Protective strategies and motivations to control drinking among Brazilian college students: a qualitative study.

BACKGROUND: To develop prevention programs or early interventions to reduce alcohol consumption and related problems among college students, it is essential to understand their motivations for drinking and the spontaneous (effective and non-effective) strategies they employ to control, considering the social and cultural contexts influence. This study aimed to explore these factors and the student's application of selfcare in different situations and environments, as well as to identify their reasons for not drinking. METHODS: The students were invited to participate using a snowball sampling, up to the theoretical saturation point. Qualitative individual semi-structured interviews were carried out and the interviews contents were analyzed using the NVivo software. The participants were 23 college students between 18 and 24 years old, with diverse patterns of alcohol use (low-risk to suggestive of dependence). RESULTS: Data analysis highlighted three main themes: (a) Contexts (such as bars, "open bar" parties and others) and consumption patterns; (b) Protective Strategies (such as stop-drinking intervals, eating before or during drinking, returning home in the company of a friend); (c) Motivations to control drinking (such as sense of responsibility, bad previous experiences, family and religious issues). Protective strategies and motivation to control drinking were perceived to be less prominent in specific contexts that favor high alcohol consumption, as open bar parties. CONCLUSIONS: Motivations and protective strategies varied according to the drinkers' profile, social situations and settings in which they consumed alcohol. The results highlight the need for preventive interventions planned for specific drinking patterns and contexts.

Late-life drinking and smoking in primary care users in Brazil.

To estimate the prevalence of at-risk drinking and smoking and associated factors among older adults in primary care in Brazil.A cross-sectional study carried out in seven primary care units with 503 older adults (60+), in a city in the state of Sao Paulo, Brazil. At-risk drinking was defined by AUDIT-C and by consumption of units per week. Poisson regression was used to assess the association between the sociodemographic and health characteristics and smoking and at-risk drinking.The median age of the 503 participants was 69.6 (SD ± 6.7; range:60-93). One third of participants (33.6%) were current drinkers, 16% were at-risk drinkers (AUDIT-C), 4% at-risk drinkers (units per week), and 13% of the sample were regular smokers. The prevalence of at-risk drinking (AUDIT-C) was higher for males (RP: 4.89; 95% CI: 2.52-9.49) and for those with higher levels of education (RP: 1,861.85 95% CI: 1.08-3.14), and lower for those over the age of 70 (RP: 0.50; 95% CI: 0.30-0.84). The prevalence of smoking was higher for those with depressive symptoms (RP: 1.95; 95% CI: 1.03-3.66), and lower for those over age 70 (RP: 0.52; 95% CI: 0.29-0.94).The results point to a set of factors associated with at-risk drinking (being male, younger and having a higher education), and with smoking (being younger and having depressive symptoms). Our findings could help health professionals to identify at-risk drinkers and smokers, as well as support strategies for future interventions by the identification of the groups most vulnerable to these behaviors.

Effects of Mindfulness-Based Relapse Prevention on the Chronic use of Hypnotics in Treatment-Seeking Women with Insomnia: a Randomized Controlled Trial.

BACKGROUND: Hypnotics are one of the most frequently prescribed drugs worldwide, especially for women, and their chronic use may lead to tolerance, dosage escalation, dependence, withdrawal syndrome, and cognitive impairments, representing a significant public health problem. Consistent evidence from previous studies shows benefits of mindfulness-based interventions (MBIs) for substance use disorders (SUD) and insomnia. However, to date, there is a lack of research about effects of MBIs on reduction/cessation of chronic hypnotic use among women with insomnia. METHOD: The present randomized trial evaluated the efficacy of the 8-week group-delivered mindfulness-based relapse prevention (MBRP) program in an intervention group (IG, n = 34) compared with weekly phone monitoring only in the control group (CG, n = 36) in reducing hypnotic use and insomnia severity over a 6-month follow-up period. RESULTS: There were significant differences between groups at baseline regarding hypnotic use but not insomnia. Group effects on hypnotic use were found immediately after the intervention (bT1 = 2.01, p < 0.001) and at the 2-month follow-up (bT2 = 2.21, p < 0.001), favoring the IG. The IG also had a greater reduction from baseline levels than the control group in insomnia severity at the 4-month (bT3 = 0.21, p = 0.045) and 6-month (bT4 = 0.32, p = 0.002) follow-ups. CONCLUSIONS: The findings provide preliminary evidence of benefits of MBRP for reducing insomnia severity and potentially chronic hypnotic use. However, IG effects on chronic hypnotic use may have resulted from IG and control group differences in chronic hypnotic use at baseline. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT02127411.

