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Jallo N, Kinser PA, Eglovitch M, Worcman N, Webster P, Alvanzo A, Svikis D, Meshberg-Cohen S. Giving Voice to Women with Substance Use Disorder: Findings from Expressive Writing About Trauma. WOMEN'S HEALTH REPORTS (NEW ROCHELLE, N.Y.) 2024; 5:223-230. [PMID: 38516652 PMCID: PMC10956529 DOI: 10.1089/whr.2023.0173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 01/29/2024] [Indexed: 03/23/2024]
Abstract
Background Trauma exposure is a risk factor for substance use disorders (SUD) among women. This study explores written content from an expressive writing (EW) intervention conducted within a residential SUD program to examine themes across trauma experiences and characterize their deep insight into such experiences. Materials and Methods This qualitative study is a secondary data analysis of written content of the first writing session from women (n = 44) randomized to an EW condition while in residential SUD treatment. Results Nearly all participants (72.7% African American; mean age 37.3 years) reported a significant trauma event (93.2%) with an average of 3.7 types of trauma events (54.4% had a current posttraumatic stress disorder diagnosis). Four primary themes emerged: (1) trauma across the lifespan; (2) loss of safety; (3) altered self-concept; and (4) desire to move on. Most participants identified interpersonal trauma, especially at an early age, as well as parental neglect and physical and/or sexual violence. These themes indicate a pattern of interpersonal betrayal and paint a picture of trauma and the subsequent "rippling effect" such that the physical, mental, and emotional consequences were often as impactful as the event itself. However, there was also a desire to move on and gain a sense of normalcy. Conclusions Findings highlight the importance of the written word and addressing underlying trauma in addiction treatment to facilitate healing and the woman's desire to move on.
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Affiliation(s)
- Nancy Jallo
- Department of Family and Community Health Nursing, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Patricia A. Kinser
- Department of Family and Community Health Nursing, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Michelle Eglovitch
- Department of Psychology, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Nicola Worcman
- Interdisciplinary Cooperation for Ayahuasca Research and Outreach, State University of Campinas, Campinas, Brazil
| | - Parker Webster
- Chinle Comprehensive Healthcare Facility, Indian Health Service, Chinle, Arizona, USA
| | - Anika Alvanzo
- Substance Use Disorders Consultation Services, School of Medicine, Johns Hopkins University, Baltimore, Maryland, USA
| | - Dace Svikis
- Department of Psychology, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Sarah Meshberg-Cohen
- Department of Psychiatry, Yale University School of Medicine, West Haven, Connecticut, USA
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Wei SY, Tsai TH, Tsai TY, Chen PS, Tseng HH, Yang YK, Zhai T, Yang Y, Wang TY. The Association between Default-mode Network Functional Connectivity and Childhood Trauma on the Symptom Load in Male Adults with Methamphetamine Use Disorder. CLINICAL PSYCHOPHARMACOLOGY AND NEUROSCIENCE : THE OFFICIAL SCIENTIFIC JOURNAL OF THE KOREAN COLLEGE OF NEUROPSYCHOPHARMACOLOGY 2024; 22:105-117. [PMID: 38247417 PMCID: PMC10811392 DOI: 10.9758/cpn.23.1079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Revised: 05/25/2023] [Accepted: 08/14/2023] [Indexed: 01/23/2024]
Abstract
Objective : The relationship between adverse childhood experiences and methamphetamine use disorder (MUD) has been shown in previous studies; nevertheless, the underlying neural mechanisms remain elusive. Childhood trauma is associated with aberrant functional connectivity (FC) within the default-mode network (DMN). Furthermore, within the DMN, FC may contribute to impaired self-awareness in addiction, while cross-network FC is critical for relapse. We aimed to investigate whether childhood trauma was associated with DMN-related resting-state FC among healthy controls and patients with MUD and to examine whether DMN-related FC affected the effect of childhood trauma on the symptom load of MUD diagnosis. Methods : Twenty-seven male patients with MUD and 27 male healthy controls were enrolled and completed the Childhood Trauma Questionnaire. DMN-related resting-state FC was examined using functional magnetic resonance imaging. Results : There were 47.1% healthy controls and 66.7% MUD patients in this study with adverse childhood experiences. Negative correlations between adverse childhood experiences and within-DMN FC were observed in both healthy controls and MUD patients, while within-DMN FC was significantly altered in MUD patients. The detrimental effects of adverse childhood experiences on MUD patients may be attenuated through DMN-executive control networks (ECN) FC. Conclusion : Adverse childhood experiences were negatively associated with within-DMN FC in MUD patients and healthy controls. However, DMN-ECN FC may attenuate the effects of childhood trauma on symptoms load of MUD.
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Affiliation(s)
- Shyh-Yuh Wei
- Department of Psychiatry, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Tsung-Han Tsai
- Department of Psychiatry, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Tsung-Yu Tsai
- Department of Psychiatry, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Po See Chen
- Department of Psychiatry, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
- Institute of Behavioral Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Huai-Hsuan Tseng
- Department of Psychiatry, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
- Institute of Behavioral Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Yen Kuang Yang
- Department of Psychiatry, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
- Institute of Behavioral Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan
- Department of Psychiatry, Tainan Hospital, Ministry of Health and Welfare, Tainan, Taiwan
| | - Tianye Zhai
- Neuroimaging Research Branch, National Institute on Drug Abuse, Intramural Research Program, National Institutes of Health, Baltimore, MD, USA
| | - Yihong Yang
- Neuroimaging Research Branch, National Institute on Drug Abuse, Intramural Research Program, National Institutes of Health, Baltimore, MD, USA
| | - Tzu-Yun Wang
- Department of Psychiatry, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
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Giggie M, Boudreaux M, Harper E. Characteristics of a Southern Intensive Trauma- and Psychiatric-Focused Recovery Program. South Med J 2023; 116:776-781. [PMID: 37657788 DOI: 10.14423/smj.0000000000001598] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/03/2023]
Abstract
OBJECTIVES Treatment of substance use disorders (SUDs) is complex, involving biological, psychological, and social factors to be considered when designing effective programs. Trauma-informed psychiatric care integrated with a developmentally appropriate intensive 12-step approach is being used at A Reprieve for Women (Reprieve), a long-term intensive residential recovery program for female emerging adults with SUDs located in Tuscaloosa, Alabama. The Reprieve treatment philosophy focuses on long-term intensive care, treatment of coexisting trauma and psychiatric disorders, and development of life skills. The purpose of this article is to outline Reprieve's programmatic features and report Reprieve's 1- and 2-year sobriety rates for women who completed the 6-month residential program and compare it with national sobriety rates for other residential SUD treatment programs. METHODS Reprieve provided 1- and 2-year sobriety rates and duration of treatment from 110 deidentified participants who completed Reprieve's 6-month residential program between September 2016 and November 2020. The researchers defined sobriety as complete abstinence from any addictive substances. Reprieve staff contacted program graduates to determine sobriety status following completion of the program. This research, approved by the University of Alabama's institutional review board, involved usable data points from 68 of the 110 participants. RESULTS We determined that Reprieve has a 75% 1-year sobriety rate and a 63% 2-year sobriety rate. The national average sobriety rate for people completing SUD treatment in residential programs is 40%. CONCLUSIONS Reprieve's higher-than-national sobriety rates make it a valuable program to study. Its emphasis on the treatment of coexisting psychiatric problems and past traumas, development of life skills, and the unique needs of female emerging adults may contribute to the program's success. It is hoped that this program description and preliminary analysis of outcomes will provide valuable information for future SUD treatment program development. More rigorous study is needed to delineate the effects of specific programmatic features on sobriety.
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Affiliation(s)
- Marisa Giggie
- From the College of Community Health Sciences, University of Alabama-Tuscaloosa, Tuscaloosa
| | - Madison Boudreaux
- From the College of Community Health Sciences, University of Alabama-Tuscaloosa, Tuscaloosa
| | - Emma Harper
- From the College of Community Health Sciences, University of Alabama-Tuscaloosa, Tuscaloosa
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4
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Van Overloop E, Arms-Chavez C, Carol RN, LoBello SG. Effects of Adverse Childhood Experiences and Chronic Health Conditions on Current Depression. Community Ment Health J 2023; 59:1208-1216. [PMID: 36840804 DOI: 10.1007/s10597-023-01103-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Accepted: 02/14/2023] [Indexed: 02/26/2023]
Abstract
This study investigated the ability of three adverse childhood experience (ACE) types (household dysfunction, emotional/physical abuse, and sexual abuse) to predict current depression among adults. We also determined the contribution of ACEs to current depression after controlling for covariates and chronic illnesses. Respondents to the 2010 Behavioral Risk Factor Surveillance System (n = 20,345) were divided into depressed and not depressed groups based on Patient Health Questionnaire-8 (PHQ-8) scores. Binary logistic regression determined the ability of ACE exposure to predict depression while controlling for effects of covariates and number of chronic illnesses. Hierarchical multiple linear regression determined the association of ACEs on depression scores after accounting for the covariate set and chronic illnesses. Sexual Abuse had the single strongest association with current depression of any ACE exposure. Exposure to three ACE types has the greatest association with current depression. ACEs accounted for about 7% of the variance in depression scores.
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Affiliation(s)
- Erica Van Overloop
- University of Southern Mississippi, School of Psychology, Owings-McQuagge Hall 231, 118 College Dr., #5025, Hattiesburg, MS, 39406, United States
| | - Clarissa Arms-Chavez
- Department of Psychology, Auburn University at Montgomery, 7430 East Drive, Montgomery, AL, 36117, United States
| | - Rolando N Carol
- Department of Psychology, Auburn University at Montgomery, 7430 East Drive, Montgomery, AL, 36117, United States
| | - Steven G LoBello
- Department of Psychology, Auburn University at Montgomery, 7430 East Drive, Montgomery, AL, 36117, United States.
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Mehr JB, Bennett ER, Price JL, de Souza NL, Buckman JF, Wilde EA, Tate DF, Marshall AD, Dams-O'Connor K, Esopenko C. Intimate partner violence, substance use, and health comorbidities among women: A narrative review. Front Psychol 2023; 13:1028375. [PMID: 36778165 PMCID: PMC9912846 DOI: 10.3389/fpsyg.2022.1028375] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Accepted: 12/14/2022] [Indexed: 01/28/2023] Open
Abstract
Exposure to intimate partner violence (IPV), including physical, sexual, and psychological violence, aggression, and/or stalking, impacts overall health and can have lasting mental and physical health consequences. Substance misuse is common among individuals exposed to IPV, and IPV-exposed women (IPV-EW) are at-risk for transitioning from substance misuse to substance use disorder (SUD) and demonstrate greater SUD symptom severity; this too can have lasting mental and physical health consequences. Moreover, brain injury is highly prevalent in IPV-EW and is also associated with risk of substance misuse and SUD. Substance misuse, mental health diagnoses, and brain injury, which are highly comorbid, can increase risk of revictimization. Determining the interaction between these factors on the health outcomes and quality of life of IPV-EW remains a critical need. This narrative review uses a multidisciplinary perspective to foster further discussion and research in this area by examining how substance use patterns can cloud identification of and treatment for brain injury and IPV. We draw on past research and the knowledge of our multidisciplinary team of researchers to provide recommendations to facilitate access to resources and treatment strategies and highlight intervention strategies capable of addressing the varied and complex needs of IPV-EW.
