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Feeney K, Pintos Lobo R, Hare MM, Morris SSJ, Laird AR, Musser ED. Parental Deprivation- and Threat-Based Factors Associated with Youth Emotion-Based Neurocircuitry and Externalizing Behavior: A Systematic Review. Res Child Adolesc Psychopathol 2024; 52:311-323. [PMID: 37831222 DOI: 10.1007/s10802-023-01138-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/02/2023] [Indexed: 10/14/2023]
Abstract
Parental factors, including negative parenting practices (e.g., family conflict, low monitoring), parental depression, and parental substance use, are associated with externalizing behaviors among youth. However, the ways in which these parental factors are associated with youth brain function and consequent externalizing behavior has been less studied. Both the dimensional and stress acceleration models provide frameworks for understanding how parental factors may be associated with frontolimbic and frontoparietal networks implicated in emotional attention and regulation processes. The current review builds upon this work by examining how deprivation- and threat-based parental factors are associated with youth neurocircuitry involved in emotional functioning and externalizing behaviors. A systematic review using PRISMA guidelines was completed and included five studies assessing parenting behaviors, six studies assessing parental depressive symptoms and/or diagnosis, and 12 studies assessing parental history of substance use. Synthesis of reviewed studies discusses support for the dimensional and stress acceleration models within the context of deprivation and threat. Further, a limited number of studies tested (i.e., six studies) and supported (i.e., three studies) youth neural structure and function as a mediator of the association between parental factors and youth externalizing behavior. Specific recommendations for future work include more deliberate planning related to sample composition, improved clarity related to parental constructs, consistency in methodology, and longitudinal study design in order to better understand associations between contextual parental influences and youth neural and behavioral functioning.
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Affiliation(s)
- Kathleen Feeney
- Department of Psychology, Florida International University, Miami, FL, USA.
| | | | - Megan M Hare
- Department of Psychology, Florida International University, Miami, FL, USA
| | | | - Angela R Laird
- Department of Physics, Florida International University, Miami, FL, USA
| | - Erica D Musser
- Department of Psychology, Florida International University, Miami, FL, USA
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2
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Porreca A, De Carli P, Filippi B, Bakermans-Kranenburg MJ, van IJzendoorn MH, Simonelli A. Maternal cognitive functioning and psychopathology predict quality of parent-child relationship in the context of substance use disorder: A 15-month longitudinal study. Dev Psychopathol 2024:1-12. [PMID: 38282537 DOI: 10.1017/s0954579424000026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2024]
Abstract
This longitudinal study aimed to investigate the role of maternal cognitive functioning and psychopathology in parent-child relationship quality during residential treatment for mothers with Substance Use Disorder (SUD), in order to identify factors that may enhance or limit intervention effects.We assessed cognitive functioning (Esame Neuropsicologico Breve-2 [ENB-2]) and psychopathology (Symptom Checklist-90 Revised [SCL-90-R]) in 60 mothers diagnosed with SUD (Mage = 30.13 yrs; SD = 6.79) at treatment admission. Parent-child relationship quality was measured during free-play interactions using the Emotional Availability Scales every three months from admission (Child Mage = 17.17m; SD = 23.60) to the 15th month of the residential treatment.A main effect of maternal psychopathology and an interaction effect of time and cognitive functioning were found. More maternal psychopathology predicted lower mother-child relationship quality. Mothers with higher cognitive functioning presented a better treatment trajectory, with an increase in mother-child relationship quality, whereas mothers with lower cognitive functioning showed a decrease in relationship quality after initial improvement.These findings suggest that maternal psychopathology and cognitive functioning may influence the treatment of parent-child relationships in the context of SUD, although causality is not yet established. Implications for assessment and intervention are discussed.
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Affiliation(s)
- Alessio Porreca
- Department of Developmental and Social Psychology, University of Padua, Via Venezia, PD, Italy
| | - Pietro De Carli
- Department of Developmental and Social Psychology, University of Padua, Via Venezia, PD, Italy
- Department of Psychology, University of Milano-Bicocca, Milan, MI, Italy
| | - Bianca Filippi
- Department of Developmental and Social Psychology, University of Padua, Via Venezia, PD, Italy
| | | | - Marinus H van IJzendoorn
- Research Department of Clinical, Education and Health Psychology, Faculty of Brain Sciences, UCL, London, UK
| | - Alessandra Simonelli
- Department of Developmental and Social Psychology, University of Padua, Via Venezia, PD, Italy
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3
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Morie KP, Zhai ZW, Crowley MJ, Potenza MN, Mayes LC. Relationships Between Prenatal Cocaine Exposure, Cannabis-Use Onset and Emotional and Related Characteristics in Young/Emerging Adults. Subst Use Misuse 2024; 59:388-397. [PMID: 37964628 DOI: 10.1080/10826084.2023.2275558] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2023]
Abstract
Background: Exposure to substances in utero may have significant early-life consequences. Less is known about the effects in emerging adulthood, particularly regarding patterns of substance use and related characteristics.Objectives: In this study, we recruited emerging adults, followed since birth, who had been prenatally exposed, or not, to cocaine. Individuals reported on their cannabis, alcohol, and tobacco use, and measures of impulsivity, anhedonia, emotional regulation, and mental health were obtained. Comparisons were made between emerging adults with prenatal cocaine exposure and those without. Correlations were performed between psychological measures and substance use, and regression analyses were conducted to determine potential pathways by which such measures may relate to prenatal exposure or substance use.Results: Individuals with prenatal cocaine exposure (vs. those without) used cannabis at younger ages, reported greater cannabis-use severity, and demonstrated higher impulsivity, state anxiety, and alexithymia. Earlier age of onset of cannabis use was associated with higher impulsivity, state anxiety, alexithymia, and social and physical anhedonia. Cannabis-use age-of-onset mediated the relationship between prenatal cocaine-exposure status and state anxiety and between prenatal cocaine-exposure status and cannabis-use severity in emerging adulthood but not relationships between prenatal cocaine-exposure status and impulsivity or alexithymia in emerging adulthood. Findings suggest that adults with prenatal cocaine exposure may use cannabis at younger ages, which may relate to increased anxiety and more severe use.Conclusions: These findings suggest both mechanisms and possible intervention targets to improve mental health in emerging adults with prenatal cocaine exposure.
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Affiliation(s)
- Kristen P Morie
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
- Child Study Center, Yale University School of Medicine, New Haven, CT, USA
| | - Zu Wei Zhai
- Department of Neuroscience, Middlebury College, Middlebury, VT, USA
| | - Michael J Crowley
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
- Child Study Center, Yale University School of Medicine, New Haven, CT, USA
| | - Marc N Potenza
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
- Child Study Center, Yale University School of Medicine, New Haven, CT, USA
- Connecticut Council on Problem Gambling, Wethersfield, CT, USA
- Department of Neuroscience, Connecticut Mental Health Center, New Haven, CT, USA
- Department of Neuroscience, Yale School of Medicine, New Haven, CT, USA
| | - Linda C Mayes
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
- Child Study Center, Yale University School of Medicine, New Haven, CT, USA
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4
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Haslam SK, Munroe A, Hamilton-Hinch B, Torres S, Grant T, Ross N, Gilbert R. Adverse childhood experiences and stress among oral health students: a descriptive correlational study. CANADIAN JOURNAL OF DENTAL HYGIENE : CJDH = JOURNAL CANADIEN DE L'HYGIENE DENTAIRE : JCHD 2023; 57:149-160. [PMID: 38020077 PMCID: PMC10662426] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Revised: 11/30/2022] [Accepted: 02/24/2023] [Indexed: 12/01/2023]
Abstract
Background Stress is a challenge to many post-secondary students and, if prolonged and unmanaged, can affect academic success. Understanding factors that contribute to students' stress is important. One possible contributor may be adverse childhood experiences (ACEs); that is, traumatic events that occur during the first 18 years of life. Inverse relationships between the number of ACEs and indicators of poor mental well-being have been proposed. Objective To describe ACEs in oral health students (OHS) and the associations between the number and types of ACEs and levels of perceived stress, an indicator of mental well-being. Methods Invitations to participate in an anonymous online cross-sectional survey were sent to all OHS, 19 years and older, attending Dalhousie University in Halifax, Nova Scotia, Canada. Self-reports of ACEs and perceived stress were collected. Zero-order correlations and regression modelling were used to examine associations. Results Twenty-six percent (26%, n = 66) of OHS completed the survey. Respondents reported an average of 2.20 ACEs; 34.9% reported ≥ 3 ACEs. Emotional abuse (41%) was the most reported ACE. Associations were observed between numbers of ACEs and stress. Levels of stress increased with the number of ACEs (r = 0.23, p < 0.05). Regression modelling determined levels of stress were not affected by ACE type (F (3,62) = 2.24, p = 0.092). Discussion This was the first study to examine associations between ACEs and perceived stress in OHS. These students reported greater numbers of ACEs than age-matched general populations. Levels of stress were associated with numbers of ACEs. Conclusion Faculty in dental and dental hygiene programs should recognize the prevalence of ACEs among OHS and the potential impact on their mental well-being.
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Affiliation(s)
| | - Amy Munroe
- School of Health Sciences, Dalhousie University, Halifax, NS, Canada
| | | | - Sara Torres
- School of Social Work, Laurentian University, Sudbury, ON, Canada
| | - Tonya Grant
- School of Social Work, Dalhousie University, Halifax, NS, Canada
| | - Nancy Ross
- School of Social Work, Dalhousie University, Halifax, NS, Canada
| | - Robert Gilbert
- School of Health Sciences, Dalhousie University, Halifax, NS, Canada
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5
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Scarlett H, Moirangthem S, van der Waerden J. The impact of paternal mental illness on child development: an umbrella review of systematic reviews and meta-analyses. Eur Child Adolesc Psychiatry 2023:10.1007/s00787-023-02261-1. [PMID: 37540476 DOI: 10.1007/s00787-023-02261-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Accepted: 07/07/2023] [Indexed: 08/05/2023]
Abstract
Whilst there is growing evidence highlighting the importance of paternal mental illness (PMI) on child development, this relationship still remains under-studied and often over-looked. Considering the increasingly active role of fathers in their children's upbringing, a comprehensive overview of the impact of PMI on child development is overdue. This study aimed to combine and synthesise currently available evidence on the relationship between PMI and multiple domains of child development. Narrative synthesis of systematic reviews and meta-analyses on the relationship between PMI and child development (mental health and social, emotional, language, cognitive or adaptive behaviour), published between 1980 to December 2021, was conducted in line with PRISMA 2020 guidelines. Review quality was assessed based on AMSTAR-2 criteria and respective study confidence was interpreted in line with GRADE scoring. All relevant meta-analytic effect sizes were converted to odds ratios (OR) and grouped using a random effects model. Grouped meta-analyses saw PMI to have a significant, detrimental effect on all studied domains of child development [OR: 1.54; 95% CI (1.36-1.74)]. Subgroup analyses saw PMI affecting both internalising [OR: 1.62; 95% CI (1.27-2.08)] and externalising [OR: 1.63; 95% CI (1.28-2.08)] child behaviours to a similar extent. However, included reviews were of poor methodological quality, demonstrating either low or critically low confidence. These results show a consistent and influential effect of PMI on child development. The relationship between fathers' mental illness and child development warrants further investigation, as current research is limited in scope, particularly regarding cognitive domains of child development and non-affective PMI diagnoses.
