Bereavement-related regrets and unfinished business with the deceased.

Unresolved relational issues with the deceased have been considered a prominent risk factor for negative bereavement outcomes. However, this area of study has suffered from a lack of conceptual clarity, with some commentators focusing on bereavement-related regret and others focusing on "unfinished business," or lingering or unspoken conflicts with the deceased. This study examined the two concepts in a sample of 229 bereaved individuals, finding them to be overlapping but distinct constructs. Unfinished business occurred more frequently with immediate family and friends and in cases of sudden and violent death of loved ones. Both forms of unresolved issues were associated with bereavement outcome, with the relation between distress over unfinished business and complicated grief symptomatology being particularly robust.

Family Behavior Therapy for Alcohol and Drug Problems in Later-Life.

Alcohol and drug use problems among older individuals are a growing public health concern. However, few treatments have been developed for this population, despite an emerging body of literature suggesting that older substance users are more likely to benefit from interventions tailored to meet their specific needs. In particular, older adults with a history of substance abuse have expressed a preference for treatments that focus on financial problems, physical health, and mobility issues, and make attempts to prescriptively involve supportive others in treatment. To address these needs, we developed a modified version of Family Behavior Therapy (FBT) for older individuals with substance use problems that involves participation from significant others and covers skills that are relevant to an older clientele. This modified form of FBT is illustrated through the case of Jack-a 55-year-old man with a longstanding addiction to methamphetamine. After completing 16 sessions, Jack's alcohol and drug use was substantially reduced, and he reported strong confidence in his ability to resist substance use in the future. Despite this promising first case, further work is needed to fully examine the efficacy of this modified version of FBT for older individuals with substance use problems.

Examination of the relationship between social support and treatment outcomes in mothers referred by Child Protective Services utilizing the Significant Other Support Scale.

Supportive social networks may play an important role in recovery for mothers within the umbrella of Child Protective Services (CPS). However, investigators have yet to assess how the quality of significant other support assists family-based treatment. In this study the influence of significant others was examined in the family-based treatment of 38 mothers who were referred for behavioral treatment by CPS. The Significant Other Support Scale (SOSS) was empirically developed, and subsequently utilized to assess the extent to which participants' significant others were perceived by treatment providers to support the participants' goals during treatment sessions. Results indicated that SOSS scores (but not participant and significant other session attendance) were associated with lower participant child abuse potential and drug use frequency at the conclusion of treatment. There was no relationship found between SOSS scores and participant session attendance. However, there was a positive correlation between SOSS scores and significant other session attendance (r = .489, p < .01). The results of this study suggest the quality of significant other support during treatment sessions in this population of mothers may be more important to improving treatment outcomes than session attendance per se. Future directions are discussed in light of the results.

Examination of the Influence of Cognitive Behavior Therapy Components, Consumer Satisfaction and Engagement in Mothers Referred for Drug Abuse and Child Neglect on Treatment Outcomes.

Psychological interventions for child maltreatment have predominately been limited to family-supported, multi-component behavioral therapies. Although these comprehensive programs have resulted in positive outcomes, they are relatively costly and there is limited information available as to how the components of these programs influence treatment outcomes. In this study, the CBT components of an evidence-based treatment for child neglect and drug abuse (Family Behavior Therapy) were examined in regards to consumer preferences, consumer engagement and treatment outcomes. Thirty-five mothers identified for child neglect and drug abuse were administered various CBT components successively and cumulatively based on their preferences. Repeated measure ANOVAs indicated that participants chose to receive components that were specific to managing antecedents to drug abuse and child neglect most frequently, followed by parenting skills training, communication skills training, and job/financial skills training. No differences were found in treatment providers' ratings of the participants' engagement across intervention components throughout treatment. Participants rated the intervention components as similarly helpful. Partial correlations revealed that participants' ratings of helpfulness and provider ratings of participants' engagement were not associated with improved drug use outcomes at 6- and 10-months post baseline. Participants' ratings of helpfulness were associated with child maltreatment outcomes at 10-month post baseline, and provider ratings of participants' engagement were associated with child maltreatment outcomes at both 6- and 10-month post baseline. Participants identified for neglect not related to drug exposure in utero improved at a higher percentage than did participants identified for in utero drug exposure, and receiving behavioral intervention components more frequently led to greater percentages of participants improving in both drug use and child maltreatment outcomes.

Contribution of Illicit/Non-Prescribed Marijuana and Hard-Drug Use to Child-Abuse and Neglect Potential while Considering Social Desirability.

