Abstinence self-efficacy in people with severe mental illness

Exploring the use of activity-based group therapy in increasing self-efficacy and subjective well-being in acute mental health

Background/Objectives

Self-efficacy is a key component in mental health recovery and improvement in well-being. Mental illness is often resultant of environmental stressors, highlighting the importance of coping skills. Occupational therapists commonly utilise activity-based group therapy to encourage use of activities as coping strategies. However, there has been little research concerning these groups and their role in enhancing self-efficacy in behavioural-based coping skills. This study aimed to explore factors that affect behavioural-based coping self-efficacy during activity-based group therapy in an acute mental health ward. It investigates the relationships between (1) behavioural-based coping self-efficacy with overall mental health self-efficacy and (2) mental health self-efficacy and subjective well-being.

Methods

Immediately after the first group, participants completed a post-group questionnaire. Participation level was also rated. At discharge, the participants were asked to complete the UK Office of National Statistics subjective well-being tool and the Mental Health Self-Efficacy Scale. Descriptive statistics, independent sample t-tests and one-way analysis of variance were done to examine possible covariates and confounders of all outcome variables. General linear models were then conducted.

Results

Post-group questionnaire reflected moderate-high self-efficacy (M = 6.92, SD = 2.48) and positive well-being with higher happiness scores (M = 7.42, SD = 2.20) and lower anxiety scores (M = 3.79, SD = 2.85). Coping self-efficacy significantly predicted overall mental health self-efficacy (p = .014), which in turn significantly predicted positive domains of well-being.

Conclusions

Performing behavioural-based coping strategies in groups can enhance coping self-efficacy and positive well-being, with possible positive influence on mental health self-efficacy and well-being at discharge.

Psychometric properties of the Anxiety Sensitivity Index-3 in adults with substance use disorders

Anxiety sensitivity, or the fear of anxiety-related sensations, has demonstrated relevance to a broad range of psychiatric conditions, including substance use disorders (SUDs). Anxiety sensitivity is typically measured through self-report instruments, most commonly the Anxiety Sensitivity Index-3 (ASI-3). Despite the widespread use of the ASI-3 in studies of SUDs, little is known about its psychometric properties within this population. Patients on an inpatient detoxification unit seeking treatment for SUDs (N = 1248) completed a battery of self-report measures, including the ASI-3. Psychometric properties of the ASI-3 were examined. An exploratory factor analysis with half of the sample (n = 624) supported a 3-factor structure corresponding to the ASI-3 subscales (Social Concerns, Cognitive Concerns, Physical Concerns). Confirmatory factor analysis was used to validate this 3-dimensional structure in a separate subsample (n = 624), resulting in adequate fit when testing a second-order hierarchical model. Internal consistency and convergent and discriminant validity results also supported the use of the ASI-3 in people with SUDs. Despite its widespread use in SUD research, this is the first psychometric investigation of the ASI-3 among individuals seeking treatment for SUDs.

Recovery resources and psychiatric severity among persons with substance use disorders

A comparative analysis of recovery resources (abstinence social support, abstinence self-efficacy) was conducted among two groups exiting inpatient treatment for substance use disorders: persons with psychiatric comorbid substance use disorders and persons with substance use disorders. Both groups reported comparable levels of abstinence social support, but this resource was not significantly related to substance use among persons with psychiatric comorbid substance use disorders. Although abstinence self-efficacy was significantly related to substance use, persons with psychiatric comorbid substance use disorders reported significantly lower levels of abstinence self-efficacy than persons with substance use disorders. Findings suggest that persons with psychiatric comorbid substance use disorders exit alcohol/drug treatment with lower levels of abstinence self-efficacy compared to their substance use disorder peers.

Tobacco retailer proximity and density and nicotine dependence among smokers with serious mental illness

OBJECTIVES

We examined the density and proximity of tobacco retailers and associations with smoking behavior and mental health in a diverse sample of 1061 smokers with serious mental illness (SMI) residing in the San Francisco Bay Area of California.

METHODS

Participants' addresses were geocoded and linked with retailer licensing data to determine the distance between participants' residence and the nearest retailer (proximity) and the number of retailers within 500-meter and 1-kilometer service areas (density).

RESULTS

More than half of the sample lived within 250 meters of a tobacco retailer. A median of 3 retailers were within 500 meters of participants' residences, and a median of 12 were within 1 kilometer. Among smokers with SMI, tobacco retailer densities were 2-fold greater than for the general population and were associated with poorer mental health, greater nicotine dependence, and lower self-efficacy for quitting.

CONCLUSIONS

Our findings provide further evidence of the tobacco retail environment as a potential vector contributing to tobacco-related disparities among individuals with SMI and suggest that this group may benefit from progressive environmental protections that restrict tobacco retail licenses and reduce aggressive point-of-sale marketing.