苯丙胺滥用者心理健康状况及其与患者个性的相关性分析

目的：研究苯丙胺滥用者的心理健康状况及其与个性的关系。方法：采用心理症状自评量表和卡特尔16种人格因素量表,对苯丙胺滥用者（119例）与正常人群（109例）的心理健康状况和个性特质进行对比研究,应用多元方差分析和回归分析进行统计处理。结果：相对正常人群,苯丙胺滥用者的敌对和躯体化程度较高（敌对：F[1424]=16.32,P〈0.01;躯体化：F[1424]=6.72,P〈0.05）,苯丙胺滥用者的个性特质对他们的心理健康状况具有显著的影响;苯丙胺滥用者的个性特质中的恃强性、兴奋性、敢为性、敏感性、怀疑性和幻想性显著高于对照组。结论：苯丙胺滥用者存在严重的心理健康问题,并且苯丙胺滥用者的个性特征对其心理健康状况具有显著的影响。     

Alcoholics Anonymous attendance following 12-step treatment participation as a link between alcohol-dependent fathers' treatment involvement and their children's externalizing problems

We investigated longitudinal associations between alcohol-dependent fathers' 12-step treatment involvement and their children's internalizing and externalizing problems (N = 125, M(age) = 9.8 +/- 3.1), testing the hypotheses that fathers' greater treatment involvement would benefit later child behavior and that this effect would be mediated by fathers' posttreatment behaviors. The initial association was established between fathers' treatment involvement and children's externalizing problems only, whereas Structural Equation Modeling (SEM) results supported mediating hypotheses. Fathers' greater treatment involvement predicted children's lower externalizing problems 12 months later, and fathers' posttreatment behaviors mediated this association: Greater treatment involvement predicted greater posttreatment Alcoholics Anonymous attendance, which in turn predicted greater abstinence. Finally, fathers' abstinence was associated with lower externalizing problems in children. Theoretical and practical implications of these findings are discussed.     

Health‐related lifestyle,physical and mental health in children of alcoholic parents

Aim. To identify potential differences between children of alcoholics (COAs) and controls in their health‐related lifestyle, mental and physical health. Methods. The recruitment of COAs took place in inpatient and outpatient treatment and rehabilitation units. Controls were recruited in elementary and high schools. 57 COAs (72% response rate) and 84 controls (88% response rate) aged between 12 and 18 years completed a postal questionnaire about their health‐related lifestyle, and mental and physical health. Results. Bivariate analysis showed that COAs' families have higher unemployment rates and lower economic status (P = 0.000). COAs reported poorer school performance (P = 0.000), spending more time in sedentary (television: P = 0.000, Internet: P = 0.014, music: P = 0.040) and less time in physical activities (P = 0.048), having poorer eating habits (fruits and vegetables: P = 0.001, sweets: P = 0.001, fast food: P = 0.000, soft drinks: P = 0.004), a higher substance use (cigarettes: P = 0.030; marijuana: P = 0.564, heavy drinking: P = 0.050) and more mental health difficulties (emotional symptoms: P = 0.015, conduct problems: P = 0.012, suicidal tendencies: P = 0.007, mental disorder: P = 0.040). Among COAs, girls reported more emotional and somatic symptoms compared to boys (P = 0.020 and P = 0.047, respectively). Multivariate analysis showed that after controlling for socioeconomic status, significant mental health and health‐related lifestyle inequalities between COAs and controls persist. Conclusion. Our findings suggest that COAs have a less healthy lifestyle and more mental health difficulties above and beyond the poorer economic environment they live in.[Serec M, ?vab I, Kol?ek M, ?vab V, Moesgen D, Klein M. Health‐related lifestyle, physical and mental health in children of alcoholic parents. Drug Alcohol Rev 2012;31:861–870]     

Substance use behaviors, mental health problems, and use of mental health services in a probability sample of college students

This research examined 1) the prevalence of substance use behaviors in college students, 2) gender and academic level as moderators of the associations between mental health problems and substance use, and 3) mental health service use among those with co-occurring frequent binge drinking and mental health problems. As part of the Healthy Minds Study, a probability sample of 2843 college students completed an Internet survey on mental health problems, substance use behaviors, and utilization of mental health care. Response propensity weights were used to adjust for differences between respondents and non-respondents. Major depression, panic disorder, and generalized anxiety disorder were positively associated with cigarette smoking. Frequent binge drinking was negatively associated with major depression and positively associated with generalized anxiety disorder, and these associations were significantly stronger for males than females. Among students with co-occurring frequent binge drinking and mental health problems, 67% perceived a need for mental health services but only 38% received services in the previous year. There may be substantial unmet needs for treatment of mental health problems and substance use among college students.     

