Spatial and Environmental Correlates of Prevalence of Treatment for Substance Use Disorders, Retention, and SUD Services Utilization in South Sardinia.

This study explored the economic, social, and spatial correlates of treatment prevalence, retention, and service utilization for substance use disorder (SUD) in South Sardinia. Data from 1,667 patients with an ICD-10 diagnosis of SUD were extracted from the medical records of individuals assisted by three public addiction services in 2019. We used a spatial autoregressive model, a parametric proportional hazard model, and Poisson regression to examine the associations of spatial factors and residents' socioeconomic status with the prevalence of treatment at the census block level, treatment retention, and SUD service utilization at the individual level. The prevalence was higher among residents of areas closer to competent treatment centers, with the worst building conservation status, a lower percentage of high school and university graduates, and a higher percentage of unemployed, divorced, separated, or widowed residents. Men who were older at the time of their first treatment access; primary users of cocaine, cannabis, and alcohol; had higher education level; and who lived far from competent treatment centers and closer to drug trafficking centers interrupted their treatment earlier. Primary heroin users experienced more SUD treatment encounters. Living in economically and socially disadvantaged areas and near treatment facilities was associated with a higher prevalence, whereas living near drug-dealing centers and far from competent treatment centers was associated with a decrease in treatment retention.

Effects of Affective Proximity and Treatment on Emotional Response toward People with Substance Use.

BACKGROUND: Emotions act as mediators of the relationship between stereotypes and inclinations to discriminate against and isolate individuals with substance use disorders (SUD). Emotional responses toward people with SUD are more negative than toward those people with non-drug-related mental disorders. This study explored the effects of affective bonds with substance users and treatment on the type and frequency of emotions, valence, and interpersonal distance. METHODS: A convenience sample of 1,195 individuals was included in this survey-based study. Participants responded to questions regarding their knowledge of psychoactive drugs and beliefs about substance use disorders and were requested to report the emotions they imagined having felt in four scenarios depicting a substance user whose characteristics varied according to two dimensions: the substance user was a relative or an unknown; the substance user was in treatment for SUD, or not. RESULTS: Emotions toward relative drug users were more negative and expressed greater interpersonal distance. Treatment was associated with more positive valence and lower interpersonal distance, but emotions toward relatives in treatment were more negative than those not. CONCLUSION: Specific interventions for relatives of people with SUD may be necessary because of the emotional burden caused by the courtesy stigma.

Adult Attachment Dimensions: Differential Effects on Physiological and Subjective Response During the Recollection of Childhood Memories.

The aim of this study was to explore the relationship between adult attachment dimensions and emotional response induced by the recall of potentially painful memories from childhood. A convenience sample of 100 women responded to an interview that focused on experiences with their caregivers during childhood, and a control interview, in counterbalanced order. Skin conductance level (SCL), heart rate (HR), heart rate variability (HRV), as well as subjective distress measures were collected. Results from generalized linear mixed model indicated that individuals high in avoidance showed a pattern of SCL increase from baseline that persisted during rest phases regardless of the topic addressed. Attachment dimensions did not affect HR, neither alone nor interacting with the interviews content, whereas baseline resting vagal tone was the most important factor. No attachment dimensions effects were observed on subjective measures of emotion; the time-varying vagal tone during rest phases did not moderate their relationships. Limited evidence was observed in support of the hypothesis that attachment Avoidance and Anxiety are associated with distinct physiological regulation profiles during the recall of potentially painful childhood memories.

Association between adult ADHD, self-report, and behavioral measures of impulsivity and treatment outcome in cocaine use disorder.

A large and growing body of literature supports the association between cocaine addiction and impulsivity. The aim of the study was to test whether pretreatment screening for adult ADHD, and self-report and behavioral measures of impulsivity have prognostic utility in clinical practice with cocaine users. We enrolled a cohort of N = 86 treatment-seeking cocaine users, assisted by a public addiction service, in a 24 week study. At baseline, we performed screening for adult ADHD, assessed the presence of co-occurring mental disorders, and applied measures of drug use severity, trait-like impulsivity (Barratt Impulsiveness Scale; BIS-11), decision-making (Iowa Gambling Task; IGT), risk-taking (Balloon Analogue Risk Task; BART), and ability to inhibit cognitive interference (Stroop Color Word Test; SCWT). Patients positive to the screening for ADHD showed a higher level of self-reported impulsivity and a longer history of drug use, but did not differ from those without ADHD in adherence to psychosocial treatments and number of negative urines for cocaine during the 24 weeks. Among all of the self-report and behavioral measures used, only IGT BIS-11 was associated with cocaine abstention. The small effect size and the problematic direction of the associations found do not give strong support to the routine use of self-regulation measures to guide clinical decisions in public addiction treatment settings.