Impulsivity and Mindfulness among Inpatients with Alcohol Use Disorder.

BACKGROUND: Impulsivity is both a risk factor for and a consequence of alcohol use disorder (AUD), for which mindfulness-based approaches have been proven to be effective. However, the specific relationship between mindfulness and impulsivity has been little explored in the literature, especially in people with AUD. This study aims to investigate the relationship between different facets of dispositional mindfulness and impulsivity among people with AUD in an inpatient setting in Brazil. Methods: Participants (n = 165) completed the following self-report measures: the Alcohol Use Disorders Identification Test (AUDIT), the Five Facets of Mindfulness Questionnaire (FFMQ-SF), and the Short UPPS-P Impulsive Behavior Scale (SUPPS-P). Multiple imputation techniques and linear models were employed to assess the relationships between dispositional mindfulness and impulsivity. Results: In complete case analysis, the UPPS-P facet "lack of premeditation" was inversely related to the FFMQ facet "non-reactivity" (B = -0.17; p = 0.01); and "positive urgency" was inversely related to "act with awareness" (B = -0.27, p = 0.02) and "non-reactivity" (B = -0.17, p = 0.01). Conclusion: Relationships of varying magnitudes between dispositional mindfulness and impulsivity domains among people with AUD were found, suggesting that higher mindfulness skills are related to less impulsive traits. Our results encourage further longitudinal studies evaluating the potential of specific mindfulness components to decrease impulsivity among AUD inpatients, including its underlying mechanisms.

Effectiveness of Mindfulness-Based Relapse Prevention Program as an Adjunct to the Standard Treatment for Smoking: A Pragmatic Design Pilot Study.

INTRODUCTION: Posttreatment relapse is a major roadblock to stemming the global epidemic of tobacco-related illness. This article presents results from a pilot trial evaluating the feasibility and initial efficacy of Mindfulness-Based Relapse Prevention (MBRP) as an adjunct to standard relapse prevention treatment (ST) for smoking cessation. AIMS AND METHODS: Smokers (n = 86) in the maintenance phase of treatment were randomized to receive either ST plus MBRP (MBRP) (n = 44) or ST alone (ST) (n = 42). Data were collected at baseline and at 4-, 12-, and 24-week follow-up points. We evaluated the feasibility of the protocol with frequency analysis, and the efficacy with both intention to treat and complete case analyses of the effects of MBRP on abstinence. Secondary outcomes included mindfulness, craving, depression, anxiety, and positive/negative affect. RESULTS: High adherence suggested MBRP is acceptable and feasible. Participants in the MBRP group reported increases in mindfulness (M = -7.833, p = .016), and reductions in craving (M = 17.583, p = .01) compared with the ST group. Intention to treat analysis found that, compared with MBRP (36.4%), ST (57.1%) showed trend-level superiority in abstinence at Week 4 (Prevalence Ratio = 0.63, p = .06); however at Week 24, the ST group (14.3%) demonstrated a twofold greater decrease in abstinence, compared with the MBRP group (20.1%) (Prevalence Ratio = 2.25, p = .08). Therefore, the MBRP group maintained a higher abstinence rate for longer. Reported effects were greater in the complete case analysis. CONCLUSIONS: MBRP holds promise for preventing relapse after aided tobacco quit attempts. IMPLICATIONS: Findings suggest that MBRP is acceptable, feasible, and valued by participants. At 24-week follow-up, there was a large effect size and a statistical trend toward fewer MBRP patients relapsing compared with ST patients. MBRP conferred ancillary benefits including reductions in craving and increases in levels of mindfulness. MBRP for tobacco cessation is highly promising and merits further research. TRIAL REGISTRATION: clinicaltrials.gov. IDENTIFIER: NCT02327104.