Racial/ethnic disparities in the patterns of co-occurring mental health problems in adolescents in substance abuse treatment

This study examines disparities in co-occurring mental health and substance use problems by race/ethnicity to inform the development of culturally appropriate treatment approaches. Using pooled clinical data collected with the Global Assessment of Individual Needs, we identified racial/ethnic and other factors associated with co-occurring internalizing problems, externalizing problems, and the combination thereof in adolescents in federally funded treatment facilities. Results show that after controlling for demographic and socioenvironmental factors, African Americans, Hispanics, and mixed-race adolescents were more likely than Whites to have co-occurring internalizing problems. African Americans and Native Americans were less likely than Whites to have externalizing problems and to have combined internalizing and externalizing problems. Presence of co-occurring problems was also associated with victimization, homelessness, and family substance abuse. These results indicate that co-occurring mental health problems vary by race/ethnicity, and therefore, refined approaches are needed for culturally appropriate care of patients.     

Comparing barriers to mental health treatment and substance use disorder treatment among individuals with comorbid major depression and substance use disorders

Barriers to both mental health and substance use disorder treatments have rarely been examined among individuals with comorbid mental health and substance use disorders. In a sample of 393 adults with 12-month major depressive episodes and substance use disorders, we compared perceived barriers to these two types of treatments. Data were drawn from the 2005–2011 US National Surveys on Drug Use and Health. Overall, the same individuals experienced different barriers to mental health treatment versus substance use disorder treatment. Concerns about negative views of the community, effects on job, and inconvenience of services were more commonly reported as reasons for not receiving substance use disorder treatment. Not affording the cost of care was the most common barrier to both types of treatments, but more commonly reported as a barrier to mental health treatment. Improved financial access through the Affordable Care Act and parity legislation and integration of mental health and substance use disorder services may help to reduce treatment barriers among individuals with comorbid mental health and substance disorders.     

Flourishing,languishing and moderate mental health: Prevalence and change in mental health during recovery from drug and alcohol problems

The aim was to explore the utility of Keyes’ concept of mental health in a substance addiction context. Mental health is considered the presence of emotional wellbeing in conjunction with high levels of social and psychological functioning. Using Keyes' measure, the frequency of languishing and flourishing is compared between clients who became abstinent and those continuing to use substances following treatment. It was hypothesised that there would be a significant interaction between substance use and levels of mental health over time. Participants were 794 individuals (79.5% male) attending residential substance abuse treatment provided by The Australian Salvation Army. The current sample was drawn from a larger longitudinal study evaluating routine client outcomes. At entry to treatment there were higher rates of languishing compared to population estimates, yet greater rates of flourishing at all time points compared to community normative data. There was a significant interaction between continuous mental health and substance use status. Mental health was rated significantly higher by individuals who were abstinent than those who had used substances at 3-month post-discharge follow-up. The comorbidity of mental illness and substance misuse has previously been investigated, but this is the first study to investigate the prevalence of mental health. While participants who remained abstinent achieved the highest levels of flourishing, at follow-up there were lower rates of languishing than found in a general community sample. Additionally, results suggested that improved mental health was a consequence of reduced severity of alcohol and other drug abuse, and followed reductions in cravings.     

Harm reduction approaches to alcohol use: health promotion,prevention, and treatment

Harm reduction approaches to alcohol problems have endured a controversial history in both the research literature and the popular media. Although several studies have demonstrated that controlled drinking is possible and that moderation-based treatments may be preferred over abstinence-only approaches, the public and institutional views of alcohol treatment still support zero-tolerance. After describing the problems with zero-tolerance and the benefits of moderate drinking, the research literature describing prevention and intervention approaches consistent with a harm reduction philosophy are presented. Literature is reviewed on universal prevention programs for young adolescents, selective and indicated prevention for college students, moderation-based self-help approaches, prevention and interventions in primary care settings, pharmacological treatments, and psychosocial approaches with moderation goals. Overall, empirical studies have demonstrated that harm reduction approaches to alcohol problems are at least as effective as abstinence-oriented approaches at reducing alcohol consumption and alcohol-related consequences. Based on these findings, we discuss the importance of individualizing alcohol prevention and intervention to accommodate the preferences and needs of the targeted person or population. In recognizing the multifaceted nature of behavior change, harm reduction efforts seek to meet the individual where he or she is at and assist that person in the direction of positive behavior change, whether that change involves abstinence, moderate drinking, or the reduction of alcohol-related harm. The limitations of harm reduction and recommendations for future research are discussed.     

