美研究发现母亲吸烟易使孩子也吸烟

美国亚利桑那大学的一项研究发现,如果母亲在怀孕时或在孩子幼小时吸烟,孩子在22岁时吸烟的几率大大增加,并且一旦养成吸烟习惯,今后比他人更难戒烟。研究人员解释说,从生理学上说,母亲在怀孕时吸烟会使子宫和大脑化学成分发生变化,因而,孩子尚在母体中时就已经受到烟草的“熏陶”,加上他们在成长过程中受到母亲行为的影响,所以很容易效仿。研究人员要求女性在怀孕前必须戒烟,以免殃及孩子。     

抑郁症母亲的养育方式及其子女行为问题的研究

目的 探讨抑郁症母亲的养育方式,及其与子女行为问题的关系.方法 应用父母养育方式评价量表(EMBU)及Achenbach儿童行为量表(CBCL),对符合入组标准的61例抑郁症母亲及其子女进行评估,并与60例正常母亲及其子女进行对照.结果 无论男孩女孩,研究组母亲养育方式中情感温暖理解(M1)因子分均低于对照组,差异...     

怀孕早期使用ACEI与新生儿先天缺陷相关

美国一项新的流行病学研究发现，在怀孕的头三个月里使用血管紧张素转换酶抑制剂（ACEI）（Ⅰ）会增加新生儿患严重先天畸形的风险。 在怀孕的头三个月里接受（Ⅰ）出生的婴儿比未接受（Ⅰ）出生的婴儿患严重先天畸形的风险提高了2．7倍。鉴于此前已有在怀孕第4～6月和7～9月使用（Ⅰ）会伤害胎儿甚至导致胎儿死亡的结论，这项研究意义重大。此药的美国标签中的黑框警告中指出了这一风险，并建议一经确认怀孕立即停止用药。     

儿童早期喂养行为的研究分析

目的通过调查分析108例儿童家长,了解其对孩子的喂养行为,并探讨其喂养行为对儿童健康成长的影响。方法通过回顾性分析调查统计108例儿童的家庭情况(家长接受教育程度)、儿童食品制备情况、接受喂养人行为、喂养人行为、喂养环境等。结果随着家长教育程度的提高,喂食优良率有显著提高。能做到一天给孩子做2～4顿饭的家长能占到88.98%,但是单独做饭的比例较少,只有38.89%。能做到专心进食的儿童较少,占35.19%;自己主动学习进食的儿童比例也很低,占25.93%。88.89%的喂养人可以做到鼓励进食,但辅食的添加率却有些偏低。未做清洁工作的人数也较多,占28.70%。我们看到喂养环境相对安静的比例较少,只有32.41%。结论经过本次调查我们发现,儿童早期喂养情况不甚理想。家长需要接受相关指导或教育,以提高喂养效果,促进儿童健康成长。     

吸烟患者在支气管镜检查中相关问题的分析性研究

目的：探讨不同吸烟量患者在支气管镜检查中的相关问题。方法分析在本院接受电子纤维镜检查的550例患者吸烟量对整个检查的影响。结果550例患者在检查中麻醉的效果、麻醉药物的用量、舒适感、分泌物的量、血氧饱和度、氧流量和维持的时间差异有统计学意义（P＜0.05）。结论吸烟患者在检查时比不吸烟患者麻药效果差、麻药用量多、舒适感差、分泌物多、氧饱和度低、吸氧时间长、用氧流量高。     

对我国青少年吸烟现状的认识与思考

烟草危害是当今世界最严重的公共卫生问题之一,目前全球共有11亿吸烟者,每年导致近500万人死亡。中国是世界上最大的烟草生产国和消费国,在过去的10年中,我国烟民的人数以7％的速度增长,其吸烟年龄正从中老年向青少年方向发展。青少年吸烟已成为一种普遍的社会问题。     

儿童行为问题影响因素的典型相关分析

目的:探讨不同因素对儿童行为的影响及相关性分析.方法:采用Achenbach儿童行为量表及自制调查问卷对儿童的行为及相关因素进行了调查,应用典型相关分析方法对儿童行为问题的影响因素进行了分析.结果:儿童行为问题检出率为8.2%,儿童身高、母亲年龄、父母关系等因素对儿童行为问题有影响(P<0.05).结论:典型相关分析结果更为科学,可为降低儿童行为问题的发生率提供更加科学的依据.     

