Stress, social support, and self-esteem of young alcoholics in recovery

Alcohol and tobacco use among methadone maintenance patients in Vietnamese rural mountainside areas

Introduction

The expansion of methadone maintenance treatment (MMT) program requires more data about the factors affecting the effectiveness of treatment, especially behavioral data such as smoking and alcohol use among patients. This study aimed to examine the prevalence of tobacco and alcohol consumption and identify related factors among MMT patients in the Vietnamese rural mountainside.

Methods

We interviewed 241 MMT patients in two clinics in Tuyen Quang, a mountainous province in Vietnam. Patients were asked to report the smoking status (current smoker or not), nicotine dependence (by Fagerström test for nicotine dependence - FTND) and alcohol use (by using the Alcohol Use Disorders Identification Test – AUDIT-C). EuroQol-5 dimensions-5 levels (EQ-5D-5L) and EQ-Visual analogue scale (EQ-VAS) were employed to measure health-related quality of life. Multivariate logistic and Tobit regressions were used to identify the associated factors.

Results

The majority of respondents were current smokers (75.7%) and a low proportion were hazardous drinkers (18.3%). People receiving treatment in a rural clinic (OR = 0.45; 95%CI = 0.22–0.92) and had problems in usual activities (OR = 0.20; 95%CI = 0.06–0.70) were less likely to be smokers. Q-VAS score (Coef. = 0.03; 95%CI = 0.02–0.05) and having problems in mobility (Coef. = 0.72; 95%CI = 0.03–1.42) was found to be associated with the increase of nicotine dependence. In terms of alcohol drinking, people with other jobs were more likely to drink hazardously compared to unemployed patients (OR = 2.86; 95%CI = 1.20–6.82). Similarly, patients having higher duration of MMT had higher likelihood of being hazardous drinkers (OR = 1.07; 95%CI = 1.01–1.13).

Conclusions

This study highlights the low rate of alcohol abusers but a considerably high proportion of current smokers among MMT patients in the rural mountainside area. Alcohol and tobacco counseling programs combined with social and family support also play an essential role in alcohol and tobacco control. In addition, implementing mass community-based behavioral change campaigns to reduce drug addiction-related stigmatization should also be prioritized.

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Rates of tobacco and alcohol use w​ere high among MMT patients in the rural mountainside area.

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The bi-directional association existed between being at risk of hazardous drinking and MMT duration.

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A comprehensive MMT approach is needed to improve both physical and mental health outcome, which facilitates MMT patients to quit smoking and alcohol use.

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Alcohol and tobacco counseling programs combined with social and family support are necessary.

Self-cognitions in antisocial alcohol dependence and recovery

Cross-sectional relationships between content and structural properties of the self-concept and alcohol use in young adults with antisocial alcohol dependence (AAD) (n = 24), those in recovery from AAD (n = 18), and controls (n = 23) were examined using the schema model of the self-concept. Persons with AAD had a trend toward fewer positive self-schemas than did controls, and had more negative self-schemas and a trend toward higher interrelatedness than did those in recovery and controls. They also showed evidence of a drinking-related self-schema, whereas those in recovery showed evidence of a recovery-related self-schema. Finally, evidence to support a model using properties of the self-concept to predict high levels of alcohol use was found. These findings provide a beginning empirical foundation for the development of nursing interventions aimed at altering self-structure to prevent the development of and promote recovery from antisocial alcohol dependence.

Understanding homeless adults by testing the theory of self-care

This article explicates, within a sample of homeless adults, the relationship between self-care agency, self-care, and well-being, while controlling for select basic conditioning factors. Self-care is found to explain 30% of the variance in current well-being. Self-esteem and affect balance, along with the power components of self-care agency, are found to explain 25% of the variance in self-care and, together with select basic conditioning factors, to explain 54% of its variance. Affect is proposed as an energy disposition, a dimension of self-care agency. Recommendations are made to strengthen the homeless individual's self-care agency.

Co-factors affecting substance abuse among homosexual men: an investigation within a midwestern gay community

In an effort to begin formation of an empirically based model of gay substance abuse, this study examined the effects of three psychosocial factors, homosexual identity formation, self-esteem and a familial history of substance abuse in the evolution of this phenomenon among homosexual men, a group that appears to manifest appreciably higher rates and concomitantly greater associated problems than the general population. Data were obtained by voluntary subject return of a self-report instrument that was distributed widely over a 6 month period in the metropolitan Cleveland area, resulting in a moderately sized sample. Although the sampling method limited the generalizability of the results, diminished self-esteem and a familial history of substance abuse had significant associations with both alcohol and drug abuse and were confirmed to be salient predictors, together accounting for almost half the variance in alcohol abuse and over one-third the variance in drug abuse. Moreover, both had the ability to significantly discern between alcohol and drug use groups versus groups found to be alcohol and drug abusive. Levels of a gay identity were not meaningfully associated with substance abuse. Finally, recommendations for further research were explicated.

Relationship between hope and self-esteem in renal transplant recipients

In the transplant community great emphasis is placed on health and well-being. Because hope and self-esteem are linked with a positive health outcome, knowledge of transplantation should include an understanding of the extent to which hope is influenced by self-esteem. Few researchers have addressed the topic of hope and its impact on self-esteem; therefore, we sought to ascertain whether a relationship exists between hope and self-esteem in renal transplant recipients.

Loneliness and alcohol abuse: a review of evidences of an interplay

This report contains a review of the literature about the interplay between loneliness and the abuse of alcohol. A theoretical discussion based on clinical observations can be dated back to the 1950's. Systematic empirical studies, however, appear sparsely and have mainly been performed during the last decade. Thus, knowledge is still incomplete, but the review indicates that loneliness may be significant at all stages in the course of alcoholism: as a contributing and maintaining factor in the growth of abuse and as an encumbrance in attempts to give it up. Concordant reports demonstrate that alcoholics do feel more lonely than members of most other groups do. In advanced abusers, loneliness is obviously connected with a number of negative characteristics and, together with several of those, directly linked to a poor prognosis. There are, however, no obvious relations to the external social situation (i.e. network) or amount of drinking. Instead, the feeling of loneliness appears to be more connected with a general negative perception about oneself and one's relations to other people and also with a general dissatisfaction with most things in life. The lonely abuser seems likewise resigned and unable to bring himself to change his/her situation. There are also associations with a broad array of psychopathology. In comparison to people with other health problems, the supportive value of the social network of alcoholics appears to be more wavering.

Enhancing the self-esteem of inpatient alcoholics

This study examined the effect of pairing inpatient alcoholics with nursing home residents (NHRs) on the alcoholics' self-esteem. In this PALS program, the alcoholic inpatients assumed a helping-companion relationship with the NHRs for 2 hr per day during their last 2 weeks of treatment. Fifty alcoholic inpatients were randomly assigned to the PALS program (n = 25) or to the library for free reading time (n = 25). The Tennessee Self-Concept Scale (TSCS) was administered to all subjects in both groups before and after the interventions. Of the nine TSCS scales, the improvement on the Moral-Ethical scale was significantly greater in the PALS group. Because the alcoholic inpatients in the PALS group engaged in altruistic (moral) behavior, this study provides a logical link between the intervention and the outcome, which has been a prevalent weakness in previous studies of self-esteem in alcoholics.