1
|
López-Toro E, Wolf CJH, González RA, van den Brink W, Schellekens A, Vélez-Pastrana MC. Network Analysis of DSM Symptoms of Substance Use Disorders and Frequently Co-Occurring Mental Disorders in Patients with Substance Use Disorder Who Seek Treatment. J Clin Med 2022; 11:jcm11102883. [PMID: 35629008 PMCID: PMC9145186 DOI: 10.3390/jcm11102883] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Revised: 05/10/2022] [Accepted: 05/15/2022] [Indexed: 02/04/2023] Open
Abstract
Background: Substance use disorders (SUD) often co-occur with other psychiatric conditions. Research on SUD and comorbid disorders generally flows from a categorical diagnostic or dimensional latent variable perspective, where symptoms are viewed as independent indicators of an underlying disorder. In contrast, the current study took a network analysis perspective to examine the relationships between DSM symptoms of SUD, ADHD, conduct disorder (CD), depression (MDD), and borderline personality disorder (BPD). In addition, we explored possible gender differences in the network structures of these symptoms. Method: In a sample of 722 adult treatment-seeking patients with SUD from the International ADHD in Substance Use Disorders Prevalence Study (IASP) we estimated the network structure for 41 symptoms of SUD, ADHD, CD, MDD, and BPD. We described the structure of symptom networks and their characteristics for the total sample, and we compared the symptom networks for males and females. Results: Network analyses identified seven clusters of symptoms, largely corresponding with the DSM diagnostic categories. There were some connections between clusters, mainly between some hyperactivity symptoms and CD and depressive symptoms. ADHD hyperactivity was most central in the symptom network. Invariance tests revealed no significant gender differences in the structure of symptom networks. Conclusions: The current findings support the categorical DSM classification of mental disorders in treatment-seeking patients with SUD. Future network analyses should include a broader range of symptoms and prospectively explore changes in the symptoms network of patients during treatment.
Collapse
Affiliation(s)
- Edith López-Toro
- PhD Program in Clinical Psychology, Universidad Carlos Albizu, P.O. Box 9023711, San Juan, PR 00902-3711, USA;
| | - Casper J. H. Wolf
- Department of Psychiatry, Radboud University Medical Center, 6525 GA Nijmegen, The Netherlands; (C.J.H.W.); (A.S.)
- Department of Cognitive Neuroscience, Donders Institute for Brain Cognition and Behaviour, Radboud University, 6525 EN Nijmegen, The Netherlands
- Nijmegen Institute for Scientist-Practitioners in Addiction (NISPA), 6525 HR Nijmegen, The Netherlands
| | - Rafael A. González
- National Adoption and Fostering Service & National Conduct Problems Team, Michael Rutter Centre, South London and Maudsley NHS Foundation Trust, London SE5 8AZ, UK;
- Centre for Psychiatry, Imperial College London, London W12 0NN, UK
| | - Wim van den Brink
- Department of Psychiatry, Amsterdam University Medical Center, Location Academic Medical Center, Meibergdreef 5, 1105 AZ Amsterdam, The Netherlands;
| | - Arnt Schellekens
- Department of Psychiatry, Radboud University Medical Center, 6525 GA Nijmegen, The Netherlands; (C.J.H.W.); (A.S.)
