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1.
Fortschr Neurol Psychiatr ; 87(11): 634-637, 2019 Nov.
Artigo em Alemão | MEDLINE | ID: mdl-31756742

RESUMO

Aggressive behaviour is a typical phenomenon in childhood and adolescence. Aggression is one of the frequent reasons for parents to seek child and adolescent psychiatric and psychotherapeutic treatment. Disorders with increased aggressive behaviour, such as conduct or oppositional defiant disorder, carry an increased risk for long-lasting negative impact on well-being, especially when comorbid with substance abuse or affective symptoms. Barriers for treatment are frequently a lack of insight into consequences and non-compliance with intervention shown by adolescents. In addition, interdisciplinary intervention needs to combine psychiatric and psychotherapeutic interventions as well as complex interventions supported by the youth welfare system, and in particular including families. Further research is needed for the implementation of evidence-based treatments in routine care as well in special populations, such as girls with conduct disorders or youth with substance abuse.


Assuntos
Transtorno da Personalidade Antissocial/terapia , Transtorno da Conduta/terapia , Adolescente , Agressão , Transtorno da Personalidade Antissocial/complicações , Transtorno da Personalidade Antissocial/psicologia , Transtorno da Conduta/complicações , Transtorno da Conduta/psicologia , Feminino , Humanos , Transtornos Relacionados ao Uso de Substâncias/complicações , Transtornos Relacionados ao Uso de Substâncias/psicologia , Adulto Jovem
2.
Fortschr Neurol Psychiatr ; 87(11): 638-641, 2019 Nov.
Artigo em Alemão | MEDLINE | ID: mdl-31756746

RESUMO

This text examines post-traumatic stress disorders and trauma sequel disorders in adolescence, focusing in particular on the problem of transition. On the one hand, on the diagnostic level traumatizations are often not PTSD-specific, but rather self-help and self-medication measures as well as alcohol and drug addiction and dissociality, which are often not sufficiently questioned in the adult psychiatric system. On the other hand, it is about the further development and implementation of trauma pedagogical approaches, especially for young people who grow up in critical high-risk constellations or who are already in institutions of youth welfare or integration assistance. Here, not only a blatant lack of initial, further and continuing training for the occupational groups involved is noted, but also a lack of empirical therapy studies.


Assuntos
Transtornos de Estresse Pós-Traumáticos/complicações , Transtornos de Estresse Pós-Traumáticos/psicologia , Transtornos Relacionados ao Uso de Substâncias/complicações , Adolescente , Humanos , Transtornos de Estresse Pós-Traumáticos/terapia , Transtornos Relacionados ao Uso de Substâncias/psicologia , Transtornos Relacionados ao Uso de Substâncias/terapia
3.
Psychiatr Prax ; 46(8): 445-450, 2019 Nov.
Artigo em Alemão | MEDLINE | ID: mdl-31683335

RESUMO

OBJECTIVE: Substance use patterns and sociodemographic variables of Berlin's party scene were investigated to derive preventive measures and harm reduction services, which meet the needs of the consumers. METHODS: A questionnaire was used online and in the field among Berlin partygoers (N = 877) and structured interviews (N = 20) were conducted with professionals working in this area, including social workers, emergency medical service, police and club owners and users. RESULTS: A risky consumption pattern was found in 67 % of participants, who also stated need for counseling and a wish for reduction of their substance use. Of all preventive measures, drug checking was requested most often. Substances with the highest prevalence were alcohol, cannabis, amphetamine, MDMA, cocaine and ketamine, whereas methamphetamine and new psychoactive substances were barely stated. CONCLUSION: There is an urgent need to expand current preventive measures. There is a willingness of the scene to use according services, especially by those who need it the most.


Assuntos
Consumo de Bebidas Alcoólicas , Redução do Dano , Transtornos Relacionados ao Uso de Substâncias , Consumo de Bebidas Alcoólicas/epidemiologia , Consumo de Bebidas Alcoólicas/psicologia , Berlim , Alemanha , Humanos , Prevalência , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Transtornos Relacionados ao Uso de Substâncias/psicologia
5.
Orthopade ; 48(12): 1030-1035, 2019 Dec.
Artigo em Alemão | MEDLINE | ID: mdl-31659423

RESUMO

Physical activity and exercise is widely connected with positive effects on human health. However, exercise may also pose as a risk factor for health under specific circumstances. Primarily, the risks connected with exercise are physical risks, but also psychological risks may appear, especially when exercise is conducted excessively. Psychological risks include eating disorders, illegal and legal substance use and exercise dependence. The aims of the present article are to focus on potential risks and side effects of exercise and physical activity and to put the risks in the context of the positive effects of exercise on health.


