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Namusoke J, Amone-P’Olak K, Nakanwagi CC, Kibedi H, Mayengo N, Ssenyonga J, Omech B. The mediating role of self-control on the relations between adverse childhood experiences and substance use among adolescents in Uganda. Front Psychol 2024; 15:1297565. [PMID: 38807955 PMCID: PMC11132265 DOI: 10.3389/fpsyg.2024.1297565] [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: 09/21/2023] [Accepted: 04/09/2024] [Indexed: 05/30/2024] Open
Abstract
Objective Adverse childhood experiences (ACEs) are established risk factors for undesirable consequences in adolescence and early adulthood, including substance use and a lack of self-control. Based on the Social Bonds Theory (SBT), this study aims to expand our knowledge of the pathways from ACEs and self-control to substance use in adolescence and early adulthood. Methods The extent to which self-control mediates the association between ACEs and substance use was examined in a cross-sectional survey of 358 adolescents and young adults (N = 234, 65.5% girls, mean age 17.7, SD 0.58, range 15-18). Data were gathered using the Adverse Childhood Experiences (ACE-10) questionnaire, the Drug Abuse Screening Test (DAST-10), and the 10-item self-control scale to assess childhood adversity, substance use, and self-control, respectively. Results ACEs were widely reported and significantly associated with substance use and a lack of self-control. Self-control strongly predicted substance use, independent of ACEs. Among those reporting no ACEs, one to two, three to four, and five or more, there were significant variations in the respondents' substance use (F(3, 400) = 12.69, p = 0.001). Self-control explained 51.2% (95% confidence interval [CI]: 41, 61%) of the associations between ACEs and substance use as assessed by linear regression. Conclusion Self-control is key to understanding why adolescents and young adults with a history of childhood adversity indulge in substance use. Therefore, there is a need to advocate for psychological interventions such as cognitive and behavioural therapy that have demonstrated efficacy in promoting self-control in adolescents and young adults.
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Affiliation(s)
- Jane Namusoke
- Department of Psychology, Kyambogo University, Kampala, Uganda
| | | | | | - Henry Kibedi
- Department of Psychology, Kyambogo University, Kampala, Uganda
| | - Nathaniel Mayengo
- Department of Foundations of Education and Educational Psychology, Kyambogo University, Kampala, Uganda
| | - Joseph Ssenyonga
- Department of Foundations of Education and Educational Psychology, Kyambogo University, Kampala, Uganda
| | - Bernard Omech
- Directorate of Graduate Training and Research, Lira University, Lira, Uganda
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Kumbet SJ, Oseni TIA, Mensah-Bonsu M, Damagum FM, Opare-Lokko EBA, Namisango E, Olawumi AL, Ephraim OC, Aweh B. Common adolescent mental health disorders seen in Family Medicine Clinics in Ghana and Nigeria. PLoS One 2023; 18:e0285911. [PMID: 37971998 PMCID: PMC10653403 DOI: 10.1371/journal.pone.0285911] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Accepted: 10/30/2023] [Indexed: 11/19/2023] Open
Abstract
BACKGROUND Mental health disorders among adolescents is on the rise globally. Patients seldom present to mental health physicians, for fear of stigmatization, and due to the dearth of mental health physicians. They are mostly picked during consultations with Family Physicians. This study seeks to identify the common mental health disorders seen by family Physicians in Family Medicine Clinics in Nigeria and Ghana. METHODS A descriptive cross-sectional study involving 302 Physicians practicing in Family Medicine Clinics in Nigeria and Ghana, who were randomly selected for the study. Data were collected using self-administered semi-structured questionnaire, and were entered into excel spreadsheet before analysing with IBM-SPSS version 22. Descriptive statistics using frequencies and percentages was used to describe variables. RESULTS Of the 302 Physicians recruited for the study, only 233 completed the study, in which 168 (72.1%) practiced in Nigeria and 65 (27.9%) in Ghana. They were mostly in urban communities (77.3%) and tertiary health facilities (65.2%). Over 90% of Family Medicine practitioners attended to adolescents with mental health issues with over 70% of them seeing at least 2 adolescents with mental health issues every year. The burden of mental health disorder was 16% and the common mental health disorders seen were depression (59.2%), Bipolar Affective Disorder (55.8%), Epilepsy (51.9%) and Substance Abuse Disorder (44.2%). CONCLUSION Family Physicians in Nigeria and Ghana attend to a good number of adolescents with mental health disorders in their clinics. There is the need for Family Physicians to have specialized training and retraining to be able to recognize and treat adolescent mental health disorders. This will help to reduce stigmatization and improve the management of the disease thus, reducing the burden.
