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Erga AH, Ushakova A, Elstad M, Fodstad EC, Belfrage A. The Relationship Between Self-Reported Childhood Maltreatment and Mental Health in Substance Use Disorders: A 6-Year Retrospective Analysis. J Dual Diagn 2024:1-13. [PMID: 38648609 DOI: 10.1080/15504263.2024.2338799] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/25/2024]
Abstract
OBJECTIVE This longitudinal cohort study aims to investigate the relationship between self-reported childhood maltreatment (CM) and the retrospective trajectory of substance use, mental health, and satisfaction with life in individuals with substance use disorders. METHODS One hundred eleven treatment-seeking individuals with substance use disorder were recruited from clinical settings and monitored prospectively for 6 years. The participants' substance use, mental health, and satisfaction with life were assessed using standardized measures. Cluster analysis divided the cohort into two groups-low CM and high CM-based on their scores on the Childhood Trauma Questionnaire Short Form at year 6. Mixed-effects linear models were fitted to assess the association between longitudinal scores on drug use, mental health, and satisfaction with life and CM group. RESULTS Most participants (92%) reported at least 1 CM. Out of all participants, 36% were categorized into the high-CM group, while 59% were categorized into the low-CM group. CM group was not associated with the amount of substance or alcohol use. CM group was significantly associated with the longitudinal course of mental health and life satisfaction. CONCLUSIONS This study underscores the association between self-reported CM and mental health and life satisfaction in patients with substance use disorder. Our results may imply an increased risk of adverse outcomes in patients with high levels of CM, while bearing in mind that both current and retrospective mental health and substance use problems can influence the accuracy of recalling CM.
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Affiliation(s)
- Aleksander H Erga
- Center for Alcohol and Drug Research, Stavanger University Hospital, Stavanger, Norway
- Department of Social Studies, University of Stavanger, Stavanger, Norway
- The Norwegian Centre for Movement Disorders, Stavanger University Hospital, Stavanger, Norway
| | - Anastasia Ushakova
- Department of Research, Section of Biostatistics, Stavanger University Hospital, Stavanger, Norway
| | - Maria Elstad
- Center for Alcohol and Drug Research, Stavanger University Hospital, Stavanger, Norway
- Faculty of Life Sciences and Medicine, King's College London, London, UK
| | - Elise Constance Fodstad
- Center for Alcohol and Drug Research, Stavanger University Hospital, Stavanger, Norway
- Department of Psychosocial Science, Faculty of Psychology, University of Bergen, Bergen, Norway
| | - Anna Belfrage
- Center for Alcohol and Drug Research, Stavanger University Hospital, Stavanger, Norway
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Martinelli TF, Roeg DPK, Bellaert L, Van de Mheen D, Nagelhout G. Understanding the Process of Drug Addiction Recovery Through First-Hand Experiences: A Qualitative Study in the Netherlands Using Lifeline Interviews. Qual Health Res 2023; 33:857-870. [PMID: 37279186 PMCID: PMC10426251 DOI: 10.1177/10497323231174161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Understandings of drug addiction recovery are still being debated. Research on perspectives from first-hand experiences with recovery is rare and often contains short-term experiences in the context of a treatment setting. We aim to gain further understanding of recovery by analyzing autobiographical data from persons in different stages of drug addiction recovery who are not linked to any specific treatment service. We conducted 30 in-depth qualitative interviews with participants from various parts of the Netherlands. Participants self-identified as being "in recovery" or "recovered" from drug addiction for at least 3 months. Men and women are equally represented, and the sample consists of an equal number of participants in early (<1 year, n = 10), sustained (1-5 years, n = 10), and stable (>5 years, n = 10) recovery. We undertook a data-driven thematic analysis. Participants described that recovery is a broad process of change because addiction is interwoven with everything (theme 1); that recovery is reconsidering identity, seeing things in a new light (theme 2); that recovery is a staged long-term process (theme 3); and that universal life processes are part of recovery (theme 4). Thus, Drug addiction recovery is experienced as an interwoven long-term process, including identity change and common or universal life processes. Policy and clinical practice should therefore be aimed at supporting long-term tailored recovery goals and disseminating first-hand recovery experiences to enhance long-term outcomes and reduce stigmatization.