Assuntos
Comportamento Aditivo/psicologia , Exercício/psicologia , Transtornos da Alimentação e da Ingestão de Alimentos/psicologia , Transtornos Relacionados ao Uso de Substâncias/psicologia , Comportamento Aditivo/complicações , Exercício/fisiologia , Transtornos da Alimentação e da Ingestão de Alimentos/complicações , Humanos , Fatores de Risco , Transtornos Relacionados ao Uso de Substâncias/complicações
6.
Niger Postgrad Med J ; 26(4): 211-215, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31621660

RESUMO

Introduction: Recent evidence suggests that rates of drug use and abuse in Nigeria exceed the global average. There is a strong treatment demand for psychoactive drug use disorders in Nigeria; however, it is not known whether available treatment facilities are attending to the array of treatment needs. This audit compares the pattern of presentations at a tertiary facility with a community-based survey. Methods: A review of cases (n = 212) seen at a regional drug treatment facility over a 4-year period, using local data retrieved from the Nigerian Epidemiological Network of Drug Use (NENDU) and comparison with data from the recently published national drug use survey. Results: Nine out of ten clients seen were male (93.4%). About half (49.5%) of the clients used psychoactive substances for the first time between ages 10 and 19 years. Cannabis was the primary drug of use overall and also among males, while females were more likely to present with opiate abuse. Over half had a co-occurring physical or mental disorder, and a minority had received testing for hepatitis C in the past 12 months. Conclusion: Although patterns of drug abuse presentations were consistent with findings from a national community-based survey, there was an under-representation of females in treatment. Implications for policy development and practice are discussed.


Assuntos
/efeitos adversos , Transtornos Mentais/epidemiologia , Pacientes/estatística & dados numéricos , Transtornos Relacionados ao Uso de Substâncias/terapia , Adolescente , Adulto , Distribuição por Idade , Alcoolismo/epidemiologia , Alcoolismo/reabilitação , Criança , Comorbidade/tendências , Estudos Transversais , Feminino , Hospitais Psiquiátricos , Humanos , Tempo de Internação/estatística & dados numéricos , Tempo de Internação/tendências , Masculino , Abuso de Maconha/epidemiologia , Transtornos Mentais/reabilitação , Pessoa de Meia-Idade , Nigéria/epidemiologia , Pacientes/psicologia , Fatores de Risco , Distribuição por Sexo , Fatores Socioeconômicos , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Transtornos Relacionados ao Uso de Substâncias/psicologia , Inquéritos e Questionários , Adulto Jovem
7.
BMC Public Health ; 19(1): 1307, 2019 Oct 17.
Artigo em Inglês | MEDLINE | ID: mdl-31623586

RESUMO

BACKGROUND: The popularity of ketamine for recreational use has been increasing in Asia, including Taiwan. Still, little known about the pattern of ketamine expectancies and whether such patterns are related to ketamine use. This study aimed to examine whether the positive and negative ketamine expectancies are differentially associated with ketamine-using behavior, and whether such relationship may differ by early-onset use of tobacco or alcohol. METHODS: Participants were recruited using respondent-driven sampling (RDS) among regular tobacco and alcohol users, aged 18 to 50, residing in Taipei from 2007 to 2010. Totally 1115 participants (with an age distribution skewed to the right, median = 26; interquartile range: 22-32) had information on substance use and completed a 12-item ketamine expectancies questionnaire (with 6 positive and 6 negative statements). Using two axes of High and Low expectancies, the four combinations of binary positive and binary negative ketamine expectancies were created. Each participant's drug-using experience was categorized into illicit drug naïve, exclusive ketamine use, polydrug ketamine use, or other illicit drug use. Using the weights in the network output by RDS Analysis Tool, multivariable logistic regression analysis was then conducted. RESULTS: The weighted prevalence was 2.4% for exclusive ketamine use, 9.0% for polydrug ketamine use, and 9.1% for the other illicit drug use. Ketamine users (11.4%) had greater positive expectancies and lower negative expectancies, particularly the combination of High Positive with Low Negative, as compared to the illicit drug-naïve or other illicit drug users. After adjustment for early-onset tobacco (or alcohol) use and sociodemographic characteristics, High Positive, Low Negative, and their combination of High Positive-Low Negative expectancies remained strongly associated with ketamine uses, without evidence of moderation from early-onset use of tobacco or alcohol. CONCLUSIONS: Positive and negative ketamine expectancies were associated in opposite directions with ketamine use, independent of early-onset use of tobacco or alcohol. Our results indicate ketamine expectancies as possible targets for future intervention and prevention of ketamine use, with a less confrontational feedback on decreasing an individual's positive expectancies is essential in preventing young people from the initiation of ketamine use.


