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1.
Nat Rev Neurosci ; 21(5): 247-263, 2020 05.
Artículo en Inglés | MEDLINE | ID: mdl-32231315

RESUMEN

Compulsion is a cardinal symptom of drug addiction (severe substance use disorder). However, compulsion is observed in only a small proportion of individuals who repeatedly seek and use addictive substances. Here, we integrate accounts of the neuropharmacological mechanisms that underlie the transition to compulsion with overarching learning theories, to outline how compulsion develops in addiction. Importantly, we emphasize the conceptual distinctions between compulsive drug-seeking behaviour and compulsive drug-taking behaviour (that is, use). In the latter, an individual cannot stop using a drug despite major negative consequences, possibly reflecting an imbalance in frontostriatal circuits that encode reward and aversion. By contrast, an individual may compulsively seek drugs (that is, persist in seeking drugs despite the negative consequences of doing so) when the neural systems that underlie habitual behaviour dominate goal-directed behavioural systems, and when executive control over this maladaptive behaviour is diminished. This distinction between different aspects of addiction may help to identify its neural substrates and new treatment strategies.


Asunto(s)
Conducta Adictiva/psicología , Conducta Compulsiva/psicología , Trastornos Relacionados con Sustancias/psicología , Animales , Comportamiento de Búsqueda de Drogas , Humanos , Vías Nerviosas , Refuerzo en Psicología
2.
Epidemiol Psychiatr Sci ; 29: e113, 2020 Apr 06.
Artículo en Inglés | MEDLINE | ID: mdl-32248873

RESUMEN

AIMS: Psychotropic prescription rates continue to increase in the United States (USA). Few studies have investigated whether social-structural factors may play a role in psychotropic medication use independent of mental illness. Food insecurity is prevalent among people living with HIV in the USA and has been associated with poor mental health. We investigated whether food insecurity was associated with psychotropic medication use independent of the symptoms of depression and anxiety among women living with HIV in the USA. METHODS: We used cross-sectional data from the Women's Interagency HIV Study (WIHS), a nationwide cohort study. Food security (FS) was the primary explanatory variable, measured using the Household Food Security Survey Module. First, we used multivariable linear regressions to test whether FS was associated with symptoms of depression (Center for Epidemiologic Studies Depression [CESD] score), generalised anxiety disorder (GAD-7 score) and mental health-related quality of life (MOS-HIV Mental Health Summary score; MHS). Next, we examined associations of FS with the use of any psychotropic medications, including antidepressants, sedatives and antipsychotics, using multivariable logistic regressions adjusting for age, race/ethnicity, income, education and alcohol and substance use. In separate models, we additionally adjusted for symptoms of depression (CESD score) and anxiety (GAD-7 score). RESULTS: Of the 905 women in the sample, two-thirds were African-American. Lower FS (i.e. worse food insecurity) was associated with greater symptoms of depression and anxiety in a dose-response relationship. For the psychotropic medication outcomes, marginal and low FS were associated with 2.06 (p < 0.001; 95% confidence interval [CI] = 1.36-3.13) and 1.99 (p < 0.01; 95% CI = 1.26-3.15) times higher odds of any psychotropic medication use, respectively, before adjusting for depression and anxiety. The association of very low FS with any psychotropic medication use was not statistically significant. A similar pattern was found for antidepressant and sedative use. After additionally adjusting for CESD and GAD-7 scores, marginal FS remained associated with 1.93 (p < 0.05; 95% CI = 1.16-3.19) times higher odds of any psychotropic medication use. Very low FS, conversely, was significantly associated with lower odds of antidepressant use (adjusted odds ratio = 0.42; p < 0.05; 95% CI = 0.19-0.96). CONCLUSIONS: Marginal FS was associated with higher odds of using psychotropic medications independent of depression and anxiety, while very low FS was associated with lower odds. These complex findings may indicate that people experiencing very low FS face barriers to accessing mental health services, while those experiencing marginal FS who do access services are more likely to be prescribed psychotropic medications for distress arising from social and structural factors.


