Culturally Appropriate Substance Abuse Treatment for Parenting African American Women

Culturally appropriate strategies have been deemed necessary for the treatment of substance abuse among African American women. This qualitative study was conducted utilizing a grounded theory methodology within a womanist theoretical framework to explore the process by which parenting African American women participate in formal substance abuse treatment programs. Study findings yielded significant insights into this process and support the notion that culturally appropriate frameworks are necessary to help substance-abusing African American women enter into treatment programs and remain in recovery. In addition, specific interventions for treating substance-abusing African American women within a culturally relevant framework are discussed.     

Self-Injurious Behavior and Suicide Attempts Among Indonesian College Students

This study reports the prevalence of self-injurious behavior and suicide attempts among college students in Indonesia and examines risk factors distinguishing between 3 groups: self-injury with suicide attempt, non-suicidal self-injury, and non-self-injury. Self-report questionnaires measuring self-injury and suicide attempts, negative mood regulation expectancies (NMRE), depression, and childhood trauma were administered to 314 students. Of participants, 38% had deliberately injured themselves; among those, 21% also reported a suicide attempt. The 3 groups differed significantly on NMRE, depression, and child neglect. More self-injury and suicide attempts were associated with weaker NMRE and greater depression and child neglect.     

Prior Physical and Sexual Abuse in Women with Chronic Headache: Clinical Correlates

SYNOPSIS
Physical and/or sexual abuse in women with chronic headache has never been addressed. This pilot study addressed differences in women with chronic headache who reported such a history, compared to a control group of women with chronic headache without a traumatic history. Thirty women were divided into two groups, based on self-report of abuse, and all women given an MMPI as part of their assessment. Sixty-six percent of women reported significant traumatic histories, with a mean of 8 years of abuse; headache pain developed after trauma in 100% of these cases. Abused women had shorter chronicity of headache but reported greater psycho-social distress and significantly more headaches. Results lend support to a model of life stress etiologically involved in the development of headache. Variables related to personality prior to headache development may be more important than the chronicity determinant. Assessment and identification of abuse early in the cycle may prevent long-term adjustment problems.     

Substance Abuse in Women : Etiology and Prevention

Substance abuse, or the use of alcohol or drugs to the extent that normal functioning is impaired, is often viewed as a unique behavior, not subject to the same laws that govern other behaviors. This assumption has led to a plethora of conflicting theories about its etiology that do not take into account extant knowledge about behavior development. (See Lettieri et al., 1980.) This chapter is based upon the assumption that substance abuse has multiple determinants, both within and across individuals, as do other complex behaviors, such as working long hours, driving very fast, eating a lot of sugar, or talking very much. This viewpoint enables us to integrate findings from diverse studies into a coherent picture of substance abuse, including the variables and processes that increase its probability of occurrence.     

Self-Reported History of Sexual Coercion and Rape Negatively Impacts Resilience to Suicide Among Women Students

A substantial literature has documented that sexual abuse relates to suicidal behaviors but relatively less is known about resilience to suicide, especially cognitive deterrents to suicide. The present study investigated the effects of a history of sexual victimization on reasons for living. Female participants (N = 138; M age = 24.4 years; SD = 7.3 years; range = 18 to 53 years; 79% Caucasian) completed the Sexual Experiences Survey (SES) and the Reasons for Living (RFL) Inventory. According to SES responses, participants were classified into 5 mutually exclusive groups: no victimization, sexual contact, sexual coercion, attempted rape, and rape. Analyses of variance showed that degree of sexual victimization had a significant effect on the RFL Total scale and 2 subscales (Survival and Coping Beliefs; Moral Objections). The general pattern was that mean RFL scores in the no victimization group were significantly higher than the mean scores in the sexual coercion and rape groups. An implication is that having a history of sexual victimization, especially sexual coercion and rape, limits one's later reasons for not committing suicide. Bolstering these modifiable deterrents to suicide should be part of suicide prevention efforts among at-risk women.     