Interpersonal relationships and drug use over time among homeless people: a qualitative study.

BACKGROUND: Homelessness is one of the most severe forms of social exclusion and is an important public health issue. It is characterized by processes of weakening of interpersonal bonds. The objective of this study was, therefore, to elucidate how interpersonal relationships change over the life cycle of homeless drug and alcohol users. METHOD: We used a qualitative methodology. The participants were adults who had a history of homelessness and use of alcohol and other drugs. The interviews were semi structured and used a timeline instrument. All interview were audio recorded, transcribed, and submitted to thematic analysis. RESULTS: Twenty individuals participated in the study. Reports on social exclusion over time stood out in respect of four main themes and their respective subthemes: Theme 1 - Childhood: instability upbringing, abuse, violence, and an absent or not very present father figure; Theme 2 - Adolescence: school dropout and failure; acceptance of gender and sexual orientation; birth of first child, living with a partner or getting married: Theme 3 - Adulthood: estrangement or conflicting relationship with family; health problems; drug trafficking and prostitution; Theme 4 - Cross-cutting factors: death of relatives and substance use. CONCLUSION: The results suggest that interpersonal relationships are permeated by successive breakups, conflicts and other events that start in childhood and can have a cumulative effect in later stages of life, and cross the subsequent phases. Substance abuse and dependence are mentioned as cross-cutting factors that intensify social exclusion in all stages of life.

Tobacco smoking and risk for dementia: evidence from the 10/66 population-based longitudinal study.

Objective: This study aimed to estimate the association between tobacco smoking and risk for dementia in seven low- and middle-income countries.Methods: Secondary analysis of the 10/66 population-based cohort study was conducted with 11,143 dementia-free individuals aged 65 years and older who were followed-up for an average of 3.8 years totalling 42,715 person-years. Cox regression with competing-risk analyses was used, controlling for age, gender, number of assets, past hazardous drinking, exercise and self-report of heart disease. Exposure was measured in packyears and smoking status. The number of packyears was calculated by multiplying the average number of packs per day by years of consumption up to 50 years old and up to age at baseline.Results: Meta-analysis of the results from each country yielded non-significant pooled relative risk ratios for all comparisons. There was no difference in risk for any dementia between 'ever smokers' compared to 'never smokers' (HR 0.96; 95% CI 0.82-1.13); 'current smokers' compared to 'never smokers' (HR 0.83; 95% CI 0.66-1.06); 'former smokers' compared to 'never smokers' (HR 1.06; 95% CI 0.88-1.27); 'current smokers' compared to 'former smokers' (HR 0.86; 95% CI 0.66-1.13). Results were similar for Alzheimer's disease (AD) and Vascular Dementia (VaD) as outcomes. Lifetime tobacco consumption (packyears) was not associated with any dementia (HR 1.00; 95% CI 0.99-1.00), nor with AD or VaD.Conclusion: Pooled results from all the countries showed no significant association between smoking and the onset of any dementia. Selective quitting in later-life might have biased the results towards no effect.

The Role of Mindfulness in the Insomnia Severity of Female Chronic Hypnotic Users.

PURPOSE: To investigate dispositional mindfulness, psychiatric symptoms, and their relationship with insomnia severity among female chronic hypnotic users. METHODS: Observational, cross-sectional study, including 76 women with chronic hypnotic use. Participants completed several self-report questionnaires: sociodemographic characteristics, depressive symptoms (CES-D), anxiety levels (STAI-T), dispositional mindfulness (FFMQ), and insomnia severity (ISI). Exploratory linear regression models were used to identify factors related to insomnia severity. RESULTS: Multiple linear regression models showed that, for the total sample (N = 76), age (B = - 0.14, p = 0.003), depressive symptoms (B = 0.16, p = 0.005), and the mindfulness facets "observe" (B = 0.21. p = 0.013) and "act with awareness-auto pilot" (B = - 0.48, p = 0.017) were correlated to insomnia severity. CONCLUSION: Results confirm a relationship between mindfulness and insomnia among female chronic hypnotic users, specifically regarding the ability to observe and act with awareness. A higher score on the "observe" facet was positively correlated with insomnia. This may be because the skill of observing itself, isolated from other mindfulness precepts, does not provide sufficient strategies to cope with the observed discomfort. Increased "acting with awareness-autopilot" was negatively correlated with insomnia severity, arguably because it stimulates breaking automatic patterns of thoughts and behaviors that contribute to the perpetuation of the insomnia cycle.