- Nijmegen Institute for Scientist-Practitioners in Addiction (NISPA), 6525 HR Nijmegen, The Netherlands
| | - María C. Vélez-Pastrana
- PhD Program in Clinical Psychology, Universidad Carlos Albizu, P.O. Box 9023711, San Juan, PR 00902-3711, USA;
- Correspondence: ; Tel.: +1-787-725-6500
| | | |
Collapse
|
2
|
Vélez-Pastrana MC, González RA, Ramos-Fernández A, Ramírez Padilla RR, Levin FR, Albizu García C. Attention Deficit Hyperactivity Disorder in Prisoners: Increased Substance Use Disorder Severity and Psychiatric Comorbidity. Eur Addict Res 2020; 26:179-190. [PMID: 32615575 DOI: 10.1159/000508829] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2020] [Accepted: 05/18/2020] [Indexed: 11/19/2022]
Abstract
OBJECTIVES Attention deficit hyperactivity disorder (ADHD) and substance use disorders (SUD) are overrepresented among incarcerated populations. We examined whether ADHD was associated with increased severity of comorbid SUD and with increased psychiatric comorbidity among prisoners. METHODS Cross-sectional study of 500 randomly selected Latino male prisoners in the Puerto Rico Correctional System using validated diagnostic measures to assess Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-5) ADHD and SUD diagnosis, antisocial personality disorder (ASP) and borderline personality disorder (BPD), major depression, and generalized anxiety disorder (GAD). We defined SUD severity by symptom count and by presence of at least 2 current SUD diagnoses (polysubstance). RESULTS Participants with ADHD had increased risk for lifetime (p < 0.05) and current (p < 0.01) SUDs, all comorbid psychiatric disorders, and suicidality (p < 0.001). They had more severe SUD, both in number of symptoms and number of SUD (polysubstance) diagnoses (p < 0.01). ADHD was associated with increased psychiatric comorbidity, as participants with ADHD were more likely to have a second diagnosis, and a greater number of comorbid disorders (p < 0.001). ASP, BPD, major depression, and GAD, but not ADHD, were significant predictors of SUD severity in adjusted models. CONCLUSIONS Findings highlight the complex mental health needs of incarcerated populations, where SUD, ADHD, and other psychiatric disorders are prevalent and interrelated.
Collapse
Affiliation(s)
- María C Vélez-Pastrana
- PhD Program in Clinical Psychology, Universidad Carlos Albizu, San Juan, Puerto Rico, .,Center for Evaluation and Sociomedical Research, Graduate School of Public Health, University of Puerto Rico, Rio Piedras, Puerto Rico, USA,
| | - Rafael A González
- National Adoption and Fostering Service & National Conduct Problems Team, Michael Rutter Centre, South London and Maudsley NHS Foundation Trust, London, United Kingdom.,Centre for Psychiatry, Division of Brain Sciences, Department of Medicine, Imperial College London, London, United Kingdom
| | | | - Rafael R Ramírez Padilla
- Center for Evaluation and Sociomedical Research, Graduate School of Public Health, University of Puerto Rico, Rio Piedras, Puerto Rico, USA
| | - Frances R Levin
- New York State Psychiatric Institute, Columbia University Irving Medical Center, New York, New York, USA
| | - Carmen Albizu García
- Center for Evaluation and Sociomedical Research, Graduate School of Public Health, University of Puerto Rico, Rio Piedras, Puerto Rico, USA
| |
Collapse
|
3
|
González RA, Vélez-Pastrana MC, Blankers M, Bäcker A, Konstenius M, Holtmann M, Levin FR, Noack M, Kaye S, Demetrovics Z, van de Glind G, van den Brink W, Schellekens A. Onset and Severity of Early Disruptive Behavioral Disorders in Treatment-Seeking Substance Use Disorder Patients with and without Attention-Deficit/Hyperactivity Disorder. Eur Addict Res 2020; 26:211-222. [PMID: 32594079 DOI: 10.1159/000508653] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2020] [Accepted: 05/13/2020] [Indexed: 11/19/2022]
Abstract
AIMS This study addressed the age of onset of conduct disorder (CD) and oppositional defiant disorder (ODD) in treatment-seeking substance use disorder (SUD) patients with and without adult attention-deficit/hyperactivity disorder (ADHD) and its association with early onset of SUD. METHODS We examined data from the 2nd International ADHD in Substance Use Disorders Prevalence Study, including 400 adults in SUD treatment from Puerto Rico, Hungary, and Australia. ADHD, SUD, and CD/ODD were assessed with the Conners Adult ADHD Diagnostic Interview for DSM-IV, the MINI International Neuropsychiatric Interview, and the K-SADS, respectively. Cox regression analyses modeled time to emergence of CD/ODD separately for SUD patients with and without adult ADHD. Linear regression models examined associations between age of onset of SUD and presence of ADHD and adjusted for sex, age, and country. To assess the mediating role of CD/ODD on the association of ADHD with onset of SUD, adjusted regression models were estimated. RESULTS Treatment-seeking SUD patients with ADHD presented an earlier onset of CD/ODD compared with those without ADHD. CD/ODD symptom loads were higher among the SUD and ADHD group. Age of first substance use and SUD were significantly earlier in SUD patients with ADHD, and these findings remained significant after adjustment for demographics and coexisting CD/ODD. CONCLUSIONS ADHD is associated with earlier onset of SUD as well as with an earlier onset of more frequent and more severe disruptive behavioral disorders. These findings may inform preventive interventions to mitigate adverse consequences of ADHD.
