Artificial Neural Network Analysis Examining Substance Use Problems Co-Occurring with Anxiety and Depressive Disorders Among Adults Receiving Mental Health Treatment.

Objective: The co-occurrence of anxiety disorders, depressive disorders, and substance use problems was examined. Methods: The Mental Health Client-Level Data dataset was used to conduct logistic regression models and an artificial neural network analysis. Logistic regression analyses were conducted among adults with anxiety (n = 547,473) or depressive disorders (n = 1,610,601) as their primary diagnosis who received treatment in a community mental health center. The artificial neural network analysis was conducted with the entire sample (N = 2,158,074). Results: Approximately 30% of the sample had co-occurring high-risk substance use or substance use disorder. Characteristics including region of treatment receipt, age, education, gender, race and ethnicity, and the presence of co-occurring anxiety and depressive disorders were associated with the co-occurring high-risk substance use or a substance use disorder. Conclusions: Findings from this study highlight the importance of mental health facilities to screen for and provide integrated treatment for co-occurring disorders.

Patterns of Familial and Racial Trauma and Their Associations with Substance Use Disorders among Racial/Ethnic Minority Adults.

BACKGROUND: Racial/ethnic minorities in the United States often experience many different types of traumatic events. We examine the patterns of familial and racial trauma and their associations with substance use disorders (SUDs) among racial/ethnic minority adults. METHODS: We used data from the National Epidemiologic Survey of Alcohol and Related Conditions-III. The study sample included 17,115 individuals who were Hispanic (43.6%), Black (34.9%), Asian American and Pacific Islander (17.0%), and American Indian or Alaska Native (AI/AN, 4.6%). Latent class analysis models with covariates and distal outcomes were analyzed to investigate patterns of trauma exposure and estimate binary outcomes of SUDs. Familial and racial trauma was measured by ten areas of adverse childhood experiences (ACEs) and six items of racial discrimination. RESULTS: We found four distinctive groups: low trauma (Class 1, 62.1%), high discrimination (Class 2, 17.2%), high ACEs (Class 2, 14.9%), and high trauma (Class 4, 5.9%). Compared to Class 1, other groups were more likely to include Black and AI/AN adults. Participants in Class 2 reported greater risks for alcohol and other drug use disorders. Those in Class 3 and 4 reported greater risks for alcohol, opioid, stimulant, and other drug use disorders. CONCLUSION: Given a higher risk of trauma exposure in Black and AI/AN adults, racially and ethnically sensitive trauma-focused interventions may help prevent and reduce SUDs in those populations.

Stress and Depression in Ohio Social Workers during the COVID-19 Pandemic: The Buffering Role of Social Connectedness.

Although social workers have an elevated risk of infection with COVID-19, no previous studies have investigated the virus's impact on practitioners. Using survey data (N = 441), this study identified associations between stress, depression, and COVID-related factors and explored the role of social connectedness as a moderator for mental health among Ohio social workers. The results of the study showed that among social workers with a positive COVID-19 diagnosis, 70 percent experienced moderate/high levels of stress, and 37 percent met the criteria for clinical depressive symptoms. Results from the multiple regression analyses showed that perceived stress was positively associated with a positive COVID-19 diagnosis for social workers, and depression was positively associated with working with a client with a positive COVID-19 diagnosis. An interaction effect was also identified between social connectedness and social workers' mental health. These findings suggest that the provision of individual or organizational interventions that emphasize social connectedness can help to protect social workers' mental health.

Routes Out of Child Abuse to School Adjustments: A Comparison Between North Korean Adolescent Refugees and Native South Korean Adolescents.

This study aimed to examine pathways from child abuse to school adjustment and the roles of self-control and academic stress on the link among North Korean adolescent refugees living in South Korea and native South Korean adolescents. A total of 610 students (adolescents from South Korea = 325 and adolescents from North Korea = 285) living in South Korea, from juniors in middle schools to seniors in high schools, were interviewed in 2017. Multigroup structural equation modeling was used to examine differences in the country of origin on the pathways from abuse to school adjustment via self-control and academic stress. North Korean adolescent refugees were less likely to adjust to their school life than South Korean adolescents. Academic stress was found as a significant mediator between self-control and school adjustment in both South Korean and North Korean adolescents. Child abuse was associated with self-control of South Korean adolescents. Childhood abuse from parents can have an overall influence on individual characteristics and school life for adolescents. By paying attention to this process, comprehensive solutions are urgently required not only to intervene in the problem of abusive parenting behaviors but also to block the path of the expanding negative consequences among both groups of adolescents.

Trends and distinct profiles of persons who inject drugs in the United States, 2015-2019.