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Affiliation(s)
- Jacqueline B. Mehr
- School of Environmental and Biological Sciences, Rutgers University – New Brunswick, New Brunswick, NJ, United States
| | - Esther R. Bennett
- School of Social Work, Rutgers University - New Brunswick, New Brunswick, NJ, United States
| | - Julianne L. Price
- Department of Kinesiology and Health, Rutgers University - New Brunswick, New Brunswick, NJ, United States,Center of Alcohol and Substance Use Studies, Graduate School of Applied and Professional Psychology, Rutgers University - New Brunswick, New Brunswick, NJ, United States
| | - Nicola L. de Souza
- School of Graduate Studies, Biomedical Sciences, Rutgers Biomedical and Health Sciences, Newark, NJ, United States,Department of Rehabilitation and Movement Sciences, School of Health Professions, Rutgers Biomedical and Health Sciences, Newark, NJ, United States,Department of Rehabilitation and Human Performance, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Jennifer F. Buckman
- Department of Kinesiology and Health, Rutgers University - New Brunswick, New Brunswick, NJ, United States,Center of Alcohol and Substance Use Studies, Graduate School of Applied and Professional Psychology, Rutgers University - New Brunswick, New Brunswick, NJ, United States
| | - Elisabeth A. Wilde
- Department of Neurology, School of Medicine, The University of Utah, Salt Lake City, UT, United States,George E. Wahlen, VA Salt Lake City Healthcare System, Research Care Line, Salt Lake City, UT, United States
| | - David F. Tate
- Department of Neurology, School of Medicine, The University of Utah, Salt Lake City, UT, United States,George E. Wahlen, VA Salt Lake City Healthcare System, Research Care Line, Salt Lake City, UT, United States
| | - Amy D. Marshall
- Department of Psychology, College of the Liberal Arts, The Pennsylvania State University, State College, PA, United States
| | - Kristen Dams-O'Connor
- Department of Rehabilitation and Human Performance, Icahn School of Medicine at Mount Sinai, New York, NY, United States,Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Carrie Esopenko
- Department of Rehabilitation and Movement Sciences, School of Health Professions, Rutgers Biomedical and Health Sciences, Newark, NJ, United States,Department of Rehabilitation and Human Performance, Icahn School of Medicine at Mount Sinai, New York, NY, United States,*Correspondence: Carrie Esopenko,
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Allison MK, Henderson H, Curran G, Zielinski MJ. Emergency Department Nurses' Perceptions of Patient Substance Use, Impact on Sexual Assault Care, and Access to Follow-up Behavioral Health Resources. J Emerg Nurs 2022; 48:698-708. [PMID: 36075768 PMCID: PMC9669220 DOI: 10.1016/j.jen.2022.07.010] [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] [Received: 10/26/2021] [Revised: 06/30/2022] [Accepted: 07/29/2022] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Patients may present to the emergency department for sexual assault care under the influence of drugs or alcohol. However, many emergency nurses are not prepared to meet their unique needs or aware of follow-up behavioral health resources. The purpose of this study was to (1) summarize current resources provided to patients and processes for referral to behavioral health services after sexual assault care, (2) explore emergency nurses' attitudes and behaviors toward patient substance use, and (3) explore nurses' perceptions of adjunct mobile health interventions for follow-up behavioral health care and describe anticipated barriers to use. METHODS Fifteen emergency nurses participated in semi-structured qualitative interviews. RESULTS Participants had mixed perceptions of patient intoxication during sexual assault care. They felt that conversations about substance use may be more appropriate after the ED visit. Participants recognized the opportunity to connect ED patients with substance use treatment or prevention resources but perceived that there are few local service providers. Most participants were not referring patients with substance use issues to behavioral health services after sexual assault care and said that their emergency departments did not have processes for referral to these services. Acceptability of mobile health for follow-up behavioral health care was high, but participants had concerns for patient privacy and internet access. Participants gave recommendations to improve referral practices and patient engagement with mobile health interventions. DISCUSSION This study highlights the need for emergency nurses to consider patient intoxication during sexual assault care and opportunities to connect patients with resources post-assault.
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Affiliation(s)
- M. Kathryn Allison
- Department of Health Behavior and Health Education, Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences
| | - Hannah Henderson
- Psychiatric Research Institute, University of Arkansas for Medical Sciences
| | - Geoffrey Curran
- Center for Implementation Research, University of Arkansas for Medical Sciences
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The Effects of Childhood Emotional and Physical Maltreatment on Adolescents' Disordered Eating Behaviors: The Mediating Role of Borderline Personality Features. J Nerv Ment Dis 2022; 210:831-837. [PMID: 35703279 DOI: 10.1097/nmd.0000000000001556] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Over time, a complex crossroad between disordered eating behaviors (DEBs) and borderline personality features (BPFs) and their association with childhood emotional and physical maltreatment have been established. The present study aimed at evaluating the direct and indirect effect of physical and emotional abuse and neglect on DEB via BPF in a nonclinical adolescent sample. A total of 786 adolescents (48.3% male; mean age, 16.25 years; SD, 1.76) participated in the study. The mediation model suggested the pivotal predictive role of emotional maltreatment compared with the physical one. Indeed, both emotional abuse and neglect directly and indirectly predicted disordered eating via BPF ( β = 0.097; p < 0.001 and β = 0.042; p < 0.01, respectively). Likely, the emotional maltreatment represents the beginning of a developmental cascade that culminates in DEB as a maladaptive coping strategy in response to negative emotions, through BPF. On the contrary, physical maltreatment seems to be less involved in the developmental cascade.
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Hans SL, Herriott AL, Finger B, Edwards RC, McNeilly CG. Parenting Among Women in Methadone Treatment: Contributions of Mental Health Problems and Violence Exposure. Child Psychiatry Hum Dev 2022:10.1007/s10578-022-01463-z. [PMID: 36308598 DOI: 10.1007/s10578-022-01463-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/12/2022] [Indexed: 11/30/2022]
Abstract
The aim of the current study is to explore factors associated with quality of parenting among women in treatment for opioid use disorders. 150 Black American women with 3-5 year old children were recruited through methadone treatment programs. Parenting representations were assessed through the Working Model of the Child Interview and parenting behavior through video recordings of mother-child interaction. Interviews were used to assess mothers' history of violence exposure and to make DSM diagnoses. Mothers' mood disorder was related to distorted representations and to expressions of concerned affect (anxiety, fear, guilt). Mothers' personality disorder was related to expressions of negative affect (anger and frustration) and inversely related to sensitive parenting behavior. Mothers' experience of family violence during childhood and partner violence during adulthood were related to concerned affect in their representations. Women in treatment for substance use disorder have complex and interconnected needs, including parenting supports and trauma-informed mental health services.
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Affiliation(s)
- Sydney L Hans
- Crown Family School of Social Work, Policy, and Practice, The University of Chicago, 969 E 60th Street, Chicago, IL, 60637, USA.
| | - Anna L Herriott
- Crown Family School of Social Work, Policy, and Practice, The University of Chicago, 969 E 60th Street, Chicago, IL, 60637, USA
| | - Brent Finger
- Department of Psychology, Montana State University, Billings, MT, USA
| | - Renee C Edwards
- Crown Family School of Social Work, Policy, and Practice, The University of Chicago, 969 E 60th Street, Chicago, IL, 60637, USA
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9
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Scarlett H, Melchior M, Davisse-Paturet C, Aarbaoui TE, Longchamps C, Figueiredo N, Ducarroz S. Substance Use Among Residents of Homeless Shelters During the COVID-19 Pandemic: Findings From France. Int J Public Health 2022; 67:1604684. [PMID: 36090832 PMCID: PMC9452639 DOI: 10.3389/ijph.2022.1604684] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Accepted: 07/26/2022] [Indexed: 12/01/2022] Open
Abstract
Objectives: To record the prevalence and risk factors of substance use amongst homeless persons during the COVID-19 pandemic. Methods: The ECHO study consisted in two independent cross-sectional waves of data collection in the regions of Paris, Lyon, and Strasbourg during the Spring of 2020 (n = 530) and 2021 (n = 319). Factors associated with substance use were explored using generalised logistic regression models. Results: The most prevalent substance used was tobacco (38%–43%), followed by alcohol (26%–34%). The use of both substances positively associated with each other, although risk factors varied depending on the substance. The only factors consistently associated with alcohol and tobacco use were being male, exposure to theft/assault and participants’ region of origin. Whilst the rate of tobacco use was relatively stable between Spring 2020 and 2021, alcohol use was more common in 2021. Conclusion: These findings highlight a high prevalence of substance use amongst homeless persons. People experiencing homelessness face specific challenges in the context of the pandemic, alongside greater vulnerability to illness and low healthcare access, therefore the need to improve prevention and support services for substance abuse within this population is vital.