Asunto(s)
Abastecimiento de Alimentos/estadística & datos numéricos , Infecciones por VIH/psicología , Trastornos Mentales/tratamiento farmacológico , Psicotrópicos/uso terapéutico , Calidad de Vida , Trastornos Relacionados con Sustancias/psicología , Adulto , Antidepresivos/uso terapéutico , Antipsicóticos/uso terapéutico , Ansiedad/tratamiento farmacológico , Ansiedad/psicología , Estudios de Cohortes , Estudios Transversales , Depresión/tratamiento farmacológico , Depresión/psicología , Femenino , Infecciones por VIH/complicaciones , Infecciones por VIH/epidemiología , Humanos , Hipnóticos y Sedantes/uso terapéutico , Trastornos Mentales/epidemiología , Trastornos Mentales/psicología , Salud Mental , Pobreza , Factores Socioeconómicos , Trastornos Relacionados con Sustancias/complicaciones , Estados Unidos/epidemiología
3.
Acta Med Port ; 33(4): 237-245, 2020 Apr 01.
Artículo en Inglés | MEDLINE | ID: mdl-32238237

RESUMEN

INTRODUCTION: In Sao Tome and Principe there are no studies on alcohol and drug use among students, who could be potential allies in preventive interventions. The objectives of the present study are 1) to determine the frequency of alcohol and drug consumption in the school population, and 2) to identify the main characteristics associated with this behaviour. MATERIAL AND METHODS: We applied a biographical, demographic and socioeconomic questionnaire on the use of licit and illicit substances to a sample of 2064 students. Demographic and social characteristics are presented based on observed frequencies and comparisons between groups were made using chi-square tests. Significance was assessed at α = 0.05. RESULTS: More than half of the students reported consumed alcohol at least once in their lifetime, and 32% consumed in the last 30 days. Older students were more likely to consume alcohol (p < 0.0001), but even in students under 16 years, 17% consumed in the last 30 days. We also found that 7% consumed one or more times per week in the last 30 days. The reasons presented for frequent consumption were different for boys ("participation in their group of friends") and girls ("decrease anxiety") (p = 0.005). Less than 1% of respondents admitted to having used marijuana, cocaine, crack or ecstasy. DISCUSSION: Despite some limitations, such as self-reporting, we provide a first overview showing high consumption of alcohol by young people and the existence of illegal drugs circulating in the schools. CONCLUSION: It is urgent to implement preventive interventions, namely in the context of public health communication.


Asunto(s)
Consumo de Bebidas Alcohólicas/epidemiología , Encuestas Epidemiológicas/métodos , Trastornos Relacionados con Sustancias/epidemiología , Adolescente , Adulto , Consumo de Bebidas Alcohólicas/psicología , Estudios Transversales , Femenino , Humanos , Masculino , Santo Tomé y Príncipe/epidemiología , Factores Sexuales , Factores Socioeconómicos , Estudiantes/psicología , Estudiantes/estadística & datos numéricos , Trastornos Relacionados con Sustancias/psicología , Adulto Joven
7.
Prax Kinderpsychol Kinderpsychiatr ; 69(2): 156-169, 2020 Mar.
Artículo en Alemán | MEDLINE | ID: mdl-32114947

RESUMEN

Multiple Substance Abuse as a Form of High Risk Behavior in Adolescence We identify multiple substance abuse as a form of high risk behavior in adolescence based on a sample of in-patient adolescents. 43 adolescents were treated for substance abuse over the course of 20 months. 70 % reported the use of three or more different drugs, with an average of 5,35 consumed substances. The most commonly abused substance was cannabis, followed by synthetic drugs such as cocaine or ecstasy. We observed a high rate of non-suicidal self-injury as a comorbidity of multiple substance abuse in our sample. 73,3 % of adolescents with high risk, multiple substance abuse fulfilled diagnostic criteria for non-suicidal self-injury.


Asunto(s)
Asunción de Riesgos , Trastornos Relacionados con Sustancias/psicología , Adolescente , Comorbilidad , Humanos , Conducta Autodestructiva/epidemiología , Conducta Autodestructiva/psicología , Trastornos Relacionados con Sustancias/epidemiología
8.
Prax Kinderpsychol Kinderpsychiatr ; 69(2): 126-140, 2020 Mar.
Artículo en Alemán | MEDLINE | ID: mdl-32114950

