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Mavragani A, Wielgosz J, Hallenbeck HW, Chang A, Rosen C, Owen J, Kuhn E. The PTSD Family Coach App in Veteran Family Members: Pilot Randomized Controlled Trial. JMIR Form Res 2023; 7:e42053. [PMID: 36602852 PMCID: PMC9893731 DOI: 10.2196/42053] [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: 08/19/2022] [Revised: 10/10/2022] [Accepted: 11/03/2022] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND Posttraumatic stress disorder (PTSD) among US military veterans can adversely impact their concerned significant others (CSOs; eg, family members and romantic partners). Mobile apps can be tailored to support CSO mental health through psychoeducation, coping skills, and stress monitoring. OBJECTIVE This study assessed the feasibility, acceptability, and potential efficacy of PTSD Family Coach 1.0, a free, publicly available app that includes psychoeducation, stress management tools, self-assessments, and features for connecting to alternative supports, compared with a psychoeducation-only version of the app for cohabitating CSOs of veterans with PTSD. METHODS A total of 200 participants with an average age of 39 (SD 8.44) years, primarily female (193/200, 97%), and White (160/200, 80%) were randomized to self-guided use of either PTSD Family Coach 1.0 (n=104) or a psychoeducation-only app (n=96) for 4 weeks. Caregiver burden, stress, depression, anxiety, beliefs about treatment, CSO self-efficacy, and relationship functioning assessed using measures of dyadic adjustment, social constraints, and communication danger signs were administered via a web survey at baseline and after treatment. User satisfaction and app helpfulness were assessed after treatment. Data were analyzed using linear mixed methods. RESULTS Overall, 50.5% (101/200) of randomized participants used their allocated app. Participants found PTSD Family Coach 1.0 somewhat satisfying (mean 4.88, SD 1.11) and moderately helpful (mean 2.99, SD 0.97) to use. Linear mixed effects models revealed no significant differences in outcomes by condition for caregiver burden (P=.45; Cohen d=0.1, 95% CI -0.2 to 0.4), stress (P=.64; Cohen d=0.1, 95% CI -0.4 to 0.6), depression (P=.93; Cohen d= 0.0, 95% CI -0.3 to 0.3), anxiety (P=.55; Cohen d=-0.1, 95% CI -0.4 to 0.2), beliefs about treatment (P=.71; Cohen d=0.1, 95% CI -0.2 to 0.3), partner self-efficacy (P=.59; Cohen d=-0.1, 95% CI -0.4 to 0.2), dyadic adjustment (P=.08; Cohen d=-0.2, 95% CI -0.5 to 0.0), social constraints (P=.05; Cohen d=0.3, 95% CI 0.0-0.6), or communication danger signs (P=.90; Cohen d=-0.0, 95% CI -0.3 to 0.3). Post hoc analyses collapsing across conditions revealed a significant between-group effect on stress for app users versus nonusers (β=-3.62; t281=-2.27; P=.02). CONCLUSIONS Approximately half of the randomized participants never used their allocated app, and participants in the PTSD Family Coach 1.0 condition only opened the app approximately 4 times over 4 weeks, suggesting limitations to this app version's feasibility. PTSD Family Coach 1.0 users reported moderately favorable impressions of the app, suggesting preliminary acceptability. Regarding efficacy, no significant difference was found between PTSD Family Coach 1.0 users and psychoeducation app users across any outcome of interest. Post hoc analyses suggested that app use regardless of treatment condition was associated with reduced stress. Further research that improves app feasibility and establishes efficacy in targeting the domains most relevant to CSOs is warranted. TRIAL REGISTRATION ClinicalTrials.gov NCT02486705; https://clinicaltrials.gov/ct2/show/NCT02486705.
