Foll B. The Impact of religiosity/spirituality on slowing the progression of substance use: Based on the National Epidemiological Survey of Alcohol and Related Conditions (NESARC-III). Int J Soc Psychiatry 2023; 69:1399-1408. [PMID: 36951385 DOI: 10.1177/00207640231162819] [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: 03/24/2023]
Abstract
BACKGROUND Religiosity has been suggested to be protective against substance use disorder (SUD) initiation but its impact of the progression of development is not known. AIMS This study investigated the impact of religiosity/spirituality on the development of heavy use and SUD following substance use initiation (alcohol, cannabis, and tobacco) utilizing data from the 2012 to 2013 National Epidemiologic Survey on Alcohol and Related Conditions-III. METHOD Individuals with a known age at onset of substance initiation were included (n = 30,590, n = 11,126, and n = 14,083; for alcohol, cannabis, or tobacco users, respectively). Religiosity was measured by importance of religious/spiritual beliefs and frequency of religious service attendance. The percentage of individuals who progressed to an SUD after substance initiation in each substance was estimated. Discrete-time analysis and survival analysis were used to measure the impact of religiosity on the progression from substance initiation to heavy use and from heavy use to SUD. RESULTS After controlling for various variables, religious services attendance frequency was statistically associated with a slower progression from substance initiation to heavy use for all three substances: tobacco by 8% to 15%, cannabis by 5% to 26%, and alcohol 9% (p ⩽ .01). Religious importance was associated with slower progression to heavy use in cannabis users by 16% to 21% (p ⩽ .02). Religiosity (believes and attendance) was associated with slowed progression from heavy use to SUD development in alcohol users only. CONCLUSIONS The findings illustrate strongest association between attending religious services and lower probabilities of progressing to heavy/daily use after substance use initiation for alcohol, tobacco, and cannabis users. This indicates the potential use of religious services as social support for individuals with risky substance use.
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Affiliation(s)
- Ahmed N Hassan
- Department of Psychiatry, Department of Medicine, King Abdulaziz University, King Abdulaziz University Hospital, Jeddah, Saudi Arabia
- Centre for Addiction and Mental Health, Campbell Family Mental Health Research Institute, Toronto, ON, Canada
- Department of Pharmacology and Toxicology, Faculty of Medicine, University of Toronto, ON, Canada
- Department of Psychiatry, Faculty of Medicine, University of Toronto, ON, Canada
- Institute of Medical Sciences, University of Toronto, ON, Canada
| | - Zena Agabani
- Centre for Addiction and Mental Health, Campbell Family Mental Health Research Institute, Toronto, ON, Canada
- Department of Pharmacology and Toxicology, Faculty of Medicine, University of Toronto, ON, Canada
| | - Fardowsa Ahmed
- Centre for Addiction and Mental Health, Campbell Family Mental Health Research Institute, Toronto, ON, Canada
| | - Benjamin Shapiro
- Department of Psychiatry and Behavioral Neurosciences, Faculty of Health Sciences, McMaster University, Hamilton, Canada
| | - Bernard Le Foll
- Centre for Addiction and Mental Health, Campbell Family Mental Health Research Institute, Toronto, ON, Canada
- Department of Medicine, Faculty of Health Sciences, McMaster University, Hamilton, Canada
- Waypoint Research Institute, Waypoint Centre for Mental Health Care, Penetanguishene, ON, Canada
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Reporting and Interpreting Effect Sizes in Applied Health-Related Settings: The Case of Spirituality and Substance Abuse. Healthcare (Basel) 2022; 11:healthcare11010133. [PMID: 36611592 PMCID: PMC9818974 DOI: 10.3390/healthcare11010133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2022] [Revised: 12/28/2022] [Accepted: 12/28/2022] [Indexed: 01/03/2023] Open
Abstract
Inferential analysis using null hypothesis significance testing (NHST) allows accepting or rejecting a null hypothesis. Nevertheless, rejecting a null hypothesis and concluding there is a statistical effect does not provide a clue as to its practical relevance or magnitude. This process is key to assessing the effect size (ES) of significant results, be it using context (comparing the magnitude of the effect to similar studies or day-to-day effects) or statistical estimators, which also should be sufficiently interpreted. This is especially true in clinical settings, where decision-making affects patients' lives. We carried out a systematic review for the years 2015 to 2020 utilizing Scopus, PubMed, and various ProQuest databases, searching for empirical research articles with inferential results linking spirituality to substance abuse outcomes. Out of the 19 studies selected, 11 (57.9%) reported no ES index, and 9 (47.4%) reported no interpretation of the magnitude or relevance of their findings. The results of this review, although limited to the area of substance abuse and spiritual interventions, are a cautionary tale for other research topics. Gauging and interpreting effect sizes contributes to a better understanding of the subject under scrutiny in any discipline.