Assuntos
Ketamina , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Transtornos Relacionados ao Uso de Substâncias/psicologia , Adolescente , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Motivação , Prevalência , Inquéritos e Questionários , Taiwan/epidemiologia , Adulto Jovem
8.
Actas esp. psiquiatr ; 47(5): 179-189, sept.-oct. 2019. tab
Artigo em Espanhol | IBECS | ID: ibc-185170

RESUMO

Introducción. El suicidio es un problema de salud importante en España. Examinamos la relación entre la reincidencia de los intentos y el nivel de letalidad alcanzado, y el perfil de los pacientes reincidentes que realizan intentos más letales. El objetivo es establecer los factores sociodemográficos y clínicos predictores de una mayor letalidad y reincidencia. Método. Todos los pacientes atendidos por intento suicida en un área sanitaria de 360.000 habitantes de 2009 a 2014 (N = 711) fueron valorados de forma sistemática. Comparamos las características clínicas y demográficas en función de la letalidad (leve versus moderada-severa) y la reincidencia (1-2 intentos versus > 2 intentos) usando análisis univariantes y modelos de regresión. Posteriormente, repe-timos los análisis tras distribuir la muestra en cuatro grupos en función de la presencia o ausencia de alta letalidad y/o reincidencia. Resultados. La reincidencia se asoció con la edad media (35-65 años), inactividad laboral, y los trastornos de personalidad o por uso de sustancias. La letalidad se asoció con el género masculino, edades extremas, método violento y los trastornos afectivos, pero no con la reincidencia. La coincidencia de múltiples intentos y letalidad severa en un mismo paciente parece relacionarse con el grupo de edad de 35-65 años, sexo masculino, uso de métodos violentos, trastornos mentales y la inactividad laboral. Conclusiones. Distintos factores demográficos y clínicos se asocian al riesgo de letalidad médica y de reincidencia. Nuestros resultados muestran que aquellos pacientes que repiten los intentos y realizan al menos un intento de alta letalidad, tienen mayor presencia de psicopatología, sobre todo trastornos afectivos


Introduction. Suicidal behaviour is a major health problem in Spain. The aim of this study is to examine the relationship between the recurrence of suicide attempts and the level of lethality reached, and the profile of repeaters who perform more lethal attempts. Method. All patients admitted for attempted suicide in a health area of 360,000 inhabitants from 2009 to 2014 (N = 711) were systematically assessed. We compared clinical and demographic characteristics of these patients in terms of lethality (low versus moderate-severe) and recidivism (1-2 attempts versus >2 attempts) using univariate analyses and regression models. Later, we repeated the analyses after distributing the sample into four groups depending on the presence or absence of high lethality and/or recidivism. Results. Recidivism was associated with the middle-age group (35-65 years), the lack of professional activity, and personality or substance use disorders. Lethality was associated with male gender, extreme age-groups, the use of a violent method, and affective disorders, but not with recidivism. Multiple suicide attempts and high lethality in a single patient was associated with 35-65 years age-group, male gender, violent methods, mental disorders, and inactivity. Conclusions. Different demographic and clinical factors indicate an increased risk of medical lethality and recurrence in suicidal patients. Our results show that at least some recidivist patients end up making more lethal and violent attempts with the passage of time, especially if they have psychiatric comorbidity


Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Idoso , Tentativa de Suicídio/psicologia , Transtorno da Personalidade Antissocial/mortalidade , Transtornos Relacionados ao Uso de Substâncias/mortalidade , Reincidência/psicologia , Modelos Lineares , Transtornos Relacionados ao Uso de Substâncias/psicologia , Transtornos do Humor/psicologia , Transtornos Mentais/mortalidade , Transtornos Mentais/psicologia
9.
Physiol Rev ; 99(4): 2115-2140, 2019 10 01.
Artigo em Inglês | MEDLINE | ID: mdl-31507244

RESUMO

Drug consumption is driven by a drug's pharmacological effects, which are experienced as rewarding, and is influenced by genetic, developmental, and psychosocial factors that mediate drug accessibility, norms, and social support systems or lack thereof. The reinforcing effects of drugs mostly depend on dopamine signaling in the nucleus accumbens, and chronic drug exposure triggers glutamatergic-mediated neuroadaptations in dopamine striato-thalamo-cortical (predominantly in prefrontal cortical regions including orbitofrontal cortex and anterior cingulate cortex) and limbic pathways (amygdala and hippocampus) that, in vulnerable individuals, can result in addiction. In parallel, changes in the extended amygdala result in negative emotional states that perpetuate drug taking as an attempt to temporarily alleviate them. Counterintuitively, in the addicted person, the actual drug consumption is associated with an attenuated dopamine increase in brain reward regions, which might contribute to drug-taking behavior to compensate for the difference between the magnitude of the expected reward triggered by the conditioning to drug cues and the actual experience of it. Combined, these effects result in an enhanced motivation to "seek the drug" (energized by dopamine increases triggered by drug cues) and an impaired prefrontal top-down self-regulation that favors compulsive drug-taking against the backdrop of negative emotionality and an enhanced interoceptive awareness of "drug hunger." Treatment interventions intended to reverse these neuroadaptations show promise as therapeutic approaches for addiction.