The Impact of Childhood Sexual Abuse on Psychological Distress Among Women in New Zealand

PROBLEMS: In order to better understand the long‐term impact of child sex abuse, this study examined the association between women's experience of abuse, health symptoms, and psychological distress in adulthood. There is limited information about child abuse outside the United States. METHODS: Nine hundred sixty‐one women participated in a structured interview. RESULTS: Participants who had experienced abuse (13%) were significantly more vulnerable to psychological distress in adulthood if they were younger, less satisfied with their standard of living, and resided in urban areas. CONCLUSION: Dissemination and evaluation of therapies for the treatment of sex abuse in the New Zealand context is warranted.     

Childhood Attachment,Childhood Sexual Abuse,and Onset of Masturbation Among Adult Sexual Offenders

Written autobiographies of 48 incarcerated adult male sexual offenders (22 rapists, 13 intrafamilial child molesters, and 13 extrafamilial child molesters) were used to generate retrospective self-report measures of their childhood maternal and paternal attachment, childhood sexual abuse experiences, and onset of masturbation. Contrary to expectation, the offenders as a combined group more often reported secure than they did insecure childhood maternal and paternal attachment. There were no differences between the three offender subgroups with respect to maternal attachment; however the rapists and the intrafamilial child molesters were more likely to report insecure paternal attachment than were the extrafamilial child molesters. There were no differences between these offender subgroups in the frequency with which childhood sexual abuse was reported. However, offenders with insecure paternal attachment were more likely to report having been sexually abused than were those with secure paternal attachment. Sexually abused offenders in turn reported earlier onset of masturbation than did those who were not sexually abused. These results are consistent with contemporary attachment models linking insecure childhood attachment to childhood sexual abuse, and with traditional conditioning models linking childhood sexual abuse, early masturbation, and sexual offending.     

Substance Abuse in Latin American Countries: Priorities, Challenges, and Actions

Substance abuse is a global phenomenon and its extent and nature have increased the mortality and morbidity of the population, and placed heavy demands on health and social care services. This is a selected review of some of the significant developments and the challenges faced by the Latin American and Caribbean countries in tackling drug and alcohol abuse. The Inter-American Drug Abuse Control Commission (CICAD) takes a public health approach to drug abuse prevention and treatment programs with more emphasis on the relationship among HIV/AIDS, sexually transmitted diseases, and substance abuse. In 1997 CICAD began developing a project with the aim of creating a cadre of professional nurses with academic, clinical, and research expertise in the prevention and care of substance abusers. One of the significant challenges is to overcome the marginalization of the importance of substance abuse components in nurse education curricula and clinical practice at undergraduate and postgraduate levels. Areas of concern are the professional attitudes towards those abusing drug and alcohol, the stigma attached to these conditions, and their impact on care. Another challenge for academics and clinicians is the need to develop nursing research in drug and alcohol abuse. Critical to the development and expanded role of the nurse or public health worker in working with substance abusers is the creation of a Latin American Association to act as an advocate and support group for nurses and other public health workers who are involved in the prevention, management, and treatment of substance abusers. The establishment of a communication network in examining issues related to substance abuse in those countries should be of high priority. The provision of counselling, support groups, and treatment services for professionals with problems with drug and alcohol should be part of the occupational health assistance program of any institution.     

Research Synthesis: Adolescent Suicide and Substance Abuse in the United States, 1990-2002

The purpose of this research synthesis was to analyze the research conducted in the domain of adolescent suicide and substance abuse through studies in the United States between 1990 and 2002. A systematic examination for research focus, hypotheses, research and analytic design, sample, validity and reliability of instrumentation, variables and accompanying study outcomes, strengths, and limitations was conducted on 19 adolescent suicide studies. The Research Analysis Tool (RAT) developed by Moody, Wilson, Smyth, Schwartz, Tittle, and VanCott (1988) was used for data organization.     

