Characteristics of Suicide Attempters and Ideators in a Clinical Sample of Substance Users.

There is little research to distinguish those who attempt suicide and those who only consider suicide, and the role that substance use plays in this progression. We aim to describe clinical correlates of suicide attempters versus ideators in substance users. We examined characteristics of substance users (N = 185) that had either a suicide attempt within the last 6 months (n = 94) or were suicide ideators (n = 91). Suicide attempters displayed significant different clinical profiles to that of non-attemptors. Relative to ideators, attempters had greater scores on impulsivity, the brief psychiatric scale and more likely to be female and a recent psychostimulant user. Logistic regression revealed that male gender was associated with a decreased odds of a previous suicide attempt (OR = 0.37, p < 0.05) and greater impulsivity scores were associated with increased odds of an attempt (OR = 1.15, p < 0.05), although entering interaction terms diminished the role of impulsivity and revealed a significant interaction of alcohol use x depression. While impulsivity was a significant predictor of suicide attempt relative to depression or alcohol use alone, this reduced when considering interactions between psychological characteristics and substance use, whereby the effect of alcohol use on the likelihood of a recent suicide attempt varied at different levels of depression.

Safe sex practices of Indian immigrant men living in Australia: an exploratory research.

There is a paucity of scientific information about safe sex practices of Indians immigrants living in popular multicultural nations such as Australia. An online survey of adult Indian men living in Australia was conducted to measure the frequency of use of safe sex practices using the Safe Sex Behavior Questionnaire (SSBQ). Among the respondents of the SSBQ (n = 184), 16.8% (n = 31) reported that never insist on condom use, when having sexual intercourse. One in two men surveyed, agreed that it is difficult for them to discuss safe sex issues with their sexual partners. One in two men said that they used alcoholic beverages prior to or during sexual intercourse. There were no significant differences in SSBQ data among Indian men based on their relationship status. The current study has assessed a range of safe sex practices by involving a community sample of Indian men, and provides baseline data for further evaluation and comparison.

Surviving a gender-variant childhood: the views of transgender adults on the needs of gender-variant children and their parents.

Adults with gender-variant childhoods have often lived traumatic lives because of the attitudes and limited understanding that people in their environment had of the concept of gender variance. This study explores the childhoods of transgender adults with the aim to understand their gender-related difficulties as children, in order to identify their needs and the needs of their parents at that time. The authors conducted a semi-structured survey with 110 transgender adults in order to explore their retrospective childhood experiences. Responses were analyzed through content and thematic coding. Their needs most commonly identified as children were for educated authority figures; acceptance and support to discuss their gender variance; freedom of identity expression; validation; and recognition. The needs most commonly allocated to their parents were access to information, education to increase other's awareness, peer support, and access to educated professionals.

Predicting future anabolic-androgenic steroid use intentions with current substance use: findings from an internet-based survey.

OBJECTIVE: To explore how current substance use, including the use of sports supplements and illicit drugs, may impact upon a person's future intentions to use anabolic-androgenic steroids (AAS). DESIGN: Web-based survey. PARTICIPANTS: Two hundred fourteen exercising males (mean age, 30 years; range, 17-61 years) recruited from 5 gymnasia in Sydney, Australia, completed a web-based survey. The survey contained questions relating to sport supplement use, illicit substance use, reasons for currently not using AAS, and reasons for intending to use AAS in the future. INTERVENTIONS: Participants completed a structured interview schedule that included questions regarding licit and illicit substance use, reasons for non-AAS use, and, where appropriate, reasons for intended future AAS use. MAIN OUTCOME MEASURES: The planned main outcome measure was positive intention to use AAS. RESULTS: Sixteen percent of the sample indicated that they would use AAS in the future. Reasons for future AAS use included increasing muscle size (80%), improving appearance (74%), and increasing strength (57%). Four-fifths (80%) of the sample reported use of sports supplements, with vitamins and protein supplements commonly reported (83% and 67%, respectively); more than one-third (36%) reported use of creatine in the past 6 months. Half (52%) of the sample reported use of illicit substances in the preceding 6 months, with amphetamines and cannabis commonly reported (66% and 62%, respectively). Significant predictors of intending to use AAS included past 6-month use of creatine and knowing AAS users. CONCLUSIONS: The use of sport supplements and/or illicit substances may remove barriers for the future use of such drugs as AAS. Future research is necessary to explore in depth whether such substances may act as a "gateway" to future AAS use.

Addition of cue exposure to cognitive-behaviour therapy for alcohol misuse: a randomized trial with dysphoric drinkers.

