Life after incarceration: The impact of stability on formerly imprisoned Oxford House residents.

According to the National Institute on Drug Abuse, roughly 65% of the US prison population is diagnosed with a substance use disorder (SUD) and over 600,000 individuals are released from incarceration yearly. Thus, it is important to better understand the factors that allow individuals recovering from SUD to reintegrate into communities after incarceration. This study sought to understand the relationship between a personality mediator (stability) and quality of life (QOL) and belonging support (BS), as well as the relationship between this mediator and QOL and psychological sense of community (PSOC) for 131 individuals living in Oxford House (OH) recovery homes. Stability was found to mediate the relationship between BS and QOL, as well as PSOC and QOL. The findings suggest that OH is a supportive and positive recovery community for those with criminal justice backgrounds, particularly those with higher stability.

Cortical hypoactivation during resting EEG suggests central nervous system pathology in patients with chronic fatigue syndrome.

We investigated central fatigue in 50 patients with chronic fatigue syndrome (CFS) and 50 matched healthy controls (HC). Resting state EEG was collected from 19 scalp locations during a 3 min, eyes-closed condition. Current densities were localized using exact low-resolution electromagnetic tomography (eLORETA). The Multidimensional Fatigue Inventory (MFI-20) and the Fatigue Severity Scale (FSS) were administered to all participants. Independent t-tests and linear regression analyses were used to evaluate group differences in current densities, followed by statistical non-parametric mapping (SnPM) correction procedures. Significant differences were found in the delta (1-3 Hz) and beta-2 (19-21 Hz) frequency bands. Delta sources were found predominately in the frontal lobe, while beta-2 sources were found in the medial and superior parietal lobe. Left-lateralized, frontal delta sources were associated with a clinical reduction in motivation. The implications of abnormal cortical sources in patients with CFS are discussed.

Differentiating Multiple Sclerosis from Myalgic Encephalomyelitis and Chronic Fatigue Syndrome.

Multiple Sclerosis (MS), Myalgic Encephalomyelitis (ME), and Chronic Fatigue syndrome are debilitating chronic illnesses, with some overlapping symptoms. However, few studies have compared and contrasted symptom and disability profiles for these illnesses for the purpose of further differentiating them. The current study was an online self-report survey that compared symptoms from a sample of individuals with MS (N = 120) with a sample of individuals with ME or CFS (N = 269). Respondents completed the self-report DePaul Symptom Questionnaire. Those individuals with ME or CFS reported significantly more functional limitations and significantly more severe symptoms than those with MS. The implications of these findings are discussed.

Testing a Multidimensional Acculturation Model on Latinos who Completed Substance Abuse Treatment.

Disparities in substance abuse treatment (SAT) utilization and completion suggest that traditional substance abuse models may fall short of addressing the complex needs of Latinos, increasing the odds of relapsing. The need for substance use models that integrate multiple acculturation domains in relation to substance abuse is warranted. The goal of the present study is twofold: a) test a multidimensional acculturation model on Latinos who completed SAT; and b) examine the association between the proposed multidimensional acculturation and days consuming alcohol and illicit drugs in the past six months. A total of 131 participants (Mage=36.15, SD ± 10.5, 86.3% males, 48.1% non-U.S. born with a mean length of stay of 19 years in the U.S. (SD ± 13.71) were interviewed upon completion of SAT. Results from the SEM indicated adequate model fit to the population under study, supporting the use of a multidimensional acculturation approach for this population. Subsequent results from the structured regression analysis suggest that multidimensional acculturation is negatively associated with days using alcohol in the past 6 months. The implications of these findings are discussed.

Kindling and Oxidative Stress as Contributors to Myalgic Encephalomyelitis/Chronic Fatigue Syndrome.

Myalgic Encephalomyelitis/chronic fatigue syndrome (ME/CFS) is one of the more complex illnesses involving multiple systems within the body. Onset of ME/CFS frequently occurs quickly, and many patients report a prior exposure to a viral infection. This debilitating illness can affect the immune, neuroendocrine, autonomic, and neurologic systems. Abnormal biological findings among some patients have included aberrant ion transport and ion channel activity, cortisol deficiency, sympathetic nervous system hyperactivity, EEG spike waves, left ventricular dysfunction in the heart, low natural killer cell cytotoxicity, and a shift from Th1 to Th2 cytokines. We propose that the kindling and oxidative stress theories provide a heuristic template for better understanding the at times conflicting findings regarding the etiology and pathophysiology of this illness.