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Affiliation(s)
| | - Joseph Wielgosz
- Department of Psychiatry & Behavioral Sciences, Stanford University School of Medicine, Palo Alto, CA, United States.,National Center for PTSD, Veteran Affairs Palo Alto Healthcare System, Palo Alto, CA, United States
| | - Haijing Wu Hallenbeck
- Department of Psychiatry & Behavioral Sciences, Stanford University School of Medicine, Palo Alto, CA, United States.,National Center for PTSD, Veteran Affairs Palo Alto Healthcare System, Palo Alto, CA, United States
| | - Andrew Chang
- National Center for PTSD, Veteran Affairs Palo Alto Healthcare System, Palo Alto, CA, United States
| | - Craig Rosen
- Department of Psychiatry & Behavioral Sciences, Stanford University School of Medicine, Palo Alto, CA, United States.,National Center for PTSD, Veteran Affairs Palo Alto Healthcare System, Palo Alto, CA, United States
| | - Jason Owen
- National Center for PTSD, Veteran Affairs Palo Alto Healthcare System, Palo Alto, CA, United States
| | - Eric Kuhn
- Department of Psychiatry & Behavioral Sciences, Stanford University School of Medicine, Palo Alto, CA, United States.,National Center for PTSD, Veteran Affairs Palo Alto Healthcare System, Palo Alto, CA, United States
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Mpanza DM, Govender P, Voce A. Perspectives of service providers on aftercare service provision for persons with substance use disorders at a Rural District in South Africa. Subst Abuse Treat Prev Policy 2022; 17:60. [PMID: 35962363 PMCID: PMC9373456 DOI: 10.1186/s13011-022-00471-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/04/2022] [Indexed: 11/30/2022] Open
Abstract
Background Provision of aftercare services for persons with substance use disorders (PWSUD) within a rural context is typically met with various intersecting challenges, including unclear policy implications and lack of resources. In the South African context, service providers are expected to provide aftercare services that should successfully reintegrate persons with PWSUD into society, the workforce, family and community life as mandated by Act No. 70 of 2008, despite population diversity. Little has been established on the provision of aftercare services in South Africa and specifically within a rural context. This article explores service providers’ perspectives in aftercare service provision for PWSUD in a rural district. Methods A qualitative exploratory study design was conducted in a rural district in South Africa using semi-structured interviews and focus group discussions with forty-six service providers from governmental and non-governmental institutions, ranging from implementation to policy level of service provision. Data were analyzed thematically using a deductive approach. Codes were predetermined from the questions and the aims and objectives of the study used Beer’s Viable Systems Model as a theoretical framework. NVivo Pro 12 qualitative data analysis software guided the organization and further analysis of the data. Results Four themes emanated from the data sets. Theme 1 on reflections of the interactional state of aftercare services and program content identified the successes and inadequacies of aftercare interventions including relevant recommendations for aftercare services. Themes 2, 3, and 4 demonstrate reflections of service provision from implementation to policy level, namely, identifying existing barriers to aftercare service provision, situating systemic enablers to aftercare service provision, and associated aftercare system recommendations. Conclusions The intersecting systemic complexities of providing aftercare services in a rural context in South Africa was evident. There existed minimal enablers for service provision in this rural district. Service providers are confronted with numerous systemic barriers at all levels of service provision. To strengthen the aftercare system, policies with enforcement of aftercare services are required. Moreover, a model of aftercare that is integrated into the existing services, family centered, sensitive to the rural context and one that encourages the collaboration of stakeholders could also strengthen and sustain the aftercare system and service provision.
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Baloh J, Curran GM, Timko C, Grant KM, Cucciare MA. Al-Anon Intensive Referral (AIR): A qualitative formative evaluation for implementation. J Subst Abuse Treat 2022; 132:108520. [PMID: 34111772 PMCID: PMC8636615 DOI: 10.1016/j.jsat.2021.108520] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Revised: 05/28/2021] [Accepted: 05/28/2021] [Indexed: 01/03/2023]
Abstract
INTRODUCTION The Al-Anon mutual-help program helps concerned others (COs; e.g., families, friends) of persons with excessive alcohol use. Despite widespread availability of Al-Anon meetings, participation is limited and little is known about how to best facilitate engagement. Al-Anon Intensive Referral (AIR) was developed to facilitate COs' engagement in Al-Anon and is being tested in a randomized controlled trial (RCT). Toward the end of the recruitment for the RCT, a qualitative formative evaluation was conducted to learn about facilitators, barriers, and recommendations for AIR implementation in substance use disorder (SUD) treatment clinics. METHODS Thirty-one directors and staff at ten VA and community SUD clinics were interviewed. Semi-structured interviews were based on the Consolidated Framework for Implementation Research and were thematically analyzed to identify facilitators, barriers, and recommendations for AIR implementation. RESULTS Perceived facilitators of AIR implementation included AIR's face validity, adaptability, and alignment with staff values and skills, requiring only minimal training. Several interviewees in community settings thought AIR would fit with their current practices (e.g., family groups), and some clinics reported having sufficient staff available for delivering AIR. Perceived barriers included limited staff time, and VA clinics having limited resources for providing services to COs. Furthermore, many clients have no COs, or COs who are unwilling or unable to engage with them. Recommendations included fitting AIR within existing workflows and focusing on COs with highest readiness to receive support. Interviewees also thought AIR could be adapted to a website format or smartphone app, which may expand its reach while decreasing staff burden and cost; however, it may not be as effective and appealing to some demographic groups (e.g., older COs). CONCLUSIONS AIR has strong potential for implementation in SUD treatment settings, but clinics vary on implementation capacity. Most clinics could implement AIR partially (e.g., case-by-case basis) while clinics with sufficient capacity (e.g., staff time) could implement it more fully. These findings can also inform implementation of other interventions for concerned others.