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Affiliation(s)
- Honor Scarlett
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie Et de Santé Publique, 75012, Paris, France.
| | - Simi Moirangthem
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie Et de Santé Publique, 75012, Paris, France
| | - Judith van der Waerden
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie Et de Santé Publique, 75012, Paris, France
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6
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Miller SE, Maggs JL, Eiden RD, Almeida DM. Familial Predictors of Alcohol and Drug Use-Related Problems Among Middle-Aged and Older Adults. JOURNAL OF FAMILY ISSUES 2023; 44:1838-1858. [PMID: 37483651 PMCID: PMC10361669 DOI: 10.1177/0192513x211064877] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/25/2023]
Abstract
This study evaluated whether recent family member alcohol and substance use problems (ASP) and density of family ASP (i.e., number of members with ASP) predict alcohol-related problems and drug use-related problems among middle-aged and older adults. Data were drawn from participants (age 42-93 years, n=2,168) in the longitudinal Midlife in the United States Study (MIDUS). Poisson regression models revealed that adults' alcohol- and drug use-related problems were predicted by similar problems among family members. In particular, parent and partner ASP, but not child ASP, predicted alcohol-related problems in the middle-aged and combined samples, while only partner ASP predicted participants' drug use-related problems. In addition, density of family ASP predicted alcohol-related problems, but not drug use-related problems. There were no gender interactions. Study findings highlight that understanding how adult children, spouses, and aging parents impact each other's substance use should be a priority of future aging and family research.
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Affiliation(s)
- Sara E Miller
- Department of Human Development and Family Studies, The Pennsylvania State University
- Center for Healthy Aging, The Pennsylvania State University
| | - Jennifer L Maggs
- Department of Human Development and Family Studies, The Pennsylvania State University
| | - Rina D Eiden
- Department of Psychology, The Pennsylvania State University
| | - David M Almeida
- Department of Human Development and Family Studies, The Pennsylvania State University
- Center for Healthy Aging, The Pennsylvania State University
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7
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Anderson AS, Siciliano RE, Pillai A, Jiang W, Compas BE. Parental drug use disorders and youth psychopathology: Meta-analytic review. Drug Alcohol Depend 2023; 244:109793. [PMID: 36758372 PMCID: PMC10015502 DOI: 10.1016/j.drugalcdep.2023.109793] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Revised: 01/24/2023] [Accepted: 01/24/2023] [Indexed: 02/05/2023]
Abstract
Parental drug use disorders (PDUDs) represent a highly prevalent risk factor for youth's development of psychological and substance misuse. However, most research on associations between parental substance use and child mental health focuses on composites of parental drug, alcohol, and tobacco use. PDUDs are associated with a range of legal, health, and environmental risks that make them substantially distinct from tobacco and alcohol misuse, yet associations between PDUDs and youth psychopathology symptoms have yet to be assessed quantitatively using meta-analytic techniques. Accordingly, the present meta-analysis assessed the association between PDUDs and youth's internalizing, externalizing, substance use, and total psychological problems across 30 studies (N = 8433). Meta-analytic findings showed that PDUDs were associated with greater substance use and total psychological problems in youth. Across studies, PDUDs were not associated with broad dimensions of youth internalizing and externalizing symptoms but demonstrated a positive relation with youth ADHD and conduct disorder symptoms. There were significant moderation effects for study quality, symptom informant, and child age, where the association between PDUDs and child symptoms of psychopathology was stronger for older youth, in higher quality studies, and studies using joint parent-child symptom informants. Taken together, the meta-analytic findings suggest that PDUDs present a significant risk factor for youth. Future research targeting the relation between parental drug use and youth psychopathology is warranted for prevention and intervention efforts. Implication of findings, mechanisms of interest, and an agenda for future research are discussed.
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Affiliation(s)
- Allegra S Anderson
- Department of Psychology and Human Development, Vanderbilt University, Nashville, TN, USA.
| | - Rachel E Siciliano
- Department of Psychology and Human Development, Vanderbilt University, Nashville, TN, USA
| | - Arnav Pillai
- Department of Psychology and Human Development, Vanderbilt University, Nashville, TN, USA
| | - Wenyi Jiang
- Department of Psychology and Human Development, Vanderbilt University, Nashville, TN, USA
| | - Bruce E Compas
- Department of Psychology and Human Development, Vanderbilt University, Nashville, TN, USA
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8
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Pandey G, Kuo SIC, Horne-Osipenko KA, Pandey AK, Kamarajan C, de Viteri SS, Kinreich S, Chorlian DB, Kuang W, Stephenson M, Kramer J, Anokhin A, Zang Y, Kuperman S, Hesselbrock V, Schuckit M, Dick D, Chan G, McCutcheon VV, Edenberg H, Bucholz KK, Meyers JL, Porjesz B. Associations of parent-adolescent closeness with P3 amplitude, frontal theta, and binge drinking among offspring with high risk for alcohol use disorder. ALCOHOL, CLINICAL & EXPERIMENTAL RESEARCH 2023; 47:155-167. [PMID: 36680783 PMCID: PMC10910630 DOI: 10.1111/acer.14973] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Revised: 10/04/2022] [Accepted: 11/03/2022] [Indexed: 01/22/2023]
Abstract
BACKGROUND Parents impact their offspring's brain development, neurocognitive function, risk, and resilience for alcohol use disorder (AUD) via both genetic and socio-environmental factors. Individuals with AUD and their unaffected children manifest low parietal P3 amplitude and low frontal theta (FT) power, reflecting heritable neurocognitive deficits associated with AUD. Likewise, children who experience poor parenting tend to have atypical brain development and greater rates of alcohol problems. Conversely, positive parenting can be protective and critical for normative development of self-regulation, neurocognitive functioning and the neurobiological systems subserving them. Yet, the role of positive parenting in resiliency toward AUD is understudied and its association with neurocognitive functioning and behavioral vulnerability to AUD among high-risk offspring is less known. Using data from the Collaborative Study on the Genetics of Alcoholism prospective cohort (N = 1256, mean age [SD] = 19.25 [1.88]), we investigated the associations of closeness with mother and father during adolescence with offspring P3 amplitude, FT power, and binge drinking among high-risk offspring. METHODS Self-reported closeness with mother and father between ages 12 and 17 and binge drinking were assessed using the Semi-Structured Assessment for the Genetics of Alcoholism. P3 amplitude and FT power were assessed in response to target stimuli using a Visual Oddball Task. RESULTS Multivariate multiple regression analyses showed that closeness with father was associated with larger P3 amplitude (p = 0.002) and higher FT power (p = 0.01). Closeness with mother was associated with less binge drinking (p = 0.003). Among male offspring, closeness with father was associated with larger P3 amplitude, but among female offspring, closeness with mother was associated with less binge drinking. These associations remained statistically significant with father's and mothers' AUD symptoms, socioeconomic status, and offspring impulsivity in the model. CONCLUSIONS Among high-risk offspring, closeness with parents during adolescence may promote resilience for developing AUD and related neurocognitive deficits albeit with important sex differences.
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Affiliation(s)
- Gayathri Pandey
- Department of Psychiatry and Behavioral Sciences, State University of New York, Downstate Health Sciences University, New York, Brooklyn, USA
| | - Sally I-Chun Kuo
- Department of Psychiatry, Robert Wood Johnson Medical School, Rutgers University, Piscataway, New Jersey, USA
| | - Kristina A. Horne-Osipenko
- Department of Psychiatry and Behavioral Sciences, State University of New York, Downstate Health Sciences University, New York, Brooklyn, USA
| | - Ashwini K. Pandey
- Department of Psychiatry and Behavioral Sciences, State University of New York, Downstate Health Sciences University, New York, Brooklyn, USA
| | - Chella Kamarajan
- Department of Psychiatry and Behavioral Sciences, State University of New York, Downstate Health Sciences University, New York, Brooklyn, USA
| | - Stacey Saenz de Viteri
- Department of Psychiatry and Behavioral Sciences, State University of New York, Downstate Health Sciences University, New York, Brooklyn, USA
| | - Sivan Kinreich
- Department of Psychiatry and Behavioral Sciences, State University of New York, Downstate Health Sciences University, New York, Brooklyn, USA
| | - David B. Chorlian
- Department of Psychiatry and Behavioral Sciences, State University of New York, Downstate Health Sciences University, New York, Brooklyn, USA
| | - Weipeng Kuang
- Department of Psychiatry and Behavioral Sciences, State University of New York, Downstate Health Sciences University, New York, Brooklyn, USA
| | - Mallory Stephenson
- Department of Psychiatry, Robert Wood Johnson Medical School, Rutgers University, Piscataway, New Jersey, USA
| | - John Kramer
- Department of Psychiatry, University of Iowa, Iowa City, Iowa, USA
| | - Andrey Anokhin
- Department of Psychiatry, Washington University School of Medicine in St. Louis, St. Louis, Missouri, USA
| | - Yong Zang
- Department of Biostatistics, School of Medicine, Indiana University, Indianapolis, Indiana, USA
| | - Samuel Kuperman
- Department of Psychiatry, University of Iowa Carver College of Medicine, Iowa City, Iowa, USA
| | - Victor Hesselbrock
- Department of Psychiatry, University of Connecticut School of Medicine, Farmington, Connecticut, USA
| | - Marc Schuckit
- Department of Psychiatry, University of California San Diego, La Jolla, California, USA
| | - Danielle Dick
- Department of Psychiatry, Robert Wood Johnson Medical School, Rutgers University, Piscataway, New Jersey, USA
| | - Grace Chan
- Department of Psychiatry, University of Connecticut School of Medicine, Farmington, Connecticut, USA
| | - Vivia V. McCutcheon
- Department of Psychiatry, Washington University School of Medicine in St. Louis, St. Louis, Missouri, USA
| | - Howard Edenberg
- Department of Biochemistry and Molecular Biology, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Kathleen K. Bucholz
- Department of Psychiatry, Washington University School of Medicine in St. Louis, St. Louis, Missouri, USA
| | - Jacquelyn L. Meyers
- Department of Psychiatry and Behavioral Sciences, State University of New York, Downstate Health Sciences University, New York, Brooklyn, USA
| | - Bernice Porjesz
- Department of Psychiatry and Behavioral Sciences, State University of New York, Downstate Health Sciences University, New York, Brooklyn, USA
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9
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Wiss DA, Prelip ML, Upchurch DM, von Ehrenstein OS, Tomiyama AJ, Shoptaw SJ. Perceived social support moderates the association between household dysfunction adverse childhood experiences (ACEs) and self-reported drug use among men who have sex with men in Los Angeles, California. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2022; 110:103899. [PMID: 36334318 DOI: 10.1016/j.drugpo.2022.103899] [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] [Received: 08/01/2022] [Revised: 10/19/2022] [Accepted: 10/25/2022] [Indexed: 11/05/2022]
Abstract
BACKGROUND Adverse childhood experiences (ACEs) have been shown to be associated with drug use in adulthood. The single ACE of household substance use history (part of the household dysfunction category) has frequently been associated with drug use. Resilience factors such as perceived social support appear to buffer the association between ACEs and drug use and may be particularly relevant for urban men who have sex with men (MSM). The current study of low-income mostly Black and Latino MSM aims to investigate whether the cumulative ACE score predicts self-reported drug use in a dose-response manner and whether this potential association differs by perceived social support. METHODS Data was utilized from a longitudinal study of MSM (mean age=34; SD=7.1) with varied substance use behaviors (n = 321) collected between August 2014 and April 2022. Cumulative, household dysfunction ACEs, and the single ACE of household substance use history were investigated as predictors of self-reported drug use (methamphetamine, ecstasy, cocaine/crack, heroin/fentanyl, party drugs [GHB, special K, mushrooms, LSD/acid], other drugs [bath salts, PCP]) during the past six months in mixed-effects logistic regression models, with moderation analyses by perceived social support (measured by the Multidimensional Scale of Perceived Social Support) across all models using stratified analysis and one model of multiplicative interaction. RESULTS There was no suggestion of a dose-response relationship between the number of ACEs and the predicted probability of self-reported drug use. Cumulative ACEs did not predict the outcome overall (aOR=1.99; 95% CI: 0.86-4.59), however, a positive association was estimated for individuals reporting lower levels of perceived social support (aOR=2.80; 95% CI: 0.97-8.06). The dimension of household dysfunction had a positive association with drug use (aOR=1.32; 95% CI: 1.00-1.74) whereas the dimension of childhood maltreatment did not. The association between household dysfunction and drug use was moderated by the perception of social support, with those reporting lower levels having greater odds of reporting drug use (aOR=2.94; 95% CI: 1.04-8.31). The association between household substance use history and self-reported drug use was similarly moderated by perceived social support in a multiplicative interaction model (p = .02). CONCLUSION Perceived social support emerged as a potential buffering factor for any reported drug use, particularly for the single ACE of household substance use history. Given that the association between ACEs and drug use was weak among those with higher levels of perceived social support, promotion of social ties in the community may help reduce the burden of substance use among MSM exposed to ACEs.