RESUMEN

The Association Between Illicit Drug Use, Borderline Personality Disorder and Depression in a Help-Seeking Sample of Adolescents Risk-taking behavior is a common phenomenon in adolescence. Even prevalence rates for illicit drug use are considerably high in youth and associated with a range of psychiatric disorders, especially depression and Borderline Personality Disorder (BPD). However, there is a lack of data investigating differences in psychopathology between different substance user groups. Therefore, aim of the study was to investigate occurrence of depression and BPD symptoms in different drug risk groups (no use vs. occasional use vs. frequent use). Further aim of the study was to examine risk profiles regarding single BPD criteria. Data of n = 347 adolescents (81.7 % female, mean age 14.95, SD = 1.50) presenting at the specialized outpatient clinic for risk-taking and self-harming behavior (AtR!Sk) in Heidelberg were analyzed. Results show that BPD is clearly associated with illicit drug use in adolescence. There is no difference between occasional and frequent users in terms of mean number of BPD criteria. However, frequent users differ from occasional users regarding greater number of impulsivity and anger criteria. After adjusting for sociodemographic variables there was no association between drug use and depression. Since even single events of illicit drug use are associated with higher levels of BPD, clinicians should rapidly target to stop consumption. Further, psychotherapeutic interventions for BPD in high-risk consumers should especially focus on facilitating adaptive emotion regulation skills in regards to impulsivity and anger.


Asunto(s)
Trastorno de Personalidad Limítrofe/complicaciones , Trastorno de Personalidad Limítrofe/psicología , Depresión/complicaciones , Depresión/psicología , Conducta de Búsqueda de Ayuda , Trastornos Relacionados con Sustancias/complicaciones , Trastornos Relacionados con Sustancias/psicología , Adolescente , Trastorno Depresivo/complicaciones , Trastorno Depresivo/psicología , Femenino , Humanos , Masculino , Conducta Autodestructiva
9.
East Mediterr Health J ; 26(2): 212-218, 2020 Feb 24.
Artículo en Inglés | MEDLINE | ID: mdl-32141600

RESUMEN

Background: Parenting approach and early childhood experiences are thought to be two important factors in the initiation of substance use. Aims: We aimed to explore the nurse's role in the prevention of childhood addiction. Methods: In this qualitative study we conducted in-depth interviews with young men and women who were either in treatment for their addiction or were active drug users as well as with family members and nurses. The data analysis followed Strauss and Corbin's constant comparison method. Results: The data analysis revealed six categories: traumatic events during childhood, inappropriate parenting approach, Lack of knowledge and a tolerant attitude toward drug use, turning a blind eye on the threat of drug use, nurses' poor experience of drug use prevention, and the lack of a clear definition of the nurse's role in prevention of drug use. Conclusions: Nurses who work with young people and their families have a special opportunity for prevention, early detection and timely intervention for drug dependency.


Asunto(s)
Consumidores de Drogas/psicología , Rol de la Enfermera , Trastornos Relacionados con Sustancias/enfermería , Adolescente , Adulto , Conducta Adictiva/enfermería , Conducta Adictiva/prevención & control , Conducta Adictiva/psicología , Niño , Femenino , Humanos , Acontecimientos que Cambian la Vida , Masculino , Investigación Cualitativa , Estrés Psicológico/psicología , Trastornos Relacionados con Sustancias/prevención & control , Trastornos Relacionados con Sustancias/psicología
10.
Nat Protoc ; 15(4): 1542-1559, 2020 04.
Artículo en Inglés | MEDLINE | ID: mdl-32203485

RESUMEN

It is difficult to translate results from animal research on addiction to an understanding of the behavior of human drug users. Despite decades of basic research on neurobiological mechanisms of drug addiction, treatment options remain largely unchanged. A potential reason for this is that mechanistic studies using rodent models do not incorporate a critical facet of human addiction: volitional choices between drug use and non-drug social rewards (e.g., employment and family). Recently, we developed an operant model in which rats press a lever for rewarding social interaction with a peer and then choose between an addictive drug (heroin or methamphetamine) and social interaction. Using this model, we showed that rewarding social interaction suppresses drug self-administration, relapse to drug seeking, and brain responses to drug-associated cues. Here, we describe a protocol for operant social interaction using a discrete-trial choice between drugs and social interaction that causes voluntary abstinence from the drug and tests for incubation of drug craving (the time-dependent increase in drug seeking during abstinence). This protocol is flexible but generally requires 8-9 weeks for completion. We also provide a detailed description of the technical requirements and procedures for building the social self-administration and choice apparatus. Our protocol provides a reliable way to study the role of operant social reward in addiction and addiction vulnerability in the context of choices. We propose that this protocol can be used to study brain mechanisms of operant social reward and potentially impairments in social reward in animal models of psychiatric disorders and pain.