儿童行为问题与父母酗酒关系的探讨

关于酒危害的报道已不罕见，而行为问题儿童与其父母酗酒关系的探讨则相对较少，本文在就此专题，在呼和浩特市区取样１９所中，小学生校蒙族学生２６２６名，采用Ｒｕｔｔｅｒ氏行为量表筛查出行为问题儿童７８名，对其挨门逐户详细采集病史，用自拟父母饮酒情况调查表，其与呼市一所普通中学正常儿童１００名作对照研究，发现二者在父，母亲孕期酗酒方面均有非常显著性差异（Ｐ〈０．００５）；而行为组父，母对照，则显示父亲酗洒     

学龄前儿童行为问题调查与分析

目的:了解学龄前儿童行为问题与家庭环境的关系,为减少儿童行为问题,针对性地开展学龄前儿童心理卫生工作提供依据.方法:采用Achbenach儿童行为量表(CBCL)和自编家庭环境调查表,调查新会城区1 872名2～6岁学龄前儿童心理行为问题发生情况及其影响因素.结果:新会城区学龄前儿童行为问题检出率为15.06%,男、女性别检出率差异无统计学意义(P＞0.05),4岁以下儿童行为问题发生率高于4岁以上儿童(P＜0.05),学龄前儿童有围产高危因素史、出生后由祖辈带养、不良的教育方式及父母关系、父母低文化程度、较低家庭收入及学习型家庭,其行为问题的发生率显著高于对照组(P＜0.01).结论:家庭环境及教养方式、态度是儿童行为问题的主要形成因素,应从家庭教育入手,开展儿童心理卫生工作,降低儿童心理行为问题发生率.     

儿童行为问题及相关因素比较分析

目的：了解儿童发生行为问题的情况,比较发生儿童行为问题的相关因素。方法：通过分层整群抽样途径,对家长通过Achenbach儿童行为量表作调查问卷,以Logistic逐步回归研究调查结果。结果：儿童行为问题的检出率达到61.2%,年龄、性别无差异。回归分析表明,发生儿童行为问题的因素主要是父母了解子女的程度、父母婚姻、城乡及父母管教子女的方法等。结论：儿童行为问题中家庭环境因素很重要,家庭环境改善可以减少儿童行为问题的发生率。     

Motivation and the stages of change among individuals with severe mental illness and substance abuse disorders

A complicating factor affecting the treatment of individuals with coexisting substance use problems and serious mental illness is their motivation for change and how these interacting, chronic conditions affect the entire process of intentional behavior change. This selective review explores conceptual and assessment issues related to readiness to modify substance use and readiness to initiate behaviors helpful for managing mental illness in the search for a better understanding of patient motivation for change. The recent but limited research on motivation and stages of change among dually diagnosed patients indicates that these individuals appear to access and use an intentional behavior change process. However, it is not completely clear how this process works and what precise adaptations are needed to assess and to access motivation to change to encourage sustained behavior change in this population. Nevertheless, motivation and readiness to change are important dimensions that need to be addressed in treatment and research with dually diagnosed populations.     

Application of the Transtheoretical Model of change: psychometric properties of leading measures in patients with co-occurring drug abuse and severe mental illness

People with severe mental illness (SMI) have high rates of substance use disorders. The Transtheoretical Model (TTM) is a framework for understanding behavior change. There are five leading measures associated with the TTM - University of Rhode Island Change Assessment, Processes of Change Scale, Decisional Balance Scale, Abstinence Self-Efficacy Scale, and Temptation to Use Drugs Scale. While these measures have been found to be reliable and valid in primary substance abusers, it is unknown if these measures are relevant in people with co-occurring SMI and substance use disorders (SUD). We evaluated the psychometric properties of these measures in a sample (n=240) of people with co-occurring disorders. Participants met DSM-IV criteria for schizophrenia/schizoaffective disorder or non-psychotic affective disorder, and current cocaine dependence or cocaine dependence in remission. All subscales showed good reliability and validity in the total sample. Analyses within diagnostic groups showed good reliability and validity in most groups, with some falling off in the affective disorders and remitted cocaine dependence groups. Overall, findings support the use of these measures in people with co-occurring disorders.     

Prevention of drug abuse by promoting mental health among school students

An approach to the prevention of drug abuse among adolescents by promoting mental health was implemented in a study carried out in 1983 in the schools of La Reina, a district of the metropolitan region of Santiago, Chile. A series of workshops, organized for the training of students and teachers, focused on the acquisition of communication abilities, the resolution of day-to-day conflicts and the improvement of self-esteem. The workshop training was intended to enable the trainees to replicate the knowledge and experience gained with their fellow classmates and teachers. The evaluation, carried out by means of a questionnaire administered at the beginning and at the end of the training programme, showed positive results among students and teachers, but better results were obtained among the teachers.     

Abstinence self-efficacy in people with severe mental illness

To validate the Brief Situational Confidence Questionniare (BSCQ) with people diagnosed with severe mental illness (N = 129), we examined the associations between abstinence self-efficacy (BSCQ) and alcohol consumption level (within the previous 6 months), drug use, and problems related to substance use while controlling for key symptoms of major mental illness and motives for alcohol use (Drinking Motives Questionnaire). Regression models revealed that abstinence self-efficacy was a significant predictor of all three substance use measures suggesting that, even when controlling for psychiatric symptoms and substance use motives, abstinence self-efficacy accounts for unique variance in alcohol use, drug use, and related problems. This study is limited by the cross sectional design and lack of structured diagnostic interviewing.     