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Affiliation(s)
- Honor Scarlett
- Sorbonne Université, INSERM, Institut Pierre Louis d’Epidémiologie et de Santé Publique, Paris, France
- *Correspondence: Honor Scarlett, ; Simon Ducarroz,
| | - Maria Melchior
- Sorbonne Université, INSERM, Institut Pierre Louis d’Epidémiologie et de Santé Publique, Paris, France
- CNRS, Institut Convergences Migration, Aubervilliers, France
| | - Camille Davisse-Paturet
- Research on Healthcare Performance RESHAPE, INSERM U1290, Université Claude Bernard Lyon 1, Lyon, France
| | - Tarik El. Aarbaoui
- Sorbonne Université, INSERM, Institut Pierre Louis d’Epidémiologie et de Santé Publique, Paris, France
| | - Cécile Longchamps
- Sorbonne Université, INSERM, Institut Pierre Louis d’Epidémiologie et de Santé Publique, Paris, France
| | - Natasha Figueiredo
- Sorbonne Université, INSERM, Institut Pierre Louis d’Epidémiologie et de Santé Publique, Paris, France
| | - Simon Ducarroz
- Sorbonne Université, INSERM, Institut Pierre Louis d’Epidémiologie et de Santé Publique, Paris, France
- CNRS, Institut Convergences Migration, Aubervilliers, France
- *Correspondence: Honor Scarlett, ; Simon Ducarroz,
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10
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Robinson LD, Kelly PJ, Larance BK, Griffiths S, Deane FP. Eating Disorder Behaviours and Substance Use in Women Attending Treatment for Substance Use Disorders: a Latent Class Analysis. Int J Ment Health Addict 2022. [DOI: 10.1007/s11469-021-00497-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
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11
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Edwards KM, Siller L, Ullman SE, Lee KDM, Murphy SB. Post-traumatic Growth in Women With Histories of Addiction and Victimization Residing in a Sober Living Home. JOURNAL OF INTERPERSONAL VIOLENCE 2022; 37:NP11180-NP11197. [PMID: 33541201 DOI: 10.1177/0886260521991283] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Research consistently documents the deleterious sequelae of interpersonal trauma, including domestic and sexual violence (DSV). More recently, however, researchers and practitioners have focused on positive outcomes, such as post-traumatic growth (PTG), in survivors of DSV. Although research has begun to document the prevalence and correlates of PTG, no study to our knowledge has explored PTG in a sample of women with histories of addiction and victimization residing in a trauma-informed sober living home (SLH). The purpose of the current study was to examine this gap in the literature. Participants were 59 women (89.8% White; 86.4% heterosexual; mean age = 41.6) who completed a survey while residing in a SLH. Most women reported moderate to high levels of PTG. At the bivariate level PTG was related to less depression, post-traumatic stress disorder, and financial worries, and greater active coping, and sense of community. PTG was also related to the absence of past 6-month physical intimate partner violence. In regression analyses, PTG was related to less depression and greater sense of community. These data offer insights into modifiable factors such as fostering a sense of community while also promoting mental health treatment that could be the focus of interventions to increase PTG in women with histories of addiction and victimization residing in SLHs.
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12
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Ward E, Carlisle N, Williams E, Heath SL, Meloun K, Walter LA. Prevalence of hepatitis C in sexual assault survivors presenting to a SANE clinic: A descriptive analysis. J Viral Hepat 2022; 29:487-492. [PMID: 35357765 DOI: 10.1111/jvh.13675] [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: 11/17/2021] [Revised: 01/26/2022] [Accepted: 03/11/2022] [Indexed: 12/09/2022]
Abstract
While previous epidemiologic research has demonstrated that sexual assault survivors (SAS) may be at disproportionate risk for exposure to Hepatitis C (HCV), HCV screening in SAS is not addressed in current post-sexual assault testing recommendations. We sought to identify the prevalence of HCV among a SAS cohort along with associated basic demographics. Opt-out HCV antibody screening and RNA confirmatory testing was provided for all SAS at a Sexual Assault Nurse Examiner (SANE) clinic in Birmingham, Alabama, from April 2020 through March 2021. A retrospective chart review was conducted using descriptive statistical and Chi-squared analyses. A total of 293 SAS presented to the clinic during the study timeframe. Two hundred forty-two (82.6%) were screened for HCV and 26 (8.9%) were found to be HCV antibody (Ab) positive [significantly higher than state (<1.0%) and national (1.0%) HCV incidence rates (p < 0.0001)]. SAS age groups 25-34 and 35-44 were more likely to screen HCV Ab-positive (15.2% and 14.9% respectively; p = 0.02). Female SAS were more likely to be tested for HCV then males (p = 0.02), although male SAS were more likely to be found HCV Ab-positive when screened (24.4%, p < 0.0001). Overall, SAS demographics also demonstrate the presence of significant social vulnerabilities, specifically high rates of homelessness (4.4%) and incarceration (5.1%). This data highlight the potential impact of universal HCV screening and risk counselling in a high social risk population and suggests a potential for future focused interventions.
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Affiliation(s)
- Erin Ward
- Heersink School of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Nicholas Carlisle
- Division of Infectious Diseases, Heersink School of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Ebony Williams
- Division of Infectious Diseases, Heersink School of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Sonya L Heath
- Division of Infectious Diseases, Department of Internal Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Kellie Meloun
- Crisis Center Birmingham, Sexual Assault Nurse Examiner (SANE), SANE Clinic Director, Birmingham, Alabama, USA
| | - Lauren A Walter
- Department of Emergency Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA
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Wahab S, Sivarajah R, Azmi AD, Chemi N, Mahadevan R. Association between childhood trauma, intimate partner violence, and perceived parental competence among women abusing amphetamine-type stimulant. Front Psychiatry 2022; 13:994324. [PMID: 36684009 PMCID: PMC9845574 DOI: 10.3389/fpsyt.2022.994324] [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: 07/14/2022] [Accepted: 11/21/2022] [Indexed: 01/06/2023] Open
Abstract
INTRODUCTION This cross-sectional study examines the correlation between childhood trauma, intimate partner violence (IPV), and parenting self-efficacy among women who reported using amphetamine-type stimulants (ATS) in an institutional drug rehabilitation center. METHODS A total of 106 participants were recruited by purposive sampling, of which 88 were mothers. Questionnaires were used to collect sociodemographic data and study variables. RESULTS Most of these women had experienced emotional abuse, sexual abuse, and physical neglect in their childhood. IPV assessments revealed that 70.5% (n = 74) and 30.5% (n = 32) had experienced physical and sexual violence, respectively. In terms of parenting competency, they scored 79.5% for self-efficacy and 54.4% for parenting satisfaction. Childhood emotional abuse significantly increases the odds of individuals experiencing sexual violence by 20.9%. DISCUSSION We found that childhood trauma and IPV did not have a significant relationship with parenting efficacy. Conversely, childhood emotional abuse and physical abuse were negatively correlated to parenting satisfaction. It is imperative that any form of childhood abuse be recognized and stopped early to reduce the harm it brings to women later in life.
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Affiliation(s)
- Suzaily Wahab
- Department of Psychiatry, Universiti Kebangsaan Malaysia Medical Centre, Bandar Tun Razak, Malaysia
| | - Rubini Sivarajah
- Department of Psychiatry, Hospital Kajang, Bandar Kajang, Selangor, Malaysia
| | - Amirul Danial Azmi
- Department of Psychiatry, Universiti Kebangsaan Malaysia Medical Centre, Bandar Tun Razak, Malaysia
| | - Norliza Chemi
- Department of Psychiatry, Hospital Kajang, Bandar Kajang, Selangor, Malaysia
| | - Raynuha Mahadevan
- Department of Psychiatry, Universiti Kebangsaan Malaysia Medical Centre, Bandar Tun Razak, Malaysia
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Mental illness, physical and sexual abuse associated with HIV risk behaviors among adults evaluated for substance use and treatment planning in the National Addictions Vigilance Intervention and Prevention Program - United States, 2014-2019. DRUG AND ALCOHOL DEPENDENCE REPORTS 2021; 1:100009. [PMID: 36843912 PMCID: PMC9949317 DOI: 10.1016/j.dadr.2021.100009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Revised: 11/18/2021] [Accepted: 11/19/2021] [Indexed: 11/21/2022]
Abstract
Background The association between sexual and physical abuse history, mental illness, and HIV risk behaviors among persons starting treatment for substance use is not well-understood. Methods The study population included 216,877 US residents in the National Addictions Vigilance Intervention and Prevention Program (NAVIPPRO) from January 1, 2014-December 31, 2019. We used logistic regression models to estimate strength of pairwise association between mental illness, sexual or physical abuse histories and each of 3 HIV risk outcomes. Results Compared with no history of physical or sexual abuse, a history of sexual and physical abuse combined was associated with greater odds ratios for: (1) injection drug use among persons without a history of mental illness (odds ratio [OR] 2.4; 95% confidence interval [CI]: 2.3-2.6) than among persons with a history of mental illness (OR 2.0; 95% CI: 1.9-2.0); (2) prostitution conviction among persons without mental illness (OR 3.8; 95% CI: 2.8-5.1) than among persons with mental illness (OR 2.8; 95% CI: 2.4-3.4); and (3) and ≥2 sex partners within the past 30 days with a history of mental illness (OR 1.3; 95% CI: 1.2-1.4). Conclusions The findings imply that efforts to reduce HIV risk behaviors during and after substance use treatment can be improved by considering the patient's history of physical or sexual abuse and mental illness when providing care.
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Kimmel SD, Kim JH, Kalesan B, Samet JH, Walley AY, Larochelle MR. Against Medical Advice Discharges in Injection and Non-injection Drug Use-associated Infective Endocarditis: A Nationwide Cohort Study. Clin Infect Dis 2021; 73:e2484-e2492. [PMID: 32756935 PMCID: PMC8563193 DOI: 10.1093/cid/ciaa1126] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Accepted: 07/30/2020] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Among those with injection drug use-associated infective endocarditis (IDU-IE), against medical advice (AMA) discharge is common and linked to adverse outcomes. Understanding trends, risk factors, and timing is needed to reduce IDU-IE AMA discharges. METHODS We identified individuals ages 18-64 with International Classification of Diseases, 9thRevision, diagnosis codes for infective endocarditis (IE) in the National Inpatient Sample, a representative sample of United States hospitalizations from January 2010 to September 2015. We plotted unadjusted quarter-year trends for AMA discharges and used multivariable logistic regression to identify factors associated with AMA discharge among IE hospitalizations, comparing IDU-IE with non-IDU-IE. RESULTS We identified 7259 IDU-IE and 23 633 non-IDU-IE hospitalizations. Of these hospitalizations, 14.2% of IDU-IE and 1.9% of non-IDU-IE resulted in AMA discharges. More than 30% of AMA discharges for both groups occurred before hospital day 3. In adjusted models, IDU status (adjusted odds ratio [AOR], 3.92; 95% confidence interval [CI], 3.43-4.48)] was associated with increased odds of AMA discharge. Among IDU-IE, women (AOR, 1.21; 95% CI, 1.04-1.41) and Hispanics (AOR, 1.32; 95% CI, 1.03-1.69) had increased odds of AMA discharge, which differed from non-IDU-IE. Over nearly 6 years, odds of AMA discharge increased 12% per year for IDU-IE (AOR, 1.12; 95% CI, 1.07-1.18) and 6% per year for non-IDU-IE (AOR, 1.06; 95% CI. 1.00-1.13). CONCLUSIONS AMA discharges have risen among individuals with IDU-IE and non-IDE-IE. Among those who inject drugs, AMA discharges were more common and increases sharper. Efforts that address the rising fraction, disparities, and timing of IDU-IE AMA discharges are needed.