Assuntos
Comportamento Aditivo , Encéfalo/fisiopatologia , Usuários de Drogas/psicologia , Recompensa , Transtornos Relacionados ao Uso de Substâncias/fisiopatologia , Transtornos Relacionados ao Uso de Substâncias/psicologia , Animais , Encéfalo/metabolismo , Neurônios Dopaminérgicos/metabolismo , Humanos , Vias Neurais/metabolismo , Vias Neurais/fisiopatologia , Plasticidade Neuronal , Fatores de Risco , Transtornos Relacionados ao Uso de Substâncias/metabolismo , Transtornos Relacionados ao Uso de Substâncias/reabilitação
10.
Artigo em Inglês | MEDLINE | ID: mdl-31527470

RESUMO

BACKGROUND: This study aims to identify the association between parenting styles and behavioral changes among adolescents regarding the consumption of alcohol, tobacco, cannabis, cocaine/crack. METHODS: A group of ninety-nine adolescents (39 girls and 60 boys), aged 14 to 19 years (17.05 ± 1.51), who called in to a call center that provides counseling to substance users, was followed-up for 30 days. Data collection occurred between March 2009 and October 2015. The adolescents answered questions regarding parental responsiveness and demanding nature on a scale to assess parental styles and provided sociodemographic data, substance abuse consumption characteristics, and the Contemplation Ladder scale score. RESULTS: The parental styles most reported by the adolescents were authoritative (30%) and indulgent (28%). Children who perceived their mothers as having an indulgent style and who had absent fathers presented more difficulties in making behavioral changes to avoid alcohol and cocaine/crack consumption. CONCLUSION: The study found that parent-child relationships were associated with a lack of change in the adolescent regarding substance use behavior, particularly the consumption of alcohol and cocaine/crack.


Assuntos
Relações Pais-Filho , Poder Familiar , Transtornos Relacionados ao Uso de Substâncias , Adolescente , Comportamento do Adolescente , Adulto , Consumo de Bebidas Alcoólicas , Brasil/epidemiologia , Cocaína Crack , Pai , Feminino , Humanos , Masculino , Mães , Estudos Prospectivos , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Transtornos Relacionados ao Uso de Substâncias/prevenção & controle , Transtornos Relacionados ao Uso de Substâncias/psicologia , Adulto Jovem
11.
BMC Health Serv Res ; 19(1): 656, 2019 Sep 10.
Artigo em Inglês | MEDLINE | ID: mdl-31500620

RESUMO

BACKGROUND: In Thailand, two community-based drug treatment approaches are common. The first one is the traditional community-based treatment program (FAST) which brings the principles of community therapy as a guideline for treatment. The second one is the military hospital-based drug treatment program (PMK), derived from the basic military training, the Buddhist Twelve Steps, CBT and the Minnesota Rehabilitation Model. This study aimed to investigate and compare the efficacy of PMK vs. FAST. METHOD: The experiment was conducted from January-March 2016 at the rehabilitation center for patients with drug addiction in Thailand. Quasi-experimental methods were introduced, and ASSIST, WHOQOL-BRIEF-THAI and self-efficacy interview form were applied. After completing the drug rehabilitation program at a total duration of 120 days, the researcher continued at follow up times at 3 and 6 months. RESULTS: Compared with baseline scores, both programs significantly reduced the severity of drugs and increased self-efficacy at 6-month follow-up. PMK had better improved scores in the relationship and environment dimensions of quality of life at 3-month follow-up (P = 0.026, 0.006). The mean quality of life scores in PMK at 3 and 6 months showed better results than mean scores at baseline (P = < 0.001). CONCLUSION: Both community-based programs in Thailand significantly reduced the severity of drugs and increased self-efficacy scores at 6-month follow-up. PMK and FAST has not shown any significant difference in treatment outcome results in the aspects of self-efficacy and reduced severity of drugs used. However, PMK had significant positive effects on the quality of life.


Assuntos
Qualidade de Vida , Autoeficácia , Transtornos Relacionados ao Uso de Substâncias/reabilitação , Adulto , Serviços Comunitários de Saúde Mental/estatística & dados numéricos , Hospitais Militares , Humanos , Masculino , Pessoa de Meia-Idade , Centros de Tratamento de Abuso de Substâncias , Transtornos Relacionados ao Uso de Substâncias/psicologia , Tailândia , Resultado do Tratamento
12.
Int J Gynaecol Obstet ; 147(3): 368-374, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31502667

RESUMO

OBJECTIVE: To evaluate drug use among mothers during the postpartum period after a severe pregnancy-related complication. METHODS: A retrospective cohort study of maternal morbidity including maternal near-miss and control groups conducted in a tertiary hospital in Campinas, Brazil, between July 2008 and June 2012. The Alcohol, Smoking, and Substance Involvement Screening Test (ASSIST) was used to assess drug use during lifetime, pregnancy, and in the previous 3 months. RESULTS: Of 638 women evaluated, drug use was reported by 165 (25.8%). Alcohol was the most common substance used (n=133, 20.6%), followed by tobacco (n=85, 13.2%), and cocaine (n=15, 2.3%). The highest risk for postpartum drug use was among those using drugs during pregnancy. There were no differences between the morbidity and control groups, but there was a significant difference in the need for intervention to reduce alcohol consumption in the severe maternal morbidity group. Risk for substance abuse intervention increased three-fold in women with PTSD criteria, and all aspects of quality of life were worse among drug users. CONCLUSION: Drug use during pregnancy and maternal complications are linked to postpartum drug abuse. These women should be managed during pregnancy; postpartum follow-up requires updated guidance and must go beyond family planning.