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Affiliation(s)
- T. F. Martinelli
- IVO Research Institute, Den Haag, Netherlands
- Tranzo Scientific Centre for Care and Wellbeing, School of Social and Behavioural Sciences, Tilburg University, Tilburg, Netherlands
| | - D. P. K. Roeg
- Tranzo Scientific Centre for Care and Wellbeing, School of Social and Behavioural Sciences, Tilburg University, Tilburg, Netherlands
- Kwintes Housing and Rehabilitation Services, Zeist, Netherlands
| | - L. Bellaert
- Department of Special Needs Education, Ghent University, Ghent, Belgium
| | - D. Van de Mheen
- Tranzo Scientific Centre for Care and Wellbeing, School of Social and Behavioural Sciences, Tilburg University, Tilburg, Netherlands
| | - G.E. Nagelhout
- IVO Research Institute, Den Haag, Netherlands
- Department of Health Promotion, Maastricht University (CAPHRI), Maastricht, Netherlands
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Marceau EM, Berry J, Grenyer BFS. Neurocognition of females with substance use disorder and comorbid personality disorder: Divergence in subjective and objective cognition. Appl Neuropsychol Adult 2023; 30:368-378. [PMID: 34251923 DOI: 10.1080/23279095.2021.1948413] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
At least one in four patients with substance use disorder (SUD) meet criteria for personality disorder and overlapping neurocognitive deficits may reflect shared neurobiological mechanisms. We studied neurocognition in females attending residential SUD treatment by comparing SUD with (n = 20) or without (n = 30) comorbid personality disorder. Neuropsychological testing included working memory, inhibition, shifting, verbal fluency, design fluency, psychomotor speed, immediate and delayed verbal memory, processing speed, premorbid functioning, cognitive screening, and self-reported executive function. As expected, whole-sample deficits included working memory (d = -.91), self-reported executive function (d = -.87), processing speed (d = -.40), delayed verbal memory recall (d = -.39), premorbid functioning (d = -.51), and cognitive screening performance (d = -.61). Importantly, the comorbid personality disorder group showed greater self-reported executive dysfunction (d = -.67) and poorer shifting performance (d = -.65). However, they also evidenced better working memory (d = .84), immediate (d = .95) and delayed (d = .83) verbal memory, premorbid functioning (d = .90), and cognitive screening performance (d = .77). Overall executive dysfunction deficits were concordant with those observed in previous SUD studies. Surprisingly, comorbid personality disorder was associated with a pattern indicating poorer subjective (self-report) but better objective performance on a number of tasks, apart from shifting deficits that may relate to emotion dysregulation. Subjective emotional dysfunction may influence the cognitive deficits observed in the personality disorder group.
