scholarly journals Adapting Psychotherapy for Comorbid Substance use and Bipolar Disorder in Older Sexual Minorities: A Case Study

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 998-999
Author(s):  
Sarah Nanami Morehouse ◽  
Kirenia Brunson ◽  
Ashley Stripling ◽  
Jodie Maccarrone ◽  
Jessica Choe ◽  
...  
Keyword(s):  
Bipolar Disorder ◽  
Substance Use ◽  
Progress Monitoring ◽  
Suicide Attempts ◽  
Behavioral Therapy ◽  
Dually Diagnosed ◽  
Short Term ◽  
Booster Sessions ◽  
Mood Stabilization

Abstract Approximately 65 to 95% of individuals with bipolar disorder (BD) are diagnosed with an additional psychiatric condition (Kessler, 1999). Alcohol, the most commonly abused substance amongst individuals with BD (Xiao et al., 2016), has been linked to significant increases in suicide attempts, disability, hospitalizations, and mortality (Baldessarini et al., 2008; Goldberg et al., 1999; Mitchell et al., 2007; Nery & Soares, 2011). Despite these ill effects, little is known about how to effectively treat, or adapt existing treatment appropriately, for the growing numbers of individuals who are dually diagnosed with BD and alcohol use disorder (AUD) and hold the identity of lesbian, gay, bisexual, transgender, or queer (LGBTQ) in late life. Thus, the purpose of this study is to demonstrate how treatment was adapted to a self-identified gay man with comorbid BD and AUD from a relational, culturally sensitive perspective while simultaneously implementing two short-term interventions: cognitive behavioral therapy (CBT) and a behavioral substance use program. In line with Knight & Poon’s (2008) Contextual Life Span Theory for Adapting Psychotherapy with Older Adults (CALTAP) and a multicultural lens that incorporates relevant research on older LGBTQ individuals, modifications were made to the content, structure, language, and duration of therapy while cultivating a safe and empathic space. Idiographic data and progress monitoring measures suggests treatment resulted in substance use and distress reduction, as well as mood stabilization. However, additional booster sessions may be advantageous given the risk for substance abuse relapse and the compounding effect it may exert on persons with BD.

scholarly journals Tobacco smoking and other substance use disorders associated with recurrent suicide attempts in bipolar disorder

2019 ◽  
Vol 256 ◽  
pp. 348-357
Author(s):  
R. Icick ◽  
I. Melle ◽  
B. Etain ◽  
P.A. Ringen ◽  
S.R. Aminoff ◽  
...  
Keyword(s):  
Bipolar Disorder ◽  
Substance Use ◽  
Substance Use Disorders ◽  
Tobacco Smoking ◽  
Suicide Attempts

Mechanisms of impulsivity in bipolar disorder and related illness

2010 ◽  
Vol 19 (2) ◽  
pp. 120-130 ◽  
Author(s):  
Alan C. Swann
Keyword(s):  
Bipolar Disorder ◽  
Substance Use ◽  
Personality Disorder ◽  
Substance Use Disorders ◽  
Antisocial Personality Disorder ◽  
Suicide Attempts ◽  
Affective State ◽  
Rapid Response ◽  
Antisocial Personality ◽  
Course Of Illness

SummaryAims – Impulsivity is a multifaceted aspect of behavior that is prominent in psychiatric disorders and has serious behavioral consequences. This paper reviews studies integrating behavioral and physiological mechanisms in impulsivity and their role in severity and course of bipolar and related disorders. Methods – This is a review of work that used questionnaire, human behavioral laboratory, and neurophysiological measurements of impulsivity or related aspects of behavior. Subjects included individuals with bipolar disorder, substance-use disorders, antisocial personality disorder, and healthy controls. Results – Models of impulsivity include rapid-response impulsivity, with inability to reflect or to evaluate a stimulus adequately before responding, and reward-based impulsivity, with inability to delay response for a reward. In normal subjects, rapid-response impulsivity is increased by yohimbine, which increases norepinephrine release. Impulsivity is increased in bipolar disorder, whether measured by questionnaire, by measures of rapid-response impulsivity, or by measures of ability to delay reward. While affective state has differential effects on impulsivity, impulsivity is increased in bipolar disorder regardless of affective state or treatment. Impulsivity, especially rapid-response, is more severe with a highly recurrent course of illness or with comorbid substance-use disorder, and with history of medically severe suicide attempt. In antisocial personality disorder, rapid-response impulsivity is increased, but rewardbased impulsivity is not. In general, impulsivity is increased more in bipolar disorder than in antisocial personality disorder. In combined bipolar disorder and antisocial personality disorder, increased impulsivity is associated with substance-use disorders and suicide attempts. Conclusions – Impulsivity is associated with severe behavioral complications of bipolar disorder, antisocial personality disorder, and substance-use disorders.