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Affiliation(s)
- Simeon D Kimmel
- Clinical Addiction Research and Education (CARE) Unit, Section of General Internal Medicine, Department of Medicine, Boston Medical Center/Boston University School of Medicine, Boston, Massachusetts, USA
- Section of Infectious Diseases, Department of Medicine, Boston Medical Center/Boston University School of Medicine, Boston, Massachusetts, USA
| | - June-Ho Kim
- Division of General Internal Medicine, Department of Medicine, Brigham and Women’s Hospital/Harvard Medical School, Boston, Massachusetts, USA
- Ariadne Labs, Harvard T. H. Chan School of Public Health & Brigham and Women’s Hospital, Boston, Massachusetts, USA
| | - Bindu Kalesan
- Section of Preventative Medicine and Epidemiology, Department of Medicine, Boston Medical Center/Boston University School of Medicine, Boston, Massachusetts, USA
| | - Jeffrey H Samet
- Clinical Addiction Research and Education (CARE) Unit, Section of General Internal Medicine, Department of Medicine, Boston Medical Center/Boston University School of Medicine, Boston, Massachusetts, USA
| | - Alexander Y Walley
- Clinical Addiction Research and Education (CARE) Unit, Section of General Internal Medicine, Department of Medicine, Boston Medical Center/Boston University School of Medicine, Boston, Massachusetts, USA
- Massachusetts Department of Public Health, Boston, Massachusetts, USA
| | - Marc R Larochelle
- Clinical Addiction Research and Education (CARE) Unit, Section of General Internal Medicine, Department of Medicine, Boston Medical Center/Boston University School of Medicine, Boston, Massachusetts, USA
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Shiri SS, Shanmugam B, Ezhumalai S. Profile of Women Seeking Treatment for Substance Use Disorder in Tertiary Care Government De-Addiction Centre. JOURNAL OF PSYCHOSOCIAL WELL-BEING 2021; 2:68-75. [PMID: 34553129 PMCID: PMC8454904 DOI: 10.5281/zenodo.5105523] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Background There is an increasing trend among women using substance. However, very few women seek treatment for substance use disorder in Government de-addiction centre. There is limited literature available regarding the same. Aim To examine the profile of women seeking treatment for substance use disorder in Government De-addiction Centre, Bengaluru. Methods The study was retrospective in nature. All the female patients who sought in-patient treatment from centre for addiction medicine, NIMHANS, Bengaluru from Apr 2015- Sept 2016 were included in the study. Method of data collection: Content analysis was used to collect the secondary data from the hospital record. Descriptive statistics such as mean, frequency distribution was used for statistical analysis. Results Mean age of women who sought treatment for substance use disorder in the centre was 42 ±14 years. The mean age at initiation of alcohol was 27 ±9 years, alcohol dependence was 34 ±10.6 years. Majority (65%) belonged below poverty line. 59% were married and living with their spouse. 55% of them sought treatment either on their own or brought by family members, 38% referred by the psychiatrist. More than one-third (36%) had primary school education. Nearly one-third (27%) of them had repeated admissions more than once. More than one-third of them (34%) were homemakers, nearly one-fourth (24%) of them were lost their previous job, 6% of them students and professionals respectively. Conclusion The majority (68%) of women had diagnosis of alcohol dependence, nicotine (44%), benzodiazepine (14%), opioid dependence (11%), cannabis dependence (1.6%), less than 1% had other forms behavioural addictions.
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Affiliation(s)
- Sahana Supriya Shiri
- Former Psychiatric Social Worker, Department of Psychiatric Social Work, National Institute of Mental Health and Neurosciences, Bangalore-560029
| | - Backiyaraj Shanmugam
- Former Psychiatric Social Worker, Center for Addiction Medicine, Department of Psychiatric Social Work, National Institute of Mental Health and Neurosciences, Bangalore-560029
| | - Sinu Ezhumalai
- Associate Professor, Department of Psychiatric Social Work, National Institute of Mental Health and Neurosciences, Bangalore-560029
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Prevalence of Adverse Childhood Experiences of Parenting Women in Drug Treatment for Opioid Use Disorder. Community Ment Health J 2021; 57:872-879. [PMID: 32556861 DOI: 10.1007/s10597-020-00661-0] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2020] [Accepted: 06/11/2020] [Indexed: 10/24/2022]
Abstract
Descriptive adverse childhood experience (ACE) prevalence data on parenting women seeking treatment for opioid use disorder (OUD) is limited, despite this group being one of the fastest growing sub-populations of the opioid epidemic. The aim of this study was to: (1) determine prevalence of ACEs) in a population of parenting women in treatment for OUD, (2) characterize ACEs, and (3) compare study ACE data to Pennsylvania Behavioral Risk Factor Surveillance System (PA BRFSS) to normalize study results. Between 2014 and 2018, ACEs were collected from parenting women (N = 152) enrolled in treatment for OUDs. Results showed on average women were 30.3 years of age (SD 4.6, range 22-41 years) non-Hispanic (87.0%), white (74.0%), and held a high school education or less (76.0%). The mean total ACE score was 4.3 (SD 2.3; range 0-8). Most women reported 4 ≥ ACEs (65.0%), while only 5.0% reported 0 ACEs. The current sample had higher mean ACE score (4.3 PSMDT vs. 1.4 PA BRFSS Data) than PA BRFSS Data. The burden of ACEs in parenting women in treatment for OUD is significant. Understanding the trauma parenting women in drug treatment have experienced, may support efforts to reduce stigma of this population. Public health intervention and policy work that is trauma proactive is needed to address this growing epidemic.
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Understanding pathways to e-cigarette use across sexual identity: A multi-group structural equation model. Addict Behav 2021; 114:106748. [PMID: 33296821 DOI: 10.1016/j.addbeh.2020.106748] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2020] [Revised: 11/16/2020] [Accepted: 11/17/2020] [Indexed: 12/28/2022]
Abstract
This study explored the relationships between sexual violence, smoking behaviors, suicidality and past 30-day e-cigarette use under the theoretical framework of Minority Stress Theory. The 2017 National Youth Risk Behavioral Survey was utilized to study a nationally representative sample of sexual minority (lesbian, gay, bisexual, and unsure) and heterosexual high school students (N = 7882). Multi-group structural equation modeling (SEM) was employed to examine whether sexual violence and suicidality had a direct effect on e-cigarette use, after controlling for prior smoking behaviors (cigarette, cigar, and marijuana use). Suicidality and smoking behaviors were examined as mediators of the relationship between sexual violence and e-cigarette use, and suicidality was examined as a mediator of the relationship between sexual violence and smoking behaviors. This model was tested for invariance across sexual minority and heterosexual students. For both groups, smoking behaviors had significant direct effects on e-cigarette use, yet suicidality revealed no significant direct effects. Both suicidality and sexual violence had significant indirect effects on e-cigarette use through their effects on smoking behaviors. Sexual violence had a significant direct effect on e-cigarette use for sexual minority students, but not for heterosexual students. Despite this notable difference, the model was found to be invariant across the two groups. These findings suggest that students who report sexual violence may experience suicidality and victimization may lead to smoking behaviors and e-cigarette use. Students' mental health and substance use behaviors should continue to be targeted in schools, particularly among sexual minority youths.
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O’Rourke-Suchoff D, Sobel L, Holland E, Perkins R, Saia K, Bell S. The labor and birth experience of women with opioid use disorder: A qualitative study. Women Birth 2020; 33:592-597. [DOI: 10.1016/j.wombi.2020.01.006] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2019] [Revised: 12/18/2019] [Accepted: 01/08/2020] [Indexed: 10/25/2022]
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Yang Y, Perkins DR, Stearns AE. “I Started to Feel Better now”: Qualitative Findings from Client Narratives on Early Recovery in Inpatient Substance Use Treatment. Int J Ment Health Addict 2020. [DOI: 10.1007/s11469-019-00107-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
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Self -image and selected clinical variables in the context of childhood abuse in subjects with alcohol dependence. CURRENT PROBLEMS OF PSYCHIATRY 2020. [DOI: 10.2478/cpp-2019-0016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Abstract
Objective: The objective of the study was to determine the differences in selected clinical variables and self-image in people with alcohol dependence differing in severity of physical, emotional and sexual abuse experienced before age 18.
Method: The study included 90 people with alcohol dependence. The following research tools were used: Early Trauma Inventory (ETI), Adjective Check List (ACL), MAST, SAAD, and a questionnaire designed by the authors. In order to identify groups with varying indices of physical, emotional and sexual childhood abuse, a cluster analysis method was used.
Results: Two groups of subjects with alcohol dependence were identified: Group 1 with high indices of physical, emotional and sexual childhood abuse and Group 2 with low indices. In terms of self-image the subjects in Group 1 compared to subjects in Group 2 were characterized by a lower self-esteem, self-acceptance, resistance to stress, less intense needs for achievement, endurance, order, nurturing others, interaction with opposite-sex partners, subordinations but more intense need for change. The age of alcohol use initiation and the onset of regular alcohol drinking was statistically significantly lower in Group 1. The severity of alcohol dependence was significantly lower in Group 2. The subjects in Group 1 significantly more frequently confirmed the history of a hereditary predisposition to alcohol dependence, suicidal ideation, suicide attempts and self-harm.
Discussion: The obtained results closely correspond to the data available in the literature.
Conclusions: An assessment of exposure to various forms of childhood abuse appears to be an indispensable element of collecting medical history of people with alcohol dependence.
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Cannabinoids as an Emerging Therapy for Posttraumatic Stress Disorder and Substance Use Disorders. J Clin Neurophysiol 2020; 37:28-34. [PMID: 31895187 DOI: 10.1097/wnp.0000000000000612] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
Posttraumatic Stress Disorder (PTSD) is a leading psychiatric disorder that mainly affects military and veteran populations but can occur in anyone affected by trauma. PTSD treatment remains difficult for physicians because most patients with PTSD do not respond to current pharmacological treatment. Psychotherapy is effective, but time consuming and expensive. Substance use disorder is often concurrent with PTSD, which leads to a significant challenge for PTSD treatment. Cannabis has recently received widespread attention for the potential to help many patient populations. Cannabis has been reported as a coping tool for patients with PTSD and preliminary legalization data indicate Cannabis use may reduce the use of more harmful drugs, such as opioids. Rigorous clinical studies of Cannabis could establish whether Cannabis-based medicines can be integrated into treatment regimens for both PTSD and substance use disorder patients.
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Seghete KLM, Graham AM, Shank TM, Alsup SL, Fisher PA, Wilson AC, Ewing SWF. Advancing preventive interventions for pregnant women who are opioid using via the integration of addiction and mental health research. CURRENT ADDICTION REPORTS 2020; 7:61-67. [PMID: 32201680 DOI: 10.1007/s40429-020-00296-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Purpose of Review This review examines how research focused on treatment for opioid use in perinatal populations and preventive interventions for postpartum psychopathology have remained separate, despite significant overlap. Recent Findings Guidelines for best practice in caring for pregnant women with opioid use disorder suggest the use of medication-assisted treatment with additional comprehensive care, including behavioral and mental health interventions. However, intervention research often mutually excludes these two populations, with studies of behavioral interventions for opioid use excluding women with psychopathology and research on preventive interventions for postpartum psychopathology excluding women who are substance using. Summary There is a limited evidence-base to inform the selection of appropriate preventive interventions for pregnant women with opioid use disorder that can address opioid use and/or treatment adherence and concurrent mental health risks. We argue it is critical to integrate research on pregnant women who are opioid using and preventive perinatal mental health interventions to catalyze pivotal change in how we address the opioid epidemic within this growing population.