Assuntos
Consumo de Bebidas Alcoólicas/epidemiologia , Complicações na Gravidez/psicologia , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Adulto , Consumo de Bebidas Alcoólicas/psicologia , Brasil/epidemiologia , Estudos de Casos e Controles , Feminino , Humanos , Morbidade , Período Pós-Parto , Gravidez , Complicações na Gravidez/epidemiologia , Qualidade de Vida , Estudos Retrospectivos , Transtornos Relacionados ao Uso de Substâncias/psicologia
13.
Int J Equity Health ; 18(1): 122, 2019 08 05.
Artigo em Inglês | MEDLINE | ID: mdl-31382979

RESUMO

BACKGROUND: Unmet need for mental health services remains high in the United States and is disproportionately concentrated in some groups. The scale and nature of these disparities have not been fully elucidated and bear further scrutiny. As such, in this study, we examine the demographic, socioeconomic, and health correlates of unmet need for mental health treatment as well as the reasons for unmet need. METHODS: We draw upon the National Survey for Drug Use and Health (NSDUH) from 2002 to 16 for adults aged 18 and over in the United States (n = 579,017). Using multivariable logistic regression, we simultaneously model the demographic, socioeconomic, and health correlates of unmet need for mental health treatment from 2002 to 16. We also analyse the reasons for unmet need expressed by these populations, reasons which include cost, perceived stigma, minimisation of symptoms, low perceived effectiveness of treatment, and structural barriers. RESULTS: Major characteristics associated with increased odds of unmet need include past year substance abuse or dependence (other than hallucinogens and sedatives), fair, poor, or very poor health, being female, and an educational attainment of college or higher. With respect to reasons for unmet need, cost was most often cited, followed by perceived stigma, structural barriers, and minimisation. Characteristics associated with increased odds of indicating cost as a reason for unmet need include: being uninsured or aged 26-35. Minimisation and low perceived effectiveness are mentioned by high-income persons as reasons for unmet need. College-educated persons and women had higher odds of citing structural barriers as a reason for unmet need. CONCLUSIONS: The correlates and causes of unmet need highlight the intersectionality of individual health needs with implications on addressing inequities in mental health policy and practice.


Assuntos
Acesso aos Serviços de Saúde/estatística & dados numéricos , Necessidades e Demandas de Serviços de Saúde/estatística & dados numéricos , Pessoas sem Cobertura de Seguro de Saúde/estatística & dados numéricos , Serviços de Saúde Mental/estatística & dados numéricos , Adulto , Feminino , Inquéritos Epidemiológicos , Humanos , Masculino , Pessoas sem Cobertura de Seguro de Saúde/psicologia , Saúde Mental , Pessoa de Meia-Idade , Fatores Socioeconômicos , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Transtornos Relacionados ao Uso de Substâncias/psicologia , Estados Unidos , Adulto Jovem
14.
Artigo em Inglês | MEDLINE | ID: mdl-31370374

RESUMO

Substance use carries a higher risk of unnatural death. A retrospective analysis of 42 treatment seekers between 2011-2015 was conducted through medical record review to understand the profile and circumstances leading to premature deaths. Ninety percent of the subjects were males. The mean age at death was 44.9 (SD ± 13.1). Opioids (52.4%), benzodiazepines (45.2%) and alcohol (35.7%) were the main substances used by the group. Suicide was the most common cause of death (n = 27, 64.3%) followed by accidents (n = 15; 35.7%). Among the suicide cases, alcohol was the main substance used (33.3%) followed by opioids (25.9%). A total of 58.5% (n = 24) deaths occurred within a year of their last visit while 41.5% (n = 17) were dead more than a year after their last visit. Of the total cases (n = 41), 63% had a history of mental illness with depressive disorder (53.8%) being the most common. History of suicide attempts were reported in 34.1% (n = 14) of cases and 50% of the subjects (n = 21) had a history of suicidal ideation. Drug related offences were reported in 57.1% of the subjects, of which 60% (n = 18) committed suicide. The findings support the need for appropriate treatment resources to reduce the untimely deaths among substance users.