Collapse
Affiliation(s)
- Rafael A González
- National Adoption and Fostering Service & National Conduct Problems Team, Michael Rutter Centre, South London and Maudsley NHS Foundation Trust, London, United Kingdom, .,Centre for Psychiatry, Imperial College London, London, United Kingdom,
| | - María C Vélez-Pastrana
- PhD Program in Clinical Psychology, Universidad Carlos Albizu, San Juan, Puerto Rico, USA
| | - Matthijs Blankers
- Arkin Mental Health Care, Department of Research, Amsterdam, The Netherlands.,Trimbos institute, Netherlands Institute of Mental Health and Addiction, Utrecht, The Netherlands.,Department of Psychiatry, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Amanda Bäcker
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Maija Konstenius
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Martin Holtmann
- LWL-University Hospital for Child and Adolescent Psychiatry, Ruhr-University Bochum, Hamm, Germany
| | - Frances R Levin
- New York State Psychiatric Institute, Columbia University Irving Medical Center, New York, New York, USA
| | - Moritz Noack
- LWL-University Hospital for Child and Adolescent Psychiatry, Ruhr-University Bochum, Hamm, Germany
| | - Sharlene Kaye
- National Drug and Alcohol Research Centre, University of New South Wales, Sydney, New South Wales, Australia
| | - Zsolt Demetrovics
- Institute of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary
| | - Geurt van de Glind
- Radboudumc, Donders Centre for Medical Neuroscience, Department of Psychiatry, Nijmegen, The Netherlands.,Nijmegen Institute for Scientist Practitioners in Addiction, Nijmegen, The Netherlands
| | - Wim van den Brink
- Department of Psychiatry, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Arnt Schellekens
- Radboudumc, Donders Centre for Medical Neuroscience, Department of Psychiatry, Nijmegen, The Netherlands.,Nijmegen Institute for Scientist Practitioners in Addiction, Nijmegen, The Netherlands
| | | |
Collapse
|
4
|
Sánchez-García NC, González RA, Ramos-Quiroga JA, van den Brink W, Luderer M, Blankers M, Grau-Lopez L, Levin FR, Kaye S, Demetrovics Z, van de Glind G, Schellekens A, Vélez-Pastrana MC. Attention Deficit Hyperactivity Disorder Increases Nicotine Addiction Severity in Adults Seeking Treatment for Substance Use Disorders: The Role of Personality Disorders. Eur Addict Res 2020; 26:191-200. [PMID: 32564016 DOI: 10.1159/000508545] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2020] [Accepted: 05/07/2020] [Indexed: 11/19/2022]
Abstract
AIMS To examine the role of attention deficit/hyperactivity disorder (ADHD) and impulsive personality disorders in nicotine addiction severity among treatment-seeking substance use disorder (SUD) patients. METHODS In a cross-sectional study, we examined data from the second International ADHD in Substance Use Disorders Prevalence Study (IASP-2) on 402 adults in SUD treatment from Puerto Rico, Hungary, and Australia using diagnostic interviews for ADHD, antisocial (ASP) and borderline (BPD) personality disorders, and the self-report Fagerström Test of Nicotine Dependence (FTND). We compared SUD patients with and without ADHD on nicotine addiction severity. We tested direct and indirect pathways from ADHD to nicotine addiction and mediation through ASP and BPD. RESULTS Overall, 81.4% of SUD patients reported current cigarette smoking. SUD patients with ADHD had higher FTND scores and smoked more cigarettes than those without ADHD, with an earlier onset and more years of smoking. ASP mediated the effect of ADHD on all aspects of nicotine addiction severity, whereas BPD did so only on some aspects of nicotine addiction severity. CONCLUSIONS SUD patients with comorbid ADHD show more severe nicotine addiction than those without, which is largely explained by comorbid impulsive personality disorders. In SUD patients, it is important to screen for adult ADHD and other psychiatric disorders, especially those with impulse control deficits such as ASP and BPD.