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Affiliation(s)
| | - Alice M Graham
- Department of Psychiatry, Oregon Health & Science University, Portland, OR
| | - Taylor M Shank
- School of Graduate Psychology, Pacific University, Hillsboro, OR
| | - Shelby L Alsup
- School of Graduate Psychology, Pacific University, Hillsboro, OR
| | | | - Anna C Wilson
- Department of Pediatrics, Oregon Health & Science University, Portland, OR
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Sun J, Kranzler HR, Gelernter J, Bi J. A genome-wide association study of cocaine use disorder accounting for phenotypic heterogeneity and gene–environment interaction. J Psychiatry Neurosci 2020; 45:34-44. [PMID: 31490055 PMCID: PMC6919916 DOI: 10.1503/jpn.180098] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND Phenotypic heterogeneity and complicated gene–environment interplay in etiology are among the primary factors that hinder the identification of genetic variants associated with cocaine use disorder. METHODS To detect novel genetic variants associated with cocaine use disorder, we derived disease traits with reduced phenotypic heterogeneity using cluster analysis of a study sample (n = 9965). We then used these traits in genome-wide association tests, performed separately for 2070 African Americans and 1570 European Americans, using a new mixed model that accounted for the moderating effects of 5 childhood environmental factors. We used an independent sample (918 African Americans, 1382 European Americans) for replication. RESULTS The cluster analysis yielded 5 cocaine use disorder subtypes, of which subtypes 4 (n = 3258) and 5 (n = 1916) comprised heavy cocaine users, had high heritability estimates (h2 = 0.66 and 0.64, respectively) and were used in association tests. Seven of the 13 identified genetic loci in the discovery phase were available in the replication sample. In African Americans, rs114492924 (discovery p = 1.23 × E−8), a single nucleotide polymorphism in LINC01411, was replicated in the replication sample (p = 3.63 × E−3). In a meta-analysis that combined the discovery and replication results, 3 loci in African Americans were significant genome-wide: rs10188036 in TRAK2 (p = 2.95 × E−8), del-1:15511771 in TMEM51 (p = 9.11 × E−10) and rs149843442 near LPHN2 (p = 3.50 × E−8). LIMITATIONS Lack of data prevented us from replicating 6 of the 13 identified loci. CONCLUSION Our results demonstrate the importance of considering phenotypic heterogeneity and gene–environment interplay in detecting genetic variations that contribute to cocaine use disorder, because new genetic loci have been identified using our novel analytic method.
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Affiliation(s)
- Jiangwen Sun
- From the Department of Computer Science and Engineering, University of Connecticut, School of Engineering, Storrs, CT (Sun, Bi); the University of Pennsylvania Perelman School of Medicine, Department of Psychiatry, Center for Studies of Addiction and Corporal Michael Crescenz VAMC, Philadelphia, PA (Kranzler); and the Yale University School of Medicine, Department of Psychiatry, Division of Human Genetics and Departments of Genetics and Neurobiology; and VA CT Healthcare Center, New Haven, CT (Gelernter)
| | - Henry R. Kranzler
- From the Department of Computer Science and Engineering, University of Connecticut, School of Engineering, Storrs, CT (Sun, Bi); the University of Pennsylvania Perelman School of Medicine, Department of Psychiatry, Center for Studies of Addiction and Corporal Michael Crescenz VAMC, Philadelphia, PA (Kranzler); and the Yale University School of Medicine, Department of Psychiatry, Division of Human Genetics and Departments of Genetics and Neurobiology; and VA CT Healthcare Center, New Haven, CT (Gelernter)
| | - Joel Gelernter
- From the Department of Computer Science and Engineering, University of Connecticut, School of Engineering, Storrs, CT (Sun, Bi); the University of Pennsylvania Perelman School of Medicine, Department of Psychiatry, Center for Studies of Addiction and Corporal Michael Crescenz VAMC, Philadelphia, PA (Kranzler); and the Yale University School of Medicine, Department of Psychiatry, Division of Human Genetics and Departments of Genetics and Neurobiology; and VA CT Healthcare Center, New Haven, CT (Gelernter)
| | - Jinbo Bi
- From the Department of Computer Science and Engineering, University of Connecticut, School of Engineering, Storrs, CT (Sun, Bi); the University of Pennsylvania Perelman School of Medicine, Department of Psychiatry, Center for Studies of Addiction and Corporal Michael Crescenz VAMC, Philadelphia, PA (Kranzler); and the Yale University School of Medicine, Department of Psychiatry, Division of Human Genetics and Departments of Genetics and Neurobiology; and VA CT Healthcare Center, New Haven, CT (Gelernter)
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Higgins K, O’Neill N, O’Hara L, Jordan JA, McCann M, O’Neill T, Clarke M, O’Neill T, Campbell A. Evidence for public health on novel psychoactive substance use: a mixed-methods study. PUBLIC HEALTH RESEARCH 2019. [DOI: 10.3310/phr07140] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Background
Novel psychoactive substances (NPSs) contribute to the public health impact of substance misuse. This report provides research evidence addressing 11 research questions related to NPSs, covering types, patterns and settings of use; supply sources; and implications for policy and practice.
Methods
The study used a conceptually linked three-phase mixed-methods design with a shared conceptual framework based on multiple-context risk and protective factors. Phase 1 was a quantitative phase involving secondary data analysis of the longitudinal Belfast Youth Development Study (BYDS), a latent class analysis using the 2039 BYDS participants. Phase 2 was an extensive qualitative analysis via narrative interviews with participants, sampled from BYDS, drug/alcohol services and prisons, to explore NPS use trajectories. Phase 3 was the final quantitative phase; generalisability of the shared risk factor part of the model was tested using the manual three-step approach to examine risk factors associated with latent class membership. The quantitative and qualitative analyses were integrated, thus allowing emerging findings to be further explored.
Results
The data suggest that NPSs have a place within a range of polydrug use trajectories. Models showed no distinctive NPS class, with no clear evidence of differential risks for NPS use compared with the use of other substances. From the qualitative analysis, a taxonomy of groups was derived that explored how and where NPSs featured in a range of trajectories. This taxonomy was used to structure the analysis of factors linked to use within a risk and protective framework. Drivers for use were considered alongside knowledge, perceptions and experience of harms. Suggestions about how interventions could best respond to the various patterns of use – with special consideration of synthetic cannabinoids (SCs), including how they relate to the use of heroin and the potential for NPSs to operate as a ‘snare’ to more problem use – were also presented.
Limitations
The study was conducted during 2016/17; generalisability beyond this sample and time point is limited. The level of missing data for some of the BYDS analysis was a limitation, as was the fact that the BYDS data were collected in 2011, so in a different context from the data collected during the narrative interviews. The Psychoactive Substances Act 2016 (Great Britain. Psychoactive Substances Act 2016. London: The Stationery Office; 2016) came into force during qualitative fieldwork and, although not particularly influential in this study, may be influential in future work. It is acknowledged that many of the data related to SCs and mephedrone. Although drug use was measured by self-report, the strength of rapport within interviews, reflective diaries and methodological acceptability checks helped to mitigate self-report bias.
Conclusions
NPSs continue to present significant challenges for legislation and monitoring, researching and developing interventions. Understanding of usage patterns remains poor, with most information based on populations and settings where problems have already occurred. This research contributes to the evidence base by providing much needed further empirical data on the lived experiences of NPS users across a range of settings. In the light of these data, implications for policy and practice are discussed.
Future work
Future research must generate improved epidemiological data on the extent, patterns and motivations for use longitudinally. The uniqueness of the information concerning SC use points to a specific set of findings not evidenced in other literature (e.g. intensity of SC withdrawal). Future research should focus on the symbiotic link between SC and heroin use.
Funding
The National Institute for Health Research Public Health Research programme.
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Affiliation(s)
- Kathryn Higgins
- Centre for Evidence and Social Innovation, Queen’s University Belfast, Belfast, UK
- School of Social Sciences, Education and Social Work, Queen’s University Belfast, Belfast, UK
| | - Nina O’Neill
- Centre for Evidence and Social Innovation, Queen’s University Belfast, Belfast, UK
- School of Social Sciences, Education and Social Work, Queen’s University Belfast, Belfast, UK
| | - Leeanne O’Hara
- Centre for Evidence and Social Innovation, Queen’s University Belfast, Belfast, UK
- School of Social Sciences, Education and Social Work, Queen’s University Belfast, Belfast, UK
| | - Julie-Ann Jordan
- Centre for Evidence and Social Innovation, Queen’s University Belfast, Belfast, UK
- School of Social Sciences, Education and Social Work, Queen’s University Belfast, Belfast, UK
| | - Mark McCann
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK
| | - Tara O’Neill
- Centre for Evidence and Social Innovation, Queen’s University Belfast, Belfast, UK
- School of Psychology, Queen’s University Belfast, Belfast, UK
| | - Mike Clarke
- School of Medicine, Dentistry and Biomedical Sciences, Queen’s University Belfast, Belfast, UK
| | - Tony O’Neill
- Centre for Evidence and Social Innovation, Queen’s University Belfast, Belfast, UK
- School of Medicine, Dentistry and Biomedical Sciences, Queen’s University Belfast, Belfast, UK
| | - Anne Campbell
- Centre for Evidence and Social Innovation, Queen’s University Belfast, Belfast, UK
- School of Social Sciences, Education and Social Work, Queen’s University Belfast, Belfast, UK
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De Neve J, Thas O, Gerds TA. Semiparametric linear transformation models: Effect measures, estimators, and applications. Stat Med 2019; 38:1484-1501. [DOI: 10.1002/sim.8078] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2018] [Revised: 10/11/2018] [Accepted: 12/03/2018] [Indexed: 11/08/2022]
Affiliation(s)
- Jan De Neve
- Department of Data Analysis; Ghent University; Ghent Belgium
| | - Olivier Thas
- Center for Statistics; Hasselt University; Diepenbeek Belgium
- National Institute for Applied Statistics Research Australia; University of Wollongong; New South Wales Australia
| | - Thomas A. Gerds
- Department of Biostatistics; University of Copenhagen; Copenhagen Denmark
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Armstrong EM, Glover Reed B, Bennett LW. How and How Much: Combined Services for Domestic Violence and Substance Abuse. Violence Against Women 2019; 25:1450-1470. [PMID: 30600781 DOI: 10.1177/1077801218820201] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
This study generates practice-based evidence about organizational strategies for addressing co-occurring domestic violence (DV) and substance abuse (SA) using a survey of organizations working on both issues (N = 204). How (the strategies) and how much (the extensiveness) organizations attend to both issues vary by organizational type (DV, SA, or multiservice) and populations served. While most SA and multiservice organizations address DV internally, most DV organizations use external collaborations; all offer services to DV perpetrators at similar rates. Findings underscore the importance of including multiple, nuanced measures of organizational activities related to co-occurring DV and SA in future research.