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Affiliation(s)
- David A Wiss
- Department of Community Health Sciences, Fielding School of Public Health, University of California Los Angeles, 650 Young Drive South, Los Angeles, CA 90095, USA.
| | - Michael L Prelip
- Department of Community Health Sciences, Fielding School of Public Health, University of California Los Angeles, 650 Young Drive South, Los Angeles, CA 90095, USA
| | - Dawn M Upchurch
- Department of Community Health Sciences, Fielding School of Public Health, University of California Los Angeles, 650 Young Drive South, Los Angeles, CA 90095, USA
| | - Ondine S von Ehrenstein
- Department of Community Health Sciences, Fielding School of Public Health, University of California Los Angeles, 650 Young Drive South, Los Angeles, CA 90095, USA; Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, 650 Young Drive South, Los Angeles, CA 90095, USA
| | - A Janet Tomiyama
- Department of Psychology, University of California Los Angeles, 502 Portola Plaza, Los Angeles, CA 90095, USA
| | - Steven J Shoptaw
- Department of Family Medicine, David Geffen School of Medicine, University of California Los Angeles, 10880 Wilshire Blvd., Los Angeles, CA 90024, USA
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10
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Anthony R, Paine AL, Westlake M, Lowthian E, Shelton KH. Patterns of adversity and post-traumatic stress among children adopted from care. CHILD ABUSE & NEGLECT 2022; 130:104795. [PMID: 33172646 DOI: 10.1016/j.chiabu.2020.104795] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Revised: 10/15/2020] [Accepted: 10/24/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND Children adopted from care are more likely to have experienced early adversity, but little is known about the impact of early adversity on later post-traumatic stress (PTS) symptoms. OBJECTIVE To investigate sub-groups of adversity in a sample of adopted children and examine the association with later PTS symptoms. PARTICIPANTS AND SETTING A study of British children adopted from care using social worker records (N = 374) and questionnaire-based longitudinal study of n = 58 children over 4-years post adoptive placement. METHODS We used latent class analysis to identify subgroups of children based on commonalities in perinatal and postnatal adversity experienced prior to adoption and examined differences in PTS symptoms at 4-years post-placement between subgroups. RESULTS Nearly one in five (19 %) children were in the clinical or borderline ranges for symptoms of PTS arousal, 14 % for PTS avoidance and 8 % for PTS intrusion. The 5-class solution fitted the data best, with one class characterized by children with a low probability of experiencing any adversity, one perinatal adversity class and three classes capturing different patterns of adversity. The multiple complex adversity class involving both perinatal and postnatal adversity had significantly higher symptoms of PTS avoidance and arousal than other sub-groups. CONCLUSIONS The prevalence and complexity of PTS symptoms among adoptive children highlights the need for effective interventions considering different profiles of early adversity.
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Affiliation(s)
- R Anthony
- Centre for Development, Evaluation, Complexity, and Implementation in Public Health Improvement (DECIPHer), School of Social Sciences, Cardiff University, 1-3 Museum Place, Cardiff CF10 3BD, UK.
| | - A L Paine
- School of Psychology, Cardiff University, Tower Building, 70 Park Place, Cardiff CF10 3AT, UK
| | - M Westlake
- School of Psychology, Cardiff University, Tower Building, 70 Park Place, Cardiff CF10 3AT, UK
| | - E Lowthian
- Centre for Development, Evaluation, Complexity, and Implementation in Public Health Improvement (DECIPHer), School of Social Sciences, Cardiff University, 1-3 Museum Place, Cardiff CF10 3BD, UK
| | - K H Shelton
- School of Psychology, Cardiff University, Tower Building, 70 Park Place, Cardiff CF10 3AT, UK
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11
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Insights from Expanded Adverse Childhood Experiences Screening in a Hospital-Based Outpatient Psychiatry Service. Psychiatr Q 2022; 93:677-687. [PMID: 35380332 DOI: 10.1007/s11126-022-09982-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/13/2022] [Indexed: 01/20/2023]
Abstract
Adverse childhood experiences (ACEs) are associated with poor mental health in adulthood. Comprehensive prevalence data encompassing all 10 ACE questionnaire items has not previously been described in a hospital-based outpatient psychiatric clinic. This study assessed the prevalence of 10 ACEs in such a clinic and correlated ACEs with indicators of case severity. For 252 patients newly evaluated in an urban clinic, a retrospective chart review was completed and data was collected on ACE questionnaire responses, psychiatric, substance-related, and medical diagnoses, psychiatric hospitalizations, suicide attempts, and suicide and violence risk. Patients in the clinic had an average of 3.4 ACEs, higher than national community sample averages of 1.6. The percentages of patients with at least one, two, and four ACEs were 82% (n = 207), 68% (n = 172), and 42% (n = 106) respectively (compared with 61%, 38%, and 15% nationally). ACEs had statistically significant correlations with an increased number of psychiatric diagnoses, substance use disorders, medical illnesses, suicide attempts, and suicide risk level. This study demonstrated that patients seeking psychiatric care from a hospital-based outpatient clinic are likely to be traumatized to a degree far exceeding what is typical in the general population. While a high prevalence of ACEs in a psychiatric population is an expected finding given the literature to date, this is the first study presenting data on the prevalence of ACEs in such a hospital-based community clinic. Additionally this study reinforces prior research correlating childhood adversity and case severity.
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12
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van Draanen J, Aneshensel CS. Parental and own substance use disorder: The intersection of gender and early adversity. Drug Alcohol Depend 2022; 234:109393. [PMID: 35338899 PMCID: PMC9018609 DOI: 10.1016/j.drugalcdep.2022.109393] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Revised: 12/16/2021] [Accepted: 03/01/2022] [Indexed: 11/03/2022]
Abstract
BACKGROUND Children who are exposed to parental substance use disorder (SUD) have a higher risk of SUD themselves. This study examines the extent to which the association between parental and own SUD is conditional upon childhood trauma, socioeconomic status, and gender. METHODS This study uses data from the Nashville Stress and Health Study with 1234 respondents ages 25-65 collected from 2011 to 2014, weighted be representative of the general population. The association between parental SUD and own SUD was estimated using Cox Proportional Hazard Models, controlling for covariates, and testing for interactions. RESULTS Other things being equal, the risk of own SUD is more strongly associated with parental SUD in households with childhood traumas among men, but not women. Childhood trauma is not associated with own SUD in the absence of parental SUD among men. For men with parental SUD exposure, just one traumatic event is associated with a 38% increased risk of own SUD (HR=1.382, SE=.201, p < 0.05). For men, living with grandparents is associated with added SUD risk (HR=1.476, SE=.228, p < 0.05). For women, childhood trauma is not associated with own SUD, but parental SUD (HR=1.556, SE=.238, p < 0.01), and early onset mood or anxiety disorder (HR=1.682, SE=.316, p < 0.01) are. For both genders, those who are African American have lower risk of SUD than those who are White (HR=0.774, SE=.109, p < 0.05 for women; HR=0.672, SE=.079, p < 0.01 for men). CONCLUSIONS Parental SUD is associated with a substantial increase in risk for own SUD, and this association differs by gender and early trauma.
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Affiliation(s)
- Jenna van Draanen
- Department of Community Health Sciences, University of California, Los Angeles, 650 Charles E Young Drive S, Los Angeles, CA 90095, USA.
| | - Carol S. Aneshensel
- Department of Community Health Sciences, University of California, Los Angeles, 650 Charles E Young Drive S, Los Angeles, California, USA, 90095
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13
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Aguilar MPO, Palomera PR, Núñez CL, Maroño CT, Gallegos SV, Cabrera NJP, Deus JER. The Role of Age of Onset in Problematic Alcohol Consumption: Artefact or Cohort Effect? CLÍNICA Y SALUD 2022. [DOI: 10.5093/clysa2021a11] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
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14
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Ottonello M, Torselli E, Caneva S, Fiabane E, Vassallo C, Pistarini C. Mental Imagery Skills in Alcohol-Dependent Subjects and Their Associations With Cognitive Performance: An Exploratory Study During Residential Rehabilitation. Front Psychiatry 2021; 12:741900. [PMID: 34912249 PMCID: PMC8666508 DOI: 10.3389/fpsyt.2021.741900] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Accepted: 11/10/2021] [Indexed: 11/15/2022] Open
Abstract
People in alcohol-detoxification experience deficits in motor and non-motor functions including cognitive performance. Imagery, the cognitive process of generating visual, auditory or kinesthetic experiences in the mind without the presence of external stimuli, has been little studied in Alcohol Use Disorders (AUD). This pilot study aims to observe the cognitive abilities useful for the inspection, maintenance, generation and manipulation of images in these patients during residential rehabilitation and investigate the relationships with their cognitive performance. Thirty-six subjects who completed the 28-day rehabilitation program for alcohol addiction, completed the Mental Imagery Test (MIT) and Neuropsychological Battery (ENB-2). The global score at MIT did not show pathological scores. The 11.1% of AUD patients showed an impaired global score in the cognitive performance and the 5.7% with scoring at limits of norm. Significant correlations were found between Mental Imagery abilities and ENB-2 subscale and stepwise regression analysis showed the close association between the ability of imagery (Mental Imagery Test) and the overall cognitive performance (ENB-2) in alcohol dependent patients and this relationship is stronger than other cognitive tasks.