Collapse
Affiliation(s)
| | - Rafael A González
- National Adoption and Fostering Service & National Conduct Problems Team, Michael Rutter Centre, South London and Maudsley NHS Foundation Trust, London, United Kingdom.,Centre for Mental Health, Division of Brain Sciences, Department of Medicine, Imperial College London, London, United Kingdom
| | - Josep A Ramos-Quiroga
- Department of Psychiatry, Hospital Universitari Vall d'Hebron, CIBERSAM, Barcelona, Spain.,Group of Psychiatry, Mental Health and Addiction, Vall d'Hebron Research Institute, Barcelona, Spain.,Department of Psychiatry and Forensic Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Wim van den Brink
- Amsterdam University Medical Centers, Academic Medical Center, University of Amsterdam, Department of Psychiatry, Amsterdam, The Netherlands
| | - Mathias Luderer
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital, Goethe University Frankfurt, Frankfurt, Germany
| | - Matthijs Blankers
- Department of Research, Arkin Mental Health Care, Amsterdam, The Netherlands.,Trimbos Institute, Netherlands Institute of Mental Health and Addiction, Utrecht, The Netherlands.,Department of Psychiatry, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Lara Grau-Lopez
- Department of Psychiatry, Hospital Universitari Vall d'Hebron, CIBERSAM, Barcelona, Spain.,Department of Psychiatry and Forensic Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Frances R Levin
- Department of Psychiatry, Columbia University Medical Center, New York, New York, USA.,CUMC/Herbert Pardes Building, New York State Psychiatric Institute, New York, New York, USA
| | - Sharlene Kaye
- Research Unit, Justice Health and Forensic Mental Health Network, Sydney, New South Wales, Australia.,National Drug and Alcohol Research Centre, University of New South Wales, Sydney, New South Wales, Australia
| | - Zsolt Demetrovics
- Department of Clinical Psychology and Addictions, Institute of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary
| | - Geurt van de Glind
- Department of Psychiatry, Donders Centre for Medical Neuroscience, Radboudumc, Nijmegen, The Netherlands.,Department of Psychiatry, Nijmegen Institute for Scientist Practitioners in Addiction, Nijmegen, The Netherlands
| | - Arnt Schellekens
- Department of Psychiatry, Donders Centre for Medical Neuroscience, Radboudumc, Nijmegen, The Netherlands.,Department of Psychiatry, Nijmegen Institute for Scientist Practitioners in Addiction, Nijmegen, The Netherlands
| | | | | |
Collapse
|
5
|
González RA, Vélez-Pastrana MC, McCrory E, Kallis C, Aguila J, Canino G, Bird H. Evidence of concurrent and prospective associations between early maltreatment and ADHD through childhood and adolescence. Soc Psychiatry Psychiatr Epidemiol 2019; 54:671-682. [PMID: 30903235 DOI: 10.1007/s00127-019-01659-0] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2018] [Accepted: 01/17/2019] [Indexed: 01/04/2023]
Abstract
PURPOSE An emerging body of work suggests a link between childhood maltreatment and attention-deficit hyperactivity disorder (ADHD). However, research examining the role of maltreatment in the early course of the disorder lacks robust evidence from longitudinal studies. Our aim was to examine concurrent and prospective associations between maltreatment experiences and ADHD diagnosis and sex differences, and to estimate the association between repetitive maltreatment exposure and ADHD through childhood and adolescence. METHODS Data were obtained from the Boricua Youth Study, a longitudinal study of 2480 children and adolescents of Puerto Rican background. Neglect, physical, emotional and sexual abuse, and foster placement were regressed on ADHD diagnosis measured at each of three waves using the Diagnostic Interview Schedule for Children-IV. Multilevel