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Affiliation(s)
- Jure Baloh
- University of Arkansas for Medical Sciences, Little Rock, AR, USA,Corresponding author: Department of Health Policy and Management, College of Public Health, 4301 W. Markham St., Mail slot 820, Little Rock, AR 72205,
| | - Geoffrey M. Curran
- University of Arkansas for Medical Sciences, Little Rock, AR, USA,Central Arkansas Veterans Healthcare System, North Little Rock, AR, USA
| | - Christine Timko
- VA Palo Alto Health Care System, Palo Alto, CA, USA,Stanford University School of Medicine, Palo Alto, CA, USA
| | - Kathleen M. Grant
- VA Nebraska-Western Iowa Healthcare System (Omaha), Omaha, NE, USA,University of Nebraska Medical Center, Omaha, NE, USA
| | - Michael A. Cucciare
- University of Arkansas for Medical Sciences, Little Rock, AR, USA,Central Arkansas Veterans Healthcare System, North Little Rock, AR, USA
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Di Sarno M, De Candia V, Rancati F, Madeddu F, Calati R, Di Pierro R. Mental and physical health in family members of substance users: A scoping review. Drug Alcohol Depend 2021; 219:108439. [PMID: 33333362 DOI: 10.1016/j.drugalcdep.2020.108439] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2020] [Revised: 11/02/2020] [Accepted: 11/17/2020] [Indexed: 12/20/2022]
Abstract
BACKGROUND Due to the high pressure they sustain, family members of substance users are thought to experience negative consequences in mental and physical health. This scoping review provided a comprehensive overview on the mental and physical health of adult Affected Family Members (AFMs). METHOD We searched in-journal English articles in PubMed, with no date limit, guided by the concepts of stress, strain, and burden, and including several terms related to substance use. Eligibility criteria included focus on adult AFMs, mental and physical health, and clinical forms of substance use. RESULTS PubMed search identified 3549 articles, with 46 additional papers from other sources. Fifty-six articles were included, quantitative (N = 39), qualitative (N = 15) and both (N = 2). Quantitative findings show that AFMs are subject to increased stress and burden, and impaired mental health. Variable rates of physical problems emerge, with some medical conditions being more common among AFMs of substance users versus controls. Finally, evidence shows increased risk for aggression and reduced quality of life and social adjustment. AFMs report higher stress and strain if they are women, in low socio-economic families, and co-habiting with more severe substance users. Qualitative studies additionally suggest that stigma, self-blame, and social isolation are common. CONCLUSIONS AFMs of substance users represent a population at higher risk for negative health-related outcomes and should be systematically regarded as targets for treatment.
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Affiliation(s)
- Marco Di Sarno
- Department of Psychology, University of Milan-Bicocca, Milan, Italy; Centro per lo studio e la terapia dei disturbi della personalità (C.R.E.S.T), Milan, Italy.
| | | | - Fabio Rancati
- Centro per lo studio e la terapia dei disturbi della personalità (C.R.E.S.T), Milan, Italy
| | - Fabio Madeddu
- Department of Psychology, University of Milan-Bicocca, Milan, Italy; Centro per lo studio e la terapia dei disturbi della personalità (C.R.E.S.T), Milan, Italy; Personality Disorders Lab (PDlab), Parma - Milan, Italy
| | - Raffaella Calati
- Department of Psychology, University of Milan-Bicocca, Milan, Italy; Department of Adult Psychiatry, Nîmes University Hospital, Nîmes, France
| | - Rossella Di Pierro
- Department of Psychology, University of Milan-Bicocca, Milan, Italy; Centro per lo studio e la terapia dei disturbi della personalità (C.R.E.S.T), Milan, Italy; Personality Disorders Lab (PDlab), Parma - Milan, Italy
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Timko C, Grant KM, Cucciare MA. Functioning of Concerned Others When Adults Enter Treatment for an Alcohol Use Disorder. Alcohol Clin Exp Res 2019; 43:1986-1993. [PMID: 31335974 DOI: 10.1111/acer.14153] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2019] [Accepted: 07/12/2019] [Indexed: 11/30/2022]
Abstract
BACKGROUND Poor functioning among Concerned Others (COs; family and friends of an individual with an alcohol or other substance use disorder) is a significant public health problem. The purpose of this study was to inform interventions for COs by examining potential correlates of 3 aspects of functioning: quality of life, mental health, and knowledge of how to handle problems related to their drinker. METHODS This study collected data from 277 COs when their friend or family member (their "drinker") was entering treatment for an alcohol use disorder. Potential correlates were the drinker's substance use severity, the CO-drinker relationship and communication, and COs' coping and perceived stigma related to involvement with their drinker. RESULTS In a summary analysis, only stressors in the CO-drinker relationship (the drinker's criticism, disagreement, anger, and demands) were consistently associated with poorer functioning as indicated by COs' poorer quality of life and mental health. In contrast, only COs' use of approach coping was associated with COs' knowing how to handle problems related to the drinker. CONCLUSIONS Because reducing both relationship stressors and the link between stressors and poor functioning can be achieved through CO and drinker education and intervention, these findings inform how to effectively support COs' goals for better functioning.