Asunto(s)
Conducta de Elección/fisiología , Condicionamiento Operante/fisiología , Comportamiento de Búsqueda de Drogas/fisiología , Modelos Psicológicos , Autoadministración/métodos , Animales , Modelos Animales de Enfermedad , Femenino , Heroína/administración & dosificación , Masculino , Metanfetamina/administración & dosificación , Ratas , Ratas Long-Evans , Ratas Sprague-Dawley , Remifentanilo/administración & dosificación , Conducta Social , Trastornos Relacionados con Sustancias/psicología
11.
Psychiatr Hung ; 35(2): 182-210, 2020.
Artículo en Húngaro | MEDLINE | ID: mdl-32191222

RESUMEN

A recent paradigm shift in medicine resulted in the emergence of so-called evolutionary medicine, which studies the interactions between the environment and biological phenomena in a timeline to understand diseases and develop new treatments. In the course of evolutionary discussion of chemical substance abuse, the issue was approached through five steps. The biological level helps to understand the interference and coevolution of chemical agents and biochemical mechanisms, thus demonstrating the vulnerability toward chemical agents. The psychological level approaches behavior and its change, taking into account the consequences of the substance-induced false feelings. The social, cultural and civilization levels take into account the effects of the non-physical environment by discussing the interactions among individuals, the benefits of communication and group formation, and the subsequently emerging conflicts. The integration at individual level is implemented by the Zinberg three-pillar model, while for the integration at the level of population the phenomenon of run-away is recommended in the literature. The paper disputes the latter and suggests the concept of civilization disease to describe the phenomenon. To explain the epidemic of chemical substance abuse in our age, two additional, interrelated reasons are listed: the change in the relation to time and spirituality. And also, the question whether the appearance of epigenetics in medical thinking means the renaissance of degenerationism is raised in the article. The author has finally arrived at the conclusion that the reasons for the increase of chemical substance use in the postmodern era are basically the consequences of the strengthened psycho-social mismatch such as the rate of environmental change, changes in social control, social insecurity and anxiety, and the secularization of drug use. Therefore, the clue to solve the problem is the rethinking of the opportunities provided by the development of technology and the role of human being therein. With other words a further paradigm changing is needed.


Asunto(s)
Trastornos Relacionados con Sustancias , Ansiedad , Humanos , Trastornos Relacionados con Sustancias/tratamiento farmacológico , Trastornos Relacionados con Sustancias/psicología
12.
BMC Public Health ; 20(1): 146, 2020 Jan 31.
Artículo en Inglés | MEDLINE | ID: mdl-32005222

RESUMEN

BACKGROUND: Substance use disorders are a major risk factor for suicide. However, less is known about specific risk factors for suicide in people with substance use disorders. METHODS: This population cohort study assessed suicide among people treated for drug use disorders in Denmark 2000-2010, and described risk factors for completed suicide. Data from 27,942 individuals enrolled in treatment were linked to national registers and matched with controls without drug use disorder and with (n = 138,136) or without psychiatric history (n = 1574). Competing risk regression was used to identify risk factors of completed suicide. RESULTS: There were 163 suicides among patients with a history of drug treatment (0.6% of patients). Increased risk was associated with younger age at enrolment (hazard ratio [HR] = 0.97, 95% confidence interval (CI): 0.95, 0.98), history of psychiatric care (HR = 1.96, CI 95%: 1.39, 2.77), opioid use (HR = 1.81, 95% CI: 1.23, 2.68), and alcohol use (HR = 1.56, 95% CI: 1.09, 2.23). Lower risk was associated with cannabis use (HR = 0.69, 95% CI: 0.50, 0.96). Compared with age- and gender-matched controls without a history of treatment for substance use disorders or recent psychiatric care, the standardized mortality ratio due to suicide was 7.13 for people with drug use disorder without a history of psychiatric care (95% CI: 5.81, 8.44), 13.48 for people with drug use disorder and psychiatric history (95% CI: 9.75, 17.22), and 13.61 for people with psychiatric history only (95% CI: 6.72, 20.50). CONCLUSIONS: Risk of suicide is increased among people with drug use disorders. Access to treatment for co-morbid mental health problems for people with drug use disorders could potentially reduce risk of suicide.