Assuntos
Causas de Morte , Transtornos Relacionados ao Uso de Substâncias/mortalidade , Adolescente , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Aceitação pelo Paciente de Cuidados de Saúde , Estudos Retrospectivos , Fatores de Risco , Singapura/epidemiologia , Transtornos Relacionados ao Uso de Substâncias/psicologia , Transtornos Relacionados ao Uso de Substâncias/terapia , Adulto Jovem
15.
Nord J Psychiatry ; 73(8): 482-489, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31419392

RESUMO

Purpose: To examine gender-specific associations between multiple lifestyle-related risk factors, appearance satisfaction and depressive symptoms in a sample of Norwegian adolescents (13-16 years of age), and to study the role of appearance satisfaction as a possible confounder in the associations between lifestyle and depressive symptoms. Materials and methods: Data were obtained from Ungdata, a cross-sectional national survey of adolescents in Norway. In total 4379 subjects were included in the study. We constructed a lifestyle risk index and used multiple logistic regressions to examine the associations between lifestyle-related risk factors, appearance satisfaction, and depressive symptoms. Results: High screen time and use of alcohol were significantly associated with depressive symptoms among girls, while high screen time, tobacco and cannabis use were significantly associated with depressive symptoms among boys. An additive relationship was observed between the lifestyle risk index scores and the likelihood of depressive symptoms for both genders, the relationship being strongest among boys. Low appearance satisfaction was strongly associated with depressive symptoms, especially among boys, and identified as an important confounder in the associations between lifestyle and depressive symptoms, particularly among girls. Conclusions: High screen time was the most prevalent lifestyle risk behavior independently associated with depressive symptoms. Multiple lifestyle changes and improvement of appearance satisfaction should be included in measures targeting adolescents for the prevention and treatment of depressive symptoms. Future studies should elaborate on the gender differences in other adolescent age groups. Appearance satisfaction should be acknowledged as an important confounder in future studies of lifestyle and depressive symptoms.


Assuntos
Depressão/epidemiologia , Depressão/psicologia , Estilo de Vida , Satisfação Pessoal , Aparência Física , Tempo de Tela , Adolescente , Estudos Transversais , Depressão/diagnóstico , Feminino , Humanos , Masculino , Noruega/epidemiologia , Aparência Física/fisiologia , Fatores de Risco , Fatores Sexuais , Transtornos Relacionados ao Uso de Substâncias/diagnóstico , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Transtornos Relacionados ao Uso de Substâncias/psicologia
16.
Pediatrics ; 144(3)2019 09.
Artigo em Inglês | MEDLINE | ID: mdl-31427462

RESUMO

CONTEXT: Compared with cisgender (nontransgender), heterosexual youth, sexual and gender minority youth (SGMY) experience great inequities in substance use, mental health problems, and violence victimization, thereby making them a priority population for interventions. OBJECTIVE: To systematically review interventions and their effectiveness in preventing or reducing substance use, mental health problems, and violence victimization among SGMY. DATA SOURCES: PubMed, PsycINFO, and Education Resources Information Center. STUDY SELECTION: Selected studies were published from January 2000 to 2019, included randomized and nonrandomized designs with pretest and posttest data, and assessed substance use, mental health problems, or violence victimization outcomes among SGMY. DATA EXTRACTION: Data extracted were intervention descriptions, sample details, measurements, results, and methodologic rigor. RESULTS: With this review, we identified 9 interventions for mental health, 2 for substance use, and 1 for violence victimization. One SGMY-inclusive intervention examined coordinated mental health services. Five sexual minority-specific interventions included multiple state-level policy interventions, a therapist-administered family-based intervention, a computer-based intervention, and an online intervention. Three gender minority-specific interventions included transition-related gender-affirming care interventions. All interventions improved mental health outcomes, 2 reduced substance use, and 1 reduced bullying victimization. One study had strong methodologic quality, but the remaining studies' results must be interpreted cautiously because of suboptimal methodologic quality. LIMITATIONS: There exists a small collection of diverse interventions for reducing substance use, mental health problems, and violence victimization among SGMY. CONCLUSIONS: The dearth of interventions identified in this review is likely insufficient to mitigate the substantial inequities in substance use, mental health problems, and violence among SGMY.


Assuntos
Vítimas de Crime/psicologia , Transtornos Mentais/prevenção & controle , Minorias Sexuais e de Gênero/psicologia , Transtornos Relacionados ao Uso de Substâncias/prevenção & controle , Violência/prevenção & controle , Política de Saúde , Disparidades em Assistência à Saúde , Humanos , Transtornos Mentais/psicologia , Transtornos Mentais/terapia , Serviços de Saúde Mental , Transtornos Relacionados ao Uso de Substâncias/psicologia , Transtornos Relacionados ao Uso de Substâncias/terapia , Estados Unidos , Violência/psicologia
17.
Body Image ; 30: 165-169, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31374390

RESUMO

Latino sexual minority men (SMM) have elevated anabolic-androgenic steroid (AAS) misuse in comparison to their heterosexual and non-Latino peers. Within a gender role framework, desire to present as masculine through heightened muscularity may be related to increased AAS misuse. To assess the association between AAS misuse and a culturally-distinct masculinity, this study examined the relationship of two aspects of machismo, traditional machismo and caballerismo, with AAS misuse in the past month. Participants were 141 young adult Latino SMM recruited from the San Diego area. Participants completed a self-report questionnaire online in English or Spanish, which included measures of machismo and AAS misuse. Out of 141 participants, 27 reported AAS misuse (19.1%). Traditional machismo was positively associated with AAS misuse and caballerismo was negatively associated with AAS misuse. Traditional machismo, which emphasizes dominance, may be positively associated with AAS misuse due to its facilitation of muscle development, which could enable physical intimidation; greater musculature may also counteract assumptions about femininity and sexual orientation. Caballerismo may be negatively associated with AAS by providing a flexible masculinity model that emphasizes social cohesion over dominance. Future AAS misuse interventions could include values-based work and cognitive restructuring of masculinity schemas.