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Affiliation(s)
- Christine Timko
- Center for Innovation to Implementation, Department of Veterans Affairs Health Care System, Palo Alto, California.,Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, California
| | - Kathleen M Grant
- Mental Health and Behavioral Science Department, VA Nebraska-Western Iowa Health Care System, Omaha, Nebraska.,Pulmonary Section, Department of Internal Medicine, University of Nebraska Medical Center, Omaha, Nebraska
| | - Michael A Cucciare
- Center for Mental Healthcare and Outcomes Research, Central Arkansas Veterans Affairs Healthcare System, North Little Rock, Arkansas.,Veterans Affairs South Central Mental Illness Research, Education, and Clinical Center, Central Arkansas Veterans Healthcare System, North Little Rock, Arkansas.,Department of Psychiatry, University of Arkansas for Medical Sciences, Little Rock, Arkansas
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Birkeland B, Foster K, Selbekk AS, Høie MM, Ruud T, Weimand B. The quality of life when a partner has substance use problems: a scoping review. Health Qual Life Outcomes 2018; 16:219. [PMID: 30453992 PMCID: PMC6245914 DOI: 10.1186/s12955-018-1042-4] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2018] [Accepted: 11/01/2018] [Indexed: 01/22/2023] Open
Abstract
OBJECTIVE To examine the existing body of knowledge on quality of life (QoL) in partners of people with substance use problems (PP-SUPs) to provide a synthesized summary of the evidence and identify gaps in our knowledge on the QoL of PP-SUPs. METHODS A systematic scoping review was performed. Publications indexed in EMBASE, Medline, PsycINFO, CINAHL, SocINDEX, and CENTRAL were searched for original, empirical, peer-reviewed, full-length research papers that examined QoL in PP-SUPs. Research papers identified through a manual search of key references and known references by co-authors were also included. A total of 3070 abstracts were screened, 41 full-text papers examined, and nine were found to meet the inclusion criteria. Eligibility was determined in two steps by four and two independent researchers, respectively. The main findings were explored by content analysis. RESULTS Eight of the nine included studies had quantitative designs, one had a mixed methods design, and no qualitative studies were found. Three studies were conducted exclusively among PP-SUPs, whereas the others included various subgroups. A majority of participants were women, and no study was conducted exclusively among men. Nearly half of the studies reported on whether there were minor children in the PP-SUPs' household. The studies used established and generic QoL instruments based on different conceptual and theoretical perspectives on QoL. A majority of the studies found lower QoL in PP-SUPs than in general population, with substance use by the person with a SUP having the most impact on QoL of all evaluated factors. Two studies reported that gender was associated with QoL, with poor QoL being associated with being a male partner and vice versa for female partners. CONCLUSIONS Further research is needed to examine QoL in PP-SUPs exclusively. A variety of QoL instruments covering various, but limited, dimensions of the concept have been used in previous studies of PP-SUPs. Thus, obtaining a comprehensive understanding of PP-SUPs' QoL is challenging. Both qualitative and large-scale quantitative designs should be used in research on QoL in PP-SUPs, particularly among those with a parenting role.
