Attention and recognition memory bias for alcohol-related stimuli among alcohol-dependent patients attending residential treatment

Though studies have examined attentional bias for alcohol-related information among alcohol-dependent individuals, few have examined memory bias. This study examined attention and recognition memory biases for alcohol-related information among patients recently admitted to residential alcohol treatment (n = 100; 40% female). Participants completed a computerized attentional task wherein they classified a centrally-presented digit as odd or even. On some trials, an alcohol word, neutral word, or anagram was presented along with the digit. On these dual trials participants first classified the digit and then classified the other stimulus as a word or nonword. Participants took longer to classify digits that appeared with alcohol words compared to neutral words; suggesting the alcohol words distracted them from processing the digit. In a subsequent recognition memory test, participants showed significantly higher hit rates (i.e., correctly classifying an old item as old) and false alarm rates (i.e., incorrectly classifying a new item as old) to the alcohol words compared to the neutral words, and they also showed a more liberal response bias to alcohol words. The findings suggest that alcohol-dependent individuals exhibit both attention and memory bias for alcohol-related information.     

江西省成年居民饮酒行为抽样调查

目的了解我省成年居民饮酒行为特征及饮酒模式。方法采用多阶段整群抽样方法．于2010年8—10月从我省5个慢病危险因素监测县（区）的60个行政村／居委会抽取18岁及以上常住居民3000名进行饮酒相关问卷调查。结果我省男女成年居民及总的饮酒率分别为65．76％、33．16％和48．73％;男性饮酒者通常每日饮酒量纯酒精摄人为8．99g,女性为1．0g;男性饮酒者过量饮酒、频繁饮酒及单次大量饮酒率分别为25．13％、32．59％和56．87％,女性为9．07％、13．71％、16．99％;男性危险饮酒行为高于女性：Logiistie回归分析表明男女饮酒者过量饮酒及单次大量饮酒均与年饮酒频率密切相关。结论我省成年居民普遍饮酒,危险饮酒行为较高．应针对其分布特点和当地风俗制定及实施综合的多策略干预措施。     

自身免疫性肝病的肝移植治疗

肝移植（OLT）作为救治终末期肝病的唯一有效手段．对于自身免疫功能紊乱导致的终末期肝病也有良好的治疗效果。[第一段]     

Drinking settings,alcohol consumption,and sexual risk behavior among gay men

We sought to 1) describe the settings or groups of settings where men who have sex with men (MSM) consume alcohol in 16 U.S. metropolitan statistical areas (MSA); and 2) investigate whether certain drinking settings or groups of settings are associated with higher levels of alcohol consumption, problem drinking, and sexual risk behavior. Latent class analysis was used to develop our measure of drinking settings. The final latent class model consisted of four distinct classes which captured the typical settings where MSM consumed alcohol: “home” “social,” “bar/social,” and “general” drinkers (i.e., drinks in all settings). Regression models showed that “general” drinkers were more likely than “social” drinkers to engage in frequent heavy drinking. Compared to ‘social’ drinkers, general drinkers were also more likely to engage in unprotected anal intercourse (UAIMP) and UAIMP with men met in bars and other venues (e.g., private parties, bath houses) while intoxicated. Assessment of drinking settings may be a means of identifying MSM who are at greater risk for frequent, heavy drinking and related sexual risk behavior.     

Association of baseline characteristics and motivation to change among patients seeking treatment for substance dependence

BACKGROUND: The current study evaluated the bottoming out hypothesis by determining the extent to which composite measures of motivation to change are associated with baseline characteristics among patients seeking treatment for substance dependence. METHODS: Two hundred treatment-seeking substance-dependent veterans were assessed. Motivation to change was assessed using the composite measures of Readiness to Change (RTC) and Committed Action (CA) derived from the University of Rhode Island Change Assessment. Baseline characteristics included recent life stressors, addiction severity, depression, anxiety and hostility. Linear regression was used to determine the association between baseline characteristics and the composite measures of motivation to change while controlling for age, gender and race. RESULTS: Linear regression indicated that RTC and CA were associated with different baseline characteristics. RTC was associated with anger expression (B=-.28; 95% CI=-.6, -.01) and recent life events (B=1.1; 95% CI=.01, 2.2). CA was associated with alcohol problems (B=-.33; 95% CI=-.62, -.05) and state anxiety (B=-.13; 95% CI=-.21, -.04). CONCLUSIONS: Our findings suggest that motivation to change was negatively, not positively, associated with greater emotional distress and problem severity. With the exception of recent life events, these findings are contrary to the notion of hitting bottom. Composite measures of RTC and CA also appear to represent different types of motivation to change.     