Drug injection represents a major health problem in the US, with severe health consequences including the transmission of blood-borne infections. An examination of the most recent trends in drug injection is warranted by the fast-evolving drug epidemic and recent policy changes such as the federal funding ban on needle exchange programs. This research examines current drug injection trends, patterns, and socioeconomic and behavioral profiles of people who inject drugs (PWID). Data were derived from the 2002 to 2019 National Survey on Drug Use and Health (NSDUH). After examining the annual prevalence of drug injection since 2002, a latent class analysis was conducted to identify drug injection and other substance misuse patterns among PWID using the latest (2015-2019) NSDUH datasets. Associations between class membership and behavioral health comorbidities and treatment receipt were also assessed. The drug injection prevalence among US adults aged 18-64 increased from 0.21% in 2002/2004 to 0.36% in 2017/2019. Three distinctive groups were identified: the heroin injection group (45.2%), the methamphetamine injection group (28.0%), and the multi-drug injection group (26.8%). The methamphetamine injection group reported greater risks of experiencing serious psychological distress, suicidality, and limited substance use treatment. Special attention is needed for those who primarily injected methamphetamine. Programs to promote harm reduction and increase access to addiction treatment need to be expanded in at-risk communities while accounting for their distinct socioeconomic and drug use/misuse profiles.

Association of vision impairment with suicide ideation, plans, and attempts among adults in the United States.

OBJECTIVE: This study aims to investigate the relative strength of association between vision impairment (VI) and suicidal ideation, plans, and attempts among adults in the United States. METHOD: The study sample consisted of 214,505 adults, aged 18 years and older. Researchers used data from the 2015-2019 National Survey on Drug Use and Health, in which respondents were asked whether they had any suicidal thoughts, plans, and attempts, in the past 12 months. RESULTS: Approximately, 4.4% of respondents reported experiencing VI, being blind, or having serious difficulty seeing. Compared to their sighted peers, a relatively high proportion of adults with VI had serious thoughts about suicide (9.0%), suicidal plans (3.0%), or suicidal attempts (1.6%) in the past year. The findings showed that individuals with VI may disproportionately experience suicidal ideation, plans, and attempts, after controlling potentially confounding variables (adjusted odds ratio [AOR] = 1.36; AOR = 1.27; AOR = 1.40, respectively). CONCLUSION: With findings demonstrating such a strong association between VI and suicide, this study suggests the importance of screening for suicidal ideation, plans, and attempts among adults with VI, and the strong need for developing behavioral health services which keep this correlation in mind.

Profiles of social disadvantage and their associations with alcohol use disorder criteria among Asian Americans and Pacific Islanders.

BACKGROUND: The relationship between social disadvantage and alcohol use disorder (AUD) among Asian American and Pacific Islander (AAPI) people is poorly understood. The study explores the patterns of social disadvantage and their associations with the AUD criteria in this population. METHODS: This study used data from the National Epidemiologic Survey of Alcohol and Related Conditions-III on AAPI people's (N = 1801) social disadvantage, adverse childhood experiences (ACEs), racial discrimination, and AUD. A three-step latent class analysis (LCA) using the Bolck, Croon, and Hagenaars (BCH) method was conducted to examine the heterogeneity within response patterns to items that describe social disadvantage among AAPI people. In addition, the relationship between classes and the AUD criteria was examined. RESULTS: Three classes were identified: Class 1, labeled "High Adversity" (8.2%); Class 2, labeled "High Discrimination" (9.7%); and Class 3, labeled "Low Disadvantage" (82.2%). Results from the analyses of a multiple regression model suggest that Class 1 (High Adversity; B = 1.049, SE = 0.27, p < 0.001) is more susceptible to AUD compared to Class 3 (Low Disadvantage). CONCLUSIONS: The average number of AUD criteria among AAPI people who had experienced high levels of adversity was 2.2. Latent class models demonstrate how social disadvantage is distributed across classes and illustrate its associations with the AUD criteria. Tailored interventions for AAPI people are required. Further studies are also necessary to more effectively understand social disadvantage in AAPI populations.

Substance use disorders among adults who are deaf or hard of hearing in the United States.

BACKGROUND: There has been limited research on substance use disorders (SUDs) among individuals who are deaf or hard of hearing (DHH). This study explored associations among activities of daily living, instrumental activities of daily living, major depressive episode, risk perceptions for substance use, religiosity, and past-year SUDs within the DHH population. METHODS: Data was drawn from the 2015-2019 National Survey on Drug Use and Health (N = 214,505) to compare rates of past-year SUDs between DHH (weighted % = 5.4) and non-DHH populations. SUD measures included were past-year alcohol, marijuana, pain reliever, and illicit drug use disorders. RESULTS: SUDs are more prevalent among the DHH population than the non-DHH population. When adjusted for sociodemographic variables, DHH adults were more likely to report experiencing all four types of measured SUDs. Significant associations were also found between all four measured SUDs and disability status, major depressive episodes, and perception of risk. An association between regular religious service attendance and alcohol, marijuana, or illicit drug use disorders was also identified, as well as an association between peer religiosity and marijuana use disorders. CONCLUSION: Given the high prevalence of SUDs and limited understanding of the mechanisms associated with the SUDs within the DHH population, more research is needed to address these issues.

Understanding the role of social support and social support network for depression among informal dementia caregivers: a pilot clinical project on caregivers in NYC.