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Dachew BA, Bifftu BB, Tiruneh BT, Anlay DZ, Wassie MA. Prevalence of mental distress and associated factors among university students in Ethiopia: a meta-analysis. J Ment Health 2022; 31:851-858. [PMID: 31250685 DOI: 10.1080/09638237.2019.1630717] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
BACKGROUND Mental distress is an important public health problem and is becoming common health problems among university students. AIMS This study aimed to provide a pooled prevalence of mental distress and associated factors among university students in Ethiopia. METHOD We systematically searched PubMed, EMBASE and PsycINFO databases. A further search was performed at Google Scholar search engine for additional studies. All observational studies reporting the prevalence of mental distress and/or associated factors among university students in Ethiopia were included. Pooled prevalence with 95% confidence interval (95% CI) were calculated using random effects and quality effects models. Subgroup and sensitivity analyses were performed. Heterogeneity between studies and evidence of publication bias were assessed. RESULTS The pooled prevalence of mental distress was 35% (95% CI; 28%-43%). Being female, participating in religious programmes, having close friends, experiencing financial distress, alcohol use, khat use, conflict with friends, lack of interest in their field of study and a family history of mental illness were factors associated with mental distress among students. We found significant heterogeneity, but no evidence of publication bias. CONCLUSIONS More than one third of university students in Ethiopia have suffered with mental distress. The finding provides evidence that university students are at risk population for mental health problems and suggests the need for early intervention to prevent severe mental illness.
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Affiliation(s)
- Berihun Assefa Dachew
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Brhanu Boru Bifftu
- School of Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Bewket Tadesse Tiruneh
- School of Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Degefaye Zelalem Anlay
- School of Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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Davis CN, O’Neill SE. Treatment of Alcohol Use Problems Among Rural Populations: a Review of Barriers and Considerations for Increasing Access to Quality Care. CURRENT ADDICTION REPORTS 2022; 9:432-444. [DOI: 10.1007/s40429-022-00454-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/30/2022] [Indexed: 11/25/2022]
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Seesink HJ, Schaap-Jonker H, Ostafin B, Lokman JC, Wiers RW. Protocol for an RCT on cognitive bias modification for alcohol use disorders in a religion-based rehabilitation program. BMJ Open 2022; 12:e060820. [PMID: 36130749 PMCID: PMC9494557 DOI: 10.1136/bmjopen-2022-060820] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
INTRODUCTION Alcohol-related cues trigger relapse in patients with alcohol use disorders (AUDs). These cues may automatically activate motivational approach tendencies. Through computerised cognitive bias modification (CBM), the tendencies of patients with AUD to approach alcohol can be reduced. The present protocol describes a training intervention with approach bias modification (ApBM) incorporating religion-related stimuli as an alternative to alcohol to improve the effectiveness of CBM in a religion-based rehabilitation centre. AUD is often related to patients' religious attitudes in this treatment context. The religion-adapted ApBM, therefore, combines training in avoidance of alcohol-related motivational cues and an approach to religion-based motivational cues. This combination's effectiveness will be compared with a standard ApBM and to a sham ApBM. METHODS AND ANALYSIS Using a double-blind multiarm parallel randomised controlled trial procedure (ratio 1:1:1), 120 patients with AUD will be randomised into 1 of 3 conditions (religion-adapted ApBM, standard ApBM or sham ApBM) with personalised stimuli. The interventions are delivered over 4 consecutive days during an inpatient detoxification programme in addition to treatment as usual. Assessments occur before the start of the training and after the fourth training session, with follow-up assessments after 1 and 4 months. A multivariate analysis of variance will be used with the primary outcomes, the percentage of days abstinent and meaning in life 4-month follow-up. Secondary outcomes include differences in reported training satisfaction and symptoms of AUD. ETHICS AND DISSEMINATION This study has been reviewed and approved by the Medical Research Ethics Committee Academic Medical Center Amsterdam (Reference number: 2020_251). Further, study results will be published in peer-reviewed journals and presented at international conferences. TRIAL REGISTRATION NUMBER NL75499.018.20.
