女性服刑人员精神创伤的特征

目的调查女性服刑人员精神创伤的特征。方法在湖南新路职业学校中,采用多级随机整群抽样的原则抽取471个女性服刑人员,分青少年组（年龄≤25岁）和成年组（〉25岁）。运用创伤性生活事件问卷（TLEQ）和访谈相结合的技术评估她们的精神创伤经历。结果（1）90.4%的女性服刑人员至少经历1件创伤性事件,63.7%至少经历3件或以上的多重创伤。青少年组的事件数量多于成年组（平均为4和3件,P〈0.01）。暴力和毒品相关犯罪组的事件数量相当（平均4件）,都多于经济犯罪组（2件）;中学或相当教育程度者的事件数量最多（4件）,大专或以上者最少（2件）;未婚、离婚/丧偶2组经历的事件数量最多（4件）,已婚组最少（2件）,均差异有显著性（P〈0.05）。（2）最多见的创伤类型是机动车祸（46.9%）、目睹家庭暴力（46.1%）和被抢劫（38.9%）。16.7%的女犯在18岁以前遭遇过性虐待。与成年组相比,青少年组经历了更多的创伤类型为被抢劫、目睹被惨打、目睹家庭暴力,以及儿童期性虐待。结论我国文化背景下,女性服刑人员的精神创伤经历相当普遍,是精神创伤的潜在受害者。     

海洛因依赖伴发意识障碍与苯二氮滥用关系

目的了解海洛因依赖者脱毒时伴发意识障碍与苯二氮     

In vivo microdialysis and conditioned place preference studies in rats are consistent with abuse potential of tramadol.

The abuse potential of tramadol was investigated using both in vivo microdialysis measures of dopamine (DA) release within the nucleus accumbens (NAc) shell and the conditioned place preference (CPP) paradigm in rats. Tramadol (75 mg/kg, i.p.) induced a statistically significant increase (starting 80 min posttreatment) in DA release within the NAc shell, which was maintained for at least 120 min posttreatment. Tramadol (18.75, 37.5, and 75 mg/kg i.p.) produced a statistically significant CPP, with the effects of the two highest doses comparable to those induced by morphine (5 mg/kg, s.c.). The release of DA within the NAc shell may be responsible for the rewarding properties of tramadol and, together with the CPP results, provide evidence that tramadol may possess greater abuse potential than originally believed.     

Treatment of dual diagnosis patients: A relapse prevention group approach

The authors describe the successful use of an adjunctive group psychotherapy for substance-abusing patients with major psychiatric disorders (bipolar, schizophrenia, schizoaffective, psychotic depression, and atypical psychosis). The group utilizes a psychoeducational approach that focuses on substance abuse causes and consequences, principles of recovery, and relapse prevention strategies. Eight patients with prolonged histories of abuse of cocaine, alcohol, marijuana, or other drugs were enrolled in this weekly group treatment at a community mental health center drug treatment program, while continuing in treatment with their current case manager or primary therapist. Six of the eight patients achieved periods of stable abstinence, documented by self-report, urine toxicology screens, continued group attendance, and improved social functioning. Case examples are utilized to illustrate the group process.     

Hyperaemia in rat neocortex produced by acute exposure to methylenedioxymethamphetamine

Cerebral blood flow and glucose utilization were measured in rat neocortex, hippocampus and striatum following methylenedioxymethamphetamine injection (5 mg/kg, i.v.), using the tracers [¹⁴C]iodoantipyrine and [¹⁴C]2-deoxyglucose, respectively. In control rats, blood flow was coupled to glucose metabolism, but in methylenedioxymethamphetamine-treated rats, marked hyperperfusion was measured in frontal and parietal cortex with no change in glucose use. This suggests that methylenedioxymethamphetamine has the potential to disrupt cerebrovascular control.     

Insults to the body civil: Mistreatment of elderly in two Plains Indian tribes

The mistreatment of elderly is subject to various social constructions. On two geographically distinct Plains Indian Reservations which we call Lone Mountain and Abundant Lands, the abuse or neglect of elderly is construed as a health problem which is a dysfunction of the community as a whole. Both physical abuse and neglect are more common on the Lone Mountain Reservation, occurring in association with other indicators of community disorganization such as unemployment and substance abuse. On the Abundant Lands Reservation physical abuse was categorically denied and what neglect existed appeared to be a function of role strain, geographic dispersal, climate and terrain. We attribute differences in the prevalence of mistreatment of elders to variations in economic opportunities for younger residents. Examining the historical and present contexts of intergenerational relationships on the reservations, we discuss the implications of this study for social exchange theory and policy applications.This research was supported by the Gerontological Society of America AppliedThis research was supported by the Gerontological Society of America AppliedThis research was supported by the Gerontological Society of America AppliedThis research was supported by the Gerontological Society of America AppliedThis research was supported by the Gerontological Society of America AppliedThis research was supported by the Gerontological Society of America Applied     

Early separation and suicidal behaviour in the parental homes of 40 consecutive suicide attempters

Forty suicide-attempt patients who were consecutively admitted to an intensive-care unit, their significant others and treatment personnel were investigated by semistructured interviews. The patients were divided into neurosis (n = 14), abuse (n = 19) and psychosis (n = 7) groups. Twenty-one of the patients (52%) had lost contact with one or both parents before the age of 18, in 25% of cases owing to death and in 27% because of the parents' divorce or separation. Parents and/or siblings of 19 patients (47%) had shown suicidal behaviour in the form of attempted suicide and/or suicide. Differences between the groups were not significant. Alcohol abuse in the parental home was overrepresented in the abuse group compared with the other groups. The role of identification with the dead and suicidal parent in prompting suicidal actions in adulthood is discussed, as well as that of the impeded evolution of stable external object relations owing to parental losses.     

Aggression and substance abuse in bipolar disorder

Objectives:  The goal of this retrospective study was to examine factors differentiating persons with bipolar disorder who did or did not have comorbid lifetime substance use disorders (SUD) at an index assessment. We also explored the chronology of onset of mood and SUD.
Methods:  We studied 146 subjects with DSM-defined bipolar disorder. Subgroups with and without lifetime SUD were compared on demographic and clinical measures.
Results:  Substance abuse disorders in this bipolar sample were associated with male sex, impulsive-aggressive traits, comorbid conduct and Cluster B personality disorders, number of suicide attempts and earlier age at onset of a first mood episode. In a multivariable logistic regression analysis, male sex and aggression and possibly earlier age at mood disorder onset were associated with SUD. In those with or without SUD, the first mood episode tended to be depressive and to precede the onset of SUD.
Conclusions:  In persons with bipolar disorder, an earlier age of onset and aggressive traits appear to be factors associated with later development of comorbid SUD.