Crises and motivation for treatment in alcoholics

A minority of alcohol dependent persons ever enters specialized treatment units and there is little information on why they are admitted. This study of 50 consecutive clients revealed that admission occurred in the presence of a recent psychosocial crisis in an otherwise protracted disorder. Motivation for treatment was difficult to assess. The decision to admit for inpatient rather than outpatient treatment tended to be influenced by the distressed state of the client or the degree of disturbance created in relation to the crisis. The complex issues of crisis, motivation and treatment compliance are reviewed.     

Drinking behavior and "alcoholism".

Drinking is viewed as a functional behavior, an active response to environmental conditions, and excessive drinking as a compromise behavior resulting from ineffectiveness in mediating goals and resolving problems.     

A pilot study of motivation and treatment completion among American Indian adolescents in substance abuse treatment

This study assessed intrinsic and extrinsic motivation toward treatment among American Indian adolescents 13-18 years old admitted to a residential substance abuse treatment program and the relationship of these measures to treatment completion. Participants completed a questionnaire regarding motivation towards treatment and a diagnostic interview. Participant treatment records were also reviewed. Being an older adolescent (16-18 years old), having higher scores on a scale measuring treatment readiness and endorsing a single question regarding concern about legal problems were all associated with treatment completion. The relationship of an additional scale measuring desire for help with substance use problems was mediated by the measure of treatment readiness. This pilot study is the first to assess the relationship of motivation toward substance abuse treatment completion among American Indian adolescents and provides preliminary evidence of the applicability of these concepts to this treatment population. These concepts and their related therapeutic approaches warrant further study in this population.     

In-patient treatment for the alcohol-dependent person: a public health perspective

In accordance with public health principles, this paper is concerned with examining the individual, economic and political outcomes of in-patient treatment for alcohol dependence. It is argued that in-patient treatment for alcohol dependence per se is not justifiable at any of these levels, although in-patient treatment is justifiable for the treatment of the serious biomedical sequelae of dependence. For the alcohol-dependent person, the drinking, social, financial, psychological, work-related and health outcomes of out-patient treatment are as good as those for in-patient treatment; economically, out-patient programmes are more cost-effective than in-patient programmes; politically, moving the focus of treatment away from in-patient services is more likely to contribute to a cultural milieu which recognizes problems associated with alcohol dependence early and in their many different forms, rather than only by their long-term health consequences.     

Enabling behavior in a clinical sample of alcohol-dependent clients and their partners

Substance use disorders affect not only the identified client but significant others as well. Clinical work and some research suggest that partner responses to drinking may either facilitate or hinder treatment acceptance and recovery efforts. Female partners of male alcoholics have received much of this attention, and have been labeled as codependents or enablers. We administered a clinically derived assessment tool, the Behavioral Enabling Scale, to 42 alcoholic clients and their partners enrolled in a couples counseling program to determine the extent of specific partner behaviors that might reasonably be thought to reinforce drinking or hinder recovery. Results indicated that, among other findings, the majority of both clients and partners reported the partner took over chores or duties from the alcoholic client at some point during the relationship, drank or used other drugs with the client, and lied or made excuses to others to cover for the drinker. Moreover, particular relationship beliefs were associated with higher behavioral enabling scores, providing clear direction for cognitive and behavioral interventions. It is argued that efforts to understand and treat alcohol dependence will be more productive if partner behaviors are incorporated into assessment and intervention procedures.     

Time-varying associations between confidence and motivation to abstain from marijuana during treatment among adolescents

