22.1 LONGITUDINAL RELATIONSHIPS BETWEEN CHILDHOOD MALTREATMENT AND LATER SUBSTANCE USE: RESEARCH EVIDENCE, CLINICAL IMPLICATIONS, AND DIRECTIONS FOR FUTURE RESEARCH

Author(s):  
Amelia Arria
Author(s):  
Tali Boritz ◽  
Richard J. Zeifman ◽  
Shelley F. McMain

Research on processes and mechanisms of change aim to explain how and why an intervention leads to change. Despite some theoretical and empirical progress in understanding processes and mechanisms of change in Dialectical Behaviour Therapy (DBT), this remains an understudied area in the DBT literature. This chapter considers how DBT conceptualizes the etiology and maintenance of dysfunction, and how active ingredients in DBT treatment produce client change. It proposes four key mechanisms of change that have been a focus of scientific efforts in DBT research: (1) increased awareness and acceptance of emotion; (2) increased attentional control; (3) increased ability to modulate emotion; and (4) increased use of adaptive coping skills. Next, it reviews the research evidence to support these putative mechanisms of change. Finally, it discusses clinical implications of this research, and propose recommendations for future research on mechanisms of change in DBT.


2021 ◽  
Author(s):  
Victoria Ingram

A growing body of research has shown that executive functions play an important role in effective and sensitive parenting. No studies have examined this relation in mothers with problematic substance use, who may be at particular risk given biological, psychological, and contextual risks that may undermine executive functions and increase parenting stress. The purpose of this study was to investigate the relation between three executive functions and parenting stress. Sixty-five mothers attending substance use treatment completed tasks assessing updating, inhibition, and shifting executive functions and questionnaires assessing parenting stress, reflecting both relational and household chaos definitions of the construct. Controlling for SES and age of youngest child, lower performance on both inhibition and updating tasks was associated with increased parenting stress, when a relational definition was employed. However, no significant relations were found between executive functions and household chaos definitions of parenting stress, after depression and SES were controlled for. These preliminary results suggest a role for executive functions in parenting stress in mothers with problematic substance use, but highlight the importance of considering the type of executive function assessed and the definition of parenting stress employed. Directions for future research and clinical implications are discussed.


CNS Spectrums ◽  
2013 ◽  
Vol 19 (3) ◽  
pp. 225-230 ◽  
Author(s):  
Matt Field ◽  
Reshmi Marhe ◽  
Ingmar H. A. Franken

Individuals with substance use disorders typically show an “attentional bias” for substance-related cues: Those cues are able to grab and hold the attention, in preference to other cues in the environment. We discuss the theoretical context for this work before reviewing the measurement of attentional bias, and its relationship to motivational state and relapse to substance use after a period of abstinence. Finally, we discuss the implications of this research for the treatment of substance use disorders. We conclude that attentional bias is associated with subjective craving, and that moment-by-moment fluctuations in attentional bias may precede relapse to substance use. The evidence regarding the predictive relationship between attentional bias assessed in treatment contexts and subsequent relapse is inconsistent. Furthermore, there is currently insufficient evidence to endorse attentional bias modification as a treatment for substance use disorders. Clinical implications and suggestions for future research are highlighted.


BJPsych Open ◽  
2021 ◽  
Vol 7 (S1) ◽  
pp. S286-S287
Author(s):  
Oliver Sargent ◽  
Mayeh Omar

AimsJamaica is undergoing rapid change in its attitudes and laws regarding substance use; understanding the reasons why under-25s use substances will help inform future interventions and policy decisions. This review will investigate the determinants of substance use in under-25s in Jamaica, aiming to identify key sub-groups to target with interventions, and propose topics for further research.MethodA literature search was performed with Ovid on three databases, using wildcards and synonyms to increase the number of hits. This search produced 379 results, of which 41 remained after inclusion/exclusion criteria were applied. Additional sources were utilised as the review was written.ResultStrong family relationships are protective against illicit substance use for under-25s, with conflicting results for licit substance use. Healthy peer relationships protect against substance use, particularly in the academically-stressful university environment. All Jamaican under-25s appear to be susceptible to peer pressure, which increases the likelihood of substance use. Spirituality is protective against substance use, although male Rastafarians are more likely to use cannabis. Certain forms of childhood maltreatment make use of particular substances more likely. University students and under-18s brought up in single-parent families are key sub-groups to target with interventions. Further research on mechanisms by which these determinants work, particular religions and which determinant has the greatest effect is recommended.ConclusionVarious factors can protect against or predispose substance use in Jamaican under-25s. This review, and future research, can help inform policy decisions and intervention design for the key sub-groups found.