Sense of Community within Oxford House Recovery Housing: Impact of Resident Age and Income.

The experience of psychological sense of community (PSOC) can play an important role in the substance abuse recovery process. This study explored the relationship between PSOC and setting-level variables of age and income amongst residents living in Oxford House, a communal, self-governed recovery housing model (n = 70). Age and income variables were not related to an overall PSOC or components such as shared common mission or feelings of reciprocal responsibility. However, both age and income variables were significant predictors of the harmony felt within these houses. The role that PSOC may play in recovery facilities and other co-housing arrangements was discussed, and implications for future research and application were outlined.

Social network variables in alcoholics anonymous: a literature review.

Alcoholics Anonymous (AA) is the most commonly used program for substance abuse recovery and one of the few models to demonstrate positive abstinence outcomes. Although little is known regarding the underlying mechanisms that make this program effective, one frequently cited aspect is social support. In order to gain insight into the processes at work in AA, this paper reviewed 24 papers examining the relationship between AA and social network variables. Various types of social support were included in the review such as structural support, functional support, general support, alcohol-specific support, and recovery helping. Overall, this review found that AA involvement is related to a variety of positive qualitative and quantitative changes in social support networks. Although AA had the greatest impact on friend networks, it had less influence on networks consisting of family members or others. In addition, support from others in AA was found to be of great value to recovery, and individuals with harmful social networks supportive of drinking actually benefited the most from AA involvement. Furthermore, social support variables consistently mediated AA's impact on abstinence, suggesting that social support is a mechanism in the effectiveness of AA in promoting a sober lifestyle. Recommendations are made for future research and clinical practice.

Current smoking among young adolescents: assessing school based contextual norms.

OBJECTIVE: To extend research on the relation of school based contextual norms to current smoking among adolescents by using three analytic techniques to test for contextual effects. It was hypothesised that significant contextual effects would be found in all three models, but that the strength of these effects would vary by the statistical rigor of the model. DESIGN: Three separate analytic approaches were conducted on baseline self report student survey data from a larger study to test the relation between school level perceived peer tobacco use and individual current smoking status. PARTICIPANTS: A representative sample of 5399 sixth through eighth grade students in 14 midwestern middle schools completed the survey. All enrolled sixth through eighth grade students were eligible to participate in the survey. The student participation rate was 91.4% for the entire sample, and did not differ significantly between the schools (range 82-100%). MAIN OUTCOME MEASURE: Thirty day cigarette smoking prevalence. RESULTS: A level 2 only model based on aggregated individual responses indicated that students in schools with higher average reported peer tobacco use were more likely to be current smokers than students in schools with lower average peer tobacco use. Using a level 1 only model based on individual responses indicated that the effect of school level perceived peer tobacco use on current smoking was significant when individual perceived peer tobacco use was excluded from the model but was non-significant when individual perceived peer tobacco use was added to the model. A multilevel model also indicated that the effect of school level perceived peer tobacco use on current smoking was not significant when individual perceived peer tobacco use was added to the model. CONCLUSION: The analytic approach used to examine contextual effects using individuals' reports of peer tobacco use norms that were aggregated to obtain a context measure of the school norms may produce statistical artefacts that distort the association of the school context in general, and peer tobacco use norms in particular, with increased risk for current smoking beyond the risk associated with individual factors.

Symptom occurrence in persons with chronic fatigue syndrome.

This investigation compared differences in the occurrence of symptoms in participants with CFS, melancholic depression, and no fatigue (controls). The following Fukuda et al. [Ann. Intern. Med. 121 (1994) 953] criteria symptoms differentiated the CFS group from controls, but did not differentiate the melancholic depression group from controls: headaches, lymph node pain, sore throat, joint pain, and muscle pain. In addition, participants with CFS uniquely differed from controls in the occurrence of muscle weakness at multiple sites as well as in the occurrence of various cardiopulmonary, neurological, and other symptoms not currently included in the current case definition. Implications of these findings are discussed.

Eliminating invalid self-report survey data.

A sample of 6,370 students in Grades 6 to 8 completed a questionnaire on their attitudes and use of alcohol, tobacco, and other drugs. A subsample showed questionable data based on three criteria: missing responses, invalid responses, and inconsistent responses. Analysis indicated that this subsample was significantly different from the main group on demographic variables and self-reported life-time tobacco use. Results support efforts to identify and eliminate invalid data.