IntroductionAn important goal of addictions treatment is to develop a positive association between high levels of confidence and motivation to abstain from substance use. This study modeled the time-varying association between confidence and motivation to abstain from marijuana use among youth in treatment, and the time-varying effect of pre-treatment covariates (marijuana abstinence goal and perceived peer marijuana use) on motivation to abstain.Method150 adolescents (75% male, 83% White) in community-based intensive outpatient treatment in Pennsylvania completed a pre-treatment assessment of abstinence goal, perceived peer marijuana use, and motivation and confidence to abstain from marijuana. Ratings of motivation and confidence to abstain also were collected after each session. A time-varying effect model (TVEM) was used to characterize changes in the association between confidence and motivation to abstain (lagged), and included covariates representing pre-treatment abstinence goal and perceived peer marijuana use.ResultsConfidence and motivation to abstain from marijuana generally increased during treatment. The association between confidence and motivation strengthened across sessions 1–4, and was maintained through later sessions. Pre-treatment abstinence goal had an early time-limited effect (through session 6) on motivation to abstain. Pre-treatment perception of peer marijuana use had a significant effect on motivation to abstain only at session 2.ConclusionsEarly treatment sessions represent a critical period during which the association between confidence and motivation to abstain generally increased. The time-limited effects of pre-treatment characteristics suggest the importance of early sessions in addressing abstinence goal and peer substance use that may impact motivation to abstain from marijuana.     

Drinking for wages: alcohol use among cantineras

OBJECTIVE: This study reports on patterns of alcohol use among cantineras: recently immigrated Latina women who make a living drinking in working class Latino bars (cantinas). METHOD: Women working in 10 cantinas in a Latino neighborhood participated in a semistructured interview that included questions about their personal background and current working conditions. Twenty-one participants were interviewed at their home or place of work. RESULTS: Drinking is a duty required of women who work in cantinas, and the conditions in which alcohol is consumed varies by the type of job they perform. Cantineras establish drinking habits and routines to maximize profits and maintain their jobs, while adopting coping strategies to minimize adverse health consequences. CONCLUSIONS: The drinking behavior of cantineras presents a paradox. To make a living, they need to become efficient drinkers who profit from their behavior. At the same time, they need to recognize and set limits to their drinking. The norms of cantineras distinguish drinking as duty from drinking for recreation, and they recognize problem drinking. The heavy health burden imposed by obligatory drinking at work is the result of limited job opportunities and the marginality experienced by Latina immigrants who must find ways to cope with the pressures they endure as poor women.     

代谢相关脂肪性肝病的临床候选药物研究进展

代谢相关脂肪性肝病是全球范围内肝病的主要原因,影响了全球近1/4的人口,尚无药物获批用于治疗该病.从临床前到临床,多个制药企业分别开展了针对抗代谢、抗凋亡和抗炎、抗纤维化等靶点的研究,取得了不同的结果.总结上述不同靶点化合物在临床II～III期的研究进展,阐明代谢相关脂肪性肝病治疗药物研发中的难点,提出可能的研究思路.     

Predictors of Drinking and Signs of Heavy Drinking among High School Students

This paper reports an investigation of factors associated with drinking and heavy drinking among high school students. The relative importance of social characteristics, parental drinking, and parental rejection and control are assessed. Data were obtained from 1,439 students in two high schools. It is found that most students drink, but most drink infrequently (less than once a week and one or two drinks at a time). Multivariate analysis using the MCA program indicates that students who frequently get drunk are those who are heavy drinkers, drink away from home and in cars, and whose drinking is not known to their parents. Parents' drinking and parental rejection and control have little unique explanatory power. It is suggested that parental modeling may be of most importance at the outset of drinking, whereas place and extent of drinking is most important in predicting the signs of heavy drinking.     

Correlates of motivation to quit smoking among alcohol dependent patients in residential treatment

Substance use and smoking co-occur at high rates and substance abusers smoke more and have greater difficulty quitting smoking compared to the general population. Methods of increasing smoking cessation among alcoholics are needed to improve their health. This study investigated predictors of motivation to quit smoking among patients early in residential treatment for substance abuse. The 198 alcohol dependent patients were participating is a larger smoking study at an inner-city residential substance abuse treatment program. Motivation was measured by the Contemplation Ladder. A hierarchical multiple regression was conducted to assess whether perceived barriers to smoking cessation and self-efficacy about quitting were associated with motivation to quit smoking independent of the influence of degree of tobacco involvement, substance use, and comorbid depressive symptoms. Motivation was higher with longer previous smoking abstinence, fewer barriers to quitting, and greater self-efficacy but was not influenced by smoking rate, dependence, or gender. While the combination of alcohol and drug use, alcohol and drug problem severity, and depressive symptoms predicted motivation, no one of these variables was significant. Since barriers to change and self-efficacy are potentially modifiable in treatment, these could be salient targets for intervention efforts. This could be integrated into treatment by assessing barriers and providing corrective information about consequences and methods of overcoming barriers and by providing coping skills to increase confidence in one's ability to quit smoking.