[Internet-based alcohol interventions for college students: systematic reviewIntervenciones por Internet para reducir el consumo de alcohol de los estudiantes universitarios: revisión sistemática]. / Intervenções via Internet para redução do consumo de álcool entre universitários: uma revisão sistemática.

OBJECTIVE: To identify the main modalities of Internet-based interventions to limit alcohol use among university students, and to describe the effects of these interventions on alcohol use and related consequences. METHODS: A systematic review of PubMed, PsycINFO, and SciELO was performed using as search terms "alcohol drinking AND Internet," without date or language restrictions. Inclusion criteria were randomized controlled trial design, focus on college students and on Internet-based interventions, and evaluating the effects of the intervention on alcohol use or alcohol-related consequences. RESULTS: Thirty-six articles were analyzed. Two main intervention modalities were identified: personalized normative feedback (PNF, n=28) and multicomponent interventions (n=8). Twelve studies with PNF reported reductions in alcohol use 3 months after the intervention. Multicomponent interventions reduced alcohol use and related consequences; most studies focused on the website AlcoholEdu, which reduced alcohol consumption and the consequences of alcohol use 6 months after the intervention. CONCLUSIONS: FNP and the AlcoholEdu website, the most frequently evaluated interventions among the selected studies, were effective in reducing alcohol use in university students. These strategies are an alternative to increase the access of university students to interventions aimed at limiting alcohol use.

OBJETIVO: Determinar las principales modalidades de intervención por Internet para limitar el consumo de alcohol de los estudiantes universitarios, y describir los efectos de cada una en el consumo de alcohol y sus consecuencias. MÉTODO: Esta es una revisión sistemática hecha con artículos disponibles en las bases PubMed, PsycINFO y SciELO. Se utilizaron como términos de búsqueda alcohol drinking AND Internet, sin restricción de fecha ni de idioma. Los criterios de inclusión fueron los siguientes: estudio aleatorizado controlado con una muestra de estudiantes universitarios, enfoque en intervenciones por Internet y evaluación de los efectos de esas intervenciones en el consumo de alcohol o sus consecuencias. RESULTADOS: El análisis de 36 artículos permitió encontrar dos modalidades principales de intervención por Internet, a saber, intervenciones basadas en retroalimentación normativa personalizada (n=28) e intervenciones multicomponentes (n=8). En doce estudios con retroalimentación normativa personalizada se observó una reducción del consumo de alcohol tres meses después de la intervención. Las intervenciones multicomponentes redujeron el consumo de alcohol y sus consecuencias. La intervención más evaluada fue el sitio AlcoholEdu, que disminuyó el consumo de alcohol y sus consecuencias seis meses después de realizarla. CONCLUSIONES: La retroalimentación normativa personalizada y el sitio AlcoholEdu fueron las intervenciones más evaluadas en los estudios seleccionados y demostraron ser eficaces para reducir el consumo de alcohol en los estudiantes universitarios. Esas estrategias ofrecen una alternativa para ampliar el acceso de los estudiantes a intervenciones destinadas a limitar el consumo de alcohol.

Psychosocial factors associated with mother-child violence: a household survey.