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Affiliation(s)
- Henk-Jan Seesink
- Department of Research, De Hoop ggz, Dordrecht, The Netherlands
- Department of Psychology, University of Amsterdam, Amsterdam, The Netherlands
- Centre for Research and Innovation in Christian Mental Health Care, Eleos/De Hoop, Hoevelaken, The Netherlands
| | - Hanneke Schaap-Jonker
- Centre for Research and Innovation in Christian Mental Health Care, Eleos/De Hoop, Hoevelaken, The Netherlands
- Department of Religion and Theology, Faculteit der Geesteswetenschappen, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Brian Ostafin
- Experimental and Clinical Psychology, Department of Psychology, Rijksuniversiteit Groningen Faculteit Gedrags en Maatschappijwetenschappen, Groningen, The Netherlands
| | - John C Lokman
- Department of Psychiatry, Amsterdam UMC - University Medical Centers, Amsterdam, The Netherlands
| | - Reinout W Wiers
- Department of Psychology, University of Amsterdam, Amsterdam, The Netherlands
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Seesink HJ, Klokkenburg P, Schaap-Jonker H, Ostafin BD, Wiers RW. Without Your Therapist: Contemplative Prayer During Treatment as a Religious Exposure Intervention to Reduce Religious Struggle and Anxious God Representation. Clin Case Stud 2022. [DOI: 10.1177/15346501221082231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
This case study focuses on the treatment of a 44-year-old Dutch man presenting with an anxious God representation and religious struggles according to DSM-5 criteria. Having received prior treatment for a panic disorder and alcohol use disorder, the patient was given a 60-day treatment in which the Jesus Prayer intervention was used to address his religious and spiritual problems. To our knowledge, this is the first case study involving the Jesus Prayer in the treatment of a patient. The intervention had positive effects on the patient’s religious and spiritual problems concerning an anxious God representation, religious struggles, stress levels and surrender to God. The intervention may also play a supporting role in decreasing symptoms of depression and anxiety and in promoting global mental health, as reliable change index analyses revealed symptom reduction between baseline levels and at post-assessment levels for all measured symptoms, with a semi-gradual decrease over the course of treatment. These improvements were continued in a 3-month follow-up assessment, suggesting promise for the Jesus Prayer as an effective treatment method for religious and spiritual problems. Recommendations regarding the importance of assessing the religious life of patients and implementing spiritual interventions are discussed, as well as the relevance of the therapist’s own assumptions when treating a religious or spiritual problem.