2019 ◽  
Vol 15 (1) ◽  
pp. 503-528 ◽  
Author(s):  
Joseph W. Ditre ◽  
Emily L. Zale ◽  
Lisa R. LaRowe

Pain and substance use are highly prevalent and co-occurring conditions that continue to garner increasing clinical and empirical interest. Although nicotine and tobacco, alcohol, and cannabis each confer acute analgesic effects, frequent or heavy use may contribute to the development and progression of chronic pain, and pain may be heightened during abstinence. Additionally, pain can be a potent motivator of substance self-administration, and it may contribute to escalating use and poorer substance-related treatment outcomes. We integrated converging lines of evidence to propose a reciprocal model in which pain and substance use are hypothesized to interact in the manner of a positive feedback loop, resulting in the exacerbation and maintenance of both conditions over time. Theoretical mechanisms in bidirectional pain–substance use relations are reviewed, including negative reinforcement, social cognitive processes, and allostatic load in overlapping neural circuitry. Finally, candidate transdiagnostic factors are identified, and we conclude with a discussion of clinical implications and future research directions.


2009 ◽  
Author(s):  
Laura Elwyn ◽  
Carolyn A. Smith ◽  
Timothy O. Ireland

Author(s):  
Alison Hutton ◽  
Matthew Brendan Munn ◽  
Sydney White ◽  
Peter Kara ◽  
Jamie Ranse

Abstract Background: Dedicated on-site medical services have long been recommended to improve health outcomes at mass-gathering events (MGEs). In many countries, they are being reviewed as a mandatory requirement. While it is known that perceptions of risk shape substance use plans amongst outdoor music festival (OMF) attendees, it is unclear if attendees perceive the presence of on-site medical services as a part of the safety net. The aim of this paper is to better understand whether attendees’ perceptions of on-site medical services influence high-risk behaviors like alcohol and recreational drug use at OMFs. Method: A questionnaire was distributed to a random sample of attendees entering and attending two separate 20,000-person OMFs; one in Canada (Festival A) and one in New Zealand (Festival B). Responses focused on demographics, planned alcohol and recreational drug use, perceptions of medical services, and whether the absence of medical services would impact attendees’ planned substance use. Results: A total of 851 (587 and 264 attendees for Festival A and Festival B, respectively) attendees consented and participated. Gender distribution was equal and average ages were 23 to 25. At Festival A, 48% and 89% planned to use alcohol and recreational drugs, respectively, whereas at Festival B, it was 92% and 44%. A great majority were aware and supportive of the presence of medical services at both festivals, and a moderate number considered them a factor in attendance and something they would not attend without. There was significant (>10%) agreement (range 11%-46%; or 2,200-9,200 attendees for a 20,000-person festival) at both festivals that the absence of medical services would affect attendees’ planned use of alcohol and recreational drugs. Conclusions: This study found that attendees surveyed at two geographically and musically distinct OMFs had high but differing rates of planned alcohol and recreational drug use, and that the presence of on-site medical services may impact attendees’ perceptions of substance use risk. Future research will aim to address the limitations of this study to clarify these findings and their implications.


Author(s):  
Yoonhee Sung ◽  
Eunsil Choi

The goal of this study was to examine the reciprocal longitudinal relationships between executive dysfunction and happiness for Korean children. We used data from the Panel Study of Korean Children (PSKC) conducted by the Korean Institute of Child Care and Education. A total of 1240 valid responses from the first to third grade in elementary school were analyzed using autoregressive crossed-lagged modeling. As a result, executive dysfunction and happiness were found to have reciprocal influences over the three time points. We also found that the cross-lagged effects of executive dysfunction and happiness were stronger than those of happiness on executive dysfunction. Clinical implications and limitations were discussed.


2021 ◽  
Vol 22 (7) ◽  
pp. 3571
Author(s):  
Bonglee Kim ◽  
Ji-Eon Park ◽  
Eunji Im ◽  
Yongmin Cho ◽  
Jinjoo Lee ◽  
...  

Biocompatible nanoparticles (NPs) containing polymers, lipids (liposomes and micelles), dendrimers, ferritin, carbon nanotubes, quantum dots, ceramic, magnetic materials, and gold/silver have contributed to imaging diagnosis and targeted cancer therapy. However, only some NP drugs, including Doxil® (liposome-encapsulated doxorubicin), Abraxane® (albumin-bound paclitaxel), and Oncaspar® (PEG-Asparaginase), have emerged on the pharmaceutical market to date. By contrast, several phytochemicals that were found to be effective in cultured cancer cells and animal studies have not shown significant efficacy in humans due to poor bioavailability and absorption, rapid clearance, resistance, and toxicity. Research to overcome these drawbacks by using phytochemical NPs remains in the early stages of clinical translation. Thus, in the current review, we discuss the progress in nanotechnology, research milestones, the molecular mechanisms of phytochemicals encapsulated in NPs, and clinical implications. Several challenges that must be overcome and future research perspectives are also described.


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