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Affiliation(s)
- Marcella Ottonello
- Department of Physical and Rehabilitation Medicine of Genova Nervi Institute, Istituti Clinici Scientifici (ICS) Maugeri Spa SB, Genoa, Italy
| | - Elisa Torselli
- School of Psychotherapy, Miller Institute for Behavioral and Cognitive Therapy, Genoa, Italy
| | - Stefano Caneva
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genoa, Genoa, Italy
| | - Elena Fiabane
- Department of Physical and Rehabilitation Medicine of Genova Nervi Institute, Istituti Clinici Scientifici (ICS) Maugeri Spa SB, Genoa, Italy
| | - Claudio Vassallo
- Department of Physical and Rehabilitation Medicine of Genova Nervi Institute, Istituti Clinici Scientifici (ICS) Maugeri Spa SB, Genoa, Italy
| | - Caterina Pistarini
- Department of Neurorehabilitation Medicine of Pavia Institute, Istituti Clinici Scientifici (ICS) Maugeri, Istituti di Ricovero e Cura a Carattere Scientifico (IRCCS) Spa SB, Pavia, Italy
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15
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Lloyd AR, Savage R, Eaton EF. Opioid use disorder: a neglected human immunodeficiency virus risk in American adolescents. AIDS 2021; 35:2237-2247. [PMID: 34387219 PMCID: PMC8563394 DOI: 10.1097/qad.0000000000003051] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
In 2017 alone, 783 000 children aged 12-17 years misused opioids with 14 000 using heroin. Opioid misuse and opioid use disorder (OUD) in adolescents and young adults are significant barriers to ending the HIV epidemic. To address these synergistic scourges requires dedicated practitioners and improved access to life-saving evidence-based treatment. Adolescents and young adults make up over one in five new HIV diagnoses even though they are less likely to be tested or know they are infected. Adolescents and young adults living with HIV are less likely to be retained in care or achieve virological suppression. OUD further leads to increased rates of risky behaviours (like sex without condoms), deceased retention in HIV care and decreased rates of viral suppression in this vulnerable population. Medications for opioid use disorder (MOUD) are recommended for adolescents and young adults with severe OUD and help retain youth in HIV treatment and decrease risk of death. However, due to stigma and lack of experience prescribing MOUD in adolescents, MOUD is often perceived as a last line option. MOUD remains difficult to access for adolescents with a shortage of providers and decreased options for treatment as compared to adults. Addiction treatment is infection prevention, and integrated addiction and HIV services are recommended to improve health outcomes. A multipronged approach including patient education, provider training and policy changes to improve access to treatment and harm reduction are urgently needed confront the drug use epidemic in youth.
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Affiliation(s)
- Audrey R Lloyd
- Department of Medicine, Division of Infectious Diseases, University of Alabama at Birmingham
| | - Rebekah Savage
- Division of Adolescent Medicine, University of Alabama at Birmingham
| | - Ellen F Eaton
- Department of Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham, Alabamas, USA
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16
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Influence of Prevalence of Psychoactive Substance Use in Mexican Municipalities on Early Childhood Development. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph181910027. [PMID: 34639329 PMCID: PMC8507637 DOI: 10.3390/ijerph181910027] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/25/2021] [Revised: 09/02/2021] [Accepted: 09/11/2021] [Indexed: 11/16/2022]
Abstract
Children's early development is influenced by characteristics of the child, family, and environment, including exposure to substance abuse. The aim was to examine the association of early childhood development (ECD) with the prevalence of psychoactive substance use in Mexican municipalities. We obtained ECD data from the 2015 Survey of Boys, Girls, and Women (ENIM, for its Spanish acronym), measured with the ECD Index. The prevalence of psychoactive substance use was estimated at the municipal level, using the 2016 National Survey of Drug, Alcohol, and Tobacco Use (ENCODAT, for its Spanish acronym). Multilevel logistic models were fitted to evaluate the association between drug use and inadequacies in ECD overall and in four specific ECD domains: socio-emotional, literacy-numeric, learning, and physical. Inadequate ECD was directly associated with illegal drug use (OR = 1.10; 95% CI: 1.03, 1.17). For the specific ECD domains, inadequate socio-emotional development was directly associated with illegal drug use (OR = 1.08; 95% CI: 1.01, 1.15). These findings suggest that exposure to illegal drug use may influence ECD, and especially can lead to socio-emotional problems, although this cannot be considered the unanimous determinant of the problems presented. The implementation of evidence-based interventions to prevent drug abuse is necessary.
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17
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Karsberg S, Hesse M, Pedersen MM, Charak R, Pedersen MU. The impact of poly-traumatization on treatment outcomes in young people with substance use disorders. BMC Psychiatry 2021; 21:140. [PMID: 33685430 PMCID: PMC7941934 DOI: 10.1186/s12888-021-03129-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2020] [Accepted: 02/16/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND It is believed that clients with psychological trauma experiences have a poor prognosis with regard to treatment participation and outcomes for substance use disorders. However, knowledge on the effect of the number of trauma experiences is scarce. METHODS Using data from drug use disorder (DUD) treatment in Denmark, we assessed the impact of having experienced multiple potentially traumatic experiences on DUD treatment efficacy. Baseline and follow-up data from 775 young participants (mean age = 20.2 years, standard deviation = 2.6) recruited at nine treatment centers were included in analyses. RESULTS Analyses showed that participants who were exposed multiple trauma experiences also reported a significantly higher intake of cannabis at treatment entry, and a lower well-being score than participants who reported less types or no types of victimization experiences. During treatment, patients with multiple types of trauma experiences showed a slower rate of reduction of cannabis than patients with few or no trauma experiences. The number of trauma types was not associated with number of sessions attended or the development of well-being in treatment. CONCLUSION Overall, the results show that although traumatized youth in DUD treatment show up for treatment, helping them to reduce substance use during treatment is uniquely challenging. TRIAL REGISTRATION ISRCTN88025085 , date of registration: 29.08.2016, retrospectively registered.
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Affiliation(s)
- Sidsel Karsberg
- grid.7048.b0000 0001 1956 2722Centre for Alcohol and Drug Research, Aarhus University, Bartholins Allé 10, 8000 Aarhus, Denmark
| | - Morten Hesse
- Centre for Alcohol and Drug Research, Aarhus University, Bartholins Allé 10, 8000, Aarhus, Denmark.
| | - Michael Mulbjerg Pedersen
- grid.7048.b0000 0001 1956 2722Centre for Alcohol and Drug Research, Aarhus University, Bartholins Allé 10, 8000 Aarhus, Denmark
| | - Ruby Charak
- grid.449717.80000 0004 5374 269XDepartment of Psychological Science, The University of Texas Rio Grande Valley, 1201 W. University Dr, Edinburg, TX USA
| | - Mads Uffe Pedersen
- grid.7048.b0000 0001 1956 2722Centre for Alcohol and Drug Research, Aarhus University, Bartholins Allé 10, 8000 Aarhus, Denmark
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18
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Nolte K, Drew AL, Friedmann PD, Romo E, Kinney LM, Stopka TJ. Opioid initiation and injection transition in rural northern New England: A mixed-methods approach. Drug Alcohol Depend 2020; 217:108256. [PMID: 32947174 PMCID: PMC7769168 DOI: 10.1016/j.drugalcdep.2020.108256] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2020] [Revised: 08/14/2020] [Accepted: 08/22/2020] [Indexed: 12/02/2022]
Abstract
BACKGROUND In rural northern New England, located in the northeastern United States, the overdose epidemic has accelerated with the introduction of fentanyl. Opioid initiation and transition to opioid injection have been studied in urban settings. Little is known about opioid initiation and transition to injection drug use in rural northern New England. METHODS This mixed-methods study characterized opioid use and drug injection in 11 rural counties in Massachusetts, Vermont, and New Hampshire between 2018 and 2019. People who use drugs completed audio computer-assisted self-interview surveys on substance use and risk behaviors (n = 589) and shared personal narratives through in-depth interviews (n = 22). The objective of the current study is to describe initiation of opioid use and drug injection in rural northern New England. RESULTS Median age of first injection was 22 years (interquartile range 18-28 years). Key themes from in-depth interviews that led to initiating drug injection included normalization of drug use in families and communities, experiencing trauma, and abrupt discontinuation of an opioid prescription. Other factors that led to a transition to injecting included lower cost, increased effect/ rush, greater availability of heroin/ fentanyl, and faster relief of withdrawal symptoms with injection. CONCLUSIONS Trauma, normalization of drug use, over-prescribing of opioids, and abrupt discontinuation challenge people who use drugs in rural northern New England communities. Inadequate opioid tapering may increase transition to non-prescribed drug use. The extent and severity of traumatic experiences described highlights the importance of enhancing trauma-informed care in rural areas.
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Affiliation(s)
- Kerry Nolte
- Department of Nursing, College of Health and Human Services, University of New Hampshire, Hewitt Hall, 4 Library Way, Durham, NH, 03824, USA.
| | - Aurora L. Drew
- The Dartmouth Institute for Health Policy and Clinical Practice, Geisel School of Medicine at Dartmouth, 1 Medical Center Drive, Lebanon, NH, 03756, USA,Synergy Center for Translational Science, Geisel School of Medicine at Dartmouth, 1 Medical Center Drive, Lebanon, NH, 03756, USA
| | - Peter D. Friedmann
- Baystate Office of Research, University of Massachusetts Medical School, 3601 Main Street, 3rdFloor, Springfield, MA, 01199, USA
| | - Eric Romo
- Department of Population and Quantitative Health Sciences, University of Massachusetts Medical School, 368 Plantation Street, Worcester, MA, 01605, USA
| | - Linda M. Kinney
- The Dartmouth Institute for Health Policy and Clinical Practice, Geisel School of Medicine at Dartmouth, 1 Medical Center Drive, Lebanon, NH, 03756, USA
| | - Thomas J. Stopka
- Department of Public Health and Community Medicine, Tufts University School of Medicine, 136 Harrison Avenue, Boston, MA, 02111, USA
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19
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Abstract
PURPOSE OF REVIEW Women with opioid use disorder (OUD) face unique challenges the moment they enter treatment. This narrative review focused on recent literature regarding sex- and gender-based issues that could affect treatment outcomes in women with OUD. RECENT FINDINGS Women respond differently to opioids based on hormonal factors, are more likely to present to treatment with mental health conditions, especially depression, and are more likely to have experienced trauma via intimate partner violence compared with men. Women also face stigma when entering OUD treatment, particularly if they have children. Future research to improve OUD treatment outcomes in women should account for sex as a biological variable and gender as a social construct. Women have a fundamentally different experience than men during the course of OUD and upon treatment entry. Programs that address childcare/family support, mental health, and trauma are warranted for women with OUD.
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Affiliation(s)
- Andrew S Huhn
- Behavioral Pharmacology Research Unit, Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, 5510 Nathan Shock Drive, Baltimore, MD, 21224, USA.
| | - Kelly E Dunn
- Behavioral Pharmacology Research Unit, Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, 5510 Nathan Shock Drive, Baltimore, MD, 21224, USA
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20
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Gooden JR, Cox CA, Petersen V, Curtis A, Manning V, Lubman DI. Characterisation of presentations to a community-based specialist addiction neuropsychology service: Cognitive profiles, diagnoses and comorbidities. Drug Alcohol Rev 2020; 40:83-92. [PMID: 32789930 DOI: 10.1111/dar.13135] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2019] [Revised: 05/22/2020] [Accepted: 06/26/2020] [Indexed: 11/29/2022]
Abstract
INTRODUCTION AND AIMS Cognitive impairment is a common feature of individuals with substance-use disorders. However, research tends to exclude highly complex clinical cases, limiting the generalisability of findings for 'real-world' populations. The objective of this study was to examine the complexities associated with addiction, substance use and cognitive impairment through the characterisation of client presentations to a newly established specialised addiction neuropsychology service. DESIGN AND METHODS Retrospective case file audit. Neuropsychological assessment reports for consenting clients over a 4-year period were de-identified and reviewed. Cognitive domains assessed included attention, processing speed, working memory, intellectual functioning, memory and executive functioning. RESULTS Of the 200 case files examined, the majority were male clients, with 11 years or lower of education and a history of daily substance use, with 30% continuing to use daily. Seventy-one percent had a formal mental health diagnosis and 41% had reported a history of trauma. The most prevalent cognitive impairments were observed in complex attention (50%) and memory (40%). New diagnoses were conveyed in 25% of cases, comprising acquired brain injury (16%) and neurodevelopmental disabilities (9%). DISCUSSION AND CONCLUSIONS It is common for clients with substance use histories referred to an addiction neuropsychology service to present with complex histories including psychosocial difficulties, comorbid mental health and medical issues and cognitive impairment. As such, careful diagnostic formulations are required when multiple factors may contribute to cognitive deficits. This study highlights the importance of a state-wide specialist addiction neuropsychology service in supporting diagnostic clarification and informing relevant treatment approaches.