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Affiliation(s)
- Ely M Marceau
- School of Psychology and Illawarra Health and Medical Research Institute, University of Wollongong, Wollongong, Australia
| | - Jamie Berry
- Advanced Neuropsychological Treatment Services, Strathfield South, Australia
- Department of Psychology, Faculty of Medicine, Health and Human Sciences, Macquarie University, North Ryde, Australia
| | - Brin F S Grenyer
- School of Psychology and Illawarra Health and Medical Research Institute, University of Wollongong, Wollongong, Australia
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Rumrill SP, Bishop ML. The role of employment status, change, and satisfaction for people who have completed substance use disorder treatment. Work 2023; 74:355-369. [PMID: 36641732 DOI: 10.3233/wor-236012] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND Substance use disorder (SUD) is a complex disabling condition that is not often well understood. Despite decades of SUD research and intervention, prevalence rates remain stable and many traditional treatment options are largely ineffective in helping individuals with SUDs attain long-term abstinence and recovery. One avenue that shows promise in facilitating higher recovery and quality of life (QoL) outcomes in people with SUD is employment that occurs alongside traditional treatment. OBJECTIVE This study sought to understand the role that meaningful and satisfying employment has in SUD outcomes for treatment completers. METHODS Employing a quasi-experimental, cross-sectional, nonequivalent group design, this study examined 197 individuals with SUDs who completed treatment to explore how their employment status during treatment, employment status change from their treatment to the time of the survey, and job satisfaction influenced their recovery and QOL. RESULTS Analyses of covariance (ANCOVAs) revealed that those who made the transition from unemployed at treatment to employed at time of survey and those who were employed in "very satisfying" jobs had higher rates of recovery and QOL than those who were in "very dissatisfying" jobs or made the transition from employed during treatment to unemployed at time of survey. CONCLUSION The results of this study are promising in that employment and job satisfaction seem to be facilitative of recovery and QOL outcomes for this population of SUD treatment completers.
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Veseth M, Svendsen TS, Nesvaag S, Moltu C, Davidson L, Bjornestad J. "And then the rest happened"- A qualitative exploration of the role that meaningful activities play in recovery processes for people with a diagnosis of substance use disorder. Subst Abus 2021; 43:260-266. [PMID: 34214010 DOI: 10.1080/08897077.2021.1941506] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Background: In this qualitative exploration, we report on a thematic analysis of the key role that engaging in meaningful activities may play in recovery processes for people with a diagnosis of substance use disorder (SUD). Methods: We conducted semi-structured, individual interviews with 30 participants and analyzed the parts of this material that were related to meaningful activities. Results: The findings are summarized through the development of three broad themes: (a) the central role of work-"The wages suck, but the job is gold"; (b) mastery and commitment-"I had to get up early, find my spot, I had to be present and fully functioning all day"; and (c) repairing the bridge to community life-"It's my job and working out that has made this possible, really, I see that now." Conclusion: We discuss these findings in relation to a recovery perspective and relevant empirical studies, highlight some important implications for research and practice, and consider the strengths and limitations of the present study.
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Affiliation(s)
- Marius Veseth
- Department of Clinical Psychology, University of Bergen, Bergen, Norway
| | | | - Sverre Nesvaag
- Centre for Alcohol and Drug Research, Stavanger University Hospital, Stavanger, Norway
| | - Christian Moltu
- Department of Psychiatry, District General Hospital of Førde, Førde, Norway.,Department of Health and Caring Sciences, Western Norway University of Applied Sciences, Førde, Norway
| | - Larry Davidson
- Program for Recovery and Community Mental Health, Yale University, New Haven, Connecticut, USA
| | - Jone Bjornestad
- Department of Social Studies, Faculty of Social Sciences, University of Stavanger, Stavanger, Norway
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Abstract
This study investigated the recovery process for individuals engaged in treatment for substance use disorders (SUDs) who had co-occurring anxiety and depression. The participants were eight individuals engaged in treatment. The results of a Grounded Theory design and methods revealed the core category and substantive theory, Stumbling toward Vulnerability. Four phases in which the participants progressed in a linear way emerged. The study results have implications for the role of the advance practice psychiatric-mental health nurse in the early assessment of mental illness for clients with SUDs by providing integrated treatment for these individuals, and focusing on health and wellness as a recovery outcome. Based on the findings, hypotheses for further research are recommended.
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Affiliation(s)
- Marissa D Abram
- College of Nursing and Public Health, Adelphi University, Garden City, New York, USA.,Pulse Center for Patient Safety Education and Advocacy, Wantagh, New York, USA
| | - Jane H White
- College of Nursing and Public Health, Adelphi University, Garden City, New York, USA.,Institute for Nursing, Northwell Health, New Hyde Park, New York, USA
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