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Affiliation(s)
- Henk-Jan Seesink
- De Hoop ggz, Dordrecht, The Netherlands
- Department of Psychology, University of Amsterdam, Amsterdam, The Netherlands
- Centre for Research and Innovation in Christian Mental Health Care, Hoevelaken, the Netherlands
| | | | - Hanneke Schaap-Jonker
- Centre for Research and Innovation in Christian Mental Health Care, Hoevelaken, the Netherlands
- Department of Religion and Theology, Vrije Universiteit, Amsterdam, The Netherlands
| | - Brian D. Ostafin
- Experimental and Clinical Psychology, Department of Psychology, University of Groningen, Groningen, The Netherlands
| | - Reinout W. Wiers
- Department of Psychology, University of Amsterdam, Amsterdam, The Netherlands
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Wahab S, Chun Keat T, Azmi AD, Mahadevan R, Muhamed Ramli ER, Kian Boon L. Risk of Depression Among MMT Patients: Does Coping Strategies and Perceived Social Support Play a Role? Subst Abuse 2021; 15:11782218211049407. [PMID: 34658621 PMCID: PMC8516374 DOI: 10.1177/11782218211049407] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Accepted: 08/31/2021] [Indexed: 02/01/2023]
Abstract
INTRODUCTION Patients receiving methadone maintenance therapy (MMT) experience higher level of stress and are at greater risk of developing mental health problems such as depression which could potentially affect both quality of life and treatment outcomes. This cross-sectional study is aimed at understanding the relationship between psychosocial factors such as social support, coping, and depression among patients receiving MMT in a Malaysian Hospital. METHODS One hundred and ninety-six patients attending MMT program were recruited. The Patient Health Questionnaire-9 (PHQ-9) was used to screen for depression, Multidimensional Scale of Perceived Social Support (MSPSS) was used to assess participants' perceived social support, and the Brief COPE questionnaire was used to assess coping strategies. The diagnosis of depression was made using Mini-International Neuropsychiatric Interview (MINI). RESULTS About 13.8% of our sample were diagnosed with depression. From our analysis, it was found that having higher levels of perceived social support (OR = 0.462, 95% CI 0.238-0.899, P < .05), the use of active and emotion focused coping mechanism (OR = 0.231, 95% CI 0.095-0.565, P < .005), and support seeking and self-distraction coping mechanism (OR = 0.196, 95% CI 0.074-0.521, P < .001) was associated with lower likelihood of depression. On the contrary, the use of dysfunctional coping strategies such as denial, behavioral disengagement, and self-blame was associated with increased likelihood of depression (OR = 9.384, 95% CI 3.081-28.581, P < .001). CONCLUSION Active and emotion focused along with support and self-distraction coping strategies, and higher levels of perceived social support may serve as a buffer against depression in patients receiving MMT.
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Affiliation(s)
- Suzaily Wahab
- Department of Psychiatry, Universiti Kebangsaan Malaysia Medical Centre, Wilayah Persekutuan Kuala Lumpur, Malaysia
| | - Tee Chun Keat
- Department of Psychiatry, Hospital Tengku Ampuan Afzan, Kuantan, Pahang, Malaysia
| | - Amirul Danial Azmi
- Department of Psychiatry, Universiti Kebangsaan Malaysia Medical Centre, Wilayah Persekutuan Kuala Lumpur, Malaysia
| | - Raynuha Mahadevan
- Department of Psychiatry, Universiti Kebangsaan Malaysia Medical Centre, Wilayah Persekutuan Kuala Lumpur, Malaysia
| | | | - Law Kian Boon
- Institute for Clinical Research, Ministry of Health, Shah Alam, Selangor, Malaysia
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Livne O, Wengrower T, Feingold D, Shmulewitz D, Hasin DS, Lev-Ran S. Religiosity and substance use in U.S. adults: Findings from a large-scale national survey. Drug Alcohol Depend 2021; 225:108796. [PMID: 34119881 PMCID: PMC8918021 DOI: 10.1016/j.drugalcdep.2021.108796] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2020] [Revised: 03/15/2021] [Accepted: 03/16/2021] [Indexed: 01/21/2023]
Abstract
BACKGROUND In recent decades, the US religious landscape has undergone considerable change such as a decline in religious service attendance. These changes may indicate that religious social support structures have deteriorated, possibly leading to a decrease in strengths of associations with substance use. Considering this, and given limitations of past studies (e.g., limited control for potential confounders), large-scale general population studies are needed to reexamine associations between religiosity domains and substance use. METHODS This cross-sectional study used data from the 2012-2013 National Epidemiologic Survey on Alcohol and Related Conditions-III (N = 36,309). In unadjusted and adjusted models, controlling for religiosity domains and other covariates, we examined associations between three religiosity domains (importance of religiosity/spirituality, service attendance, and religious affiliation) and DSM-5 SUD. Focusing on service attendance, we also examined associations with other substance use-related outcomes. RESULTS Among religiosity domains, only frequency of service attendance was associated with SUD across most substances. Frequent service attendees had lower odds of alcohol use disorder (adjusted OR [aOR] = 0.4, 95 % CI 0.33,0.51), tobacco use disorder (aOR = 0.3, 95 % CI 0.22,0.33) and cannabis use disorder (aOR = 0.4, 95 % CI 0.24,0.68), compared to non-service attendees. For alcohol and tobacco, the protective effect of frequent service attendance was more robust for SUD than for respective substance use. CONCLUSIONS Despite decreasing rates of religious belief and practice in the US, service attendance independently lowered the odds of substance use and SUD across multiple substances. Results may inform religious leaders and clinicians about the value of utilizing religious social support structures in the prevention and treatment of substance use and SUD.