PURPOSE: The objective of this study was to investigate the psychosocial factors associated with violence by women against their children, using a household survey. METHODS: Households in two neighborhoods in Juiz de Fora, Brazil, with different socioeconomic profiles, were selected through probability sampling and surveyed. A total of 446 women with children up to 18 years of age were interviewed. A sociodemographic questionnaire, the CTSPC (Parent-Child Conflict Tactics Scales), the CES-D (Center for Epidemiologic Studies Depression Scale) and the AUDIT (Alcohol Use Disorders Identification Test) were applied. Using STATA statistical software, logistic regression analysis was performed to investigate the association between psychosocial variables and domestic violence against children. RESULTS: The prevalence of violence by mothers against their children during the 3 months prior to data collection was as follows: psychological aggression, 70.5% (n = 304); corporal punishment, 51.4% (n = 232); and physical maltreatment, 9.8% (n = 46). Women with a higher educational level exhibited lower odds of committing psychological aggression (OR 0.47; CI 0.24-0.91) and corporal punishment (OR 0.32; CI 0.16-0.64). Age was associated with corporal punishment, with older women (OR 0.94; CI 0.91-0.97) reporting a lower frequency of this type of violence against their children. Residing in the neighborhood with higher socioeconomic status reduced the odds of reporting psychological aggression (OR 0.45; CI 0.27-0.75). Maternal depression (OR 3.75; CI 1.51-9.31) and harmful drinking (OR 4.73; CI 1.17-19.10) were risk factors for physical maltreatment. CONCLUSIONS: The results point to the need for preventive strategies for mother-child violence in low and middle income countries, with a focus on the mothers' education and mental health, especially with regard to the younger ones.

Patterns of domestic violence and alcohol consumption among women and the effectiveness of a brief intervention in a household setting: a protocol study.

BACKGROUND: Domestic violence and harmful alcohol consumption are considered major public health problems worldwide. These phenomena often co-occur, and they share several risk factors. Nevertheless, few in-depth studies have supported integrated interventions for both phenomena, in particular among Latin American women. This project will study the consumption of alcoholic beverages among women and its relationship with patterns of domestic violence; furthermore, it will assess the effect of a brief intervention (BI) aimed at modifying these behaviors using a community household sample. METHODS/DESIGN: This project is divided into two studies. Study 1 will employ a cross-sectional observational design and will be conducted using a household sample of adult women (approximate sample size = 1600) to assess harmful alcohol consumption and domestic violence patterns. Study 2, will be a randomized clinical trial based on specific cases from Study 1, assessing the effect of a brief intervention on women who exhibit harmful levels of alcohol consumption (AUDIT ≥ 8). Approximately 73 women will be assigned to one of two groups, either a treated group (TG) or a control group (CG). A sociodemographic questionnaire, a questionnaire concerning general health and substance use, and four other standardized instruments (i.e., the Alcohol Use Disorder Identification Test [AUDIT; used to investigate problems related to alcohol consumption], the Center for Epidemiologic Studies Depression Scale [CES-D; used to measure depressive symptoms], and the Revised Conflict Tactics Scales and Parent-child Conflict Tactics Scales [CTS2 and CTSPC; used to obtain information on violence among couples and between parents and children, respectively]) will be used to collect data. DISCUSSION: The study protocol will employ a household survey of a representative sample from a neighborhood in a middle income country, where well-conducted household surveys remain rare. The present work represents a step toward a better understanding of violence in women's lives and its interaction with alcohol consumption and expands the discussion on the potential strategies for public health actions seeking to prevent both domestic violence and harmful alcohol consumption. TRIAL REGISTRATION: Brazilian Clinical Trials Registry: RBR-7rjt4t. Registered 17 October 2013.

Adaptation and validation for use in Brazil of the Confusion, Hubbub, and Order Scale (CHAOS).

BACKGROUND: The Confusion, Hubbub, and Order Scale (CHAOS in English Version) was originally developed in the USA by Matheny et al (Bringing order out of chaos: psychometric characteristics of the confusion, hubbub, and order scale. Journal of Applied Developmental Psychology 16(3):429-444, 1995) to measure chaos in the family environment, characterized by confusion, lack of routine, and organization. OBJECTIVE: To present evidence of content validity, internal structure validity, and validity based on relationships with external measures of an adapted version of the CHAOS into Brasilian Portuguese with adolescents sample in São Paulo - Brasil. METHOD: Study 1 involved the translation/back-translation and adaptation of the scale into Brazilian Portuguese [here named "Escala de Confusão, Alvoroço e Ordem no Sistema familiar" (CAOS)], assessed by 5 judges. In Study 2, we conducted an exploratory factor analyses (EFA) to determine the scale's factor structure (N = 180 adults). In Study 3, we carried out confirmatory factor analyses (CFA) to confirm the internal validity of the scale, along with complete structural equation modeling to explore convergent validity in another sample (N = 239 adolescents). RESULTS: The CAOS scale displayed content validity, and the EFA and CFA showed a unifactorial structure (with some scale adjustments) with an acceptable fit. The family chaos latent factor was associated with externalizing symptoms and perceived stress in adolescents. CONCLUSION: Overall, the Brazilian version of the scale presented evidence of construct, internal, and concurrent validity that indicate its usefulness in Brazil.