Sexual abuse, physical abuse, chronic fatigue, and chronic fatigue syndrome: a community-based study.

Using a randomly selected community-based sample, this investigation examined whether histories of childhood sexual, physical, and death threat abuse predicted adulthood outcomes of specific medical and psychiatric conditions involving chronic fatigue. This study also tested prior suggestions that most individuals with chronic fatigue syndrome report a past history of interpersonal abuse. Multinomial logistic regression was used to examine the relationship between abuse history and chronic fatigue group outcomes while controlling for the effects of sociodemographics. Compared with healthy controls, childhood sexual abuse was significantly more likely to be associated with outcomes of idiopathic chronic fatigue, chronic fatigue explained by a psychiatric condition, and chronic fatigue explained by a medical condition. None of the abuse history types were significant predictors of chronic fatigue syndrome. A closer examination of individuals in the chronic fatigue syndrome group revealed that significantly fewer individuals with CFS reported abuse as compared with those who did not. The implications of these findings are discussed.

Do participation rates change when active consent procedures replace passive consent.

Researchers face considerable ambiguity and controversy regarding the issue of informed consent. Decisions about consent procedures can affect study participation rates and prevalence estimates among specific populations. Changing from passive to active parental consent procedures was examined in a case study with an anonymous survey of sixth- through eighth-grade students' substance use. Four types of procedures for obtaining parental consent were examined. Results suggest that certain types of consent procedures can yield high levels of participation. This study also demonstrates that low participation rates with some active consent procedures can cause biases in sample characteristics and outcome data.

Oxford house: a review of research and implications for substance abuse recovery and community research.

After treatment for substance abuse, whether it is in hospital-based treatment programs, therapeutic communities, or recovery homes, many patients return to former high-risk environments or stressful family situations. Returning to these settings without a network of people to support abstinence increases chances of a relapse. As a consequence, substance abuse recidivism following treatment is high for both men and women. Alternative approaches need to be explored, and there are some promising types of recovery homes. From a public health perspective, a series of studies conducted at DePaul University suggests that one type of recovery home for alcohol abuse recovery has much potential. For example, within this self-help communal living setting, recovering alcoholics were able to maintain employment, thereby reducing their need for government subsidies. Maintaining employment for recovering alcoholics may promote increased personal responsibility, which may impact self-efficacy beliefs. These pilot studies, then, raised both theoretical and practical issues needing further evaluation.

A community-based study of seasonal variation in the onset of chronic fatigue syndrome and idiopathic chronic fatigue.

One proposed hypothesis regarding the etiology of chronic fatigue syndrome (CFS) is that there is a subgroup of patients in which symptom onset is precipitated by a viral infection. If this is indeed true, then one would anticipate a greater incidence of the emergence of CFS symptoms during months when viral infections occur with the greatest frequency. The current community-based epidemiology study examined the month of symptom onset for 31 patients with CFS and 44 others with idiopathic chronic fatigue (ICF). It was determined that the distribution of the month of illness onset for the CFS and ICF groups was nonrandom, with greater numbers of participants than expected reporting an onset of CFS and ICF during January.

Chronic fatigue syndrome and fibromyalgia: clinical assessment and treatment.

Chronic fatigue syndrome (CFS) and fibromyalgia (FM) are closely related illnesses of uncertain etiology. This article reviews the research literature on these biobehavioral conditions, with an emphasis on explanatory models, clinical evaluation of comorbid psychiatric disorders, assessment of stress factors, pharmacologic and alternative therapies, and cognitive-behavioral treatment studies. Furthermore, clinical protocols suitable for professional practice are presented based on an integration of the authors' clinical observations with published data. The article concludes with the recognition that mental health professionals can offer substantial help to these patients.

Assessing attitudes toward new names for chronic fatigue syndrome.

A questionnaire was distributed at the American Association of Chronic Fatigue Syndrome's biannual convention in Washington in January 2001 as well as through various Internet Web sites and listserves during early February and March of 2001. The sample consisted of 432 respondents. Most respondents (86%) indicated they wanted a name change, although more patients than scientists were in favor of this change. It was also apparent that the patients and physicians were clearly split between adopting a name such as myalgic encephalopathy versus one such as neuro-endocrine immune disorder. Also, among those respondents who selected either of these two choices for a new name, less than 30% of them supported the other name. Although the majority of respondents feel the name should be changed at this time, this survey suggests there are different stakeholders involved in the name-change process, each with strong and sometimes disparate feelings about changing the name.