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Affiliation(s)
- Ofir Livne
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA.
| | - Tovia Wengrower
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | | | - Dvora Shmulewitz
- New York State Psychiatric Institute, New York, NY, USA,Department of Psychiatry, Columbia University Medical Center, New York, NY, USA
| | - Deborah S. Hasin
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA,New York State Psychiatric Institute, New York, NY, USA,Department of Psychiatry, Columbia University Medical Center, New York, NY, USA
| | - Shaul Lev-Ran
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel,Lev Hasharon Medical Center, Netanya, Israel
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Charzyńska E. The Effect of Baseline Patterns of Spiritual Coping, Forgiveness, and Gratitude on the Completion of an Alcohol Addiction Treatment Program. JOURNAL OF RELIGION AND HEALTH 2021; 60:1796-1817. [PMID: 33515388 PMCID: PMC8137607 DOI: 10.1007/s10943-021-01188-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 01/16/2021] [Indexed: 05/09/2023]
Abstract
The purpose of this study was to identify distinct profiles of persons beginning alcohol addiction therapy with similar baseline configurations of spiritual coping, forgiveness, and gratitude. The associations between latent profile membership and the completion of therapy were also examined. The sample was composed of 358 alcohol-dependent persons receiving an outpatient treatment program. The Spiritual Coping Questionnaire, the Forgiveness Scale, and the Gratitude Questionnaire were used to assess the baseline levels of spirituality-related variables. Using latent profile analysis, five profiles were identified: (1) both moderately positive and negative dimensions of spirituality (33.2%), (2) moderately positive dimensions of spirituality (21.0%), (3) predominantly negative dimensions of spirituality (20.2%), (4) mixed dimensions of spirituality with the lowest positive religious coping (14.0%), and (5) highly positive dimensions of spirituality (11.6%). Notably, the latent profiles differed in terms of the treatment completion rates. The results suggest the need to carry out a multidimensional assessment of spiritual functioning of persons beginning alcohol addiction therapy to provide treatment that is adjusted to patients' spiritual potential and deficits.
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Affiliation(s)
- Edyta Charzyńska
- Faculty of Social Sciences, University of Silesia in Katowice, ul. Grażyńskiego 53, 40-126, Katowice, Poland.
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Dezfulian C, Orkin AM, Maron BA, Elmer J, Girotra S, Gladwin MT, Merchant RM, Panchal AR, Perman SM, Starks MA, van Diepen S, Lavonas EJ. Opioid-Associated Out-of-Hospital Cardiac Arrest: Distinctive Clinical Features and Implications for Health Care and Public Responses: A Scientific Statement From the American Heart Association. Circulation 2021; 143:e836-e870. [PMID: 33682423 DOI: 10.1161/cir.0000000000000958] [Citation(s) in RCA: 56] [Impact Index Per Article: 18.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Opioid overdose is the leading cause of death for Americans 25 to 64 years of age, and opioid use disorder affects >2 million Americans. The epidemiology of opioid-associated out-of-hospital cardiac arrest in the United States is changing rapidly, with exponential increases in death resulting from synthetic opioids and linear increases in heroin deaths more than offsetting modest reductions in deaths from prescription opioids. The pathophysiology of polysubstance toxidromes involving opioids, asphyxial death, and prolonged hypoxemia leading to global ischemia (cardiac arrest) differs from that of sudden cardiac arrest. People who use opioids may also develop bacteremia, central nervous system vasculitis and leukoencephalopathy, torsades de pointes, pulmonary vasculopathy, and pulmonary edema. Emergency management of opioid poisoning requires recognition by the lay public or emergency dispatchers, prompt emergency response, and effective ventilation coupled to compressions in the setting of opioid-associated out-of-hospital cardiac arrest. Effective ventilation is challenging to teach, whereas naloxone, an opioid antagonist, can be administered by emergency medical personnel, trained laypeople, and the general public with dispatcher instruction to prevent cardiac arrest. Opioid education and naloxone distributions programs have been developed to teach people who are likely to encounter a person with opioid poisoning how to administer naloxone, deliver high-quality compressions, and perform rescue breathing. Current American Heart Association recommendations call for laypeople and others who cannot reliably establish the presence of a pulse to initiate cardiopulmonary resuscitation in any individual who is unconscious and not breathing normally; if opioid overdose is suspected, naloxone should also be administered. Secondary prevention, including counseling, opioid overdose education with take-home naloxone, and medication for opioid use disorder, is important to prevent recurrent opioid overdose.