Illicit drug use by mothers has been indicated to increase child abuse and neglect. However, investigators have not assessed the relative contribution of particular drugs on child-abuse and neglect potential using validated measures with collateral reports. This study compares the contribution of marijuana and hard-drug use to child-abuse and neglect potential in mothers referred to behavioural treatment by child-protective services. Reports of marijuana and hard-drug use by mothers were three times higher than reports of the mothers' marijuana and hard-drug use by family or friends, and marijuana- and hard-drug-use reports by mothers were more consistent with urinalysis testing than their significant others. Regression analyses showed mothers' marijuana and hard-drug-use reports contributed to their potential to abuse and neglect irrespective of socially desirable responding, stress and socio-demographic variables. Reports of mothers' marijuana and hard-drug use by significant others were not associated with mothers' child-abuse and neglect potential. Thus, mothers' self-reports of marijuana and hard-drug use appear to provide greater utility in the prediction of child abuse and neglect, as compared to reports from their significant others. Future recommendations and study limitations are discussed in light of these results.

Examination of the Extent to which Employment Factors are Associated with Reduced Child Maltreatment Potential and Drug Use.

Job assistance programs are commonly recommended for parents of children who have been victimized by child maltreatment, particularly when illicit drugs are indicated. However, the relationship between employment factors, substance abuse and risk of child maltreatment has received limited empirical attention. Therefore, the current study examines employment factors in a sample of 72 mothers who were referred by Child Protective Services (CPS) for treatment of substance abuse and child neglect. Child maltreatment potential was found to be negatively associated with number of hours employed and self-reported happiness with employment. The association between child abuse potential and personal income of participants approached significance (p = .057), and the results were not influenced by social desirability. Employment satisfaction significantly contributed to the prediction of child maltreatment potential over and above other employment factors and control variables. These findings suggest that when mothers are involved in CPS their risk of perpetrating child maltreatment may be reduced when they are assisted in gainful employment that is personally satisfying. Happiness with employment was the only employment factor correlated (inversely) with substance use (biological testing, self-report of participants). Future directions are discussed in light of the results, including the importance of considering employment satisfaction when conducting vocational assistance programs in this population.

Family Assisted Contingency Management within the Context of Evidence-Supported Treatment for Child Neglect and Drug Abuse.

Contingency management (CM) has extensively been shown to be effective in reducing substance use disorders, but its effects in reducing child maltreatment have yet to be determined. The current study provides preliminary support for the utilization of an innovative family-assisted CM component in 18 mothers who were referred to an evidence-supported behavioral treatment for concurrent child neglect and drug abuse by Child Protective Service caseworkers. In the examined CM, participants were invited to indicate from a list of common actions incompatible with child neglect (i.e. positive parenting actions), the extent to which these actions had been experienced utilizing a 3-point scale (almost never, sometimes, almost always). For each item that was indicated to be almost never or sometimes experienced, the participants were queried to indicate if the neglect incompatible action should be targeted as a therapeutic goal. Contingencies were subsequently established in which the participants were rewarded by involved family members for their completion of therapeutic goals. At baseline, results indicated that there was a negative association between the number of neglect incompatible parenting actions that were infrequently experienced and child abuse potential. A hierarchical multiple regression analysis showed that the number of neglect incompatible actions targeted as therapeutic goals at baseline, but not the number of positive parenting actions experienced infrequently at baseline, predicted reduced child maltreatment potential following treatment. These findings suggest the examined CM may assist evidence supported behavioral treatment specific to child neglect and drug abuse.

Examination of Life Satisfaction, Child Maltreatment Potential and Substance Use in Mothers Referred for Treatment by Child Protective Services for Child Neglect and Substance Abuse: Implications for Intervention Planning.

There is evidence to suggest mothers who are served by child protective service agencies are relatively dissatisfied in their lives, leading some investigators to conclude life dissatisfaction may be associated with child maltreatment. To assist in better understanding this relationship the Life Satisfaction Scale for Caregivers (LSSC) was psychometrically developed in a sample of 72 mothers who were referred for behavioral treatment for child neglect and substance abuse by caseworkers from a local child protective service agency. The LSSC was developed to assess mothers' happiness in nine domains (family, friendships, employment/work, spirituality/religion, safety, sex life/dating, ability to avoid drugs, ability to avoid alcohol, control over one's own life). Results indicated two factors that appeared to be relevant to Social Satisfaction and Safety and Control Satisfaction. Higher satisfaction scores on both of these scales were negatively associated with child maltreatment potential and substance use at baseline (i.e., positive urinalysis test). Mothers who exposed their children to substances in utero or in infancy (a distinct type of child neglect) were found to report higher satisfaction scores on the LSSC than other types of child neglect. Hispanic-American, African-American, and Caucasian women reported similar levels of life satisfaction. Application of the LSSC as a non-stigmatizing, wellness-focused instrument is discussed within the context of intervention planning.