regressions estimated the effects of exposure on ADHD, adjusted by age, sex, income, household education, parental psychopathology, comorbidity and ADHD medication status. RESULTS Emotional abuse and foster placement had robust associations with ADHD diagnosis. For girls, physical abuse had a threefold increase in the odds of having ADHD diagnosis; for boys, associations were observed only for emotional abuse. Prospective models examining the risk of ADHD following maltreatment provided initial evidence for the effects of physical abuse on ADHD, and a linear trend for repetitive exposure suggested increased probability for disorder persistence. CONCLUSIONS Associations between early maltreatment and ADHD were robust. Different categories of maltreatment increase the likelihood of ADHD for girls and boys. Increased exposure to maltreatment may predict symptom persistence. Interventions addressing ADHD must consider the effects of both sex and family environment.
Collapse
Affiliation(s)
- Rafael A González
- Centre for Mental Health, Division of Brain Sciences, Department of Medicine, Imperial College London, 7th floor Commonwealth Building, Du Cane Road, London, W12 0NN, UK. .,Center for Evaluation and Sociomedical Research, Graduate School of Public Health, University of Puerto Rico, San Juan, PR, USA.
| | - María C Vélez-Pastrana
- Center for Evaluation and Sociomedical Research, Graduate School of Public Health, University of Puerto Rico, San Juan, PR, USA.,Ph.D. Program in Clinical Psychology, Carlos Albizu University, San Juan, PR, USA
| | - Eamon McCrory
- Division of Psychology and Language Sciences, University College London, London, UK
| | | | - Jivelisse Aguila
- Ph.D. Program in Clinical Psychology, Carlos Albizu University, San Juan, PR, USA
| | - Glorisa Canino
- Behavioral Sciences Research Institute, University of Puerto Rico School of Medicine, San Juan, PR, USA
| | | |
Collapse
|
6
|
Román-Ithier JC, González RA, Vélez-Pastrana MC, González-Tejera GM, Albizu-García C. Attention deficit hyperactivity disorder symptoms, type of offending and recidivism in a prison population: The role of substance dependence. Crim Behav Ment Health 2017; 27:443-456. [PMID: 27455899 PMCID: PMC5269538 DOI: 10.1002/cbm.2009] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/14/2015] [Revised: 02/14/2016] [Accepted: 06/07/2016] [Indexed: 06/06/2023]
Abstract
BACKGROUND It is unclear whether adult offenders with a history of attention deficit hyperactivity disorder (ADHD) are more likely to re-offend, and if so, in any specific offences. AIM This study aimed to examine correlates of childhood ADHD symptoms among prisoners. METHODS A randomly selected sample of 1179 participants from the adult sentenced population of Puerto Rico (USA) reported their history of violent and non-violent offences, age of first arrest and re-offending. Participants completed retrospective measures of ADHD and a diagnostic interview for substance use disorders. RESULTS Self-reported ADHD was associated with age of first arrest, a number of violent and non-violent offences and re-offending. The association with any non-violent offending was explained statistically by substance use disorders and other psychosocial covariates. ADHD was independently associated with being under 15 years of age at first arrest and with re-offending. CONCLUSIONS Although some associations between ADHD and offending may be accounted for by co-morbidity with substance use disorders, early onset of offending and repeated violent offending appear to be directly related to ADHD. Criminal justice policies should, therefore, incorporate ADHD screening accompanied by appropriate rehabilitation programmes when such neurodevelopmental disorder is identified. Copyright © 2016 John Wiley & Sons, Ltd.