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Diehl A, Clemente J, Pillon SC, Santana PRH, da Silva CJ, Mari JDJ. Early childhood maltreatment experience and later sexual behavior in Brazilian adults undergoing treatment for substance dependence. ACTA ACUST UNITED AC 2018; 41:199-207. [PMID: 30540023 PMCID: PMC6794126 DOI: 10.1590/1516-4446-2017-0020] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2017] [Accepted: 06/28/2018] [Indexed: 11/30/2022]
Abstract
Objective: To investigate the prevalence of early childhood maltreatment and associations with later sexual behavior among adult substance users. Methods: A cross-sectional study enrolled 134 substance dependents who sought outpatient care in São Paulo, Brazil. Childhood trauma prevalence was assessed using the Childhood Trauma Questionnaire (CTQ). The Sexual Addiction Screening Test (SAST), drug of choice (DOC), and sexual behavior were also investigated. Results: The sample was composed predominantly of single adult males (76.1%), with alcohol as the DOC (73.9%). Experiences of emotional neglect (88.1%), emotional abuse (80.6%), physical neglect (78.4%), physical abuse (64.2%), and sexual abuse (31.3%) were prevalent. Women were more likely to have been sexually abused (OR 2.9, 95%CI 1.15-7.61) and physically abused (OR 3.7, 95%CI 1.31-10.6) in childhood. Those who were sexually abused in adulthood were more likely to have suffered physical abuse in childhood (OR 6.9, 95%CI 1.45-11.8). The odds of having been sexually abused in childhood were higher among subjects who reported to have exchanged sexual favors for drugs (OR 5.7, 95%CI 1.35-9.64) and to have been sexually abused in adulthood (OR 6.1, 95%CI 5.2-12.36). Conclusion: Physical and sexual abuse in childhood are highly prevalent in substance-dependent adults, and are associated with sexual revictimization and high-risk sexual behavior in adulthood.
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Affiliation(s)
- Alessandra Diehl
- Departamento de Psiquiatria,Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brazil
| | - Jales Clemente
- Departamento de Psiquiatria,Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brazil
| | - Sandra C Pillon
- Departamento de Enfermagem Psiquiátrica e Ciências Humanas, Escola de Enfermagem de Ribeirão Preto, Centro Colaborador da Organização Pan-Americana de Saúde (OPAS)/Organização Mundial da Saúde (OMS) para o Desenvolvimento da Pesquisa em Enfermagem, Universidade de São Paulo (USP), Ribeirão Preto, SP, Brazil
| | | | - Claudio J da Silva
- Departamento de Psiquiatria,Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brazil
| | - Jair de J Mari
- Departamento de Psiquiatria,Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brazil
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Hingray C, Donné C, Martini H, Cohn A, El Hage W, Schwan R, Paille F. Description of type of trauma in alcohol-dependent women. EUROPEAN JOURNAL OF TRAUMA & DISSOCIATION 2018. [DOI: 10.1016/j.ejtd.2018.01.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Malik K, Chand PK, Marimuthu P, Suman LN. Stressful and Traumatic Experiences among Women with Alcohol Use Disorders in India. Indian J Psychol Med 2017; 39:611-618. [PMID: 29200557 PMCID: PMC5688888 DOI: 10.4103/ijpsym.ijpsym_411_16] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
AIM The aim of the present study was to examine lifetime stressful and traumatic experiences among women with alcohol use disorders (AUDs). METHODS The sample comprised of two groups: a clinical group of 35 women with a diagnosis of AUD and a comparison group of 60 women drawn from the community. After screening out, the participants were administered Life Stressor Checklist-Revised. RESULTS On an average, clinical group was exposed to 7.57 (standard deviation [SD] = 4.14) stressful events and comparison group was exposed to 4.03 (SD = 2.80) stressful events across the lifespan (t = 4.976; P < 0.001). Clinical group reported a high number of childhood abuse and interpersonal traumas across lifespan than comparison group. The relationship between adverse life experiences and alcohol abuse among women was bidirectional. CONCLUSION Understanding the nature and experiences of trauma in this group has implications for planning gender-sensitive treatment programs for women seeking help for AUDs in India.
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Affiliation(s)
- Kanika Malik
- Intervention Coordinator, Premium for Adolescents (PRIDE), Sangath, New Delhi, India
| | - Prabhat Kumar Chand
- Department of Psychiatry, Centre for Addiction Medicine, Bengaluru, Karnataka, India
| | - P Marimuthu
- Department of Biostatistics, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
| | - L N Suman
- Department of Clinical Psychology, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
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Treatments for opioid use disorder among pregnant and reproductive-aged women. Fertil Steril 2017; 108:222-227. [DOI: 10.1016/j.fertnstert.2017.06.011] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2017] [Accepted: 06/06/2017] [Indexed: 11/21/2022]
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Ahmadi K, Javadinia SA, Saadat SH, Ramezani MA, Sedghijalal H. Triangular relationship among risky sexual behavior, addiction, and aggression: A systematic review. Electron Physician 2017; 9:5129-5137. [PMID: 28979752 PMCID: PMC5614302 DOI: 10.19082/5129] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2017] [Accepted: 04/28/2017] [Indexed: 12/14/2022] Open
Abstract
Background Risky sexual behavior (RSB), addiction, and aggression are three important personal and social factors which influence each other. Objective To overview the potential relationship among RSB, addiction, and aggression to conduct an interactive model for the pathology and management of human behavior. Methods This review article was carried out by searching studies in PubMed, Medline, Web of Science, Ebsco, IEEE, Scopus, Springer, MagIran, and IranMedex databases from the year 1993 to 2013. The search terms were violence, aggression, drug abuse, substance abuse, illicit drug, psychoactive drug, intravenous drug users, addiction and high-risk sexual relationships, unprotected sex, high risk sexual behavior, and sexual risk-taking. In this study, forty-nine studies were accepted for further screening, and met all our inclusion criteria (in English or Persian, full text, and included the search terms). Results Forty-nine articles were included; 17 out of 26 studies showed a significant correlation between addiction and risky sexual behavior, 15 out of 19 articles indicated a statistically significant correlation between aggression and addiction, and 9 out of 10 articles reported significant correlation between aggression and risky sexual behavior. Conclusion According to the results, the triangle hypothesis of sex, addiction, and aggression led to the definition of the relationship among the variables of the hypothetical triangle based on the reviewed studies; and the proposed dual and triple relationship based on the conducted literature review was confirmed. This is not a meta-analysis, and there is no analysis of publication bias.
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Affiliation(s)
- Khodabakhsh Ahmadi
- Ph.D. in Counseling Psychology, Associate Professor, Behavioral Sciences Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Seyed Alireza Javadinia
- Resident of Radiation Oncology, Student Research Committee, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Seyed Hassan Saadat
- M.D., Behavioral Sciences Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Mohammad Arash Ramezani
- Ph.D., Associate Professor, Behavioral Sciences Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Homa Sedghijalal
- Ph.D., Behavioral Sciences Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran
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Bunford N, Wymbs BT, Dawson AE, Shorey RC. Childhood Maltreatment, Emotional Lability, and Alcohol Problems in Young Adults At-Risk for ADHD: Testing Moderation and Moderated Moderation. J Psychoactive Drugs 2017; 49:316-325. [DOI: 10.1080/02791072.2017.1325031] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Nóra Bunford
- Postdoctoral Research Fellow, Institute of Biology, Department of Ethology, Eötvös Loránd University, Budapest, Hungary
| | - Brian T. Wymbs
- Assistant Professor of Psychology, Department of Psychology, Ohio University, Athens, OH, USA
| | - Anne E. Dawson
- Doctoral Student, Department of Psychology, Ohio University, Athens, OH, USA
| | - Ryan C. Shorey
- Assistant Professor of Psychology, Department of Psychology, Ohio University, Athens, OH, USA
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Patrick SW, Schiff DM, Ryan SA, Quigley J, Gonzalez PK, Walker LR. A Public Health Response to Opioid Use in Pregnancy. Pediatrics 2017; 139:peds.2016-4070. [PMID: 28219965 DOI: 10.1542/peds.2016-4070] [Citation(s) in RCA: 135] [Impact Index Per Article: 19.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
The use of opioids during pregnancy has grown rapidly in the past decade. As opioid use during pregnancy increased, so did complications from their use, including neonatal abstinence syndrome. Several state governments responded to this increase by prosecuting and incarcerating pregnant women with substance use disorders; however, this approach has no proven benefits for maternal or infant health and may lead to avoidance of prenatal care and a decreased willingness to engage in substance use disorder treatment programs. A public health response, rather than a punitive approach to the opioid epidemic and substance use during pregnancy, is critical, including the following: a focus on preventing unintended pregnancies and improving access to contraception; universal screening for alcohol and other drug use in women of childbearing age; knowledge and informed consent of maternal drug testing and reporting practices; improved access to comprehensive obstetric care, including opioid-replacement therapy; gender-specific substance use treatment programs; and improved funding for social services and child welfare systems. The American College of Obstetricians and Gynecologists supports the value of this clinical document as an educational tool (December 2016).