This study aims to explore the association of depressive symptoms with the informal social support network reported by dementia caregivers participating in a community-based caregiver support program. Caregivers in a community-based dementia caregiver program completed an intake assessment, including the social support network instrument. Measures were completed for caregivers' social support network, using the social support network instrument (SSNI). Measures also included depression, caregiver strain, basic activities of daily living, instrumental activities of daily living, and demographics. Findings suggest the effects of social supports and social network on caregivers' depressive symptoms. Caregivers who had financial supports were less likely to have depressive symptoms. Also, the frequency of contact among social network variables predicted the decrease of depressive symptoms.

An Examination of the Patterns of Substance Use in Activity Spaces and Their Relationship to Problematic Use.

During adolescence, adolescents are given more freedom to independently interact with a variety of social contexts. The eco-developmental model suggests that the activity spaces where adolescents spend their time affect substance-use behaviors beyond peer influences, and that the relationships may differ based on the adolescent's demographic characteristics. This study examines adolescent patterns of reported substance use across activity spaces to determine whether the patterns of use are related to problematic substance use, and whether the relationships differ based on the participants' race. Cross-sectional survey data from the study, Drug Use Among Young American Indians: Epidemiology and Prediction, 1993-2006 and 2009-2013, were used. Five patterns of adolescent alcohol use and six patterns of adolescent drug use in activity spaces were identified. There were significant differences in the relationship between class membership and problematic substance use by race, suggesting that contexts may be interacting with an adolescent's race to influence use.

Impact of interprofessional collaboration on chronic disease management: Findings from a systematic review of clinical trial and meta-analysis.

Improvement of chronic disease management demands effective collaborative relationships between health and social-care which is achieved through teamwork. Interprofessional Education (IPE) and Interprofessional Collaboration (IPC) are recognized as essential for the delivery of effective and efficient healthcare. Although IPC and IPE are key components of primary care, evidence of studies evaluating how an IPE intervention prior to IPC improved chronic patient outcomes remains scarce. The aim of this study was to assess the impact of IPC interventions on the management of chronic patients compared to usual care. A systematic review and meta-analysis of Randomized Controlled Trials (RCTs) on IPC interventions on chronicity management and their impact on clinical and process outcomes was conducted. Of the 11,128 papers initially retrieved, 23 met the inclusion criteria. Meta-analyses results showed the reduction of systolic blood pressure (Mean Difference (MD) -3.70; 95 % CI -7.39, -0.01), glycosylated hemoglobin (MD -0.20; 95 % CI -0.47, -0.07), LDL cholesterol (MD -5.74; 95 % CI -9.34, -2.14), diastolic blood pressure (MD -1.95; 95 % CI -3.18, -0.72), days of hospitalization (MD -2.22; 95 % CI -4.30, -0.140). A number of positive findings for outcomes related to IPC were found reflecting an improvement of quality of care and an enhancement in the delivery of patient-centered and coordinated care. Moreover, the need for a purposeful systemic approach linking interprofessional education with interprofessional collaboration and patient health and wellbeing is necessary.

Exploring the formation of treatment program director perceptions on entry-level social workers' substance use treatment capacities in New York.

Background: This article examines how program directors of substance use treatment providers in New York state form their perceptions on the overall substance use treatment service delivery capacities of newly graduated, entry-level social workers. Methods: The study discussed consisted of a cross-sectional, quantitative survey of treatment program directors in New York state (n = 245). Program directors were asked to rate entry-level social workers' treatment skills, knowledge of treatment concepts, and overall preparedness to deliver treatment services in the field upon first entering the professional workforce. The collected data were then analyzed using multiple regression analyses to identify associations between the skill and knowledge items and perceptions of overall preparedness. Results: The results of the study showed that five of the ten skill and knowledge competency items were significantly linked with program directors' perceptions of entry-level social workers' overall preparedness to deliver treatment services, with the model accounting for 62% of the variance in the dependent variable. Of the independent variables with significant associations, the assessment competency item accounted for 50% of the variance, while the other four variables explained 1.2-6.4% of the variance respectively. Conclusions: The findings of the study suggest that training curriculums should strongly emphasize assessment competencies for new practitioners, and that implementing a standardized training curriculum is beneficial for the professional growth and preparedness of practitioners entering into the treatment field.

Is Informal Financial Aid Good for Health? Evidence from Kyrgyzstan, a Low-Income Post-Socialist Nation in Eurasia.

The importance of social capital and economic advantage for health is well established in literature. The relationship between health and social capital through informal financial aid is less understood. Using representative data (N = 7,474), authors explored an association between informal financial aid and health satisfaction in Kyrgyzstan, a post-socialist low-income country in Eurasia. Multilevel modeling revealed significant associations between informal aid and health. Cross-level interactions between individual and neighborhood financial aid were also significantly associated with health satisfaction. The results suggest that (a) social capital is influenced by socioeconomic status of the person, and (b) paths between informal aid and health vary among individuals at different levels of socioeconomic structure. Authors conclude the article with a discussion of the implications for social work practice and policy to improve health outcomes for disadvantaged individuals.