Stages of Multiple Behavior Change as a Function of Readiness for Substance Abuse Treatment Among Women at Risk

Based on a multidimensional stages-of-change model, the present work examines changes in readiness to modify several types of risk behaviors among women seeking to enter substance abuse treatment. These behaviors are: seeking mental health counseling, reducing risky sexual behaviors, reducing risk of physical violence, and improving vocational/educational skills. Participants (n = 261 women; 66.3% African American, 24.1% Latina, and 9.6% Caucasian) were assessed at baseline and an average of six months later. Results of a repeated measures analysis of variance demonstrated significant increases in readiness for behavior change. The interaction between initial readiness to modify substance abuse behaviors and longitudinal change also was significant. Implications for designing programs to address the needs of women with multiple vulnerabilities are discussed.     

Major Depression and Risky Sexual Behavior Among Substance Dependent Patients: The Moderating Roles of Distress Tolerance and Gender

The goal of the present study was to examine the main and interactive effects of major depressive disorder (MDD), distress tolerance (DT), and gender on multiple indices of risky sexual behavior (RSB) within a sample of 185 substance dependent patients in residential substance abuse treatment. Participants were interviewed to establish current MDD (as well as other Axis I and II diagnoses) and completed a behavioral measure of DT, the Paced Auditory Serial Addition Task-Computerized Version. Results provided evidence of a MDD × DT interaction for number of different past year commercial and casual sexual partners with which penetrative sex occurred. Post hoc analyses demonstrated that participants with current MDD and low DT reported the greatest number of commercial and casual sexual partners. Results highlight one psychological vulnerability (DT) that may improve our understanding of the complex relationship between depression and RSB. Treatment implications of findings are discussed.     

The Association of Pain Intensity and Suicide Attempts Among Patients Initiating Pain Specialty Services

Using Veterans Health Administration data, we assessed the extent to which mean past-year (365 days) pain intensity scores were associated with suicide attempts in the year after the initiation of pain specialty services in fiscal years 2012 to 2014 (N = 221,817). Suicide attempts in the year after initiating Veterans Health Administration pain specialty services (ie, index visit) were identified using medical records and a suicide surveillance sources. Adjusted hazard models accounted for key covariates (eg, demographics, comorbidities). Subgroup analyses were also conducted on veterans without and with a suicide attempt in the year before the index visit to examine risk for first attempt and reattempts. Adjusted analyses revealed that pain intensity scores were significantly associated suicide attempts after the index visit. Specifically, veterans with severe and moderate pain had a hazards ratio of 1.41 (95% confidence interval = 1.21-1.63) and 1.29 (95% confidence interval = 1.13-1.47), respectively. These results were consistent for those without a past-year attempt and for those with a past-year attempt. The results suggest that moderate to severe pain intensity in the year before initiating pain specialty services may be a useful indicator of suicide risk, even when considered in the context of key factors.PerspectiveThis study used national administrative and suicide surveillance data to assess the relationship between pain intensity and suicide attempts after an initial visit for pain specialty services among veterans. These findings highlight the potential usefulness of assessing pain intensity as an indicator for suicide risk.     

Depression, Physical Health Impairment and Service Use Among Older Adults

Abstract The purposes of this study were: (1) to compare service use and need among 80 community-dwelling older adults (55 women and 25 men): and (2) to examine the influence of depression on service use and need. Participants were divided into three groups based on their depression scores (no depression, mild depression, severe depression) and compared on a wide range of services (e.g., medical services, social/recreational, transportation) typically used by older adults. There were no significant differences among the three groups for demographic characteristics and chronic illness types, but there were significant differences for physical health impairment (PHI). When controlling for PHI, significant differences were found among the groups for mental health services, psychotropic medications, number of sick days, hospitalizations, home help, frequency of transportation, social/recreational services, and sports-related activities. Mildly and severely depressed older adults used and needed more medical services than did their non-depressed cohorts, but used less of other types of services (e.g., social/recreational services). Depression was a significant predictor of social/recreational service use. and for need of mental health services, psychotropic medications, financial assistance, and assessment and referral services. A consistent pattern was found of depression influencing service use and need.