RESUMEN
BACKGROUND: The relationship between the use of alcohol and aggression is complex and represents major public health issues. Delving into the nature of this association is vital, since various underlying factors may contribute to the expression of aggression. OBJECTIVE: This study examined trait aggression by assessing correlates and, subsequently, the unique contribution of alcohol craving, and dysfunctional impulsivity, by means of correlational and mediational analyses. METHODS: Forty inpatient detoxified alcohol-dependent patients were recruited. These participants completed the Desire for Alcohol Questionnaire (DAQ), Dickman Impulsivity Inventory (DII), and the Aggression Questionnaire (AQ). RESULTS: The findings indicated that aggression, dysfunctional impulsivity, and alcohol craving were all positively intercorrelated. The association between dysfunctional impulsivity and aggression was robust. The mediational analyses yielded that craving partially mediated this relationship, although not very substantial. CONCLUSION: It was shown that impulsivity, as a personality characteristic, is strongly associated with aggressive behaviors, whereby the impact of craving on the relationship between impulsivity and trait aggression in alcohol-dependent inpatients was weak. SCIENTIFIC SIGNIFICANCE: Since it has been posited that factors such as impulsivity and craving may contribute to the lucid association between substance use and aggression, these findings mirror previous research on stimulant users and, subsequently, substantiates that craving exerts only a minor weight on the strong impulsivity-aggression relationship.
Asunto(s)
Agresión/psicología , Alcoholismo/rehabilitación , Conducta Impulsiva/psicología , Adulto , Alcoholismo/psicología , Humanos , Conducta Impulsiva/epidemiología , Pacientes Internos , Masculino , Persona de Mediana Edad , Encuestas y CuestionariosRESUMEN
BACKGROUND: There is increasing interest in naltrexone, an opiate antagonist, in the treatment of opiate addicts. The effects of naltrexone are often compromised by a lack of compliance and drop-out. The effects of this compound are probably more favorable when combined with a psychosocial intervention such as the Community Reinforcement Approach (CRA). AIM: To explore the effects of a combination therapy (naltrexone plus CRA treatment) and the predictive value of sociodemographic and psychopathologic characteristics. METHOD: Using a before-and-after design, heroine addicts (n = 24) receiving a combined naltrexone plus CRA treatment are compared with a group (n = 20) on methadone maintenance therapy (reference group). RESULTS: Over a period of 6 months, 58% (14/24) did not relapse, after 1 year at least 55% (12/22) still met the initial goal of continuous abstinence. At baseline, the treatment group and the reference group were similar on nearly all variables except for the number of times clients were arrested. Within the treatment group, a comparison was made between the continuous abstinent and those who relapsed into frequent opioid use. Differences were significant in the cluster-B personality disorders and in polydrug users. CONCLUSION: The combination of naltrexone plus intensive CRA in an outpatient setting appears to be promising. A high score on cluster-B and polydrug use is associated with relapse.
Asunto(s)
Servicios Comunitarios de Salud Mental , Dependencia de Heroína/rehabilitación , Trastornos Mentales/rehabilitación , Naltrexona/administración & dosificación , Antagonistas de Narcóticos/administración & dosificación , Refuerzo en Psicología , Adulto , Terapia Combinada , Comorbilidad , Diagnóstico Dual (Psiquiatría) , Femenino , Estudios de Seguimiento , Dependencia de Heroína/epidemiología , Dependencia de Heroína/psicología , Humanos , Masculino , Trastornos Mentales/epidemiología , Trastornos Mentales/psicología , Metadona/administración & dosificación , Grupo de Atención al Paciente , Cooperación del Paciente/psicología , Cooperación del Paciente/estadística & datos numéricos , Pacientes Desistentes del Tratamiento/psicología , Pacientes Desistentes del Tratamiento/estadística & datos numéricos , Psicoterapia , Prevención SecundariaAsunto(s)
Lesión Renal Aguda/inducido químicamente , Deshidratación/inducido químicamente , Naltrexona/efectos adversos , Antagonistas de Narcóticos/efectos adversos , Trastornos Relacionados con Opioides/rehabilitación , Adulto , Humanos , Masculino , Metadona/uso terapéutico , Narcóticos/uso terapéuticoRESUMEN
Rapid opiate withdrawal and relapse prevention in opiate addicts are made possible by naltrexone, clonidine and diazepam in combination with cognitive behavioural therapy according to the Community Reinforcement Approach. In an open pilot experiment 12 addicted patients achieved initial detoxification. At follow-up after a minimum of 6 months, 10 of these had not relapsed. Good results with this detoxification method could be booked by selecting highly motivated opiate addicts.