AIM: To test whether addition of moderation-orientated cue exposure (CE) or CE after dysphoric mood induction (emotional CE, ECE) improved outcomes above those from cognitive-behaviour therapy alone (CBT) in people who drank when dysphoric. DESIGN: Multi-site randomized controlled trial comparing CBT with CBT + CE and CBT + ECE. SETTING: Out-patient rooms in academic treatment units in Brisbane and Sydney, Australia. PARTICIPANTS: People with alcohol misuse and problems controlling consumption when dysphoric (n = 163). Those with current major depressive episode were excluded. INTERVENTION: Eight weekly 75-minute sessions of individual treatment for alcohol problems were given to all participants, with CBT elements held constant across conditions. From session 2, CBT + CE participants resisted drinking while exposed to alcohol cues, with two priming doses of their preferred beverage being given in some sessions. After an initial CE session, CBT + ECE participants recalled negative experiences before undertaking CE, to provide exposure to emotional cues of personal relevance. MEASUREMENTS: Alcohol consumption, related problems, alcohol expectancies, self-efficacy and depression. RESULTS: Average improvements were highly significant across conditions, with acceptable maintenance of effects over 12 months. Both treatment retention and effects on alcohol consumption were progressively weaker in CBT + CE and CBT + ECE than in CBT alone. Changes in alcohol dependence and depression did not differ across conditions. CONCLUSIONS: These data do not indicate that addition of clinic-based CE to standard CBT improves outcomes. A different approach to the management of craving may be required.

The efficacy of an opportunistic cognitive behavioral intervention package (OCB) on substance use and comorbid suicide risk: a multisite randomized controlled trial.

OBJECTIVE: People with substance use disorders who present with suicidal behavior are at high risk of subsequent suicide. There are few effective treatments specifically tailored for this population that diminish this risk. We aimed to assess the impact of an opportunistic cognitive behavioral intervention package (OCB) among adult outpatients with a substance use and comorbid suicide risk. METHOD: A randomized controlled trial was conducted across 2 sites in which 185 patients presenting with suicide risk and concurrent substance use received either OCB (8 sessions plus group therapy) or treatment as usual (TAU) over a 6-month period. Primary outcomes were suicidal behavior (suicide attempts, suicidal intent and presence of suicide ideation) and level of drug and alcohol consumption. Secondary outcomes were changes in psychological measures of suicide ideation, depression, anxiety, and self-efficacy. RESULTS: There were no completed suicides, and only 2 participants reported suicide attempts at follow-up. Suicide ideation, alcohol consumption, and cannabis use fell over time but no significant Treatment × Time differences were found. There were also no differences between OCB and TAU over time on psychological measures of depression, anxiety, or self-efficacy. Suicide ideation at 6-month follow-up was predicted by cannabis use and higher scores on the Brief Psychiatric Rating Scale at baseline. CONCLUSIONS: The opportunistic cognitive behavioral intervention package did not appear to be beneficial in reducing suicide ideation, drug and alcohol consumption, or depression relative to treatment as usual.

Sexual health of Indian immigrant men in Australia: an exploratory research on help-seeking attitudes.

The help-seeking attitudes for sexual health of Indian men living in Australia was explored. Of all survey respondents (n=225), many preferred to seek help from medical doctors. Young (18-25 years) Indian men were three times more likely to prefer a specialist medical doctor than older men. Ethnicity and gender of the medical doctor was 'not important' for the majority of men. Most men preferred to seek help from their regular general practitioner.

Pilot study of Australian school-based sexual health education: parents' views.

BACKGROUND: Sexually transmissible infections (STIs) among young Australians increased dramatically between 1997 and 2007 with rates of chlamydia increasing by 528% and rates of gonorrhoea by 169% among 15-19 year olds. High notification rates of STIs and teenage pregnancy point to the need to investigate sexual health education (SHE) in Australian schools. This first quantitative study investigated the attitudes and experiences of parents to SHE in Australian schools. METHODS: One hundred and seventeen (117) Australian parents were recruited through purposive sampling and snowballing methods to complete an online questionnaire in 2007. RESULTS: Most respondents (97.4%) support SHE in schools and 95.7% advocate schools and parents sharing responsibility. A majority (82.9%) believe SHE should begin in primary school with discrepancy as to when specific topics should be introduced. There is consensus for a comprehensive curriculum, including topics potentially seen as controversial such as 'masturbation'. 'Abstinence' was chosen by 15.4% of parents to not be included in SHE curricula. Most parents rate the SHE their children have received in school as 'fair' in quality, and want access to resources to help them educate their children, including workshops at schools, information about school SHE, literature, and trained sexual health educators. CONCLUSIONS: Parents generally support SHE in schools. They want programs to begin in primary school. They consider the current school programs to be 'fair' in quality. Parents also point out the need for a more comprehensive curriculum and they want to be involved with schools in the development and delivery of SHE.

Development of a Controlled Drinking Self-Efficacy Scale and appraising its relation to alcohol dependence.

There is no specific self-efficacy measure that has been developed primarily for problem drinkers seeking a moderation drinking goal. In this article, we report the factor structure of a 20-item Controlled Drinking Self-Efficacy Scale (CDSES; Sitharthan et al., 1996; Sitharthan et al., 1997). The results indicate that the CDSES is highly reliable, and the factor analysis using the full sample identified four factors: negative affect, positive mood/social context, frequency of drinking, and consumption quantity. A similar factor structure was obtained for the subsample of men. In contrast, only three factors emerged in the analysis of data on female participants. Compared to women, men had low self-efficacy to control their drinking in situations relating to positive mood/social context, and subjects with high alcohol dependence had low self-efficacy for situations relating to negative affect, social situations, and drinking less frequently. The CDSES can be a useful measure in treatment programs providing a moderation drinking goal.