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Affiliation(s)
- James R Gooden
- Turning Point, Eastern Health, Melbourne, Australia.,Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Melbourne, Australia
| | | | | | - Ashlee Curtis
- Centre for Drug use, Addictive and Anti-social behaviour Research, School of Psychology, Deakin University, Geelong, Victoria, Australia
| | - Victoria Manning
- Turning Point, Eastern Health, Melbourne, Australia.,Monash Addiction Research Centre, Eastern Health Clinical School, Monash University, Melbourne, Australia
| | - Dan I Lubman
- Turning Point, Eastern Health, Melbourne, Australia.,Monash Addiction Research Centre, Eastern Health Clinical School, Monash University, Melbourne, Australia
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21
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Obadeji A, Kumolalo BF, Oluwole LO, Ajiboye AS, Dada MU, Ebeyi RC. Substance Use among Adolescent High School Students in Nigeria and Its Relationship with Psychosocial Factors. J Res Health Sci 2020; 20:e00480. [PMID: 32814700 PMCID: PMC7585748 DOI: 10.34172/jrhs.2020.15] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2020] [Revised: 05/10/2020] [Accepted: 05/30/2020] [Indexed: 11/25/2022] Open
Abstract
Background: Despite the tremendous negative consequences of substances on the health and well-being of adolescents, studies continue to report the high rates of substance use among adolescents. We aimed to identify the pattern of substance use among high school students and its relationship with psychosocial factors.
Study design: A cross-sectional study.
Methods: The study was conducted in Oct 2019 among students in the senior secondary school in Ado-Ekiti, Ekiti State; southwestern Nigeria. Participants were selected using random sampling, and data were collected using a socio-demographic questionnaire, the Kessler Psychological distress scale and an adapted version of the NIDA-Modified ASSIST. Bivariate analysis and multiple logistic regression were carried out to identify factors associated with psychological distress.
Results: Overall, 682 students participated in the study. The lifetime and current prevalence of any substance were 17.3% (95% CI: 14.7%, 20.5%) and 11.7% (95% CI: 9.0, 14.0), respectively. Although most substance use variables increases the risk of psychological distress, history of lifetime substance use AOR= 3.03 (95% CI: 1.19, 7.72, P =0.020) and absence of direct parental care AOR=2.04 (1.19, 3.48, P=0.009) significantly increases the risk of experiencing psychological distress. Parental substance use AOR=3.48 (95% CI: 1.57, 7.69, P =0.002), male gender AOR=2.97 (95% CI: 1.82, 4.83, P=0.001) significantly increased substance use risk while having married parents AOR=0.50 (95% CI: 0.27, 0.92, P=0.027) and living with parents AOR 0.39 (95% CI: 0.20, 0.75, P =0.005) were significant protective factors.
Conclusion: The prevalence of substance use among these adolescents was substantial. Drug education initiated in primary school and services aimed at promoting the mental wellbeing of adolescents may go a long way in decreasing substance use among this population.
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Affiliation(s)
- Adetunji Obadeji
- Department of Psychiatry, College of Medicine, Ekiti State University, Ado-Ekiti, Ekiti State, Nigeria.
| | - Banji F Kumolalo
- Department of Psychiatry, Ekiti State University Teaching Hospital, Ado-Ekiti, Ekiti State, Nigeria
| | - Lateef O Oluwole
- Department of Psychiatry, College of Medicine, Ekiti State University, Ado-Ekiti, Ekiti State, Nigeria
| | - Adedotun S Ajiboye
- Department of Psychiatry, Ekiti State University Teaching Hospital, Ado-Ekiti, Ekiti State, Nigeria
| | - Mobolaji U Dada
- Department of Psychiatry, College of Medicine, Ekiti State University, Ado-Ekiti, Ekiti State, Nigeria
| | - Rose Chidindu Ebeyi
- Department of Psychiatry, Ekiti State University Teaching Hospital, Ado-Ekiti, Ekiti State, Nigeria
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22
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Morie KP, Zhai ZW, Potenza MN, Mayes LC. Alexithymia, Emotion-Regulation Strategies, and Traumatic Experiences in Prenatally Cocaine-Exposed Young Adults. Am J Addict 2020; 29:492-499. [PMID: 32436341 DOI: 10.1111/ajad.13056] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2019] [Revised: 04/01/2020] [Accepted: 04/23/2020] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Exposure to early-life trauma may lead to maladaptive characteristics such as alexithymia, and thus to poorer emotional regulation. This relationship may also be influenced by exposure to substances prenatally. We hypothesized that increased alexithymia would be seen in those with prenatal cocaine exposure (PCE). Additionally, we hypothesized that early-life trauma would be associated with alexithymia, and that alexithymia would be associated with poor emotional reappraisal and emotional suppression. METHODS A moderated mediation model was developed to examine whether the hypothesized indirect relationship between trauma and emotional reappraisal through alexithymia was different in young adults with and without PCE (Total N = 57). Thirty-seven young adults with PCE and 20 with no such exposure, all of whom were members of a longitudinal cohort, were recruited for the study, and data concerning childhood trauma, alexithymia, and emotional regulation were collected. Intercorrelations were performed between the scores on each measure and moderated mediation models were constructed separately with emotional neglect or emotional abuse as the independent variable and emotional reappraisal or emotional suppression as the dependent variable. RESULTS PCE status was associated with alexithymia, and alexithymia mediated the relationship between emotional neglect and emotional reappraisal in individuals with PCE but not those without. DISCUSSION AND CONCLUSIONS The data suggest that alexithymia is a mechanism underlying poor use of emotional reappraisal in PCE individuals. SCIENTIFIC SIGNIFICANCE Individuals with early-life trauma and substance exposure may represent a vulnerable population, and alexithymia may play a key role in the development of emotional regulation skills in this population. (Am J Addict 2020;29:492-499).
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Affiliation(s)
- Kristen P Morie
- Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut.,Child Study Center, Yale University School of Medicine, New Haven, Connecticut
| | - Zu Wei Zhai
- Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut.,Department of Psychology, Middlebury College, Middlebury, Vermont
| | - Marc N Potenza
- Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut.,Child Study Center, Yale University School of Medicine, New Haven, Connecticut.,Connecticut Mental Health Center, New Haven, Connecticut.,Connecticut Council on Problem Gambling, Wethersfield, Connecticut.,Department of Neuroscience, Yale University School of Medicine, New Haven, Connecticut
| | - Linda C Mayes
- Child Study Center, Yale University School of Medicine, New Haven, Connecticut.,Department of Pediatrics, Yale University School of Medicine, New Haven, Connecticut.,Department of Psychology, Yale University School of Medicine, New Haven, Connecticut
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23
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Tiu MMH, Fung CKM, Fung WY, Lai YY, Tse CM, Wong TH, Wong TK, Wong WY, Wu MS, Yeung KM, Yeung LT, Yu YY. Experience of Drug Abusers Participating in Community-Based Drug Rehabilitation Services Provided by the Counselling Centres for Psychotropic Substance Abusers (CCPSAs) in Hong Kong. Health (London) 2020. [DOI: 10.4236/health.2020.128075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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24
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Caneva S, Ottonello M, Torselli E, Pistarini C, Spigno P, Fiabane E. Cognitive Impairments in Early-Detoxified Alcohol-Dependent Inpatients and Their Associations with Socio-Demographic, Clinical and Psychological Factors: An Exploratory Study. Neuropsychiatr Dis Treat 2020; 16:1705-1716. [PMID: 32764946 PMCID: PMC7369414 DOI: 10.2147/ndt.s254369] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2020] [Accepted: 05/20/2020] [Indexed: 12/19/2022] Open
Abstract
PURPOSE Cognitive impairment is common among patients with alcohol use disorder (AUD). However, neuropsychological assessment is not usually included as routine practice in alcohol rehabilitation programs. The aim of this study was to describe qualitatively the cognitive deficits in early-detoxified AUD patients undergoing rehabilitation and to explore relevant associations with socio-demographic, clinical and psychological factors. PATIENTS AND METHODS Forty-one patients with a diagnosis of AUD were consecutively recruited from a residential rehabilitation hospital in Northern Italy. Cognitive impairment was assessed using the Brief Neuropsychological Examination 2 (ENB-2). Anxiety, depression and severity of alcohol dependence were also evaluated using validated self-report questionnaires. Alcohol relapse was investigated 1 month after discharge. RESULTS Overall, 31.7% of AUD patients showed cognitive impairments according to the global score scale. However, 70.7% had an impaired performance on at least one test of the ENB-2, with particular regard to executive function, visuospatial and memory domains. Age, education and abstinence at admission were the most relevant factors associated with cognitive deficits in this clinical population. CONCLUSION The detection of cognitive impairments is essential in order to adapt alcohol rehabilitation treatment to patients with cognitive deficits and enhance clinical outcomes.
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Affiliation(s)
- Stefano Caneva
- Department of Physical and Rehabilitation Medicine, ICS Maugeri Spa SB, Institute of Genoa Nervi, Genoa, Italy
| | - Marcella Ottonello
- Department of Physical and Rehabilitation Medicine, ICS Maugeri Spa SB, Institute of Genoa Nervi, Genoa, Italy
| | - Elisa Torselli
- Department of Physical and Rehabilitation Medicine, ICS Maugeri Spa SB, Institute of Genoa Nervi, Genoa, Italy.,Miller Institute for Behavioral and Cognitive Therapy, Genoa, Italy
| | - Caterina Pistarini
- Department of Physical and Rehabilitation Medicine, ICS Maugeri Spa SB, Scientific Institute of Pavia, Genoa, Italy
| | - Paola Spigno
- Department of Physical and Rehabilitation Medicine, ICS Maugeri Spa SB, Institute of Genoa Nervi, Genoa, Italy
| | - Elena Fiabane
- Department of Physical and Rehabilitation Medicine, ICS Maugeri Spa SB, Institute of Genoa Nervi, Genoa, Italy.,Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
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Abstract
Objectives: Findings on gene-environment correlations suggest childhood “environments” may reflect genetic liabilities. The independent psychosocial influence of childhood trauma is unclear. This study examined such effects on adulthood depressive symptoms. Methods: Data were from the Health and Retirement Study. Trauma items included childhood physical abuse and parental substance abuse. Multinomial logit models examined genetic effects on stable and unstable reports. Linear growth models tested associations of stable trauma responses, genes, and their interaction with current depressive symptoms. Results: Genetic risk predicted both stable and unstable trauma reports. With genes controlled, stable responses were associated with life course variations but not late life change in depression. The exception was women’s physical abuse, which moderated genetic effects but had no independent influence. Discussion: Apparent gene-trauma correlations may be driven by flawed retrospective reports. Research is needed to distinguish true from artifactual genetic effects on other environmental factors and establish psychosocial implications.