Assuntos
Anabolizantes , Imagem Corporal/psicologia , Hispano-Americanos/psicologia , Masculinidade , Minorias Sexuais e de Gênero/psicologia , Transtornos Relacionados ao Uso de Substâncias/psicologia , Congêneres da Testosterona , Adolescente , Adulto , Humanos , Masculino , Inquéritos e Questionários , Adulto Jovem
18.
AIDS Behav ; 23(11): 2956-2965, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31392443

RESUMO

Miami is a Southeastern United States (U.S.) city with high health, mental health, and economic disparities, high ethnic/racial diversity, low resources, and the highest HIV incidence and prevalence in the country. Syndemic theory proposes that multiple, psychosocial comorbidities synergistically fuel the HIV/AIDS epidemic. People living with HIV/AIDS in Miami may be particularly affected by this due to the unique socioeconomic context. From April 2017 to October 2018, 800 persons living with HIV/AIDS in a public HIV clinic in Miami completed an interviewer-administered behavioral and chart-review cross-sectional assessment to examine the prevalence and association of number of syndemics (unstable housing, low education, depression, anxiety, binge drinking, drug use, violence, HIV-related stigma) with poor ART adherence, unsuppressed HIV viral load (≥ 200 copies/mL), and biobehavioral transmission risk (condomless sex in the context of unsuppressed viral load). Overall, the sample had high prevalence of syndemics (M = 3.8), with almost everyone (99%) endorsing at least one. Each syndemic endorsed was associated with greater odds of: less than 80% ART adherence (aOR 1.64, 95% CI 1.38, 1.98); having unsuppressed viral load (aOR 1.16, 95% CI 1.01, 1.33); and engaging in condomless sex in the context of unsuppressed viral load (1.78, 95% CI 1.30, 2.46). The complex syndemic of HIV threatens to undermine the benefits of HIV care and are important to consider in comprehensive efforts to address the disproportionate burden of HIV/AIDS in the Southern U.S. Achieving the 90-90-90 UNAIDS and the recent U.S. "ending the epidemic" targets will require efforts addressing the structural, social, and other syndemic determinants of HIV treatment and prevention.


Assuntos
Ansiedade/epidemiologia , Depressão/epidemiologia , Infecções por HIV/tratamento farmacológico , Infecções por HIV/psicologia , Habitação/estatística & dados numéricos , Adesão à Medicação/psicologia , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Adulto , Ansiedade/psicologia , Comorbidade , Estudos Transversais , Depressão/psicologia , Epidemias , Feminino , Florida/epidemiologia , Infecções por HIV/epidemiologia , Infecções por HIV/virologia , Humanos , Masculino , Adesão à Medicação/estatística & dados numéricos , Saúde Mental , Pessoa de Meia-Idade , Prevalência , Comportamento Sexual , Estigma Social , Transtornos Relacionados ao Uso de Substâncias/psicologia , Sindemia , Violência , Carga Viral
19.
Psicothema (Oviedo) ; 31(3): 239-245, ago. 2019. tab
Artigo em Inglês | IBECS | ID: ibc-185349

RESUMO

Background: Experimental substance use among young people is related to individual factors including personality traits such as impulsivity and sensation seeking, and genetic variations such as single nucleotide polymorphisms (SNPs) in the fatty acid amide hydrolase (FAAH) gene. The objective of this study is to analyze the relationship between these three sets of variables. Methods: Volunteer undergraduate students (N = 861, 76% female, M = 20.7 years) completed an ad hoc questionnaire on variables related to their consumption of alcohol, tobacco, cannabis, synthetic drugs and cocaine. In addition, 591 of them completed the Barratt Impulsiveness Scale-11 (BIS-11) and the Sensation Seeking Scale-V (SSS-V). All participants were genotyped in FAAH C385A SNP and its proxy variant rs12075550. Results: Consistent with previous data, both impulsivity and sensation seeking were associated with most of the variables related to experimental substance use. In addition, we found the first evidence of an association between the rs12075550 SNP and some of these consumption phenotypes. However, no significant association was found between either of the two SNPs and impulsivity or sensation seeking. Conclusions: The results highlight the importance of considering both personality and genetic differences, together with contextual factors, in the analysis of substance use