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Affiliation(s)
- Bente Birkeland
- Addiction Department, Research Unit, Sørlandet Hospital HF, P.B. 416, 4604 Kristiansand, Norway
| | - Kim Foster
- School of Nursing, Midwifery & Paramedicine, Australian Catholic University, Victoria, Australia
- NorthWestern Mental Health, Victoria, Australia
| | - Anne S. Selbekk
- Department for Research and Development, Rogaland A-senter, Stavanger, Norway
| | - Magnhild M. Høie
- Department of Psychosocial Health, Faculthy of Health and Sports Science, University of Agder, Grimstad, Norway
| | - Torleif Ruud
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Division Mental Health Services, R&D Department, Akershus University Hospital, 1478, Lørenskog, Norway
| | - Bente Weimand
- Division Mental Health Services, R&D Department, Akershus University Hospital, 1478, Lørenskog, Norway
- Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway
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Lindner P, Siljeholm O, Johansson M, Forster M, Andreasson S, Hammarberg A. Combining online Community Reinforcement and Family Training (CRAFT) with a parent-training programme for parents with partners suffering from alcohol use disorder: study protocol for a randomised controlled trial. BMJ Open 2018; 8:e020879. [PMID: 30099390 PMCID: PMC6089295 DOI: 10.1136/bmjopen-2017-020879] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
INTRODUCTION Partners and children of individuals with alcohol use disorder (AUD) present with impaired quality of life and mental health, yet seldom seek or participate in traditional supportive interventions. Engaging the parent/partner without AUD in treatment is a promising way of supporting behavioural change in both the child and the parent with AUD. Universal parent-training (PT) programmes are effective in increasing children's well-being and decreasing problem behaviours, but have yet to be tailored for children with a parent with AUD. Community Reinforcement Approach And Family Training (CRAFT) programmes are conceptually similar, and aim to promote behavioural change in individuals with AUD by having a concerned significant other change environmental contingencies. There has been no study on whether these two interventions can be combined and tailored for partners of individuals with AUD with common children, and delivered as accessible, online self-help. METHODS AND ANALYSIS: n=300 participants with a child showing mental health problems and partner (co-parent) with AUD, but who do not themselves present with AUD, will be recruited from the general public and randomised 1:1 to either a four-module, online combined PT and CRAFT programme or a psychoeducation-only comparison intervention. Primary outcome will be the child's mental health. Additional outcomes will cover the partner's drinking, the participants own mental health and drinking, the child's social adjustment, treatment seeking in all three parties and parental self-efficacy. Measures will be collected preintervention, mid-intervention and postintervention, and three times during a 2-year follow-up period. Data will be analysed using mixed-effects modelling. ETHICS AND DISSEMINATION This study has been approved by the Stockholm Regional Ethical Review Board (2016/2179-31). The results will be presented at conferences and published as peer-reviewed publications. TRIAL REGISTRATION NUMBER ISRCTN38702517; Pre-results.
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Affiliation(s)
- Philip Lindner
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
- Centre for Dependency Disorders, Stockholm Health Care Services, Stockholm County Council, Stockholm, Sweden
- Department of Psychology, Stockholm University, Stockholm, Sweden
| | - Ola Siljeholm
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
- Centre for Dependency Disorders, Stockholm Health Care Services, Stockholm County Council, Stockholm, Sweden
| | - Magnus Johansson
- Centre for Dependency Disorders, Stockholm Health Care Services, Stockholm County Council, Stockholm, Sweden
- Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden
| | - Martin Forster
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Sven Andreasson
- Centre for Dependency Disorders, Stockholm Health Care Services, Stockholm County Council, Stockholm, Sweden
- Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden
| | - Anders Hammarberg
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
- Centre for Dependency Disorders, Stockholm Health Care Services, Stockholm County Council, Stockholm, Sweden
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Parks M, Anastasiadou D, Sánchez JC, Graell M, Sepulveda AR. Experience of caregiving and coping strategies in caregivers of adolescents with an eating disorder: A comparative study. Psychiatry Res 2018; 260:241-247. [PMID: 29220681 DOI: 10.1016/j.psychres.2017.11.064] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2016] [Revised: 09/19/2017] [Accepted: 11/22/2017] [Indexed: 12/20/2022]
Abstract
Caring for a relative with an eating disorder (ED) is associated with heightened psychological distress, which, according to a stress-coping model, may be influenced by coping and appraisal. However, limited quantitative studies have assessed coping in ED caregivers. This cross-sectional study aims to assess 1) the differences in coping between caregivers of three groups: patients with an ED, patients with a substance use disorder, and healthy teens, and 2) the patient and caregiver variables associated with coping and appraisal of the caregiving experience. A one-way MANOVA was significant for caregiver group for mothers, but not fathers. Mothers of both patient groups used more self-sufficient problem focused coping than mothers of healthy teens. Patient caregivers did not significantly differ from caregivers of healthy teens in their use of avoidance. Mothers used social support strategies more than fathers. A positive experience of caregiving was significantly associated with the use of approach-oriented coping in ED caregivers and a negative experience of caregiving was significantly associated with avoidance in ED mothers. Older ED caregivers were less likely to use avoidance. Future interventions could help ED caregivers to recognize their coping preferences and how to appropriately use these strategies when faced with illness-related stressors.