Booster effects and mechanisms of web-based personalised normative feedback alcohol intervention for college students: A pragmatic randomised controlled trial.

BACKGROUND: To evaluate the effects of booster and no booster versions of web-based alcohol Personalised Normative Feedback (PNF) and whether descriptive norms mediated and/or participant motivation moderated the effectiveness of the intervention in real world conditions (i.e. no financial incentives). METHODS: Pragmatic randomised controlled trial with 1-, 3-, and 6-month assessments. Brazilian college students reporting alcohol use in the last 12 months (N=931) were recruited from May/2020 to December/2022 and allocated to 1) No booster/single PNF(S-PNF); 2) Booster/multiple PNF(M-PNF); or 3) Assessment-only control. We applied Helmert coding [1: Any intervention (S-PNF or M-PNF) vs. Control; and 2: S-PNF vs. M-PNF]. PRIMARY OUTCOMES: typical number of drinks/week and maximum number of drinks/week; secondary outcomes: drinking frequency and number of consequences. Three-months assessment was the primary interval. Descriptive norms were tested as mediator. Interest, importance, and readiness to change were examined as moderators. RESULTS: Compared to control, any intervention did not influence primary outcomes at 3-months or 6-months, but did at 1-month, when reduced typical drinking (IRR:0.77, 95%CI:0.66;0.90) and maximum number of drinks (IRR:0.69, 95%CI:0.58;0.82). There was an intervention effect on the consequences at 3-months. No differences were observed between S-PNF and M-PNF. No mediation effects were found at 3-months. At 6-months, there was an indirect effect on typical drinking through norms at 3-months (b=-0.82, 95%CI:-2.03;-0.12) and effects on maximum drinks through norms at 1-month (b=-0.54, 95%CI:-1.65;-0.02). No support for moderation was found. CONCLUSIONS: Intervention reduced alcohol drinking at 1 month only and was not effective thereafter. Mechanisms of effect remain unclear.

Heavy episodic drinking and soccer practice among high school students in Brazil: the contextual aspects of this relationship.

BACKGROUND: Heavy episodic drinking (HED) (consumption of five or more drinks on the same occasion) among adolescents is related to several problems and partaking in sport or physical activities has been suggested as an option to prevent or reduce alcohol consumption among this population. The aim of this study was to investigate the relationship between soccer practice and heavy episodic drinking among high school students from Brazil. METHODS: Data were obtained from a cross-sectional study among a representative sample of public and private high school students from all Brazilian state capitals (N=19,132). Only students aged from 14 to 18 who reported having taken part in soccer practice, other team sports or non-practicing sports in the last month were included. Characteristics of sport practice (frequency and motivation) and HED in the last month (type of drink; where and with whom they drank; frequency of HED) were also considered. Regression models were controlled for sociodemographic variables. RESULTS: For all groups studied most of the students reported drinking beer, with friends and at nightclubs or bars. Soccer practice was associated to HED when compared to non-practicing sports and to other team sports. Compared to other team sports, playing soccer for pleasure or profession, but not for keep fit or health reasons, were more associated to HED. Frequency of soccer practice from 1 to 5 days per month and 20 or more days per month, but not from 6 to 19 days per month, were also more associated to HED. CONCLUSIONS: The relationship between soccer and HED appears to be particularly stronger than in other team sports among adolescents in Brazil. Induced sociability of team sports practice cannot be assumed as the main reason for HED among soccer players. Possibly these results reflect the importance of a strong cultural association between soccer and beer in Brazil and these findings should be integrated to future prevention or intervention programs.

Interprofessional Training on Substance Misuse and Addiction: A Longitudinal Assessment of a Brazilian Experience.