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Affiliation(s)
- Stephen W. Patrick
- Departments of Pediatrics and
- Health Policy
- Mildred Stahlman Division of Neonatology
- Vanderbilt Center for Health Services Research, and
- Vanderbilt Center for Addiction Research, Vanderbilt University, Nashville, Tennessee; and
| | - Davida M. Schiff
- Department of Pediatrics, Boston Medical Center and Boston University School of Medicine, Boston, Massachusetts
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Crouch E, Strompolis M, Bennett KJ, Morse M, Radcliff E. Assessing the interrelatedness of multiple types of adverse childhood experiences and odds for poor health in South Carolina adults. CHILD ABUSE & NEGLECT 2017; 65:204-211. [PMID: 28189958 DOI: 10.1016/j.chiabu.2017.02.007] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/19/2016] [Revised: 01/19/2017] [Accepted: 02/03/2017] [Indexed: 06/06/2023]
Abstract
Adverse childhood experiences (ACEs) have been linked to negative health outcomes in adulthood, but little research has been done on the effect of ACEs on the health and well-being of adults in South Carolina (SC). This study analyzed a sample of 9744 respondents who participated in the 2014 South Carolina Behavioral Risk Factor Surveillance System (BRFSS) to examine the relationship among childhood experiences of physical, sexual, and emotional abuse, as well as witnessing household violence, on mental and physical health outcomes in adulthood among SC residents. Twenty-two percent of survey respondents reported poor general health (22.1%), and a smaller proportion reported high frequent mental distress in the past month (13.1%). Each category of childhood experiences was associated with an increase in the risk of poor general health. Individuals reporting three or more types of experiences were more likely to report poor health (aOR 2.89; 95% CI 2.86-2.92) than adults without such experiences. Respondents reporting three or more types of childhood adverse experiences were more likely to report frequent mental distress (aOR 3.29; 95% CI 3.26-3.33) compared to adults who did not report three or more types of adversity. Findings from the SC BRFSS highlight a connection between ACEs and negative health outcomes later in life. Given that results of this study also demonstrated that increased exposure to ACEs was associated with greater odds of negative health in adulthood, preventing adverse events such as experiencing abuse or witnessing domestic violence in childhood will have significant effects on later adult health.
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Affiliation(s)
- Elizabeth Crouch
- Department of Health Services Policy & Management, University of South Carolina, South Carolina Rural Health Research Center, 220 Stoneridge Drive, Suite 204, Columbia, SC 29210, United States.
| | | | - Kevin J Bennett
- Department of Family and Preventive Medicine, USC School of Medicine, 3209 Colonial Drive, Columbia, SC 29203, United States.
| | - Melanie Morse
- University of South Carolina, Department of Psychology, United States.
| | - Elizabeth Radcliff
- Department of Health Services Policy & Management, University of South Carolina, South Carolina Rural Health Research Center, 220 Stoneridge Drive, Suite 204, Columbia, SC 29210, United States.
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Edwards KM, Murphy S, Palmer KM, Haynes EE, Chapo S, Ekdahl BA, Buel S. Co-Occurrence of and Recovery from Substance Abuse and Lifespan Victimization: A Qualitative Study of Female Residents in Trauma-Informed Sober Living Homes. J Psychoactive Drugs 2017; 49:74-82. [DOI: 10.1080/02791072.2016.1273566] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Katie M. Edwards
- Professor of Psychology and Women’s Studies and Fellow, Prevention Innovations Research Center and the Carsey School of Public Policy, University of New Hampshire, Durham, NH, USA
| | - Sharon Murphy
- Associate Professor of Social Work Emerita, University of New Hampshire, Durham, NH, USA
| | - Kelly M. Palmer
- Research Assistant, University of New Hampshire, Durham, NH, USA
| | - Ellen E. Haynes
- Graduate Student in Clinical Psychology, Ohio University, Athens, OH, USA
| | - Sara Chapo
- Research Assistant, University of New Hampshire, Durham, NH, USA
| | | | - Sara Buel
- Clinical Professor of Law, Sandra Day O’Connor College of Law, Arizona State University, AZ, USA
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Saia KA, Schiff D, Wachman EM, Mehta P, Vilkins A, Sia M, Price J, Samura T, DeAngelis J, Jackson CV, Emmer SF, Shaw D, Bagley S. Caring for Pregnant Women with Opioid Use Disorder in the USA: Expanding and Improving Treatment. CURRENT OBSTETRICS AND GYNECOLOGY REPORTS 2016; 5:257-263. [PMID: 27563497 PMCID: PMC4981621 DOI: 10.1007/s13669-016-0168-9] [Citation(s) in RCA: 64] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
PURPOSE OF THE REVIEW Opioid use disorder in the USA is rising at an alarming rate, particularly among women of childbearing age. Pregnant women with opioid use disorder face numerous barriers to care, including limited access to treatment, stigma, and fear of legal consequences. This review of opioid use disorder in pregnancy is designed to assist health care providers caring for pregnant and postpartum women with the goal of expanding evidence-based treatment practices for this vulnerable population. RECENT FINDINGS We review current literature on opioid use disorder among US women, existing legislation surrounding substance use in pregnancy, and available treatment options for pregnant women with opioid use disorder. Opioid agonist treatment (OAT) remains the standard of care for treating opioid use disorder in pregnancy. Medically assisted opioid withdrawal ("detoxification") is not recommended in pregnancy and is associated with high maternal relapse rates. Extended release naltrexone may confer benefit for carefully selected patients. Histories of trauma and mental health disorders are prevalent in this population; and best practice recommendations incorporate gender-specific, trauma-informed, mental health services. Breastfeeding with OAT is safe and beneficial for the mother-infant dyad. SUMMARY Further research investigating options of OAT and the efficacy of opioid antagonists in pregnancy is needed. The US health care system can adapt to provide quality care for these mother-infant dyads by expanding comprehensive treatment services and improving access to care.
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Affiliation(s)
- Kelley A. Saia
- Department of Obstetrics and Gynecology, Boston Medical Center, 85 East Concord Street, 6th Floor, Boston, MA 02118 USA
| | - Davida Schiff
- Department of Pediatrics, Boston Medical Center, Boston, USA
| | | | - Pooja Mehta
- Department of Obstetrics and Gynecology, Boston Medical Center, 85 East Concord Street, 6th Floor, Boston, MA 02118 USA
| | - Annmarie Vilkins
- Department of Obstetrics and Gynecology, Boston Medical Center, 85 East Concord Street, 6th Floor, Boston, MA 02118 USA
| | - Michelle Sia
- Department of Obstetrics and Gynecology, Boston Medical Center, 85 East Concord Street, 6th Floor, Boston, MA 02118 USA
| | - Jordana Price
- Department of Family Medicine, Boston Medical Center, Boston, USA
| | - Tirah Samura
- Department of Obstetrics and Gynecology, Boston Medical Center, 85 East Concord Street, 6th Floor, Boston, MA 02118 USA
| | - Justin DeAngelis
- Department of Obstetrics and Gynecology, Boston Medical Center, 85 East Concord Street, 6th Floor, Boston, MA 02118 USA
| | | | | | - Daniel Shaw
- Department of Psychiatry, Boston Medical Center, Boston, USA
| | - Sarah Bagley
- Department of Internal Medicine, Boston Medical Center, Boston, USA
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Sweeney S, Air T, Zannettino L, Galletly C. Gender Differences in the Physical and Psychological Manifestation of Childhood Trauma and/or Adversity in People with Psychosis. Front Psychol 2015; 6:1768. [PMID: 26635676 PMCID: PMC4655246 DOI: 10.3389/fpsyg.2015.01768] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2015] [Accepted: 11/04/2015] [Indexed: 11/13/2022] Open
Abstract
The link between childhood trauma and/or adversity and risk of psychosis is well known. Our aim was to determine the prevalence of childhood trauma and/or adversity in people who have psychotic disorders and to investigate the association between childhood trauma and/or adversity and a range of social and health measures. Participants (n = 391, 42% male) were specifically asked about any experience of childhood trauma and/or adversity. Respondents provided information about education, employment, physical health, and health service utilization. Univariate analyses revealed that childhood trauma and/or adversity was associated with poorer levels of self-reported physical health and social problems. This includes the experience of chronic pain, headaches, arthritis, asthma, and victimization/stigma in men. Participants with a childhood trauma and/or adversity history indicated higher rates of lifetime suicide attempts with women reporting more lifetime depressive symptoms. Multivariate analyses revealed differing profiles in relation to physical and psychological health variable between males and females. Males with the experience of childhood trauma and/or adversity were significantly more likely to report cardiovascular/stroke issues, migraines and anhedonia. Females with the experience of childhood trauma and/or adversity were more likely to report a lifetime history of elevated mood and to be married or in a de facto relationship. There has been very little research into the assessment and treatment of the effects of childhood trauma and/or adversity in adults with psychosis. Childhood trauma and/or adversity may contribute to higher rates of self-reported poor health in men and is associated with increased depression in women. Our findings suggest that interventions to address the effects of past trauma are urgently needed.
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Affiliation(s)
- Shaun Sweeney
- Discipline of Psychiatry, University of Adelaide, Adelaide SA, Australia
| | - Tracy Air
- Discipline of Psychiatry, University of Adelaide, Adelaide SA, Australia
| | - Lana Zannettino
- School of Nursing and Midwifery, Flinders University, Adelaide SA, Australia
| | - Cherrie Galletly
- Discipline of Psychiatry, University of Adelaide, Adelaide SA, Australia
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Fernández-Montalvo J, López-Goñi JJ, Arteaga A. Psychological, physical, and sexual abuse in addicted patients who undergo treatment. JOURNAL OF INTERPERSONAL VIOLENCE 2015; 30:1279-1298. [PMID: 24992952 DOI: 10.1177/0886260514539843] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
This study explored the prevalence of a history as victims of abuse among patients who sought outpatient treatment for drug addiction. A sample of 252 addicted patients was assessed. Information was collected on the patients' lifetime history of abuse (psychological, physical, and/or sexual abuse), sociodemographic factors, consumption factors, psychopathological factors, and personality variables. Drug-addicted patients who present a lifelong history of abuse were compared with patients who were not abused. Of the total sample, 46% of the patients (n = 115) who were addicted to drugs had been victims of abuse. There was a statistically significant difference between the victimization rates of men (37.8%) and women (79.6%). Moreover, for some variables, significant differences were observed between patients who had been abused and those who had not. Compared with patients who had not been abused, the addicted patients with a history of victimization scored significantly higher on several European Addiction Severity Index, Millon Clinical Multiaxial Inventory-II, and maladjustment variables but not on the Symptom Checklist-90-Revised. The current results indicate that patients who present a lifelong history of abuse exhibit both a more severe addiction than patients who were not abused and several comorbidities. The implications of these results for further research and clinical practice are discussed.
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Min MO, Tracy EM, Park H. Impact of trauma symptomatology on personal networks among substance using women. Drug Alcohol Depend 2014; 142:277-82. [PMID: 25042762 PMCID: PMC4127087 DOI: 10.1016/j.drugalcdep.2014.06.032] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2014] [Revised: 06/24/2014] [Accepted: 06/25/2014] [Indexed: 11/18/2022]
Abstract
BACKGROUND Interpersonal trauma poses challenges and complications to the development and maintenance of personal networks of substance using women. Few studies have examined its effects on personal network support availability and quality of relationships, limiting our understanding of the social context in which substance using women with a history of trauma are embedded. METHODS Women with substance use disorders (SUD) who received treatment at three county-funded, women-only intensive treatment programs (N=375) were interviewed at intake and at follow ups 1, 6, and 12 months later. A network software program, EgoNet, elicited 25 network members per respondent, social support availability, and the quality of network relationship at each assessment. Trauma symptomatology was assessed with Trauma Symptom Checklist-40 at intake. RESULTS Findings from longitudinal mixed model analyses indicated that higher levels of trauma symptomatology were associated with both a negative, critical quality and less closeness in network relationships over the 12 month study period. However, trauma symptoms were not related to the number of network members reported as providing emotional, concrete, or sobriety support. Effects of trauma symptoms on the support availability in the network and the quality of network relationships were consistent over the follow-up period. CONCLUSIONS Findings highlight the potential role of trauma symptoms in determining the quality of relationships within personal networks among women with SUD, suggesting the need for routine mapping of network relationships throughout treatment.