Treating substance abuse in the context of severe and persistent mental illness: clinicians' perspectives

Patients with comorbid substance use and major mental disorders are treated frequently in the mental health system. Treatment models relevant for this subset of patients have emerged in recent years, however, few have been validated empirically and so relatively few sites benefit from this treatment development activity. Important additional sources of information about good treatment practices are the clinicians who have adopted the treatment of patients with dual disorders as a specialty. We conducted four focus groups (N = 12) with clinicians who were nominated by their peers as experienced and/or expert in treating persons with comorbid substance use and psychiatric disorders. Discussions followed a four-part outline that included (a) general questions about training and experience with the population, (b) preferred treatment methods, (c) motivational issues, and (d) recommendations to the field. Participants were trained in a variety of mental health disciplines and pursued substance abuse treatment credentials or other educational experiences outside of their primary training programs. Their treatment approaches emphasized psychoeducation, a good therapeutic relationship, and the need to be flexible regarding methods and goals. Abstinence was the preferred goal among most clinicians; even so, they expressed a pragmatic flexibility and other views consistent with the principles of harm reduction. Clinicians tended to respond to patients' ambivalent motivational states by addressing the consequences of behaviors in a nonconfrontive style; they also made use of positive incentives and external support. A number of recommendations were made to improve treatment, including greater institutional and programmatic support for the unique needs of this population.     

Sexual risk behavior among persons dually diagnosed with severe mental illness and substance use disorder

Persons dually diagnosed with severe mental illness (SMI) and substance use disorder (SUD) have disproportionately high rates of HIV and other sexually transmitted infections (STIs). This study examined the relationship between multiple sexual risk behaviors among persons with active, remitted, and no SUD. Participants were 152 adults with SMI recruited from multiple treatment sites. A structured interview assessed the participants' psychiatric, psychosocial, and behavioral factors. Rates of sexual risk behavior in the past 3 months were high and differed across the SUD groups. Multivariate logistic regression models found that lifetime SUD predicted sexual activity and partner-related risk whereas active substance abuse predicted condom-related risk. The results also support indirect effects of interpersonal and psychiatric factors (e.g., romantic partnership and psychotic disorder). Findings underscore the need for integrated HIV/STI prevention interventions targeting dually diagnosed patients.     

The long-term relationships between the motivation for change and alcohol use severity among patients with severe and persistent mental illness

This study examined the long-term relationship of changes in the motivation to remedy alcohol abuse to alcohol use severity among patients with a dual diagnosis of substance abuse disorder and severe and persistent mental illness. Linear regression analyses showed that patients who increasingly recognized alcohol use problems over a 9-month period exhibited significantly greater alcohol use severity at 9 months and a significant increase in alcohol use severity over time. Moreover, patients who became increasingly determined to take actions against alcohol use over a 9-month period exhibited significantly lower alcohol use severity at 9 months and a significant decrease in alcohol use severity over time. The findings support Prochaska et al.'s transtheoretical model of the motivation for change. They suggest that the recognition of alcohol use problems comes along with learning adverse consequences of alcohol use and that increased determination to take actions is critical to the long-term behavioral changes in alcohol use.     

Correlates of persisting drug use among former youth multiple drug abuse patients

This analysis is based on a follow-up study of 48 White male young adults who had been former youth multiple drug abuse patients in day-care treatment. For the most part, these respondents came from middle-class homes. As youthful offenders, many had been sent into treatment as an alternative to incarceration. Approximately six years after terminating their day-care treatments, interview data were collected when most were in their middle twenties. Consistent with previous research, those consuming more drugs were found to be more likely to have resisted treatment, to have trouble with the law, to have poorer work histories and diminished educational attainments, and they showed evidence of poorer psychological health. Surprisingly, the data also indicated that high-volume drug users were more likely to be living in their parental homes, compared to those whose drug use patterns were more moderate. It is suggested that the pattern of taking up residence with one's parents while drug dependent may be encouraged by parental enabling. The implications of these findings for guiding efforts in substance abuse treatment are discussed.     

Correlates of drug use and abuse among Indochinese refugees: mental health implications

The results of this study suggest that problems with alcohol and other drugs, including tobacco, will become an increasingly important issue for the Indochinese refugee community. Although the problem is relatively small in comparison to the magnitude of the problem among other disadvantaged populations, the refugees still view this issue as troublesome for their community, especially for the younger generation. A significant number of refugees use alcohol and other drugs, including tobacco, as coping mechanisms to deal with their problems, and find their own behavior troublesome. This warrants further study in order to find the conditions under which substance abuse can be decreased and prevented. The present study suggests that adjustment and mental health problems, with the lack of social and institutional support, may be one of the major reasons refugees turn to psychoactive substances to alleviate their stresses and to forget their problems. Substance abuse among refugees creates enormous health risks for a population that is already at greater risk than the general American population. Preventive measures should be implemented at this critical moment in time so that this small problem will not grow into a larger one.