Although several trainings have been offered to improve professional expertise on alcohol and other drugs, few have used an interdisciplinary approach and evaluated long-term improvements in the professional's work routine. This study aimed to evaluate the outcomes of an interprofessional training program on alcohol and other drugs offered by a Regional Reference Center for Drugs of the Federal University of São Paulo, Brazil. METHODS: the evaluation was carried out longitudinally using mixed methods (questionnaires (n = 29-177) and semistructured interviews (n = 28)). The participants were current workers from public institutions of health, education, social assistance, justice, and security system who attended the training. Data were collected at the beginning, the end, and one year after the end of the training. Descriptive statistical analyses were performed for quantitative data and thematic content analyses for qualitative data. RESULTS: professionals who attended the training enhanced their understanding of substance-related issues, reduced stigma, changed their attitude, and improved their networking among the different services providing care to users. The main characteristics related to these outcomes were the interprofessional and biopsychosocial approach, and the experiential activities developed during the training. Most participants reported difficulties in implementing changes in their work routine, but those in managerial roles have reported having more autonomy to carry out such changes. CONCLUSIONS: the mixed methods converged in terms of their results. The training promoted a better understanding of issues related to substance use disorders, reduced stigma and expanded the repertoire of skills. The interprofessional and biopsychosocial approach and field activities seem to be related to these outcomes. The potential for implementing changes in daily practice was prominent among those occupying a managerial role.

The effect of mindfulness on decision-making, inhibitory control, and impulsivity of substance use disorder in-treatment patients: A randomized clinical trial.

This study aimed to investigate the effects of Mindfulness-Based Relapse Prevention (MBRP) in decision-making, inhibitory control and impulsivity compared to Treatment as Usual (TAU) for individuals with Substance Use Disorders (SUD's) in Brazil. A randomized clinical trial was conducted with participants from a therapeutic community (n = 122). Decision-making (Iowa Gambling Task), impulsivity dimensions (UPPS-P Scale), and inhibitory control (Stroop Color-Word Test) were assessed before and after the MBRP 8-week intervention. GLM Multivariate analysis was used to evaluate the effects of MBRP on different impulsivity measures. The results showed that MBRP+TAU improved the general decision-making score (p = 0,008) compared to TAU. However, no significant effects were found in impulsivity dimensions and inhibitory control in individuals with SUDs in the therapeutic community. This study found improvement in decision-making in the total IGT score; however, no effect for self-reported impulsivity and inhibitory control among middle-aged patients after an 8-weeks intervention of MBRP protocol in an inpatient setting. It adds information to the subject, with implications and possible directions to be followed by the next clinical trials with patients with SUDs in treatment. Trial registration: EnsaiosClinicos.gov.br: RBR-6c9njc.

A randomized controlled trial of mindfulness: effects on university students' mental health.

BACKGROUND: The development of mental health disorders is common in the university population, and mindfulness-based interventions (MBIs) seem to be effective in addressing them in different contexts. Thus, this study investigated the impact of an 8-week MBI adapted to university students from the Mindfulness-Based Relapse Prevention (MBSR) on different symptoms related to mental health problems, specifically symptoms of anxiety, depression, stress and insomnia. METHODS: University students (n = 136) were randomized into MBI group (n = 71) or wait-list group (n = 65). All participants completed self-administered questionnaires before and after the intervention, and the experimental group answered questionnaires weekly during intervention. Generalized mixed models were used to assess the effects of the intervention. RESULTS: There were improvements in the symptoms of stress (B = 5.76, p < 0.001), depression (B = 1.55, p < 0.01) and insomnia (B = 1.35, p = 0.020) from the beginning of the intervention to the final assessment when it was compared to the control group. No effect was found in respect of trait anxiety. The MBI was found to be effective in reducing important symptoms related to university students' mental health, possibly grounding further research on the intervention's potential of preventing the development of mental disorders. TRIAL REGISTRATION: The research was registered in the Brazilian Registry of Clinical Trials (ReBEC) - number RBR-63qsqx, approved at 09/16/2019.

Reasons for not using ecstasy: a qualitative study of non-users, ex-light users and ex-moderate users.