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Affiliation(s)
- Melissa Parks
- Autonomous University of Madrid, Faculty of Psychology, Calle Ivan Pavlov 6, Ciudad Universitaria Cantoblanco Campus, 28049 Madrid, Spain
| | - Dimitra Anastasiadou
- Faculty of Information and Communication Sciences, Universitat Oberta de Catalunya, Rambla del Poblenou 156, 08018 Barcelona, Spain
| | - Julio César Sánchez
- Proyecto Hombre - Programa Soporte, Calle Martin de los Heros, 68, 28008 Madrid, Spain
| | - Montserrat Graell
- Child and Adolescent University Hospital "Niño Jesus," Eating Disorders Unit, Avenida de Menendez Pelayo 65, 28009 Madrid, Spain
| | - Ana R Sepulveda
- Autonomous University of Madrid, Faculty of Psychology, Calle Ivan Pavlov 6, Ciudad Universitaria Cantoblanco Campus, 28049 Madrid, Spain.
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Campêlo SR, Barbosa MA, Dias DR, Caixeta CC, Leles CR, Porto CC. Association between severity of illicit drug dependence and quality of life in a psychosocial care center in BRAZIL: cross-sectional study. Health Qual Life Outcomes 2017; 15:223. [PMID: 29149893 PMCID: PMC5693571 DOI: 10.1186/s12955-017-0795-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2017] [Accepted: 11/02/2017] [Indexed: 11/26/2022] Open
Abstract
Background Quality of life must be one of the main purposes for the treatment of drug users, requiring a better understanding of the association between the quality of life and the severity of dependency. This study aimed to investigate the correlation between severity of substance use in various areas of human functioning and quality of life of illicit drug users in a psychosocial care center for alcohol and drugs. Methods This cross-sectional study included 60 participants – illicit drug users – treated at a psychosocial care center for alcohol and drugs. Participants were evaluated with the short version of World Health Organization Quality of Life (WHOQOL-Bref) instrument to measure the quality of life, the 6th version of Addiction Severity Index (ASI-6) to assess the severity of dependence in several areas and the Mini International Neuropsychiatric Interview (MINI) to identify the presence of psychiatric disorders. Pearson and Spearman correlation tests and linear regression were applied to verify the association between the severity of dependence and the quality of life, and Student’s t-test to compare the mean quality of life between individuals with and without psychiatric comorbidities. Results Negative correlation was found between the severity of dependence on the drugs dimensions: alcohol, psychiatric, medical, legal, family/social support and family/social problems of ASI-6, and the quality of life domains measured by the WHOQOL-Bref. The evidence was strongest in the psychiatric and medical dimensions. There was a significant difference in the quality of life mean among participants presenting or not presenting psychiatric comorbidities, for the psychological domain in anxiety disorders, and for the physical and psychological domains in mood disorders. Conclusion The quality of life decreased as the severity of dependence increased, with different results in the various areas of the participant’s life. This result emphasizes the need for training the professional team which works in the substance use disorders area for more comprehensive diagnostic evaluations and more appropriate therapeutic interventions for each area. The associations were more evident in the medical and psychiatric fields, indicating the need for greater attention to be paid in relation to medical and psychiatric comorbidities. Electronic supplementary material The online version of this article (10.1186/s12955-017-0795-5) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Selva Rios Campêlo
- Medical School, Federal University of Goiás, Rua B4, Qd 5, Lt 6, Casa 2, Setor Bueno CEP, Goiás, 74210-103, Brazil.
| | | | | | | | | | - Celmo Celeno Porto
- Medical School, Federal University of Goiás, Rua B4, Qd 5, Lt 6, Casa 2, Setor Bueno CEP, Goiás, 74210-103, Brazil
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10
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Birkeland B, Weimand BM, Ruud T, Høie MM, Vederhus JK. Perceived quality of life in partners of patients undergoing treatment in somatic health, mental health, or substance use disorder units: a cross-sectional study. Health Qual Life Outcomes 2017; 15:172. [PMID: 28854928 PMCID: PMC5577829 DOI: 10.1186/s12955-017-0750-5] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2017] [Accepted: 08/25/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND This study explores (1) differences in socio-demographic, social/familial, and health variables and perceived quality of life (QoL) among partners of patients with somatic illness, mental illness, or substance use disorder (SUD); and (2) identifies factors associated with QoL. METHODS Participants (N = 213) in this cross-sectional study were recruited from inpatient or outpatient services in five hospitals in Norway, 2013-2014. QoL was measured by the QoL-5, a generic five-item questionnaire. Differences between groups were examined using Chi-square for categorical variables and Kruskal-Wallis for contiuous variables. Multiple linear regression analyses were used to examine factors associated with QoL. RESULTS The mean QoL score was similar to that of a general population sample, and 13% of the sample had a markedly low QoL. Partners in the SUD group experienced worse socio-demographic conditions in terms of occupation and income, but QoL did not differ significantly among the three groups. In a regression model, perceived family cohesion was positively associated with QoL while psychological distress (Symptom Checklist-10) was negatively related to it. The model explained 56% of the variance in QoL. CONCLUSIONS When patients are ill, clinicians should consider the partners' QoL, and brief QoL tools can be used to identify those who are struggling most. Reduced QoL is associated with higher psychological distress and lower family cohesion. Treatment initiatives focusing on these themes may serve as preventive measures to help the most vulnerable families cope with their difficult life situation.