Early alcohol experiences and adolescent mental health: a population-based study in Taiwan

In this study, we examine whether adolescent emotional and behavior problems vary by history of early alcohol experiences. A national sample of 6974 alcohol-naïve and 4337 alcohol-experienced youths aged 15–18 years were identified within the 2004 National Survey of Illegal Drug Use among Adolescents in Taiwan. Four alcohol experience groups were created based on recency and frequency of alcohol use: (1) naïve; never drank alcohol, (2) trial use; first and only consumption of alcohol occurred more than 6 months preceding the assessment, (3) past use; alcohol used on more than one occasion but had not had a drink in the 6 months prior to the assessment, and (4) current use; consumed alcohol more than once and drank within the 6 months preceding the interview. A Chinese adaptation of the Youth Self-Report (YSR) assessed eight behavior syndromes: withdrawn, anxious/depressed, somatic complaints, social problems, thought problems, attention problems, rule-breaking behavior, and aggressive behavior. Multivariate response models (GLM/GEE) were used to examine the relationship of alcohol experiences with emotional and behavior problems. Alcohol-using youth were more likely to experience several specific emotional or behavioral syndromes than their alcohol-naïve counterparts. For example, youth with a history of alcohol use had an estimated 30–60% increase in the odds of experiencing items within the aggressive behavior syndrome as compared with alcohol-naïve youth. The type of early alcohol involvement in adolescence may exert differential effects on emotions and behaviors expressed across and within syndromes; these may warrant distinctions in informing etiological research and preventive efforts.     

Severity of anxiety in mental health versus addiction treatment settings when social anxiety and substance abuse are comorbid

There is increasing interest in the co-occurrence of social anxiety and addiction. Each investigation has a specific vantage point, e.g. the effect social anxiety has in a population with addiction or that of addiction in a population with social anxiety, which could create unique findings. Among comorbid individuals, is social anxiety more severe in people seeking treatment for anxiety, as compared to those seeking treatment for addiction? This report compares social anxiety severity between subjects in two studies—one involving socially anxious individuals (n = 38) seeking treatment for addictions; the other (n = 41) subjects with social anxiety and an alcohol use disorder, seeking treatment for social anxiety. Baseline severity scores on the Liebowitz Social Anxiety Scale for social anxiety were compared between the groups. No significant differences were found. For both groups, social anxiety was largely in the severe range. The results suggest that clinicians should attend to social anxiety symptom severity in patients with co-occurring social anxiety and addiction, regardless of the condition for which treatment is sought.     

Relations among parental substance use, violence exposure and mental health: the national survey of adolescents

OBJECTIVE: To study the relations among parental substance use, violence exposure and psychopathology in a nationally representative sample of adolescents. METHOD: Random digit dialing methodology was used to obtain a nationally representative sample of 4023 adolescents, ages 12-17. Telephone surveys, conducted in 1995, assessed demographics, parental substance use, violence exposure, and three psychiatric disorders: major depressive disorder (MDE), posttraumatic stress disorder (PTSD), and substance abuse/dependence (SA/D). RESULTS: Obtained prevalence rates included: 8.2% for sexual assault, 22.5% for physical assault, and 39.7% for witnessing violence at home or in the community. Substance use by a family member was reported by 18.4% (n=721) of adolescents, with 50.6% reporting parental alcohol use and 19.1% (n=138) reporting parental drug use. Consistent with hypotheses, violence exposure and parental substance use, particularly parental alcohol abuse, were independently associated with outcomes. Additionally, parental substance use emerged as a moderator for MDE, PTSD, and SA/D; however, the moderating relations varied according to the outcome variable investigated. CONCLUSIONS: Violence-exposed adolescents reporting parental alcohol or drug use had the highest rates of psychiatric diagnoses.     

基层官兵自杀认识和态度与心理健康状况的相关性分析

目的探讨基层官兵的自杀认识和自杀态度与其心理健康的关系。方法采取整群抽样方法对某部553名官兵,使用自制自杀认识问卷和自杀态度问卷(QSA)、症状自评量表(SCL-90)进行测评,对不同年龄、不同职业,不同心理健康状况对自杀认识和自杀态度进行相关性分析。结果基层官兵对自杀认识总均分为4.84±2.14,整体认知水平偏低,且年龄、职业与心理健康状况与自杀认识的差异无显著性(P>0.05)。但官兵的心理健康状况与自杀态度存在弱相关性。对心理健康状态较好者,自杀持反对、否定、排斥和歧视态度者较多,心理健康状况较差者对自杀性质、自杀者持矛盾或中立态度者较多,对自杀者家属持理解、宽容态度者较多。结论基层官兵对自杀前行为征兆等知识了解较少,心理健康状况影响对自杀者的态度。加强自杀知识教育,提高心理健康水平,可作为预防部队官兵自杀的有效策略之一。     

Heterogeneity among Latinas and Latinos entering substance abuse treatment: findings from a national database

The current study examined differences in 30-day and lifetime substance use for a sample of Mexican American, Puerto Rican, and Cuban American men and women from the Drug Evaluation Network System, a national database on individuals seeking substance abuse treatment. There were significant gender and ethnic differences in recent and lifetime substance use after controlling for age, years of education, employment, medical, and psychological problems. Lifetime and 30-day substance use rates found in this study do not coincide with prevalence rates found in community samples of Latinas/os, indicating that the patterns of substance use may be different among individuals who seek substance abuse treatment than among those in the general population. The results of this study highlight the heterogeneity of Latinas/os who abuse substances.     