Asunto(s)
Trastornos Relacionados con Sustancias/psicología , Trastornos Relacionados con Sustancias/terapia , Suicidio/estadística & datos numéricos , Adolescente , Adulto , Anciano , Estudios de Cohortes , Comorbilidad , Dinamarca/epidemiología , Femenino , Humanos , Almacenamiento y Recuperación de la Información , Masculino , Trastornos Mentales/epidemiología , Persona de Mediana Edad , Factores de Riesgo , Trastornos Relacionados con Sustancias/epidemiología , Adulto Joven
13.
Health Qual Life Outcomes ; 18(1): 6, 2020 Jan 07.
Artículo en Inglés | MEDLINE | ID: mdl-31910879

RESUMEN

BACKGROUND: Although research on health-related quality of life (HRQoL) has increased in the addiction field, few studies have focused on the determinants of HRQoL changes. This study aimed to describe dependent patients' HRQoL changes at a 3-month follow-up and to assess whether satisfaction with care can predict those changes among outpatients starting care for alcohol or opioid dependence. METHODS: HRQoL was measured with the SF-12 at baseline and 3 months later in a prospective cohort of dependent outpatients. Satisfaction was assessed with the EQS-C early after inclusion. Data on sociodemographics, clinical characteristics and patients' levels of anxiety and depression were also collected. A multivariable analysis was performed to identify factors associated with HRQoL changes in both the physical and mental component summary scores (PCS and MCS, respectively). RESULTS: Of the 172 patients included at baseline, a total of 136 patients assessed their satisfaction with care. The mean PCS and MCS scores were initially low, and HRQoL improvement was significant after 3 months for both the PCS and MCS. Never having been married (ß = 5.5; p = 0.001) and a lower baseline PCS score (ß = - 0.6; p < 0.0001) were associated with significant PCS improvement, whereas being legally compelled to undergo drug treatment (ß = - 5.9; p = 0.02) was associated with less PCS change. Higher early satisfaction with care (ß = 0.1; p = 0.02) and a lower baseline MCS score (ß = - 0.7; p < 0.0001) were associated with significant MCS improvement. CONCLUSION: The study supported the hypothesis that greater satisfaction with care may predict HRQoL improvement among dependent outpatients. Further studies are needed to understand the factors that affect patients' early satisfaction to identify areas of improvement and thus improve HRQoL.


Asunto(s)
Satisfacción del Paciente , Calidad de Vida , Trastornos Relacionados con Sustancias/terapia , Adulto , Femenino , Humanos , Estudios Longitudinales , Masculino , Persona de Mediana Edad , Satisfacción Personal , Estudios Prospectivos , Trastornos Relacionados con Sustancias/psicología
14.
PLoS One ; 15(1): e0226004, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-31940311

RESUMEN

We examine characteristics and experiences of women who considered, but did not have, an abortion for this pregnancy. Participants were recruited at prenatal care clinics in Louisiana and Maryland for a mixed-methods study (N = 589). On self-administered surveys and structured interviews, participants were asked if they had considered abortion for this pregnancy and, if so, reasons they did not obtain one. A subset (n = 83), including participants who considered abortion for this pregnancy, completed in-depth phone interviews. Multivariable logistic regression analyses examined characteristics associated with having considered abortion and experiencing a policy-related barrier to having an abortion; analyses focused on economic insecurity and of mental health/substance use as main predictors of interest. Louisiana interviews (n = 43) were analyzed using modified grounded theory to understand concrete experiences of policy-related factors. In regression analyses, women who reported greater economic insecurity (aOR 1.21 [95% CI 1.17, 1.26]) and more mental health diagnoses/substance use (aOR 1.29 [1.16, 1.45] had higher odds of having considered abortion. Those who reported greater economic insecurity (aOR 1.50 [1.09, 2.08]) and more mental health diagnoses/substance use (aOR 1.45 [95% CI 1.03, 2.05] had higher odds of reporting policy-related barriers. Interviewees who considered abortion and were subject to multiple restrictions on abortion identified material and instrumental impacts of policies that, collectively, contributed to them not having an abortion. Many described simultaneously navigating economic insecurity, mental health disorders, substance use, and interpersonal opposition to abortion from family and the man involved in the pregnancy. Current restrictive abortion policies appear to have more of an impact on women who report greater economic insecurity and more mental health diagnoses/substance use. These policies work in concert with each other, with people's individual complex situations-including economic insecurity, mental health, and substance use-and with anti-abortion attitudes of other people to make abortion care impossible for some pregnant women to access.