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Affiliation(s)
- Bente Birkeland
- Sørlandet Hospital HF, Addiction Department, Research Unit, Addiction Unit, Sørlandet Hospital HF, P.b. 416, 4604, Kristiansand, Norway.
| | - Bente M Weimand
- Akershus University Hospital, Division Mental Health Services, Lørenskog, Norway
| | - Torleif Ruud
- Akershus University Hospital, Division Mental Health Services, Lørenskog, Norway.,University of Oslo, Institute of Clinical Medicine, Oslo, Norway
| | - Magnhild M Høie
- Department of Psychosocial Health, University of Agder, Faculty of Health and Sports Sciences, Grimstad, Norway
| | - John-Kåre Vederhus
- Sørlandet Hospital HF, Addiction Department, Research Unit, Addiction Unit, Sørlandet Hospital HF, P.b. 416, 4604, Kristiansand, Norway
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Bisetto Pons D, González Barrón R, Botella Guijarro Á. Family-Based Intervention Program for Parents of Substance-Abusing Youth and Adolescents. JOURNAL OF ADDICTION 2016; 2016:4320720. [PMID: 27800208 PMCID: PMC5069381 DOI: 10.1155/2016/4320720] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/27/2016] [Revised: 08/14/2016] [Accepted: 09/14/2016] [Indexed: 11/24/2022]
Abstract
The use of drugs among adolescents/youth often results in a high degree of distress for the family members who live with them. This in turn can lead to a deterioration of mental (psychological) health, hindering any attempt to successfully cope with the situation. The goal of our research was to study the effect of the Community Reinforcement and Family Training (CRAFT) program on parents of adolescents/young adult drug users. Study volunteers (n = 50) were parents from Valencia (Spain) that were divided into two groups. The experimental group (n = 25) was made up of parents whose sons and daughters exhibited problems with drug use and the constructed noncausal baseline group (n = 25) was made up of parents whose sons and daughters did not show any substance abuse problems. For both groups, self-esteem (Rosenberg Self-Esteem Scale), depression (BDI-II), anxiety (STAI), and anger (STAXI-II) were evaluated before and after the application of the CRAFT program. Results show a significant improvement in the experimental group's self-esteem, depression, and anger state and a decrease in negative moods. These changes in parents produce a positive effect on their substance-using sons and daughters: of the 25 participants, 15 contacted specialized addiction treatment resources for the first time.
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Affiliation(s)
- David Bisetto Pons
- Faculty of Psychology, University of Valencia, Valencia, Spain
- AEPA Foundation, Alicante, Spain
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12
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Zucker DM, Dion K, McKeever RP. Concept clarification of grief in mothers of children with an addiction. J Adv Nurs 2014; 71:751-67. [PMID: 25533713 DOI: 10.1111/jan.12591] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/29/2014] [Indexed: 11/29/2022]
Abstract
AIM To report an analysis of the concept of grief in mothers of children with an addiction. BACKGROUND The concept of grief in this context is poorly understood and often synonymously used with concepts depression, loss and chronic sorrow. In the US, the core concept grief has been recently revised by both NANDA and the DSM-V in efforts to better understand and characterize the concept. The plethora of literature on grief worldwide often characterizes grief as a response to a death. DESIGN Concept analysis. DATA SOURCES Search terms 'parental grief' and 'substance abuse' yielded 30 articles. A second review using terms 'grief' and 'substance abuse' yielded 323 articles, in PsychInfo, CINAHL, PubMed databases from 1980-2013. Limits for articles in English and for the terms 'death' and 'child' yielded 13 usable articles. METHODS The hybrid model of concept analysis, using a theoretical phase, an empirical phase and a final phase when a clarified definition of grief emerged. RESULTS Definitions in the literature and defining characteristics of grief outline bio-psycho-social aspects of the concept. For one mother grief was accompanied by recurring feelings of sadness across time, while for the other mother grief was seen as coping, after having passed through a variety of stages of grief. For both, grief was seen to fall on a continuum. CONCLUSIONS Grief is a universal concept and has a trajectory. Case study data have been essential in clarifying understandings of grief as experienced by mothers of addicted children and will provide direction for meaningful and tailored interventions.