Substance use among late adolescent urban youths: Mental health and gender influences

This paper explores gender and mental health influences on alcohol, tobacco, and illicit drug use among late adolescent urban youths. Specifically, we examine whether rates of substance use differ by gender, whether mental health indices differ by gender and are predictive of substance use, and whether gender moderates the relationship between mental health and substance use. Data from our non-clinical sample of 400 youths were collected primarily online. Analysis of cross-sectional data revealed no differences in substance use by gender. Indices of mental health differed by gender, with girls reporting greater symptoms of depression and anxiety. Ratings of hostility were similar for boys and girls. Alcohol, tobacco, and drug use were associated with greater symptoms of depression, anxiety, and hostility; this relationship, however, was not moderated by gender. Study findings provide evidence that among late adolescent youths living in urban areas, poorer mental health status is associated with increased substance use. Evidence of a moderating effect of gender on the relationship between mental health and substance use was not significant.     

Single room occupancy (SRO) hotels as mental health risk environments among impoverished women: The intersection of policy,drug use,trauma, and urban space

BackgroundDue to the significantly high levels of comorbid substance use and mental health diagnosis among urban poor populations, examining the intersection of drug policy and place requires a consideration of the role of housing in drug user mental health. In San Francisco, geographic boundedness and progressive health and housing polices have coalesced to make single room occupancy hotels (SROs) a key urban built environment used to house poor populations with co-occurring drug use and mental health issues. Unstably housed women who use illicit drugs have high rates of lifetime and current trauma, which manifests in disproportionately high rates of post-traumatic stress disorder (PTSD), anxiety, and depression when compared to stably housed women.MethodsWe report data from a qualitative interview study (n = 30) and four years of ethnography conducted with housing policy makers and unstably housed women who use drugs and live in SROs.ResultsWomen in the study lived in a range of SRO built environments, from publicly funded, newly built SROs to privately owned, dilapidated buildings, which presented a rich opportunity for ethnographic comparison. Applying Rhodes et al.’s framework of socio-structural vulnerability, we explore how SROs can operate as “mental health risk environments” in which macro-structural factors (housing policies shaping the built environment) interact with meso-level factors (social relations within SROs) and micro-level, behavioral coping strategies to impact women's mental health. The degree to which SRO built environments were “trauma-sensitive” at the macro level significantly influenced women's mental health at meso- and micro-levels. Women who were living in SROs which exacerbated fear and anxiety attempted, with limited success, to deploy strategies on the meso- and micro-level to manage their mental health symptoms.ConclusionStudy findings underscore the importance of housing polices which consider substance use in the context of current and cumulative trauma experiences in order to improve quality of life and mental health for unstably housed women.     

喹硫平与再普乐治疗酒精所致精神障碍的对照研究

目的：比较喹硫平与再普乐对酒精所致精神障碍患者的疗效和不良反应。方法：将68例酒精所致精神障碍患者随机分为喹硫平组（36例）和再普乐组（32例）,疗程6周;于治疗前及治疗后1、2、4、6周分别采用阳性症状和阴性症状量表（PANSS）、治疗时出现的症状量表（TESS）、锥体外系副反应量表（RSESE）评定疗效与不良反应。结果：喹硫平与再普乐对酒精所致精神障碍患者的治疗均有明显疗效,统计学上无显著性差异（P〉0．05）,锥体外系不良反应及其他副反应极少,两组统计学上无显著性差异（P〉0．05）。结论：喹硫平与再普乐治疗酒精所致精神障碍患者安全有效。     

Drug-abusing offenders with comorbid mental disorders: problem severity, treatment participation, and recidivism

This study examined problem severity, treatment participation, and recidivism among 1,016 offenders with co-occurring mental disorders who participated in California's Proposition 36. Participants were assessed using the Addiction Severity Index (ASI) at baseline, and their records on mental health diagnoses, drug treatment participation, and arrests were also obtained. Participants' co-occurring disorder (COD) severity was classified as mild or severe based on specific mental health diagnoses. Predictors of recidivism were examined among mild-COD and severe-COD participants separately using ordinal logistic regression. Results indicate that although previous arrests, education, and treatment retention length are predictors of recidivism generally, gender, age, primary drug, ASI drug severity score, and treatment modality are differentially important depending on COD status. These results underscore the need for COD-focused intervention strategies among offenders, taking into consideration the severity of their COD status.