Comparing the Validity of Self-Report and Urinalysis for Substance Use among Former Inmates in the Northeastern United States

Background: Problems with self-reported drug use include difficulties with recall and recognition as well as the desire to respond to questions in a socially desirable manner. Various methods have been developed to improve and/or validate estimates based on direct questioning of individuals regarding their substance use. For this study, we were interested in validating self-reported use of: 1) tobacco, 2) marijuana, and 3) other substances (i.e., heroin, cocaine, opiates, oxycodone, benzodiazepines, methamphetamine, phencyclidine, and barbiturates) employing urinalysis among inmates who participated in a randomized controlled trial of a smoking abstinence intervention in a tobacco-free prison located in the northeastern United States. Methods: Two-hundred and seven men and women with a mean age of 34.9 (standard deviation = 9.0) completed questions regarding their substance use on a 7-day Timeline Follow-Back and provided urine specimens three weeks following prison release. Results: Self-reported tobacco and marijuana use were highly consistent with urine drug testing in terms of overall agreement and Kappa (93.7% and.804 for tobacco, respectively; and 90.3% and.804 for marijuana, respectively); however, consistency was much lower for other drug use grouped together (62.7% and.270). Discussion: Although some former inmates may not accurately report substance use, our findings indicate that they are in the minority, suggesting that self-report is valid for tobacco and marijuana use but much less so for other drugs grouped together. Future research should be conducted with a larger and more diverse sample of former inmates to establish the generalizability of our findings from this study.     

Traumatic Life Events and Suicide Risk Among Jail Inmates: The Influence of Types of Events, Time Period and Significant Others

Relationships between traumatic life events and suicide risk were studied in two samples of jail inmates with a low (N = 216) and a high (N = 51) suicide risk. Although nonsuicidal inmates reported a high prevalence of traumatic life events, suicidal inmates reported even higher prevalence rates. Suicidal inmates reported more episodes of sexual abuse, physical maltreatment, emotional maltreatment, abandonment, and suicide attempts by significant others. They also had experienced more traumatic life events during childhood, later life, and detention. It is concluded that traumatic life events are associated with suicide risk and that such an association remains in a population with a high prevalence of traumatic life events. It is also concluded that suicide risk is dependent of the type of life event, the timing of the event, and the type of persons involved in the event.     

新生儿床旁护理在产科母婴同室的实施

目的 探讨新生儿床旁护理在产科母婴同室中实施的效果。方法 选取170例母婴同室的新生儿,在新生儿母亲及家属知情同意情况下将170例新生儿随机分为两组,85例新生儿采取床旁护理为观察组,85例新生儿采用常规护理为对照组,分别为对两组产妇健康知识了解、新生儿护理技能掌握及对护理工作的满意度进行比较。结果 观察组产妇健康知识得分、新生儿护理技能得分及对护理工作满意度分别为(97.5±2.1)分、(97.6±2.8)分、98.82%(84/85),对照组分别为(93.0±1.9)分(、93.1±3.5)分、91.76%(78/85),两组比较差异均有统计学意义(均P<0.05)。结论 在产科母婴同室中实施新生儿床旁护理,可明显提高产妇健康知识了解程度及对新生儿的护理技能,提高对护理工作的满意度。     

Categorization and evaluation of emotional faces in psychopathic women

Psychopathic individuals have been shown to respond less strongly than normal controls to emotional stimuli. Data about their ability to judge emotional facial expressions are inconsistent and limited to males. To measure categorical and dimensional evaluations of emotional facial expressions in psychopathic and non-psychopathic women, 13 female psychopathic forensic inpatients, 15 female non-psychopathic forensic inmates and 16 female healthy participants were tested in an emotion-categorizing task. Emotional facial expressions were presented briefly (33 ms) or until buttonpress. Participants were to classify emotional expressions, and to rate their valence and arousal. Group differences in categorization were observed at both presentation times. Psychopathic patients performed worst with briefly presented sad expressions. Moreover, their dimensional evaluation resulted in less positive ratings for happy expressions and less arousal for angry expressions compared with the responses of non-psychopathic and normal subjects. Results shed light on the mechanism possibly underlying the emotional deficits in psychopathic women.     

A Brief Alternative for Identifying Alcohol Use Disorders

This study sought to evaluate the clinical utility of a brief assessment interview in accurately classifying inmates manifesting an alcohol use disorder (AUD) based on a structured diagnostic assessment interview. Data were derived from routine clinical assessments of 7,672 inmates (89.6% male) incarcerated in the Minnesota Department of Corrections state prison system. An automated version of the Substance Use Disorder Diagnostic Schedule-IV (SUDDS-IV), which included a subset of the items comprising the Triage Assessment for Addictive Disorders (TAAD), was administered to all inmates from 2000 to 2003. Approximately 99% of the DSM-IV dependence and no diagnosis cases were appropriately classified by the TAAD. Although the TAAD identified nearly all cases with any diagnosis, 20%–24% of cases classified as abuse by the TAAD were found to be dependent by the longer instrument. Similar findings were noted when DSM-5 criteria were applied. The TAAD has the potential to provide a more clinically defensible means of identifying AUDs than brief screens when time constraints may preclude a comprehensive assessment. Limitations and implications for routine clinical practice are discussed.     