Collapse
Affiliation(s)
| | - Rafael A. González
- Centre for Mental Health, Division of Brain Sciences, Department of Medicine, Imperial College London, UK
- Center for Evaluation and Sociomedical Research, Graduate School of Public Health, University of Puerto Rico
| | - María C. Vélez-Pastrana
- Center for Evaluation and Sociomedical Research, Graduate School of Public Health, University of Puerto Rico
- Clinical Psychology PhD Program, Carlos Albizu University, San Juan, PR
| | | | - Carmen Albizu-García
- Center for Evaluation and Sociomedical Research, Graduate School of Public Health, University of Puerto Rico
| |
Collapse
|
7
|
Vélez-Pastrana MC, González RA, Cardona JR, Baerga PP, Rodríguez ÁA, Levin FR. Psychometric properties of the Barkley Deficits in Executive Functioning Scale: A Spanish-Language Version in a community sample of puerto rican adults. Psychol Assess 2016; 28:483-98. [PMID: 26302104 PMCID: PMC4766062 DOI: 10.1037/pas0000171] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Performance-based measures have shown some limitation in the assessment of executive functioning (EF) and rating scales have been proposed as an alternative. Our aim was to conduct a comprehensive psychometric evaluation of the Barkley Deficits in Executive Functioning Scale (BDEFS), as administered in 452 Latino community adults (65.5% female). The BDEFS was back-translated into Spanish. We performed exploratory factor analysis (EFA) to assess the structure of the translated BDEFS and to compare it with the original five-factor structure based on the English-language version. Confirmatory factor analysis (CFA) was performed to test the original language structure of the instrument, and also a modified version with items that loaded equally in both versions. The Adult Self-Report Scale was used to screen for ADHD symptoms. We assessed invariance on the latent factor's mean by age and gender, and to estimate associations with ADHD symptom dimensions. The five-factor structure of the BDEFS was partially supported by EFA/CFA, in which 78 out of 89 items loaded similar to the original English-language structure. Factor scores were significantly associated with ADHD symptom dimensions. Model-based contrasts revealed that inattention was primarily associated with disorganization, time-management and motivational aspects of EF; hyperactivity was predominantly related to self-restraint and self-regulation factors. The BDEFS seemingly assesses similar dimensions of the EF construct in English and in the present Spanish-language versions. Factor scores were differentially associated with ADHD subtypes. Replication and confirmation of the Spanish-language BDEFS in a larger sample is advised. (PsycINFO Database Record
Collapse
Affiliation(s)
- María C. Vélez-Pastrana
- Carlos Albizu University, San Juan, PR
- University of Puerto Rico Graduate School of Public Health
| | - Rafael A. González
- University of Puerto Rico Graduate School of Public Health
- Imperial College London, UK
| | | | | | - Ángel Alicea Rodríguez
- Carlos Albizu University, San Juan, PR
- University of Puerto Rico Graduate School of Public Health
| | - Frances R. Levin
- Columbia University, New York, NY, USA
- New York State Psychiatric Institute, USA
| |
Collapse
|
8
|
González RA, Vélez-Pastrana MC, Ruiz Varcárcel JJ, Levin FR, Albizu-García CE. Childhood ADHD symptoms are associated with lifetime and current illicit substance-use disorders and in-site health risk behaviors in a representative sample of Latino prison inmates. J Atten Disord 2015; 19:301-12. [PMID: 23212598 PMCID: PMC3641170 DOI: 10.1177/1087054712461690] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE This study aimed to explore retrospective childhood ADHD symptomatology, psychiatric comorbidity, rates of substance-use disorders (SUD), as well as their association with high-risk health behaviors in prison and adverse health outcomes. METHOD A randomly selected representative sample of inmates in the Puerto Rico correctional system (N = 1,179) was assessed with the Spanish-language Wender Utah Rating Scale (WURS); the Composite International Diagnostic Interview (CIDI) modules for lifetime/current major depression disorder (MDD), generalized anxiety disorder (GAD), and SUD; the Davidson Trauma Scale (DTS; posttraumatic stress disorder [PTSD]); and self-reports of in-site high-risk behaviors. RESULTS Wald χ(2) tests revealed significant associations of ADHD with MDD and PTSD, as well as increased risk for overdosing and intravenous drug use in prison. A logistic regression model adjusted for mood and anxiety comorbidity predicted lifetime SUD diagnosis (odds ratio = 2.38; 95% confidence interval = [1.15, 4.94]). CONCLUSION Our results provide further evidence on the association of drug dependence and ADHD symptoms, and their overrepresentation among prison inmates.