Asunto(s)
Aborto Inducido/psicología , Aborto Inducido/estadística & datos numéricos , Salud Mental/estadística & datos numéricos , Clase Social , Trastornos Relacionados con Sustancias/psicología , Adulto , Femenino , Humanos , Embarazo , Encuestas y Cuestionarios
15.
PLoS One ; 15(1): e0227331, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-31899781

RESUMEN

The aim of this study was to determine whether there are meaningful subgroups with different types of sexual risk behaviors among youth experiencing homelessness and examine the associations between potential classes and other risk variables. A latent class analysis was used to identify classes of youth according to sexual risk behaviors and sexual assault. A two-class solution was found to be the best fit for the data-Lower and Higher Risk groups. The Higher Risk class had significantly higher levels of synthetic marijuana and alcohol use, mental health diagnoses, and were more likely to have been tested for HIV than the Lower Risk group. Youth were more likely to be in the Higher Risk group if they were cisgender female or lesbian, gay, bisexual, or questioning (LGBQ). Nearly all youth (10/11) who reported having HIV infection were in the Higher Risk group. The Lower Risk group were sexually active but had lower rates of risk behaviors and sexual assault. Youth who were not sexually active had the lowest rates of marijuana and alcohol use as well as HIV testing. Health and social service providers should be aware of the added risks for stress, mental distress, mental health diagnoses, and substance use among youth who also report higher risk sexual behaviors and treat as needed.


Asunto(s)
Infecciones por VIH/epidemiología , Jóvenes sin Hogar , Conducta Sexual/psicología , Trastornos Relacionados con Sustancias/epidemiología , Adolescente , Adulto , Consumo de Bebidas Alcohólicas/efectos adversos , Consumo de Bebidas Alcohólicas/psicología , Sistema de Vigilancia de Factor de Riesgo Conductual , Bisexualidad/psicología , Femenino , Infecciones por VIH/psicología , Infecciones por VIH/virología , Homosexualidad Femenina/psicología , Humanos , Masculino , Tamizaje Masivo , Asunción de Riesgos , Trastornos Relacionados con Sustancias/psicología , Adulto Joven
16.
PLoS One ; 15(1): e0227644, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-31923269

RESUMEN

BACKGROUND: Problem gambling is a public health issue and its comorbidity with other health conditions may provide an opportunity for screening in healthcare settings; however, a high level of uncertainty and a lack of research in the field remains. The objective of this study is to investigate potential associations between problem gambling and numerous other health conditions, including substance use, mental health problems, and behavioural addictions. METHODS: A cross-sectional web-survey was distributed by a market research company to an online panel of respondents in Sweden, which aimed to be representative of the general population. Chi-squared and Mann-Whitney U tests, followed by logistic regression analysis, were performed to determine associations between screening positive for lifetime problem gambling and potential comorbid conditions and behaviours. RESULTS: Among 2038 participants, 5.7 percent screened positive for lifetime problem gambling. Significant associations were found between problem gambling and male gender, education level, daily tobacco use, moderate psychological distress, problematic shopping, and problem gaming. CONCLUSION: The association between screening for problem gambling and other health conditions, including psychological distress and behavioural addictions such as shopping and gaming, demonstrates the need to screen for problem gambling in the context of other health hazards, such as in different healthcare settings. Further research is required to identify the temporal relationship between these conditions and to investigate underlying etiological mechanisms.


Asunto(s)
Conducta Adictiva/psicología , Juego de Azar/psicología , Adolescente , Adulto , Conducta Adictiva/epidemiología , Comorbilidad , Estudios Transversales , Femenino , Juego de Azar/epidemiología , Humanos , Masculino , Trastornos Mentales/epidemiología , Trastornos Mentales/psicología , Persona de Mediana Edad , Trastornos Relacionados con Sustancias/epidemiología , Trastornos Relacionados con Sustancias/psicología , Encuestas y Cuestionarios , Suecia
18.
Artículo en Inglés | MEDLINE | ID: mdl-31877950