BACKGROUND: Although ecstasy is often consumed in the electronic music scene, not everyone with the opportunity to use it chooses to do so. The objective of this study was to understand the reasons for non-use or the cessation of use, which could provide information for public health interventions. METHODS: A qualitative reference method was used. Our "snowball" sample group consisted of 53 people who were split into three subgroups: non-users (NU, n = 23), ex-light users (EX-L, n = 12) and ex-moderate users (EX-M, n = 18). Individual, semi-structured interviews were conducted, transcribed and subjected to content analysis with the aid of NVivo8. RESULTS: Adverse health effects and personal values were given as reasons for non-use in the three groups. Non-users (NU) and ex-light users (EX-L) provided reasons that included fear of possible effects as well as moral, family and religious objections. Ex-moderate users (EX-M) cited reasons related to health complications and concomitant withdrawal from the electronic music scene. However, most of the ex-moderate users did not rule out the possibility of future use. CONCLUSIONS: Potential effects and undesirable consequences appear to guide the decisions within the different groups. Prevention might target these motivations. Individuals who have used ecstasy indicate that social and environmental factors are the most important factors.

Omega-3 for the Prevention of Alcohol Use Disorder Relapse: A Placebo-Controlled, Randomized Clinical Trial.

Background: Recent studies have sought to identify the possible benefits of the intake of omega-3, an important component of neuronal membranes, for the treatment of alcohol use disorder. Aim: The objective of the present study was to evaluate whether omega-3 supplementation is protective against alcohol use disorder relapse after hospital discharge. Methods: A randomized, double-blind, placebo-controlled study was carried out with severe alcohol dependence. Male inpatients were randomized to treatment with omega-3 (n = 59) or placebo (n = 52) for 3 months, participants were assessed after discharge at 1 month (T1), 2 months (T2), 3 months (T3), and 6 months (T4) with assessments made using self-report instruments. The primary outcomes were the possible reduction with assessments made using self-report instruments. The primary outcomes were the possible reduction in the number, intensity of relapses, amount of consumption in each relapse and number of days of consumption during relapses; as secondary outcomes were assessed symptoms of anxiety, depression, degree of dependence, compulsion, and craving. Results: The groups were similar regarding consumption amount parameters and propensity to relapse; however, an effect of treatment with omega-3 was found on the number of days of drinking at 2 months [B = 0.65 (0.09; 1, 21), p = 0.01] and 3 months [B = 2.6 (1.61; 3.58), p < 0.001] after discharge, favoring the intervention group. The effect was not maintained at follow up of 6 months. No differences were found in psychiatric symptoms and severity of addiction. Conclusion: Despite the major limitations of the present study, the group that received omega-3 had a lower number of days of consumption of standard doses of alcohol in the evaluations of 60 and 90 days after discharge. More robust studies are needed to confirm or refute these findings. Brazilian Registry of Clinical Trials: n° RBR-48mkgz7 (URL: https://ensaiosclinicos.gov.br/rg/RBR-48mkgz7).

Mindfulness-based interventions in inpatient treatment for Substance Use Disorders: A systematic review.

Inpatient treatment for Substance Use Disorder (SUD), such as Therapeutic Communities and Residential Treatment has been used to test the effect of Mindfulness-Based Interventions (MBI) over different outcomes. Although there is evidence of the effectiveness of MBIs, little is known about the particularities that the place may have in the outcomes. The main objective of this Systematic Review was to evaluate the effectiveness of MBIs for SUDs performed in the inpatient context. PubMed, Web of Science and PsycInfo were used for the search. Quantitative and qualitative studies with no control, usual treatment or other active comparator intervention for SUDs inpatient treatment from 1980 to 2020 were included. From 21 selected studies, 18 were quantitative and 3 qualitative; 12 studies were RCT. Most samples were comprised with women. Based on characteristics of outcomes, we were able to divide them into: Substance Use and Associated Outcomes, Stress, Impulsivity e Evaluation of the MBI protocol. Results suggest that stress assessment is a determining factor for treatment success in these settings. Regarding substance use, although several outcomes have been assessed, the most remarkable results were craving reduction and improvement in treatment adherence. There is evidence that MBIs in inpatient settings benefited those who participated in the experimental groups on some outcomes, such as stress and substance use. Little is mentioned about the impact of the environment over the outcomes and short follow-ups were a relevant limitation of most of the studies. Future assessments must increase follow-up time and evaluate the relationship between the context and the MBI.