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Affiliation(s)
- Meeyoung O Min
- Jack, Joseph and Morton Mandel School of Applied Social Sciences, Case Western Reserve University, 11235 Bellflower Road, Cleveland, OH 44106, United States.
| | - Elizabeth M Tracy
- Jack, Joseph and Morton Mandel School of Applied Social Sciences, Case Western Reserve University, 11235 Bellflower Road, Cleveland, OH 44106, United States
| | - Hyunyong Park
- Jack, Joseph and Morton Mandel School of Applied Social Sciences, Case Western Reserve University, 11235 Bellflower Road, Cleveland, OH 44106, United States
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De Sanctis VA, Newcorn JH, Halperin JM. A prospective look at substance use and criminal behavior in urban ADHD youth: what is the role of maltreatment history on outcome? ACTA ACUST UNITED AC 2014; 6:79-86. [DOI: 10.1007/s12402-013-0124-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2013] [Accepted: 12/13/2013] [Indexed: 11/30/2022]
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Casanueva C, Stambaugh L, Urato M, Fraser JG, Williams J. Illicit Drug Use From Adolescence to Young Adulthood Among Child Welfare-Involved Youths. JOURNAL OF CHILD & ADOLESCENT SUBSTANCE ABUSE 2013. [DOI: 10.1080/1067828x.2012.735514] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
| | | | - Matthew Urato
- a RTI International , Research Triangle Park , NC , USA
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The impact of substance use, sexual trauma, and intimate partner violence on sexual risk intervention outcomes in couples: a randomized trial. Ann Behav Med 2013. [PMID: 23208648 DOI: 10.1007/s12160-012-9455-5] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
Abstract
BACKGROUND Few HIV prevention interventions focus on sexual risk reduction as mutual process determined by couple members, though risk behaviors are inter-dependent. PURPOSE This trial examined the impact of substance use, history of sexual trauma, and intimate partner violence on sexual risk associated with participation in a risk reduction intervention. METHODS HIV seroconcordant and serodiscordant multicultural couples in Miami, Florida (n = 216) were randomized to group (n = 112) or individual (n = 104) couple-based interventions. RESULTS Group intervention participants increased condom use in couples in which women had a history of sexual trauma [F(2,221) = 3.39, p = 0.036] and by partners of alcohol users. History of sexual trauma was a determinant of conflict resolution, predicting negative communication and intimate partner violence. CONCLUSIONS Results emphasize the need for group sexual risk reduction interventions targeting sexual trauma, partner violence, and substance use among HIV seroconcordant and serodiscordant couples.
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Fernandez-Montalvo J, Lopez-Goñi JJ, Azanza P, Cacho R. Gender differences in drug-addicted patients in a clinical treatment center of Spain. Am J Addict 2013; 23:399-406. [PMID: 24961362 DOI: 10.1111/j.1521-0391.2013.12117.x] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2013] [Accepted: 08/19/2013] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND AND OBJECTIVES This study explored the characteristics of a representative sample of patients who were addicted to drugs and analyzed the differential profile of addicted women and men. METHODS A sample of 195 addicted patients (95 female and 100 male) who sought outpatient treatment in a Spanish clinical center was assessed. Information on sociodemographic status, consumption patterns and associated characteristics was collected using the European Addiction Severity Index (EuropASI). RESULTS The results showed statistically significant differences between groups. Demographically, the differences were centered on employment, with more labor problems in the female group. Regarding addiction severity, the EuropASI results showed statistically significant differences in both the interviewer severity ratings (ISR) and composite scores (CS). Women experienced more severe impacts in the medical, family social and psychiatric areas. By contrast addicted men had more severe legal problems than addicted females did. CONCLUSIONS These results suggest that, women who seek outpatient treatment in a clinical center presented with more severe addiction problems than men did. Moreover, they reported more significant maladjustment in the various aspects of life explored.
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Thompson LA, Tavares M, Ferguson-Young D, Ogle O, Halpern LR. Violence and abuse: core competencies for identification and access to care. Dent Clin North Am 2013; 57:281-299. [PMID: 23570806 DOI: 10.1016/j.cden.2013.01.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
Violence and abuse (V/A) is recognized as a significant public health problem, especially in females. Injuries to the head, neck, and/or mouth are clearly visible to the dental team during examination. This article provides compelling evidence that supports the pivotal position occupied by oral health care professionals within the arena of detection, intervention, and prevention of V/A. This article reviews the epidemiology of orofacial risk factors for V/A, diagnostic tools and surveys for identifying victims of all ages, and suggests interdisciplinary educational curricula/specific algorithms to provide the necessary core competencies for identifying victims in the oral health care environment.
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Affiliation(s)
- Lisa A Thompson
- Oral Health Policy and Epidemiology, Harvard School of Dental Medicine, Boston, MA 02115, USA.
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Lacey KK, McPherson MD, Samuel PS, Powell Sears K, Head D. The impact of different types of intimate partner violence on the mental and physical health of women in different ethnic groups. JOURNAL OF INTERPERSONAL VIOLENCE 2013; 28:359-85. [PMID: 22929348 DOI: 10.1177/0886260512454743] [Citation(s) in RCA: 80] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/15/2023]
Abstract
Intimate partner violence, including threats, stalking, emotional, physical, and sexual assault by a spouse or partner, has significant influences on the well-being of women of all racial and social backgrounds. This study of a nationally representative sample of women from varying racial and ethnic groups examined specific types of violent acts on health and well-being. An association between intimate partner violence and poor physical and mental health was found. Types of partner violence also had different associations with the well-being of women of different racial and ethnic backgrounds. Social and demographic factors played an important role in moderating women's outcomes. Suggestions for future studies are discussed.
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Affiliation(s)
- Krim K Lacey
- University of Michigan, Ann Arbor, MI 48106, USA.
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Breckenridge J, Salter M, Shaw E. Use and abuse: understanding the intersections of childhood abuse, alcohol and drug use and mental health. ACTA ACUST UNITED AC 2012. [DOI: 10.1080/17523281.2012.703224] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Hunter BA, Robison E, Jason LA. Characteristics of sexual assault and disclosure among women in substance abuse recovery homes. JOURNAL OF INTERPERSONAL VIOLENCE 2012; 27:2627-2644. [PMID: 22328648 PMCID: PMC3360117 DOI: 10.1177/0886260512436389] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
Research suggests that many women experience some form of sexual assault in their lifetime and that women who engage in substance abuse often have a higher incidence of past sexual assault than women in the general population. Given the documented rates of sexual assault among women in recovery from substance use, it is important to explore community interventions that promote positive recovery from substance use and sexual assault. One model that promotes successful substance use recovery is the Oxford House--a democratic, self-supported substance use recovery home. Research demonstrated that living in an Oxford House provides sober social support and that this increased social support may promote the use of positive coping strategies to strengthen recovery from substance use, however; the relationship between social support and sexual assault for women is unclear. Thus, the current study examines the Oxford House model for women in recovery from substance use who have experienced sexual assault. A cross-sectional sample of women living in Oxford Houses in the United States was obtained to examine the relationship among disclosure of sexual assault, social support, and self-esteem. Results suggested that many women used Oxford House as a setting in which to disclosure prior sexual assault. Results also indicated that women who disclosed their assault experience reported higher self-esteem and social support than women who had not disclosed. Possible implications include the value of substance abuse recovery homes as a safe, supportive environment for women to address issues related to sexual assault.
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Small E, Kohl PL. African American Caregivers and Substance Abuse in Child Welfare: Identification of Multiple Risk Profiles. JOURNAL OF FAMILY VIOLENCE 2012; 27:415-426. [PMID: 22962521 PMCID: PMC3433830 DOI: 10.1007/s10896-012-9442-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
Despite the strong correlation between caregiver substance abuse and child maltreatment, little information exists to understand the typology of African American caregivers with substance abuse problems in the child welfare system. Research shows African American caregivers contend with multiple problems stemming from substance abuse. Unfortunately, we do not yet know how to best tailor resources to be responsive to varying groups of African American caregivers. Using data from the National Survey of Child and Adolescent Well-being (NSCAW), this investigation tested for distinct multivariate profiles among a subset of African American caregivers with substance abuse problems (n=258). Latent Class Analysis (LCA) was used to classify caregivers, and five classes were identified among this high risk sample - each with distinct risk profiles. Based on these findings, we discuss implications for tailored practices to enhance the safety and stability of children involved with child welfare.
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Nayak MB, Lown EA, Bond JC, Greenfield TK. Lifetime victimization and past year alcohol use in a U.S. population sample of men and women drinkers. Drug Alcohol Depend 2012; 123:213-9. [PMID: 22177898 PMCID: PMC3322290 DOI: 10.1016/j.drugalcdep.2011.11.016] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2011] [Revised: 11/08/2011] [Accepted: 11/20/2011] [Indexed: 10/14/2022]
Abstract
BACKGROUND Research on alcohol use among victims of physical and sexual violence has focused mostly on women and alcohol use disorders. It is also limited by the relative lack of consideration of victimization over the lifetime and of population data on both men and women. We critically examined associations between lifetime victimization and diverse past year alcohol use patterns and problems and whether these associations differ for men and women. METHODS Population data from the 2005 U.S. National Alcohol Survey (NAS11, n=6919) are reported for 4256 adult men and women drinkers. Logistic regressions assessed associations between physical only or any sexual victimization experienced over the lifetime and past year heavy episodic drinking, drinking to intoxication, alcohol-related consequences and any alcohol use disorder. Models controlled for demographics and parental history of alcohol abuse and examined interactions of gender with victimization. RESULTS Associations between victimization experienced over the lifetime and all past year alcohol measures were significant for both men and women. These associations did not differ by type of lifetime victimization (physical only vs any sexual). The association of physical only victimization with drinking to intoxication was stronger for victimized vs non-victimized women compared to victimized vs non-victimized men. This gender difference ceased to be significant when specific victimization characteristics were controlled for. CONCLUSIONS Lifetime victimization is associated with increased risk for diverse alcohol use problems for both men and women. All prevention and treatment programs should screen men and women for lifetime victimization and diverse alcohol use problems.
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