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Abstract
Substance use disorders (SUDs) are chronic health disorders with exacerbation rates of approximately 50%. Spirituality has been identified as a factor that can improve recovery rates. Various definitions of spirituality exist that include concepts of finding meaning and connection in life and contact with the divine or something larger than ourselves. Patients generally want to include spirituality as part of their health care but barriers often exist for health care providers to address it, including lack of confidence, knowledge, and organizational support, and time constraints. Nursing programs lack content related to spirituality and should increase course content on this subject to improve comfort levels and competencies of nurses. Keeping in mind professional boundaries and respecting patients' individual differences, nurses have the potential to help patients in their recovery journey by facilitating discussion and growth in spirituality. Nurses can also advocate for their patients by including spiritual leaders in integrated health care teams. [Journal of Psychosocial Nursing and Mental Health Services, 58(9), 14-17.].
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Boroumandfar Z, Kianpour M, Afshari M. Ups and downs of drug rehab among women: a qualitative study. BMC WOMENS HEALTH 2020; 20:77. [PMID: 32321495 PMCID: PMC7178936 DOI: 10.1186/s12905-020-00946-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/15/2019] [Accepted: 04/12/2020] [Indexed: 02/03/2023]
Abstract
Background According to recent studies, the number of women drug users is dramatically increasing. However, the information on the issue of drug rehab in women is not sufficient, and there are numerous traditional, organizational, political and cultural barriers to the provision of relevant information in this regard in Iran. This study, thus, aimed to explain the factors influencing the decision of these women to stop drug use. Methods This qualitative study was conducted in two rehab camps of Isfahan (in Iran) on July to October 2017. Thirty participants (women drug users) were selected through purposive and theoretical sampling until data saturation was reached. Data collection was conducted through semi-structured interviews. The transcribed interviews were analyzed using conventional content analysis. Results Based on the analysis of the obtained results, the women’s experience of the ups and downs of stopping drug use yielded two themes and nine sub-themes. The themes were “the need for emancipation (the deviated path, being abused, compulsive drug use, acquaintance with God, a supportive family)” and “Sinking factors (non-assisting mates, pro-addictive family, unawareness of assisting official organization and non-government organization, woman’s lack of authority, ineffective opportunities)”. Conclusions It was concluded that addiction rehab strategies can lead to a brighter life for women drug users only when they are coupled with open-hearted assistance of the families and women specific rehab centers are established to help them meet their specific needs.