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Affiliation(s)
- Sonny John Kumbet
- Department of Family Medicine, Geriatric Medicine Sub Division, Federal Medical Centre, Keffi, Nigeria
| | - Tijani Idris Ahmad Oseni
- Department of Family Medicine, Ambrose Alli University, Ekpoma, Nigeria
- Lifestyle and Behavioural Medicine Unit, Department of Family Medicine, Irrua Specialist Teaching Hospital, Irrua, Nigeria
| | | | | | - Edwina Beryl Addo Opare-Lokko
- Department of Family Medicine, Greater Accra Regional Hospital, Accra, Ghana
- Faculty of Family Medicine, Ghana College of Physicians and Surgeons, Accra, Ghana
| | - Eve Namisango
- African Palliative Care Association, Kampala, Uganda
- College of Health Sciences, Makerere University, Kampala, Uganda
| | | | - Onyenwe Chibuike Ephraim
- Department of Family Medicine, Alex Ekwueme Federal University Teaching Hospital, Abakaliki, Nigeria
| | - Benjamin Aweh
- Department of Mental Health and Behavioural Medicine, Irrua Specialist Teaching Hospital, Irrua, Nigeria
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Kaswa R. Primary healthcare approach to substance abuse management. S Afr Fam Pract (2004) 2021; 63:e1-e4. [PMID: 34082558 PMCID: PMC8378164 DOI: 10.4102/safp.v63i1.5307] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Revised: 05/03/2021] [Accepted: 05/04/2021] [Indexed: 12/04/2022] Open
Abstract
Substance abuse is common amongst patients attending primary healthcare settings. Despite the substantial impact on one’s health, substance abuse is often underdiagnosed by primary care providers owing to a lack of training and time for screening. Self-reported screening tools are easy to administer and efficient to make a substance abuse diagnosis in primary care settings. Comorbid mental illness and intimate partner violence are common amongst patients presenting with substance abuse in primary care. An early diagnosis and a brief behavioural change counselling are effective in managing substance abuse before it develops into dependency. A brief motivational communication rather than a confrontation during substance abuse screening, counselling and treatment is important to achieve optimum patient outcomes.
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Affiliation(s)
- Ramprakash Kaswa
- Department of Family Medicine and Rural Health, Walter Sisulu University, Mthatha.
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van Zyl PJJ, Bantjes J, Breet E, Lewis I. Motives for deliberate self-harm in a South African tertiary hospital. S Afr J Psychiatr 2021; 27:1524. [PMID: 33604071 PMCID: PMC7876963 DOI: 10.4102/sajpsychiatry.v27i0.1524] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2020] [Accepted: 09/21/2020] [Indexed: 11/12/2022] Open
Abstract
Background Although there is a growing body of literature on the epidemiology of deliberate self-harm (DSH) in South Africa, comparatively few studies have investigated the motives for self-harm. No studies have investigated the motives for DSH in Cape Town. Aim The objective of the study was to identify the range of motives for DSH in Cape Town, and how these motives are associated with different socio-demographic factors, the severity of self-injury and levels of suicidal intent. Setting Groote Schuur Hospital in Cape Town, South Africa. Methods Data were collected from 238 consecutive patients presenting with DSH to the emergency department. The data were analysed by using bivariate and multivariate analyses. Results Patients engaged in DSH for a range of motives. Interpersonal issues were the most common motive (70%), followed by financial concerns (22%). Male patients were twice as likely as female patients to report interpersonal motives for their self-harm. Patients who reported interpersonal issues were more likely to engage in methods of DSH that involved damage to body tissues. Patients without tertiary education were more likely to report academic concerns as a motive, and patients who reported psychiatric illness as motive for DSH were more likely to require medical interventions than those who did not. Conclusion This study contributes novel insights into the motives for DSH in the Cape Town context and provides the foundation for continued research on the subject. The study also gives impetus to the development of therapeutic interventions focussed on the motives for self-harm.