Attitudes regarding chronic fatigue syndrome: the importance of a name.

Undergraduates from diverse academic backgrounds and medical trainees were assessed regarding their attitudes about and familiarity with chronic fatigue syndrome (CFS). We explored whether different names given to chronic fatigue syndrome (CFS, myalgic encephalopathy, or Florence Nightingale disease) were associated with differences in attributions regarding its cause, nature, severity, contagion, prognosis, and treatment. Participants' attributions toward the illness varied with the names used to characterize it. Participants prompted with the myalgic encephalopathy name were more likely to attribute a biomedical cause to the illness, and less likely to consider patients as candidates for organ donation than those prompted with the CFS name. Although the medical trainees were less likely to consider the patient as malingering, and more likely to view the illness as leading to poorer quality of life and a poorer prognosis, they were also more likely to consider the illness a form of primary depression, more likely to think the patient would attempt suicide, and less likely to consider associated cognitive symptoms as severe. The implications are discussed.

Feminist perspectives on the social construction of chronic fatigue syndrome.

We contrast Western medical views of chronic fatigue syndrome (CFS) etiology, diagnosis, and treatment with views maintained by a predominantly female CFS population. We argue that the failure of Western medicine to demonstrate a viral etiology for CFS led to a paradigmatic shift in research perspectives, which then embraced psychiatric and sociocultural explanations for CFS. As a result, CFS was delegitimized as a biomedical phenomenon within medical, academic, governmental, and public arenas. We compare alternative social constructions of CFS with issues pertaining to multiple sclerosis (MS), an illness that similarly predominates among women. Patient perspectives suggest that the history of medical attitudes toward CFS may eventually parallel the transformations that occurred in relation to MS. In particular, the discovery of biological markers for CFS may lay to rest the categorization of CFS as largely within the psychiatric realm.

Chronic fatigue syndrome: sociodemographic subtypes in a community-based sample.

Most chronic fatigue syndrome (CFS) studies are based on information about patients from primary or tertiary care settings. These patients might not be typical of patients in the general population. This investigation involved examinations of individuals with CFS from a community-based study. A random sample of 18,675 in Chicago was interviewed by telephone. Individuals with chronic fatigue and at least four minor symptoms associated with CFS were given medical and psychiatric examinations. A group of physicians then diagnosed individuals with CFS, who were then subclassified based on three sociodemographic categories--gender, ethnicity, and work status. Sociodemographic subgroups were analyzed in terms of symptom severity, functional disability, coping, optimism, perceived stress, and psychiatric comorbidity. Women, minorities, and nonworking individuals with CFS reported greater levels of functional disability, symptom severity, and poorer psychosocial functioning than men, Caucasians, and working individuals, suggesting sociodemographic characteristics may be associated with poorer outcomes in urban, community-based samples of CFS individuals.

Chronic fatigue syndrome, fibromyalgia, and multiple chemical sensitivities in a community-based sample of persons with chronic fatigue syndrome-like symptoms.

OBJECTIVE: The aim of this study was to determine illness comorbidity rates for individuals with chronic fatigue syndrome (CFS), fibromyalgia (FM), and multiple chemical sensitivities (MCS). An additional objective was to identify characteristics related to the severity of fatigue, disability, and psychiatric comorbidity in each of these illness groups. METHODS: A random sample of 18,675 residents in Chicago, Illinois, was first interviewed by telephone. A control group and a group of individuals with chronic fatigue accompanied by at least four minor symptoms associated with CFS received medical and psychiatric examinations. RESULTS: Of the 32 individuals with CFS, 40.6% met criteria for MCS and 15.6% met criteria for FM. Individuals with MCS or more than one diagnosis reported more physical fatigue than those with no diagnosis. Individuals with more than one diagnosis also reported greater mental fatigue and were less likely to be working than those with no diagnosis. Individuals with CFS, MCS, FM, or more than one diagnosis reported greater disability than those with no diagnosis. CONCLUSIONS: Rates of coexisting disorders were lower than those reported in prior studies. Discrepancies may be in part attributable to differences in sampling procedures. People with CFS, MCS, or FM endure significant disability in terms of physical, occupational, and social functioning, and those with more than one of these diagnoses also report greater severity of physical and mental fatigue. The findings illustrate differences among the illness groups in the range of functional impairment experienced.