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Affiliation(s)
- Zahra Boroumandfar
- Midwifery & reproductive health department, Nursing and Midwifery Care Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.
| | - Masoud Kianpour
- Department of Social Sciences, University of Isfahan, Isfahan, Iran
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Kelly JF, Eddie D. THE ROLE OF SPIRITUALITY AND RELIGIOUSNESS IN AIDING RECOVERY FROM ALCOHOL AND OTHER DRUG PROBLEMS: AN INVESTIGATION IN A NATIONAL U.S. SAMPLE. PSYCHOLOGY OF RELIGION AND SPIRITUALITY 2020; 12:116-123. [PMID: 33767804 PMCID: PMC7989793 DOI: 10.1037/rel0000295] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/15/2023]
Abstract
BACKGROUND More Americans than ever before are identifying as "spiritual but not religious". Both spirituality and religiousness (S/R) are of interest in the addiction field as they are related to alcohol and other drug (AOD) problems and are central to some recovery pathways. Yet, little is known overall about S/R identification among people in recovery, the role these play in aiding recovery, and whether they play more or less of a role for certain sub-groups (e.g., men/women, different races/ethnicities; those with treatment or 12-step histories). METHOD Nationally representative cross-sectional sample of US adults (N=39,809) screening positive to the question, "Did you use to have a problem with alcohol or drugs but no longer do?" (final weighted sample n= 2,002). Weighted Chi-Square and Poisson-distributed generalized linear mixed models tested for differences in S/R and for differences across subgroups on extent of: 1) religious, and, 2) spiritual, identification, and the extent to which these had aided recovery. RESULTS Participants reported being mostly moderately spiritual and religious, and that, overall, religion had not helped them overcome their AOD problem. In contrast, spirituality was reported as either not helping at all, or having made all the difference. Substantial differences were observed by race-ethnicity across both spirituality and religiousness, and to a lesser degree between men and women. Black Americans reported substantially more S/R than Whites and that these often made all the difference in their recovery. The exact opposite trend was observed for White and Hispanic Americans. Prior professional treatment and 12-step mutual-aid use were both related to greater spirituality, but not religiousness. CONCLUSION Overall, spirituality but not religion, appears to play a role in aiding recovery particularly among those with prior treatment or 12-step histories, but women and men, and racial-ethnic groups in particular, differ strikingly in their religious and spiritual identification and the role these have played in aiding recovery. These differences raise the question of the potential clinical utility of S/R in personalized treatment.
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Affiliation(s)
- John F Kelly
- Recovery Research Institute, Massachusetts General Hospital and Harvard Medical School, 151 Merrimac Street, 6 Floor, Boston, MA 02114
| | - David Eddie
- Recovery Research Institute, Massachusetts General Hospital and Harvard Medical School, 151 Merrimac Street, 6 Floor, Boston, MA 02114
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Grim BJ, Grim ME. Belief, Behavior, and Belonging: How Faith is Indispensable in Preventing and Recovering from Substance Abuse. JOURNAL OF RELIGION AND HEALTH 2019; 58:1713-1750. [PMID: 31359242 PMCID: PMC6759672 DOI: 10.1007/s10943-019-00876-w] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/16/2023]
Abstract
This study reviews the voluminous empirical evidence on faith's contribution to preventing people from falling victim to substance abuse and helping them recover from it. We find that 73% of addiction treatment programs in the USA include a spirituality-based element, as embodied in the 12-step programs and fellowships initially popularized by Alcoholics Anonymous, the vast majority of which emphasize reliance on God or a Higher Power to stay sober. We introduce and flesh out a typology of faith-based substance abuse treatment facilities, recovery programs, and support groups. This typology provides important background as we then move on to make an economic valuation of nearly 130,000 congregation-based substance abuse recovery support programs in the USA. We find that these faith-based volunteer support groups contribute up to $316.6 billion in savings to the US economy every year at no cost to tax payers. While negative experiences with religion (e.g., clergy sex abuse and other horrendous examples) have been a contributory factor to substance abuse among some victims, given that more than 84% of scientific studies show that faith is a positive factor in addiction prevention or recovery and a risk in less than 2% of the studies reviewed, we conclude that the value of faith-oriented approaches to substance abuse prevention and recovery is indisputable. And, by extension, we also conclude that the decline in religious affiliation in the USA is not only a concern for religious organizations but constitutes a national health concern.
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Affiliation(s)
- Brian J. Grim
- Institute for Studies of Religion, Baylor University, One Bear Place #97236, Waco, TX 76798 USA
| | - Melissa E. Grim
- Religious Freedom & Business Foundation, 1A Perry Circle, Annapolis, MD 21402 USA
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