Collapse
Affiliation(s)
- Rafael A. González
- Center for Evaluation and Sociomedical Research, Graduate School of Public Health, University of Puerto Rico, San Juan, PR,Corresponding author. 26 Troy Court, High Street Kensington, London, UK, W8RD7 Tel.: +1 (787) 758 2525 ext. 4218, Fax: +1 (787) 767 4146, (R. González)
| | | | - José J. Ruiz Varcárcel
- Center for Evaluation and Sociomedical Research, Graduate School of Public Health, University of Puerto Rico, San Juan, PR
| | - Frances R. Levin
- Department of Psychiatry, Columbia University College of Physicians and Surgeons/New York State Psychiatric Institute, New York, NY, USA
| | - Carmen E. Albizu-García
- Center for Evaluation and Sociomedical Research, Graduate School of Public Health, University of Puerto Rico, San Juan, PR
| |
Collapse
|
9
|
Castro-Díaz BL, Rodríguez-Gómez J, Vélez-Pastrana MC. Factor Structure and Reliability of the Spanish Version of the Marital Satisfaction Questionnaire for Older Persons. Journal of Couple & Relationship Therapy 2012. [DOI: 10.1080/15332691.2012.718970] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
|
10
|
Vélez-Pastrana MC, Rodríguez Gómez JR, Martínez Lugo M. [Social support, activity, and health among the elderly]. Bol Asoc Med P R 1997; 89:174-83. [PMID: 9577051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
The present study examined the relationship between social support, activity level and physical health among a sample of 96 Puerto Rican elderly persons. The Spanish version of the Inventory of Socially Supportive Behaviors (ISSB28) was used to assess social support. Two structured questionnaires were administered to obtain measures of activity level and physical health. A multiple correlation-regression analysis was performed, and partial correlation coefficients were also obtained. A partial correlation of .48 (p < .001) was observed between the ISSB scores and the measure of physical health, indicating a direct relationship between poor health and social support. This finding is inconsistent with previous studies, which suggest that better health is associated with higher levels of social support. Moderate-low, negative correlations were found between activity level and 3 indicators of poor health. Thus, higher activity levels were associated with better physical health. For example, partial correlations of-.31 (p = .003) and -.29 (p = .007), respectively, were found between the activity level and the number and length of hospital stays. The correlation between the amount of surgical interventions undergone by the patient during the previous year and the activity level was -.28 (p = .009). These findings demonstrate that higher levels of activity are associated with better physical health in elderly persons, as indicated by less frequent and shorter hospital stays, and lower frequency of surgical interventions. Several multiple regression analyses showed that social support and activity level, taken together, are statistically significant predictors of the number and length of hospital stays, and the number of surgical interventions undergone by the elderly patient. Together, these two factors explain from 11 to 18% of the variability in several indicators of physical health.
Collapse
|