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Yeoh SL, Eastwood J, Wright IM, Morton R, Melhuish E, Ward M, Oei JL. Cognitive and Motor Outcomes of Children With Prenatal Opioid Exposure: A Systematic Review and Meta-analysis. JAMA Netw Open 2019; 2:e197025. [PMID: 31298718 PMCID: PMC6628595 DOI: 10.1001/jamanetworkopen.2019.7025] [Citation(s) in RCA: 110] [Impact Index Per Article: 22.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
IMPORTANCE Prenatal opioid exposure (POE) is one of the fastest-growing global health problems, but its association with long-term neurologic and physical development remains unknown. OBJECTIVE To assess the association between POE and cognitive and motor development in children from age 6 months to 18 years. DATA SOURCES Key search terms included prenatal opioid exposure, neonatal abstinence syndrome, and neurocognitive development. Studies were searched using PubMed and Embase, with no publication date restriction, through August 20, 2018. STUDY SELECTION Only published cohort studies comparing the results of age-appropriate standardized cognitive and/or motor tests between children with any POE (aged 0-18 years) with drug-free controls were included. Data that were not convertible to means and SDs were excluded. DATA EXTRACTION AND SYNTHESIS This study was conducted according to Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) and Meta-analysis of Observational Studies in Epidemiology (MOOSE) guidelines. Data were pooled using a random-effects model. MAIN OUTCOMES AND MEASURES Standardized mean difference of cognitive and motor tests between POE and nonexposed children. RESULTS Twenty-six peer-reviewed cohort studies were included. Cognitive outcomes were compared for a total of 1455 children with POE and 2982 nonexposed children across 3 age groups (mean [SE] age at cognitive testing was 13 [1.58] months for the toddler group; 4.5 [0.38] years for the preschool group; and 13 [2.36] years for the school-aged group). Motor outcomes were compared for 688 children with POE and 1500 nonexposed children up to age 6 years (mean [SD] age at motor testing, 2 [0.45] years). Standardized mean difference was lower in cognitive tests for children with POE at 0 to 2 years (d = -0.52; 95% CI, -0.74 to -0.31; P < .001) and 3 to 6 years (d = -0.38; 95% CI, -0.69 to -0.07; P < .001); the difference was not significant for those aged 7 to 18 years (d = -0.44; 95% CI, -1.16 to 0.28; P = .23). Motor scores were lower in children with POE (d = 0.49; 95% CI, 0.23-0.74; P < .001). CONCLUSIONS AND RELEVANCE Prenatal opioid exposure appeared to be negatively associated with neurocognitive and physical development from age 6 months, and this association persisted until adolescence. The cause and association of this with POE or other factors (eg, withdrawal treatment) are uncertain but suggest that POE necessitates long-term support and intervention.
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Affiliation(s)
- Su Lynn Yeoh
- Medical student, University of New South Wales, Sydney, New South Wales, Australia
| | - John Eastwood
- Medical student, University of New South Wales, Sydney, New South Wales, Australia
- Sydney Local Health District, Croydon, New South Wales, Australia
- Ingham Institute of Applied Medical Research, Liverpool, New South Wales, Australia
- Sydney Medical School, Faculty of Medicine and Health, Sydney University, Sydney, New South Wales, Australia
- Sydney Institute for Women, Children and Their Families, Camperdown, Sydney, New South Wales, Australia
| | - Ian M. Wright
- Early Start Research Institute, University of Wollongong, Wollongong, New South Wales, Australia
- University of Queensland Centre for Clinical Research, Herston, Queensland, Australia
| | - Rachael Morton
- NHMRC Clinical Trials Centre, Faculty of Medicine and Health, University of Sydney, Camperdown, New South Wales, Australia
| | - Edward Melhuish
- University of Queensland Centre for Clinical Research, Herston, Queensland, Australia
- Department of Education, University of Oxford, Oxford, United Kingdom
- Birkbeck, University of London, London, United Kingdom
| | - Meredith Ward
- Medical student, University of New South Wales, Sydney, New South Wales, Australia
- Birkbeck, University of London, London, United Kingdom
| | - Ju Lee Oei
- Medical student, University of New South Wales, Sydney, New South Wales, Australia
- Department of Newborn Care, Royal Hospital for Women, Sydney, Australia
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Carr KL, Stewart MW. Effectiveness of School-based Health Center Delivery of a Cognitive Skills Building Intervention in Young, Rural Adolescents: Potential Applications for Addiction and Mood. J Pediatr Nurs 2019; 47:23-29. [PMID: 31022629 DOI: 10.1016/j.pedn.2019.04.013] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2019] [Revised: 04/11/2019] [Accepted: 04/12/2019] [Indexed: 10/27/2022]
Abstract
PURPOSE Uniquely positioned, school nurses address two of the most critical adolescent health issues - addiction and mood. Cognitive behavioral therapy, the mainstay in management of adolescent mood disorders, demonstrates promise in the treatment and prevention of addictive behaviors. Quality decision-making may protect adolescents from substance abuse. Executive function, a neurocognitive aspect of decision-making, involves impulse control, future thinking, and behavioral regulation. Further, the continuum of addition implicates executive function, which makes executive function a viable target for prevention and treatment of substance use. This pilot study examined the effectiveness of a nurse-led cognitive skills training intervention, Creating Opportunities for Personal Empowerment, on executive function and mood in a novel population and setting. DESIGN AND METHODS The study sample included adolescents ranging in age from 12 to 15 years and enrolled in a rural school-based health center. Fifteen (n = 15) adolescents completed the seven-week cognitive skills building intervention led by a nurse practitioner. Researchers measured executive function, anxiety, and depression at: baseline, after the intervention series, and three-months later. RESULTS One domain of executive function - behavioral regulation - improved, as did anxiety. Depression showed short-term improvement. Metacognition did not change over time. CONCLUSIONS Preliminary results indicate that cognitive skills building delivered by school nurses may enhance aspects of executive function linked with addiction and coping, such as behavioral regulation. Further, this intervention may also improve mood in this population. PRACTICE IMPLICATIONS Delivery of cognitive skills training by school nurses could be an accessible, effective piece in addressing addiction and mood in young, rural adolescents.
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Affiliation(s)
- Kayla L Carr
- University of Mississippi Medical Center, MS, United States of America.
| | - Mary W Stewart
- University of Mississippi Medical Center, MS, United States of America.
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28
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Olfactory neuroepithelium alterations and cognitive correlates in schizophrenia. Eur Psychiatry 2019; 61:23-32. [PMID: 31260908 DOI: 10.1016/j.eurpsy.2019.06.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2019] [Revised: 05/21/2019] [Accepted: 06/11/2019] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Few studies have investigated alterations of olfactory neuroepithelium (ONE) as a biomarker of schizophrenia, and none its association with cognitive functioning. METHOD Fresh ONE cells from twelve patients with schizophrenia and thirteen healthy controls were collected by nasal brushing, cultured in proper media and passed twelve times. Markers of cell proliferation (BrdU incorporation, Cyclin-D1 and p21 protein level) were quantified.Cognitive function was measured using Brief Neuropsychological Examination-2. PRIMARY OUTCOME proliferation of ONE cells from schizophrenic patients at passage 3. Secondary outcome: association between alteration of cell proliferation and cognitive function. RESULTS Fresh ONE cells from patients showed a faster cell proliferation than those from healthy controls at passage 3. An opposite trend was observed at passage 9, ONE cells of patients with schizophrenia showing slower cell proliferation as compared to healthy controls. In schizophrenia, overall cognitive function (Spearman's rho -0.657, p < 0.01), verbal memory - immediate recall, with interference at 10 s and 30 s (Spearman's rho from -0.676 to 0.697, all p < 0.01) were inversely associated with cell proliferation at passage 3. CONCLUSION Fresh ONE cells collected by nasal brushing might eventually represent a tool for diagnosing schizophrenia based upon markers of cell proliferation, which can be easily implemented as single-layer culture. Cell proliferation at passage 3 can be regarded as a promising proxy of cognitive functioning in schizophrenia. Future studies should replicate these findings, and may assess whether ONE alterations are there before onset of psychosis, serving as an early sign in patients with at risk mental state.
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Pragst F, Krumbiegel F, Thurmann D, Westendorf L, Methling M, Niebel A, Hartwig S. Hair analysis of more than 140 families with drug consuming parents. Comparison between hair results from adults and their children. Forensic Sci Int 2019; 297:161-170. [DOI: 10.1016/j.forsciint.2019.01.039] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2018] [Revised: 01/22/2019] [Accepted: 01/24/2019] [Indexed: 11/25/2022]
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Abstract
Mothers have used opioids for thousands of years but neonatal abstinence syndrome (NAS) or rather, survivors of NAS, is a modern phenomenon. Unrecognized and/or untreated opioid withdrawal was almost always fatal but with greater awareness and standardization of treatment, NAS is now an uncommon direct cause of infant death. However, opioids are now increasingly accessible and potent and the outcomes of children after the neonatal period are of great concern, especially when coupled with multiple other social and health risks. Complex individual, environmental and genetic factors need to be considered when assessing outcomes or future research for babies with NAS. Any intervention or research efforts must address these multifactorial complexities. This review will discuss pertinent post neonatal outcomes, including mortality, physical and mental health and social functioning of children with a history of NAS.
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Affiliation(s)
- Ju Lee Oei
- Department of Newborn Care, The Royal Hospital for Women, Barker Street, Randwick, NSW, 2031, Australia; School of Women's and Children's Health, University of New South Wales, High Street, Randwick, NSW, 2031, Australia; Drug and Alcohol Services, Murrumbidgee Local Health District, Wagga Wagga, NSW, 2650, Australia.
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31
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Promoting resilience in vulnerable populations: focus on opioid-exposed children, siblings of children with special healthcare needs and support for children through school-based interventions. Curr Opin Pediatr 2019; 31:157-165. [PMID: 30531404 DOI: 10.1097/mop.0000000000000722] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE OF REVIEW Resilience is an important factor in withstanding the health consequences of childhood adversity. This article discusses recent literature related to promoting resilience in opioid-exposed children and siblings of children with special healthcare needs. It also addresses ways that school systems can foster childhood resilience. RECENT FINDINGS Rising rates of opioid-exposed newborns have necessitated the development of multiple strategies to address the medical and social needs of this vulnerable pediatric population. Siblings of children with special healthcare needs are a growing but sometimes overlooked group who have unique challenges that can be supported by healthcare providers. School programs that reward positive behavior and encourage self-regulation through activities like physical activity and mindfulness can foster an environment for improved youth resiliency. SUMMARY New research has led to the development of resources that help pediatric providers assess the needs of their vulnerable patient populations and foster resilience through attention to these patients' medical, emotional and social needs. Patients benefit from national policy efforts and local school programs that each promote resilience.
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Fill MMA, Miller AM, Wilkinson RH, Warren MD, Dunn JR, Schaffner W, Jones TF. Educational Disabilities Among Children Born With Neonatal Abstinence Syndrome. Pediatrics 2018; 142:e20180562. [PMID: 30166364 PMCID: PMC6947655 DOI: 10.1542/peds.2018-0562] [Citation(s) in RCA: 69] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/27/2018] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND Neonatal abstinence syndrome (NAS) is a postnatal drug withdrawal syndrome that can occur after intrauterine opioid exposure. Adverse neurobehavioral outcomes have been documented in infants with NAS; however, educational outcomes have not been thoroughly examined. We analyzed Tennessee data to understand the need for special educational services among infants who are born with NAS. METHODS By using Tennessee Medicaid and birth certificate data, infants who were born in Tennessee between 2008 and 2011 with a history of NAS were matched (1:3) to infants who were born during the same period without a history of NAS. Groups were matched on the basis of sex, race and/or ethnicity, age, birth region of residence, and Medicaid enrollment status. Data were linked to Tennessee Department of Education special education data during early childhood (3-8 years of age). Conditional multivariable logistic regression was used to assess associations between NAS and selected special education outcomes. RESULTS A total of 1815 children with a history of NAS and 5441 children without NAS were assessed. Children with NAS were significantly more likely to be referred for a disability evaluation (351 of 1815 [19.3%] vs 745 of 5441 [13.7%]; P < .0001), to meet criteria for a disability (284 of 1815 [15.6%] vs 634 of 5441 [11.7%]; P < .0001), and to require classroom therapies or services (278 of 1815 [15.3%] vs 620 of 5441 [11.4%]; P < .0001). These findings were sustained in a multivariable analysis, with multiple models controlling for maternal tobacco use, maternal education status, birth weight, gestational age, and/or NICU admission. CONCLUSIONS Results of this novel analysis linking health and education data revealed that children with a history of NAS were significantly more likely to have a subsequent educational disability.