Neuropsychiatric correlates of traumatic brain injury (TBI) among Australian prison entrants

Primary objective: To investigate the association between reported past traumatic brain injury (TBI) and demographic, neuropsychiatric and criminographic parameters among individuals recently received into custody.

Research design: A random sample of men recently received into the New South Wales (Australia) criminal justice system were screened for a history of TBI and the details of up to five separate TBI episodes were obtained. We also screened for depression, psychosis, personality disorder, drug and alcohol use, and 'social connectedness'.

Main outcome and results: Among the 200 study participants, 82% reported past TBI. TBI was associated with a history of engagement in contact sports, school expulsion, daily illicit drug use, depression and psychosis.

Conclusions: Past TBI is common among prisoners entering the criminal justice system and, amongst other correlates, appears to be highly associated with increased rates of major mental illness.     

Substance Use Disorder Prevalence among Female State Prison Inmates

Background: Substance use disorders (SUDs) are prevalent among female inmates. As the female state prison population continues to increase, describing the specific clinical and demographic characteristics of female prisoners remains of paramount importance to better define women’s needs in the state prison system. Objectives: To determine the prevalence and patterns of current DSM-IV SUDs and explore whether particular demographic characteristics are more strongly associated with specific SUD categories. Methods: Data were derived from routine clinical assessments of 801 female inmates incarcerated in the Minnesota Department of Corrections state prison system. The Substance Use Disorder Diagnostic Schedule-IV (Hoffmann NG, Harrison PA. SUDDS-IV: Substance Use Disorder Diagnostic Schedule-IV. Smithfield, RI: Evince Clinical Assessments, 1995) was administered to all inmates as a computer-prompted interview on admission to the prison. Results: Of the inmates, 70.0% were dependent on at least one substance, and 7.9% met criteria for substance abuse. Alcohol dependence (30.2%) and cocaine dependence (30.1%) were the two most prevalent SUDs. The remaining substance dependence diagnoses that predominated were as follows: stimulant dependence, 24.1%; marijuana dependence, 15.6%; and heroin dependence, 9.6%. Over half (56.9%) were dependent on a substance other than alcohol. Prevalence of cocaine dependence [odds ratio (OR) = 2.83, 95% confidence interval (CI) = 1.92–4.16] was significantly higher among African Americans, whereas prevalence of stimulant dependence (OR = 9.24, 95% CI = 5.40–15.80) was significantly higher among Caucasians. Prevalence of alcohol (OR = 2.12, 95% CI = 1.38–3.25) and heroin (OR = 2.67, 95% CI = 1.50–4.77) dependence was significantly higher among Native Americans. Conclusions and Scientific Significance: SUDs in general, and illicit drug use disorders in particular, are prevalent among female inmates entering a state prison system. Membership to a particular ethnic group may identify a set of inmates at elevated risk for the presence of substance-specific dependence diagnoses.     

Childhood Adversities and Substance Misuse Among the Incarcerated: Implications for Treatment and Practice in Correctional Settings

Background : Incarcerated populations have high rates of childhood adversities and substance use problems. Moreover, childhood adversities are well-documented predictors of substance misuse. Objective: To investigate the impact of childhood sexual and physical abuse, caregiver abuse of drugs or alcohol, and time spent in foster care on several substance misuse outcomes. Methods: Data comes from a sample of 16,043 incarcerated men and women in the United States Survey of Inmates in State and Federal Facilities. Bivariate analyses revealed differences by sex in childhood adversities and socioeconomic characteristics. Logistic regression analyses assessed the data for a link between childhood adversities and substance misuse after adjusting for other variables. Analyses were stratified by sex to show differences in predictors of substance misuse between men and women. Results: Childhood adversities increased the risk of many substance misuse outcomes. The prevalence of physical abuse, sexual abuse, foster care, and caretaker abuse of drugs or alcohol were greatest for inmates who reported injecting and sharing drugs. Growing up with a caregiver that used drugs or alcohol was a consistent predictor of increased risk of substance misuse for men and women. However, childhood sexual abuse increased risk for only women. Conclusions: Inmates who experience physical abuse, sexual abuse, foster care involvement and caretakers who use drugs and alcohol are at an increased risk of substance misuse, injecting drug use and syringe sharing. Implications suggest correctional HIV prevention and substance misuse programs must address unresolved trauma and important gender differences.     

Connectivity,prison environment and mental health among first-time male inmates in Mexico City

Research from high-income countries suggests that prison populations are affected disproportionately by mental illness. However, little research has examined mental health among prisoners in low- and middle-income countries or associations between mental health and contextual factors surrounding the prison experience among susceptible first-time inmates in these settings. The current study examines associations between connectivity, prison environment and mental health (major depression and substance use) among novice male inmates (n?=?593) in three Mexico City prisons. Severe depression (46.2%), any substance use (53.8%) and heavy substance use (45.7%) were prevalent. Among key co-variates, recent visitors were protective for severe depression, conjugal visits for any substance use and prison employment for heavy substance use. Physical attacks were associated with increased prevalence of depression, sentence time served with both any and heavy substance use and overcrowding with any substance use. These findings suggest the need for routine health assessments to improve identification and treatment programmes to minimise mental health burden. Addressing demographic risk factors as well as contextual determinants, by decreasing physical violence and overcrowding and supporting outside connections for prisoners, may help improve inmate mental health.