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Meyers RJ, Roozen HG, Smith JE, Evans BE. Reasons for entering treatment reported by initially treatment-resistant patients with substance use disorders. Cogn Behav Ther 2014; 43:299-309. [PMID: 25059561 DOI: 10.1080/16506073.2014.938358] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Many individuals with substance use disorders are resistant to entering formal treatment, despite the negative consequences that plague their own lives and the lives of concerned significant others (CSOs). Community Reinforcement and Family Training (CRAFT) has been developed as an effective strategy for helping family members who are concerned about the alcohol/drug use of a loved one who refuses to seek treatment. The present study explored reasons and feelings that played a part in these resistant individuals' (identified patients [IPs]) decision to begin treatment. Written statements and feelings of 36 initially treatment-refusing IPs, who were engaged into treatment via their CRAFT-trained CSOs, were examined upon entering treatment. Self-report forms assessed three complementary domains about entering treatment: (1) feelings about coming for treatment, (2) important reasons for entering treatment, and (3) reasons for entering treatment narratives. It was shown that the occurrences of self-reported positive emotions and statements that expressed a positive wish for change outweighed negative feelings and statements. Although conceivably these CRAFT-exposed IPs may have provided different responses than other treatment-seeking populations, the current study's strong IP reports of positive feelings, reasons, and narrative statements regarding treatment entry nonetheless address potential concerns that treatment-refusing IPs might only enter treatment if felt coerced by family members and while experiencing salient negative feelings overall.
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Affiliation(s)
- Robert J Meyers
- a Department of Psychology , University of New Mexico , Albuquerque , NM , USA
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14
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López-Goñi JJ, Fernández-Montalvo J, Cacho R, Arteaga A. Profile of Addicted Patients Who Reenter Treatment Programs. Subst Abus 2014; 35:176-83. [DOI: 10.1080/08897077.2013.826614] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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15
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Myeong Sook Yoon, 김남희, Hyun Mi Choi. The Effects of Husband's Drinking on Life Satisfaction of Married Immigrant Women -Focusing on mediating effects of social support and domestic violence-. ACTA ACUST UNITED AC 2013. [DOI: 10.16975/kjfsw.2013..42.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Duffy P, Baldwin H. Recovery post treatment: plans, barriers and motivators. SUBSTANCE ABUSE TREATMENT PREVENTION AND POLICY 2013; 8:6. [PMID: 23363550 PMCID: PMC3573929 DOI: 10.1186/1747-597x-8-6] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/09/2012] [Accepted: 01/16/2013] [Indexed: 11/17/2022]
Abstract
Background The increasing focus on achieving a sustained recovery from substance use brings with it a need to better understand the factors (recovery capital) that contribute to recovery following treatment. This work examined the factors those in recovery perceive to be barriers to (lack of capital) or facilitators of (presence of capital) sustained recovery post treatment. Methods A purposive sample of 45 participants was recruited from 11 drug treatment services in northern England. Semi-structured qualitative interviews lasting between 30 and 90 minutes were conducted one to three months after participants completed treatment. Interviews examined key themes identified through previous literature but focused on allowing participants to explore their unique recovery journey. Interviews were transcribed and analysed thematically using a combination of deductive and inductive approaches. Results Participants generally reported high levels of confidence in maintaining their recovery with most planning to remain abstinent. There were indications of high levels of recovery capital. Aftercare engagement was high, often through self referral, with non substance use related activity felt to be particularly positive. Supported housing was critical and concerns were raised about the ability to afford to live independently with financial stability and welfare availability a key concern in general. Employment, often in the substance use treatment field, was a desire. However, it was a long term goal, with substantial risks associated with pursuing this too early. Positive social support was almost exclusively from within the recovery community although the re-building of relationships with family (children in particular) was a key motivator post treatment. Conclusions Addressing internal factors and underlying issues i.e. ‘human capital’, provided confidence for continued recovery whilst motivators focused on external factors such as family and maintaining aspects of a ‘normal’ life i.e. ‘social and physical capital’. Competing recovery goals and activities can leave people feeling under pressure and at risk of taking on or being pushed to do too much too soon. The breadth of re-integration and future plans at this stage is limited primarily to the recovery community and treatment sector. Services and commissioners should ensure that this does not become a limiting factor in individuals’ long term recovery journeys.
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Affiliation(s)
- Paul Duffy
- Criminal Justice Manager, Centre for Public Health, Liverpool John Moores University, 2nd Floor, Henry Cotton Campus, 15-21 Webster Street, Liverpool, L3 2ET, UK.
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