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Affiliation(s)
- Mary-Margaret A Fill
- Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, Georgia;
- Tennessee Department of Health, Nashville, Tennessee
- Department of Health Policy, School of Medicine, Vanderbilt University, Nashville, Tennessee; and
| | | | | | | | - John R Dunn
- Tennessee Department of Health, Nashville, Tennessee
- Department of Health Policy, School of Medicine, Vanderbilt University, Nashville, Tennessee; and
| | - William Schaffner
- Department of Health Policy, School of Medicine, Vanderbilt University, Nashville, Tennessee; and
| | - Timothy F Jones
- Tennessee Department of Health, Nashville, Tennessee
- Department of Health Policy, School of Medicine, Vanderbilt University, Nashville, Tennessee; and
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33
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Essau CA, Sasagawa S, Lewinsohn PM, Rohde P. The impact of pre- and perinatal factors on psychopathology in adulthood. J Affect Disord 2018; 236:52-59. [PMID: 29715609 PMCID: PMC6127869 DOI: 10.1016/j.jad.2018.04.088] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2018] [Revised: 04/13/2018] [Accepted: 04/18/2018] [Indexed: 01/13/2023]
Abstract
BACKGROUND There is considerable evidence that pre- and post-natal factors are associated with a wide range of psychopathology in offspring during childhood and adolescence. OBJECTIVE The main aims of the present study were to examine the associations between pre- and perinatal factors and psychopathology in offspring during adulthood, and to explore whether family factors (i.e., family cohesion, mother's social support, and father's social support) mediate these relationships. METHOD Information on pre- and perinatal events was collected from biological mothers of the participants (N = 315) when they were between 14 and 18 years who were then followed up until they reached age 30. RESULTS Maternal obstetric history and illness during first year were significant predictors of offspring anxiety disorder. Maternal emotional health predicted offspring affective disorder. Difficult delivery and breast feeding predicted disruptive disorder. The relationship between maternal obstetric history/emotional health and anxiety/affective disorder was no longer significant after controlling for family cohesion. LIMITATIONS The information was based on maternal recall when their offspring were between 14 and 18 years which may be subjected to recall bias. CONCLUSION The association between pre- and postnatal factors and psychopathology of offspring during adulthood is mediated by familial factors.
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Affiliation(s)
- Cecilia A. Essau
- Department of Psychology, Roehampton University, London SW15 4JD, UK
| | - Satoko Sasagawa
- Faculty of Human Sciences, Mejiro University, Tokyo 161-8539, Japan
| | | | - Paul Rohde
- Oregon Research Institute, Eugene, OR 97403-1983, USA
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A review of recent literature on the impact of parental substance use disorders on children and the provision of effective services. Curr Opin Psychiatry 2018; 31:363-367. [PMID: 29794556 DOI: 10.1097/yco.0000000000000421] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE OF REVIEW To provide an update of recent studies of the incidence and impact of parental substance use disorders (SUDs) on children, and to identify effective treatment programs to assist parents with SUDs and their children. RECENT FINDINGS Children of parents with alcohol and drug use disorders (COPADs) suffer from physical, mental and behavioral problems at higher rates than other children and are more likely to develop their own SUDs in adolescence. Parenting styles and familial dysfunction contribute to the intergenerational transmission of SUDs. Studies of the negative effects of parental SUDs on children identified the effects of inconsistent, disengaged or harsh parenting practices on mother-child bonding. Exposure to violence and father's hostility contribute to children's externalizing and internalizing behaviors. Family- based intervention programs, as well as programs for mothers with SUDs and their young children, have shown positive results. For high-risk families with multiple needs, the ongoing support of multidisciplinary services is required. SUMMARY Parental SUDs have a profound impact on their children, including intergenerational transmission of SUDs. A variety of interventive programs are being studied in order to devise effective programs to assist these children.
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Cantacorps L, González-Pardo H, Arias JL, Valverde O, Conejo NM. Altered brain functional connectivity and behaviour in a mouse model of maternal alcohol binge-drinking. Prog Neuropsychopharmacol Biol Psychiatry 2018. [PMID: 29526773 DOI: 10.1016/j.pnpbp.2018.03.006] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Prenatal and perinatal alcohol exposure caused by maternal alcohol intake during gestation and lactation periods can have long-lasting detrimental effects on the brain development and behaviour of offspring. Children diagnosed with Foetal Alcohol Spectrum Disorders (FASD) display a wide range of cognitive, emotional and motor deficits, together with characteristic morphological abnormalities. Maternal alcohol binge drinking is particularly harmful for foetal and early postnatal brain development, as it involves exposure to high levels of alcohol over short periods of time. However, little is known about the long-term effects of maternal alcohol binge drinking on brain function and behaviour. To address this issue, we used pregnant C57BL/6 female mice with time-limited access to a 20% v/v alcohol solution as a procedure to model alcohol binge drinking during gestation and lactational periods. Male offspring were behaviourally tested during adolescence (30 days) and adulthood (60 days), and baseline neural metabolic capacity of brain regions sensitive to alcohol effects were also evaluated in adult animals from both groups. Our results show that prenatal and postnatal alcohol exposure caused age-dependent changes in spontaneous locomotor activity, increased anxiety-like behaviour and attenuated alcohol-induced conditioned place preference in adults. Also, significant changes in neural metabolic capacity using cytochrome c oxidase (CCO) quantitative histochemistry were found in the hippocampal dentate gyrus, the mammillary bodies, the ventral tegmental area, the lateral habenula and the central lobules of the cerebellum in adult mice with prenatal and postnatal alcohol exposure. In addition, the analysis of interregional CCO activity correlations in alcohol-exposed adult mice showed disrupted functional brain connectivity involving the limbic, brainstem, and cerebellar regions. Finally, increased neurogenesis was found in the dentate gyrus of the hippocampus of alcohol-exposed offspring, suggesting neuroadaptive effects due to early alcohol exposure. Our results demonstrate that maternal binge-like alcohol drinking causes long-lasting effects on motor and emotional-related behaviours associated with impaired neuronal metabolic capacity and altered functional brain connectivity.
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Affiliation(s)
- Lídia Cantacorps
- Neurobiology of Behaviour Research Group (GReNeC-NeuroBio), Department of Experimental and Health Sciences, Universitat Pompeu Fabra, Barcelona, Spain
| | - Héctor González-Pardo
- Laboratory of Neuroscience, Department of Psychology, University of Oviedo, Plaza Feijóo, Oviedo, Spain; Instituto de Neurociencias del Principado de Asturias (INEUROPA), Oviedo, Spain
| | - Jorge L Arias
- Laboratory of Neuroscience, Department of Psychology, University of Oviedo, Plaza Feijóo, Oviedo, Spain; Instituto de Neurociencias del Principado de Asturias (INEUROPA), Oviedo, Spain
| | - Olga Valverde
- Neurobiology of Behaviour Research Group (GReNeC-NeuroBio), Department of Experimental and Health Sciences, Universitat Pompeu Fabra, Barcelona, Spain; Neuroscience Research Program, IMIM-Hospital del Mar Research Institute, Barcelona, Spain.
| | - Nélida M Conejo
- Laboratory of Neuroscience, Department of Psychology, University of Oviedo, Plaza Feijóo, Oviedo, Spain; Instituto de Neurociencias del Principado de Asturias (INEUROPA), Oviedo, Spain
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Parolin M, Miscioscia M, De Carli P, Cristofalo P, Gatta M, Simonelli A. Alexithymia in Young Adults With Substance Use Disorders: Critical Issues About Specificity and Treatment Predictivity. Front Psychol 2018; 9:645. [PMID: 29872408 PMCID: PMC5972315 DOI: 10.3389/fpsyg.2018.00645] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2017] [Accepted: 04/16/2018] [Indexed: 11/18/2022] Open
Abstract
Several studies have reported high rates of alexithymia in drug-dependent individuals, but supporting evidence attests association between alexithymia and a variety of psychiatric disorders, raising doubts about its specificity. Moreover, controversies are emerging about alexithymia assessment: self-report measures present shortcomings with respect to discriminant validity and reliability. As regards treatment for substance use disorders (SUDs), alexithymia has been linked to poorer outcomes, but the results are inconsistent. The aim of the present study is to investigate alexithymia in substance-dependent young adults by examining: (a) the specificity of alexithymia in drug-dependent inpatients, compared to healthy individuals and patients with psychiatric disorders (behavioral and emotional disorders) and (b) the predictivity of alexithymia in determining treatment outcomes in terms of relapses, drop-outs from treatment and the rate of relapse per month of treatment. Two studies were conducted to fulfill these aims: Study 1 and Study 2. Study 1 involved 90 late adolescents, aged 17-21. To fulfill the first aim, 30 inpatients diagnosed with SUD were compared with 30 healthy controls and 30 individuals referred to an outpatient neuropsychiatric unit (a). The participants completed the Toronto Alexithymia Scale-20 (TAS-20) and the Symptom Checklist-90-Revised (SCL-90-R). The results indicated that both clinical groups reported higher TAS-20 scores than the non-clinical subjects, but they did not differ from each other (a); moreover, a large correlation was detected between alexithymia and depressive symptoms, as assessed by the SCL-90-R. Study 2 involved 55 inpatients with SUD recruited in a therapeutic community. The participants completed the TAS-20, and clinicians filled out the Observer Alexithymia Scale (OAS). No association was found between self-report and observational measures. Neither self-reported nor observed alexithymia predicted the number of relapses, drop-out from treatment, or the rate of relapses per month of treatment (b). When the interaction with gender was explored, the global score of alexithymia and the "Distant" OAS subscale predicted the number rate relapses only in males. The TAS-20 did not discriminate between the clinical groups. The limited ability of both observed and self-reported measures in predicting treatment outcome raises questions on the specificity of alexithymia among the substance-dependent inpatient population.
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Affiliation(s)
- Micol Parolin
- Department of Developmental Psychology and Socialization, University of Padua, Padua, Italy
| | - Marina Miscioscia
- Department of Developmental Psychology and Socialization, University of Padua, Padua, Italy
- Department of Women's and Children's Health, University of Padua, Padua, Italy
| | - Pietro De Carli
- Department of Developmental Psychology and Socialization, University of Padua, Padua, Italy
| | | | - Michela Gatta
- Department of Women's and Children's Health, University of Padua, Padua, Italy
- Childhood Adolescence Family Unit, Ulss6 Veneto, Padua, Italy
| | - Alessandra Simonelli
- Department of Developmental Psychology and Socialization, University of Padua, Padua, Italy
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Emotional Availability, Neuropsychological Functioning, and Psychopathology: The Context of Parental Substance Use Disorder. BIOMED RESEARCH INTERNATIONAL 2018; 2018:5359037. [PMID: 29888268 PMCID: PMC5985126 DOI: 10.1155/2018/5359037] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/09/2018] [Accepted: 04/11/2018] [Indexed: 11/17/2022]
Abstract
Parental Substance Use Disorder (SUD) constitutes a high-risk condition for parent-child interactions and child development. Empirical evidence indicates high rates of psychopathology and neuropsychological impairments in individuals with SUD. Despite research indicating that parenting skills are related to psychological well-being and cognitive/neuropsychological functioning, prior studies have not examined the associations between these areas of parental functioning and the quality of parent-child interactions in the context of SUD. Aim(s). The present study adopts an integrated perspective to investigate the way in which maternal neuropsychological functioning and psychopathology are associated with mother-child emotional availability (EA), in the context of parental Substance Use Disorder. Methods. Twenty-nine mothers with SUD were assessed in interaction with their children, as well as with respect to their neuropsychological functioning and psychopathology. Results. In this group, high rates of maternal neuropsychological impairments and psychopathology, as well as generally low levels of EA, were uncovered. Regression analyses showed that maternal neuropsychological functioning was significantly associated with mother-child EA, specifically sensitivity; the role of maternal psychopathology, however, was only marginally significant. Conclusion. In the context of SUD, maternal neuropsychological impairments are significantly associated with mother-child EA. Clinical implications of the findings are discussed.