Development and initial psychometric examination of the Home Safety and Beautification Assessment in mothers referred to treatment by child welfare agents.

Unintentional injury is the leading cause of death among children, with approximately 45% of injuries occurring in and around the home. Rates of home injury are particularly high in the homes of caregivers who are referred for intervention services by child welfare agents. However, there are few validated methods of home safety assessment available. The Home Safety and Beautification Assessment (HSBA) was developed to assist intervention planning specific to home safety and appearance in a sample of 77 mothers who were referred to treatment by Child Welfare Services. Exploratory factor analysis of HSBA items indicated that safety and appearance factors emerged across rooms in the home, and internal consistencies were good. For each room, the sums of assessors' safety and appearance intervention priority item scores were correlated with the assessors' global safety and appearance ratings of the entire home, respectively. The participants' overall room attractiveness scores were correlated with the assessors' overall room appearance intervention priority scores, whereas the participants' ratings of overall room safety were not correlated with the assessors' overall room safety intervention priority scores. Participants' scores on the Abuse subscale of the Child Abuse Potential Inventory, personal income, and education level were not associated with the assessors' home safety and appearance intervention priority ratings, suggesting the HSBA is assessing constructs that are distinct from child abuse potential and socioeconomic status. The results support the HSBA in a sample referred to treatment by child welfare agents. (PsycINFO Database Record

Effects of acute or repeated paroxetine and fluoxetine treatment on affective behavior in male and female adolescent rats.

RATIONALE: The SSRI antidepressant fluoxetine is one of the few drugs that is effective at treating depression in adolescent humans. In contrast, the SSRI paroxetine has limited efficacy and is more at risk for inducing suicidal behavior. OBJECTIVE: The purpose of the present study was to more fully characterize the differential actions of paroxetine and fluoxetine. METHODS: In experiment 1, male and female rats were injected with paroxetine (2.5 or 10 mg/kg), fluoxetine (10 mg/kg), or vehicle for 10 days starting on postnatal day (PD) 35, and affective behaviors were assessed using sucrose preference and elevated plus maze tasks. A separate set of rats were used to examine monoamine levels. In experiment 2, rats were injected with paroxetine (2.5, 5, or 10 mg/kg), fluoxetine (5, 10, or 20 mg/kg), or vehicle during the same time frame as experiment 1, and anxiety-like behaviors were measured using elevated plus maze, light/dark box, and acoustic startle. RESULTS: Repeated SSRI treatment failed to alter sucrose preference, although both paroxetine and fluoxetine reduced time spent in the open arms of the elevated plus maze and light compartment of the light/dark box. Paroxetine, but not fluoxetine, enhanced acoustic startle and interfered with habituation. Serotonin turnover was decreased by both acute and repeated fluoxetine treatment but unaltered by paroxetine administration. DISCUSSION: These results show that repeated treatment with paroxetine and fluoxetine has dissociable actions in adolescent rats. In particular, paroxetine, but not fluoxetine, increases acoustic startle at low doses and may increase sensitivity to environmental stressors.

Nicotine exposure beginning in adolescence enhances the acquisition of methamphetamine self-administration, but not methamphetamine-primed reinstatement in male rats.

BACKGROUND: Nicotine is commonly abused in adolescence and is believed to be a "gateway" to other drugs of abuse [e.g., methamphetamine (METH)]. The relationship between early nicotine exposure and later METH use is complicated because the majority of juvenile smokers continue to use cigarettes into adulthood. Thus, the present investigation examined the individual and combined contribution of adolescent and adult nicotine exposure on METH self-administration. METHODS: Forty-three male rats were pretreated with saline or nicotine (0.16 or 0.64 mg/kg, SC) from postnatal day (PD) 35-50. On PD 51, subjects were split into the following groups: SAL-SAL, 0.16-0.16, 0.16-SAL, 0.64-0.64, and 0.64-SAL. Rats were then trained to lever press for METH (0.05 mg/kg) for seven days on an FR1 and seven days on an FR3 reinforcement schedule. After acquisition training, rats underwent 14 days of extinction and were then tested for METH-induced primed reinstatement (1.0mg/kg, IP). RESULTS: Data showed that rats receiving continuous injections of the low dose of nicotine (0.16-0.16) obtained more METH infusions versus the control group (SAL-SAL) on an FR1 and FR3 schedule. In addition, rats on the FR3 schedule that received a low dose of nicotine during the adolescent period only (0.16-SAL) had more METH intake than the control group (SAL-SAL). Interestingly, the high dose of nicotine exposure had no effect on METH intake and neither nicotine dose altered METH seeking behavior. CONCLUSIONS: Low dose exposure to nicotine during adolescence enhances the reinforcing effects of METH, while heavier exposure has no effect on METH intake.