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Affiliation(s)
- Petrus J J van Zyl
- Department of Psychiatry and Mental Health, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | - Jason Bantjes
- Institute for Life Course Health Research, Department of Global Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Elsie Breet
- Institute for Life Course Health Research, Department of Global Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Ian Lewis
- Department of Psychiatry and Mental Health, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
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Bout A, Kettani N, Berhili N, Aarab C, Rammouz I, Aalouane R. Les conduites d’automutilation non suicidaires dans une population recrutée pendant une hospitalisation en psychiatrie : À propos de 100 patients. ANNALES MEDICO-PSYCHOLOGIQUES 2020. [DOI: 10.1016/j.amp.2020.10.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Goldstone D, Bantjes J, Nel D, Stanbridge J, Lewis I. Alcohol use predicts emergency psychiatric unit admission for non-fatal suicidal behaviour in the Western Cape (South Africa): a case-control study. Int J Psychiatry Clin Pract 2020; 24:163-172. [PMID: 31928103 DOI: 10.1080/13651501.2019.1711419] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Objective: We aimed to describe patterns of substance use among patients admitted to an emergency psychiatric unit for non-fatal suicidal behaviour (NFSB) or another psychiatric reason and establish whether there were significant differences in patterns of substance use between the two groups.Methods: We employed a case-control design (N = 50) and collected data about participants' substance use in Cape Town, South Africa. Data were analysed using Chi-square and Mann-Whitney tests, factor analysis, and logistic regressions.Results: Prevalence of lifetime Alcohol Use Disorder (AUD) was 60% in the NFSB group and 28% in the control group. 12% of the NFSB group and 20% of the control group had a lifetime Tobacco Use Disorder. Prevalence of lifetime illicit Substance Use Disorder was 44% in the NFSB group and 60% in the control group. Hospital admission for NFSB was associated with: any past 24-hour alcohol use; quantity of past 24-hour alcohol use; quantity of past-month alcohol use; lifetime AUD; past 12-month AUD; and current AUD; and was not associated with the use of any other substances (p<.05). Past 12-month AUD was the best predictor of hospital admission for NFSB, controlling for, respectively, any past 24-hour alcohol use (aOR = 13.33, p = .023) and quantity of past 24-hour alcohol use (aOR = 9.01, p = .022)Conclusions: Patients admitted to emergency psychiatric units for NFSB have increased needs for the treatment of AUDs compared to patients admitted for another psychiatric emergency. Findings support calls for interventions to prevent NFSB among psychiatric patients with a history of AUD.Key pointsRates of substance use among patients admitted to emergency psychiatric units in South Africa were high compared to the general population.Hazardous alcohol use was uniquely associated with hospital admission for non-fatal suicidal behaviour compared to another psychiatric emergency.Tobacco use and illicit substance use were not associated with hospital admission for non-fatal suicidal behaviour compared to another psychiatric emergency.The association between hazardous alcohol use and hospital admission for non-fatal suicidal behaviour did not appear to be affected by demographic variables.Patients admitted to hospital for non-fatal suicidal behaviour have increased needs for the treatment of alcohol use disorders compared to other psychiatric patients.
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Affiliation(s)
- Daniel Goldstone
- Department of Psychology, Stellenbosch University, Stellenbosch, South Africa
| | - Jason Bantjes
- Department of Psychology, Stellenbosch University, Stellenbosch, South Africa
| | - Daan Nel
- Department of Statistics and Actuarial Science, Stellenbosch University, Stellenbosch, South Africa
| | - Jessica Stanbridge
- Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
| | - Ian Lewis
- Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
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Goldstone D, Bantjes J, Dannatt L. Mental health care providers' suggestions for suicide prevention among people with substance use disorders in South Africa: a qualitative study. Subst Abuse Treat Prev Policy 2018; 13:47. [PMID: 30526637 PMCID: PMC6286590 DOI: 10.1186/s13011-018-0185-y] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2018] [Accepted: 11/26/2018] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND People with substance use disorders (PWSUDs) are a clearly delineated group at high risk for suicidal behaviour. Expert consensus is that suicide prevention strategies should be culturally sensitive and specific to particular populations and socio-cultural and economic contexts. The aim of this study was to explore mental health care providers' context- and population-specific suggestions for suicide prevention when providing services for PWSUDs in the Western Cape, South Africa. METHODS Qualitative data were collected via in-depth, semi-structured interviews with 18 mental health care providers providing services to PWSUDs in the public and private health care sectors of the Western Cape, South Africa. Data were analysed inductively using thematic analysis. RESULTS Participants highlighted the importance of providing effective mental health care, transforming the mental health care system, community interventions, and early intervention, in order to prevent suicide amongst PWSUDs. Many of their suggestions reflected basic principles of effective mental health care provision. However, participants also suggested further training in suicide prevention for mental health care providers, optimising the use of existing health care resources, expanding service provision for suicidal PWSUDs, improving policies and regulations for the treatment of substance use disorders, provision of integrated health care, and focusing on early intervention to prevent suicide. CONCLUSIONS Training mental health care providers in suicide prevention must be augmented by addressing systemic problems in the provision of mental health care and contextual problems that make suicide prevention challenging. Many of the suggestions offered by these participants depart from individualist, biomedical approaches to suicide prevention to include a more contextual view of suicide prevention. A re-thinking of traditional bio-medical approaches to suicide prevention may be warranted in order to reduce suicide among PWSUDs.
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Affiliation(s)
- Daniel Goldstone
- Department of Psychology, Stellenbosch University, Private Bag X1, Matieland, Stellenbosch, 7602 South Africa
| | - Jason Bantjes
- Department of Psychology, Stellenbosch University, Private Bag X1, Matieland, Stellenbosch, 7602 South Africa
| | - Lisa Dannatt
- Department of Psychiatry and Mental Health, J-Block, Groote Schuur Hospital, Observatory, Cape Town, South Africa
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