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Parcianello RR, Mardini V, Ceresér KMM, Langleben DD, Xavier F, Zavaschi MLS, Rhode LAP, Pechansky F, Gubert C, Szobot CM. Increased cocaine and amphetamine-regulated transcript cord blood levels in the newborns exposed to crack cocaine in utero. Psychopharmacology (Berl) 2018; 235:215-222. [PMID: 29080905 DOI: 10.1007/s00213-017-4759-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2017] [Accepted: 10/03/2017] [Indexed: 12/20/2022]
Abstract
BACKGROUND Cocaine and amphetamine-regulated transcript (CART) is an endogenous antioxidant present since the embryonic period. CART is activated by high levels of dopamine and might be of interested in understanding the changes in the REDOX system associated with crack/cocaine intake. The goal of this study was to determine whether exposure to crack in utero is associated with increased CART levels. METHODS In this cross-sectional study with consecutive sampling, we compared the umbilical cord blood (UCB) CART levels (μg/mL) of newborns exposed to crack/cocaine in utero (EN, n = 57) to levels in non-exposed newborns (NEN, n = 99). In addition, we compared serum CART levels between EN and NEN mothers, in the immediate postpartum period. Potential confounders, such as perinatal data (e.g., weight, Apgar, etc.), psychopathology (DSM-IV), and use of drugs other than crack (ASSIST) were assessed. RESULTS According to general linear model analysis, the adjusted mean CART was significantly higher in EN (0.180, 95% CI 0.088-0.272) than in NEN (0.048, 95% CI 0.020-0.076; p < 0.002; d = 0.68). The difference in CART levels between EN and NEN mothers was not significant (p ≥ 0.05). CONCLUSION The increase in CART levels in EN UBC suggests a response to crack/cocaine-induced oxidative stress during gestational period, as a potential attempt of neuroprotection. In adult women in puerperium, however, this endogenous antioxidant recruitment does not seem to operate.
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Affiliation(s)
- Rodrigo Ritter Parcianello
- Graduate Program in Psychiatry and Behavioral Sciences, Universidade Federal do Rio Grande do Sul (UFRGS), Rua Ramiro Barcelos, 2400, Santa Cecília, Porto Alegre, RS, 90035-003, Brazil
| | - Victor Mardini
- Child and Adolescent Psychiatry Service (SPIA), Hospital de Clínicas de Porto Alegre (HCPA), Rua Ramiro Barcelos, 2350, 4° andar, sala 400N, Santa Cecília, Porto Alegre, RS, 90035-903, Brazil
| | - Keila Maria Mendes Ceresér
- Graduate Program in Psychiatry and Behavioral Sciences, Universidade Federal do Rio Grande do Sul (UFRGS), Rua Ramiro Barcelos, 2400, Santa Cecília, Porto Alegre, RS, 90035-003, Brazil
- Laboratory of Molecular Psychiatry and Instituto Nacional de Ciência e Tecnologia Translacional em Medicina (INCT-TM), HCPA, UFRGS, Rua Ramiro Barcelos, 2350, Santa Cecília, Porto Alegre, RS, 90035-903, Brazil
| | - Daniel D Langleben
- Department of Psychiatry, University of Pennsylvania, Perelman School of Medicine, Philadelphia, PA, 19104, USA
| | - Fernando Xavier
- Program in Biomedical Sciences, Centro Universitário Metodista-IPA, Rua Dona Leonor, 340, Rio Branco, Porto Alegre, RS, 90420-004, Brazil
| | - Maria Lucrécia Scherer Zavaschi
- Child and Adolescent Psychiatry Service (SPIA), Hospital de Clínicas de Porto Alegre (HCPA), Rua Ramiro Barcelos, 2350, 4° andar, sala 400N, Santa Cecília, Porto Alegre, RS, 90035-903, Brazil
| | - Luis Augusto Paim Rhode
- Graduate Program in Psychiatry and Behavioral Sciences, Universidade Federal do Rio Grande do Sul (UFRGS), Rua Ramiro Barcelos, 2400, Santa Cecília, Porto Alegre, RS, 90035-003, Brazil
- Child and Adolescent Psychiatry Service (SPIA), Hospital de Clínicas de Porto Alegre (HCPA), Rua Ramiro Barcelos, 2350, 4° andar, sala 400N, Santa Cecília, Porto Alegre, RS, 90035-903, Brazil
- Instituto Nacional de Psiquiatria do Desenvolvimento (INPD), Rua Dr. Ovídio Pires de Campos, 785, 1° andar, sala 6, Ala Sul, Cerqueira Cesar, São Paulo, SP, 05403-010, Brazil
- Department of Psychiatry, UFRGS, Rua Ramiro Barcelos, 2400, Santa Cecília, Porto Alegre, RS, 90035-003, Brazil
| | - Flávio Pechansky
- Graduate Program in Psychiatry and Behavioral Sciences, Universidade Federal do Rio Grande do Sul (UFRGS), Rua Ramiro Barcelos, 2400, Santa Cecília, Porto Alegre, RS, 90035-003, Brazil
- Department of Psychiatry, UFRGS, Rua Ramiro Barcelos, 2400, Santa Cecília, Porto Alegre, RS, 90035-003, Brazil
- Center for Drug and Alcohol Research, HCPA, UFRGS, Rua Professor Álvaro Alvim, 400, Rio Branco, Porto Alegre, RS, 90420-020, Brazil
| | - Carolina Gubert
- Laboratory of Molecular Psychiatry and Instituto Nacional de Ciência e Tecnologia Translacional em Medicina (INCT-TM), HCPA, UFRGS, Rua Ramiro Barcelos, 2350, Santa Cecília, Porto Alegre, RS, 90035-903, Brazil
- Graduate Program in Biological Sicences, Biochemistry, Universidade Federal do Rio Grande do Sul (UFRGS), Rua Ramiro Barcelos, 2600, Santa Cecília, Porto Alegre, RS, 90035-003, Brazil
| | - Claudia Maciel Szobot
- Graduate Program in Psychiatry and Behavioral Sciences, Universidade Federal do Rio Grande do Sul (UFRGS), Rua Ramiro Barcelos, 2400, Santa Cecília, Porto Alegre, RS, 90035-003, Brazil.
- Child and Adolescent Psychiatry Service (SPIA), Hospital de Clínicas de Porto Alegre (HCPA), Rua Ramiro Barcelos, 2350, 4° andar, sala 400N, Santa Cecília, Porto Alegre, RS, 90035-903, Brazil.
- Center for Drug and Alcohol Research, HCPA, UFRGS, Rua Professor Álvaro Alvim, 400, Rio Branco, Porto Alegre, RS, 90420-020, Brazil.
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39
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Oei JL, Melhuish E, Uebel H, Azzam N, Breen C, Burns L, Hilder L, Bajuk B, Abdel-Latif ME, Ward M, Feller JM, Falconer J, Clews S, Eastwood J, Li A, Wright IM. Neonatal Abstinence Syndrome and High School Performance. Pediatrics 2017; 139:peds.2016-2651. [PMID: 28093465 DOI: 10.1542/peds.2016-2651] [Citation(s) in RCA: 108] [Impact Index Per Article: 15.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/14/2016] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Little is known of the long-term, including school, outcomes of children diagnosed with Neonatal abstinence syndrome (NAS) (International Statistical Classification of Disease and Related Problems [10th Edition], Australian Modification, P96.1). METHODS Linked analysis of health and curriculum-based test data for all children born in the state of New South Wales (NSW), Australia, between 2000 and 2006. Children with NAS (n = 2234) were compared with a control group matched for gestation, socioeconomic status, and gender (n = 4330, control) and with other NSW children (n = 598 265, population) for results on the National Assessment Program: Literacy and Numeracy, in grades 3, 5, and 7. RESULTS Mean test scores (range 0-1000) for children with NAS were significantly lower in grade 3 (359 vs control: 410 vs population: 421). The deficit was progressive. By grade 7, children with NAS scored lower than other children in grade 5. The risk of not meeting minimum standards was independently associated with NAS (adjusted odds ratio [aOR], 2.5; 95% confidence interval [CI], 2.2-2.7), indigenous status (aOR, 2.2; 95% CI, 2.2-2.3), male gender (aOR, 1.3; 95% CI, 1.3-1.4), and low parental education (aOR, 1.5; 95% CI, 1.1-1.6), with all Ps < .001. CONCLUSIONS A neonatal diagnostic code of NAS is strongly associated with poor and deteriorating school performance. Parental education may decrease the risk of failure. Children with NAS and their families must be identified early and provided with support to minimize the consequences of poor educational outcomes.
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Affiliation(s)
- Ju Lee Oei
- School of Women's and Children's Health, .,Department of Newborn Care, Royal Hospital for Women, Randwick, New South Wales, Australia.,Ingham Research Centre, Liverpool, New South Wales, Australia
| | - Edward Melhuish
- Early Start Research Institute and.,Department of Education, University of Oxford, Oxford, United Kingdom.,Department of Psychological Sciences, Birkbeck, University of London, London, United Kingdom
| | | | | | | | | | - Lisa Hilder
- National Perinatal Epidemiology and Statistics Unit, University of New South Wales, Sydney, New South Wales, Australia
| | | | - Mohamed E Abdel-Latif
- Department of Neonatology, The Canberra Hospital, Garran, Australian Capital Territory, Australia.,Faculty of Medicine, the Australian National University, Deakin, Australian Capital Territory, Australia
| | - Meredith Ward
- School of Women's and Children's Health.,Department of Newborn Care, Royal Hospital for Women, Randwick, New South Wales, Australia
| | - John M Feller
- School of Women's and Children's Health.,Sydney Children's Hospital, Sydney Children's Hospital Network, Randwick, New South Wales, Australia
| | - Janet Falconer
- The Langton Centre, Surry Hills, New South Wales, Australia
| | - Sara Clews
- The Langton Centre, Surry Hills, New South Wales, Australia
| | - John Eastwood
- School of Women's and Children's Health.,Ingham Research Centre, Liverpool, New South Wales, Australia.,Community Health Services, Sydney Local Health District, Sydney, New South Wales, Australia.,School of Public Health, Menzies Centre for Health Policy, and Charles Perkins Centre, University of Sydney, Camperdown, New South Wales, Australia; and.,School of Medicine, Griffith University, Gold Coast, Queensland, Australia
| | - Annie Li
- School of Women's and Children's Health
| | - Ian M Wright
- Early Start Research Institute and.,Illawarra Health and Medical Research Institute and School of Medicine, The University of Wollongong, Wollongong, New South Wales, Australia.,Department of Paediatrics, The Wollongong Hospital, Wollongong, New South Wales, Australia
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