Antecedentes: el uso experimental de sustancias en los jóvenes está relacionada con factores individuales que incluyen rasgos de personalidad, como impulsividad o búsqueda de sensaciones, y variaciones genéticas, como polimorfismos de un solo nucleótido (SNPs) del gen amida hidrolasa de ácidos grasos (FAAH). El objetivo de este estudio es analizar la relación entre estos tres conjuntos de variables. Método: estudiantes universitarios voluntarios (N = 861, 76% mujeres, M = 20,7 años) rellenaron un cuestionario ad hoc de variables relacionadas con el consumo de alcohol, tabaco, cannabis, drogas sintéticas y cocaína. Además, 591 de ellos rellenaron las escalas BIS-11 y SSS-V. Se genotipó a todos ellos en SNP FAAH C385A y su variante proxy rs12075550. Resultados: como se esperaba, la impulsividad y la búsqueda de sensaciones estuvieron asociadas con la mayor parte de las variables relativas al uso experimental de sustancias. Además, encontramos por primera vez evidencia de una asociación entre rs12075550 y algunos de estos fenotipos de consumo. Sin embargo, no encontramos asociaciones significativas entre SNPs e impulsividad o búsqueda de sensaciones. Conclusiones: los resultados resaltan la importancia de tener en cuenta las diferencias genéticas y las de personalidad, junto con los factores contextuales, al analizar el uso de sustancias


Assuntos
Humanos , Masculino , Feminino , Adolescente , Adulto Jovem , Adulto , Amidoidrolases/genética , Comportamento Impulsivo , Personalidade , Polimorfismo de Nucleotídeo Único , Sensação , Transtornos Relacionados ao Uso de Substâncias/genética , Transtornos Relacionados ao Uso de Substâncias/psicologia , Alelos , Variação Genética , Testes de Personalidade , Fenótipo , Assunção de Riscos , Saliva , Sensação/genética , Estudantes , Transtornos Relacionados ao Uso de Substâncias/enzimologia , Inquéritos e Questionários
20.
Psicothema (Oviedo) ; 31(3): 263-270, ago. 2019. tab
Artigo em Inglês | IBECS | ID: ibc-185352

RESUMO

Background: Despite the recent popularity of the classification for maladaptive traits proposed by the DSM-5, little is known about the implications of these traits in adolescent populations. This study examines the relationship between the five broad maladaptive traits included in the DSM-5 (Negative Affect, Detachment, Antagonism, Disinhibition and Psychoticism) and a wide range of criteria of adolescent functioning: behavioural (bullying, cyberbullying, victimization, cybervictimization, problematic Internet use, substance use), emotional (negative and positive emotions, life satisfaction, self-esteem, loneliness) and motivational (extrinsic and intrinsic aspirations). Methods: Data were collected from 921 community adolescents, who were administered the brief form of the Personality Inventory for the DSM-5 (PID-5-BF) as well as self-reported measures of the behavioural, emotional and motivational criteria. Results: Antagonism and Disinhibition were the most important traits for behaviour problems, with face-to-face bullying being more associated with maladaptative traits than cyberbullying; Negative Affect, Detachment and Psychoticism were more closely related to emotional dissatisfaction, and adolescents’ goals were associated with most of the maladaptative traits. Conclusions: This study supports the relevance of the PID-5 traits for adolescents, and extends the nomological net of pathological personality traits to multiple facets of emotions, motivations and social behaviour in young people


Antecedentes: a pesar de la reciente popularidad de los rasgos desadaptativos de la personalidad propuestos por el DSM-5, se sabe poco sobre sus implicaciones en la adolescencia. Este estudio examina la relación entre los cinco grandes rasgos desadaptativos incluidos en el DSM-5 (Afecto Negativo, Desapego, Antagonismo, Desinhibición y Psicoticismo) y múltiples criterios de funcionamiento adolescente: conductuales (acoso, ciberacoso, victimización, cibervictimización, uso problemático de Internet, uso de sustancias), emocionales (emociones negativas y positivas, satisfacción con la vida, autoestima, soledad) y motivacionales (aspiraciones extrínsecas e intrínsecas). Método: se recogieron datos en 921 adolescentes de la población general, a quienes se les administró el PID-5-BF, así como medidas autoinformadas de los criterios a analizar. Resultados: Antagonismo y Desinhibición fueron los rasgos más asociados con los problemas de conducta, y el bullying se vio más relacionado con los rasgos PID que el ciberbullying; Afecto Negativo, Desapego y Psicoticismo se relacionaron más estrechamente con la insatisfacción emocional, y los rasgos desadaptativos contribuyeron también a predecir las metas de los jóvenes. Conclusiones: este estudio apoya la relevancia de los rasgos del PID-5 en la adolescencia, y extiende su red nomológica a múltiples facetas de las emociones, motivaciones y conducta social de los adolescentes


Assuntos
Humanos , Masculino , Feminino , Adolescente , Comportamento do Adolescente , Bullying/psicologia , Manual Diagnóstico e Estatístico de Transtornos Mentais , Emoções , Motivação , Transtornos da Personalidade/psicologia , Afeto , Anedonia , Vítimas de Crime/psicologia , Comportamento Impulsivo , Internet , Satisfação Pessoal , Inventário de Personalidade , Assunção de Riscos , Transtornos Psicóticos/psicologia , Autorrelato , Fatores Sexuais , Isolamento Social , Transtornos Relacionados ao Uso de Substâncias/psicologia
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