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Alcohol Alcohol ; 2021 Apr 01.
Artigo em Inglês | MEDLINE | ID: mdl-33791782


AIMS: Most inpatient alcohol detoxification patients do not seek treatment post-discharge, which increases the risk of relapse and re-hospitalization. To date, there have been no efforts to synthesize the evidence supporting the broad range of available interventions for this critical transition. The current study is a systematic review and evaluation of interventions designed to promote treatment engagement and recovery following alcohol detoxification. METHODS: The initial literature search yielded 6419 articles, published since 1999, from PubMed, CINAHL, PsycINFO, Psychology & Behavioral Sciences Collection and PsycARTICLES databases, 49 of which were eligible for full review. Data extraction included in-depth evaluation of intervention types, study and research design features, reported outcomes and study quality/bias indicators. All articles were coded by independent raters and final results were obtained through consensus. RESULTS: Interventions included medical/medication, psychological/psychosocial, technological, mutual-help and combined approaches. On average, medical/medication interventions were less, and psychological/psychosocial and technological interventions were more likely to demonstrate efficacy with respect to treatment engagement and recovery. There was significant variability in study quality/bias but no significant differences across intervention types. Studies differed considerably across measured outcomes, internal and external validity, in/exclusion criteria and documentation of co-occurring psychiatric disorders. CONCLUSION: Over half of studies reviewed reported empirical support for the intervention(s) evaluated. Although findings slightly favor non-medical interventions, the variability in study design and quality/bias requires more rigorous follow-up research. Recommendations from this review may guide future implementation and intervention development, which are critically needed to improve post-detoxification care and outcomes for patients with alcohol use disorder.

Clin Neuropsychol ; 34(6): 1088-1104, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32301397


OBJECTIVE: Many veterans of the Iraq and Afghanistan Wars have experienced traumatic brain injury (TBI). Although prior work has examined associations between TBI and development of psychiatric syndromes, less is known about associations between TBI and component emotions constituting these syndromes, especially in the long term. The purpose of this study was to examine the long-term emotional consequences of deployment-related TBI. METHODS: As part of VA Cooperative Studies Program #566, we assessed a sample of n = 456 US Army soldiers prior to an index deployment to Iraq, and again an average of 8.3 years (SD = 2.4 years) after their deployment for a long-term follow-up assessment. In this report, we used adjusted regression analyses to examine the relationship of deployment TBI to depression, anxiety, and stress symptom severity measured at the long-term follow-up assessment. A structured interview was used to determine TBI history; the Depression, Anxiety, and Stress Scale, 21-item version (DASS-21) was used to determine emotional status at the follow-up evaluation. RESULTS: Warzone TBI events, particularly when greater than mild in severity, were independently associated with depression, anxiety, and stress severity at long-term follow-up, even after taking into account variance attributable to pre-deployment emotional distress and war-zone stress. Post-hoc analyses did not detect independent associations of either number of events or injury mechanism with outcomes. CONCLUSIONS: These findings highlight the potentially enduring and multi-faceted emotional effects of deployment TBI, underscoring the need for early assessment of negative affectivity in warzone veterans reporting TBI.

Vision (Basel) ; 4(1)2020 Feb 05.
Artigo em Inglês | MEDLINE | ID: mdl-32033350


: While previous research has investigated key factors contributing to multisensory integration in isolation, relatively little is known regarding how these factors interact, especially when considering the enhancement of visual contrast sensitivity by a task-irrelevant sound. Here we explored how auditory stimulus properties, namely salience and temporal phase coherence in relation to the visual target, jointly affect the extent to which a sound can enhance visual contrast sensitivity. Visual contrast sensitivity was measured by a psychophysical task, where human adult participants reported the location of a visual Gabor pattern presented at various contrast levels. We expected the most enhanced contrast sensitivity, the lowest contrast threshold, when the visual stimulus was accompanied by a task-irrelevant sound, weak in auditory salience, modulated in-phase with the visual stimulus (strong temporal phase coherence). Our expectations were confirmed, but only if we accounted for individual differences in optimal auditory salience level to induce maximal multisensory enhancement effects. Our findings highlight the importance of interactions between temporal phase coherence and stimulus effectiveness in determining the strength of multisensory enhancement of visual contrast as well as highlighting the importance of accounting for individual differences.