RESUMEN

The quality of family relationships is important for individual and family well-being. Improving family relationships is also an important goal in methadone maintenance treatment (MMT). Little is known about factors associated with the improvement of family relationships among MMT clients. This study aimed to identify factors associated with family relationship improvement in MMT. We retrospectively analyzed existing data from 2006 to 2014 at 15 MMT clinics in Guangdong, China, including 2171 subjects with 4691 follow-ups. Generalized estimating equations were used to investigate the association between living status transitions, behavior changes and family relationship improvement, with covariates controlled for. Family relationship improvement was found in 23.1% of all follow-up intervals. Participants who began living with family, living on a regular wage, and gained employment were more likely to have improved family relationships. The quality of family relationships also improved among participants who ceased contact with drug-addicted fellows, ceased drug use, and those who were sexually active. These results suggest that improvement in living status, positive changes in drug use, and sexual activity are associated with family relationship improvement and corresponding interventions may be developed to facilitate clients' recovery.


Asunto(s)
Analgésicos Opioides/uso terapéutico , Relaciones Familiares , Metadona/uso terapéutico , Tratamiento de Sustitución de Opiáceos/psicología , Trastornos Relacionados con Sustancias/psicología , Adulto , China , Empleo , Femenino , Humanos , Masculino , Tratamiento de Sustitución de Opiáceos/métodos , Características de la Residencia , Estudios Retrospectivos , Conducta Sexual , Trastornos Relacionados con Sustancias/tratamiento farmacológico
19.
Interv. psicosoc. (Internet) ; 28(3): 139-145, dic. 2019. graf, tab
Artículo en Inglés | IBECS | ID: ibc-187444

RESUMEN

This study examines (i) the relationships between substance use and parenting style and between substance use and perceived academic self-efficacy in early and middle adolescence, (ii) the importance of these factors in predicting adolescent substance use, and (iii) the role of academic self-efficacy in the relationship between parenting styles and adolescent substance use. The sample comprised 762 adolescents (53% boys) aged 12 to 16 years (M = 13.66, SD = 1.34). The sample was selected using probabilistic cluster sampling according to type of school (secondary, public vs. semi-private) and school location in different areas of the city of Valencia (Spain). This approach accounted for different social strata of families. The results show that substance use and parents' neglect are greater in middle adolescence than in early adolescence. Support and family communication and perceived academic self-efficacy are lower. Substance use is positively related to parents' neglect, psychological control, and rejection. The relationships between neglect and psychological control and substance use are moderated by academic self-efficacy, and the relationship between psychological control and substance use is mediated by academic self-efficacy


Los objetivos de esta investigación son analizar la relación del consumo de sustancias con el estilo de crianza de los padres y la percepción de eficacia académica por parte de los adolescentes, estudiar la diferente contribución de estos factores a la predicción del consumo de sustancias en la adolescencia y observar la función de la autoeficacia académica en la relación entre el estilo de crianza y el consumo de sustancias en la adolescencia. Participaron 762 adolescentes (53% hombres), de edades comprendidas entre los 12 y los 16 años (M = 13.66, DT = 1.34). La muestra se seleccionó con criterios probabilísticos por conglomerados, atendiendo al tipo de centro (educación secundaria, público frente a privado/concertado) y ubicación en diferentes zonas de la ciudad de Valencia, para atender distintos estratos sociales familiares. Los resultados indican que en comparación con la adolescencia temprana, en la adolescencia media aumenta el consumo de sustancias y la negligencia de los padres, además de disminuir el apoyo y la comunicación familiar junto con la eficacia académica percibida. El consumo de sustancias está relacionado positivamente con la negligencia, el control psicológico y el rechazo por parte de los padres. La negligencia y el control psicológico actúan como variables moderadoras, pero solo el control psicológico actúa como variable mediadora entre la eficacia académica y el consumo de sustancias


Asunto(s)
Humanos , Masculino , Femenino , Niño , Adolescente , Trastornos Relacionados con Sustancias/psicología , Psicología del Adolescente , Psicotrópicos , Conducta Adictiva/psicología , Autoeficacia , Análisis de Regresión
20.
PLoS Med ; 16(11): e1003000, 2019 11.
Artículo en Inglés | MEDLINE | ID: mdl-31770369

RESUMEN

In an Editorial, Guest Editors Alexander Tsai, Margarita Alegria and Steffanie Strathdee discuss the accompanying Special Issue on Substance Use, Misuse and Dependence.


Asunto(s)
Trastornos Relacionados con Sustancias/psicología , Trastornos Relacionados con Sustancias/terapia , Salud Global , Humanos
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