A Pilot Study of a Short Cognitive-Behavioral Group Treatment for Female Recurrent Suicide Attempters

1996 ◽  
Vol 26 (1) ◽  
pp. 83-91 ◽  
Author(s):  
Michiel W. Hengeveld ◽  
Daan J. L. Jonker ◽  
Harry G. M. Rooijmans
Keyword(s):  
Personality Disorder ◽  
Suicidal Behavior ◽  
Group Treatment ◽  
High Frequency ◽  
Suicide Attempts ◽  
Behavioral Therapy ◽  
Cognitive Behavioral ◽  
Short Term ◽  
Suicide Attempters ◽  
Behavioral Group

Objective: To test the feasibility and effectiveness of a high-frequency short-term group cognitive-behavioral therapy (CBT) for recurrent suicide attempters. Method: CBT consisting of eight weekly and two “booster” sessions was given to nine female out-patients who had attempted suicide at least twice, seven of whom had a personality disorder. Results: Four patients dropped out during the treatment; either because they were “chronic repeaters” (i.e., had a history of more than 8 suicide attempts), or because the last suicide attempt was too long ago. Although the patients were generally positive about the content of the therapy, no effects on psychiatric symptomatology or repetition of suicidal behavior could be demonstrated. Conclusions: Based on this experience, and on the two controlled studies of CBT of recurrent suicide attempters published in the literature, it is tentatively concluded that it is difficult to organize a short-term high-frequency group treatment for recurrent suicide attempters with personality disorders, and that CBT may delay repetition of suicidal behavior, but that “major repeaters” (i.e., who made 4 or more suicide attempts) with a borderline personality disorder tend to stay major repeaters.

The Effects of Alcohol and Substance Use on a Couple System

2018 ◽  
Vol 26 (3) ◽  
pp. 341-350
Author(s):  
Elizabeth Molla ◽  
Eman Tadros ◽  
Michelle Cappetto
Keyword(s):  
Substance Use ◽  
Behavioral Therapy ◽  
Couple System ◽  
Mental Health Systems ◽  
Major Depressive ◽  
Alternative Means ◽  
Therapy Interventions ◽  
The Relationship ◽  
Patterns Of Interaction

This case study aims to analyze the effects of alcohol and substance use on a couple system. An African American, heterosexual couple was selected for analysis due to dual alcohol and substance use negatively impacting their relationship in addition to generalized anxiety and major depressive disorder. The reliance of alcohol and substance use to cope with relational stressors and mental health systems was detrimental to the relationship. The clients initially presented with trust issues stemming from infidelity; throughout the course of treatment, it became apparent the alcohol and substance use was hindering the couple’s ability to repair trust and meet their other clinical goals. The couple struggled to find alternative means of coping outside of alcohol and substance use, exacerbating their toxic patterns of interaction. This study displays how cognitive behavioral therapy interventions can be implemented within alcohol and substance abuse context to create change in a couple system.

Cathartic Effect of Suicide Attempts Not Limited to Depression

Crisis ◽  
2003 ◽  
Vol 24 (2) ◽  
pp. 73-78 ◽  
Author(s):  
Yves Sarfati ◽  
Blandine Bouchaud ◽  
Marie-Christine Hardy-Baylé
Keyword(s):  
Quality Of Life ◽  
Depressive Symptoms ◽  
Personality Traits ◽  
Rating Scales ◽  
Suicide Attempts ◽  
World Health ◽  
Life Questionnaire ◽  
Short Term

Summary: The cathartic effect of suicide is traditionally defined as the existence of a rapid, significant, and spontaneous decrease in the depressive symptoms of suicide attempters after the act. This study was designed to investigate short-term variations, following a suicide attempt by self-poisoning, of a number of other variables identified as suicidal risk factors: hopelessness, impulsivity, personality traits, and quality of life. Patients hospitalized less than 24 hours after a deliberate (moderate) overdose were presented with the Montgomery-Asberg Depression and Impulsivity Rating Scales, Hopelessness scale, MMPI and World Health Organization's Quality of Life questionnaire (abbreviated versions). They were also asked to complete the same scales and questionnaires 8 days after discharge. The study involved 39 patients, the average interval between initial and follow-up assessment being 13.5 days. All the scores improved significantly, with the exception of quality of life and three out of the eight personality traits. This finding emphasizes the fact that improvement is not limited to depressive symptoms and enables us to identify the relative importance of each studied variable as a risk factor for attempted suicide. The limitations of the study are discussed as well as in particular the nongeneralizability of the sample and setting.

History of Abuse, Substance Use Problems, and Bipolar Disorder in a County Jail Setting

2008 ◽  
Author(s):  
Edwin Shirley ◽  
Lisa Stines Doane ◽  
Toyomi Goto ◽  
Norah Feeny ◽  
Sara M. Debanne ◽  
...  
Keyword(s):  
Bipolar Disorder ◽  
Substance Use ◽  
County Jail ◽  
Substance Use Problems ◽  
History Of
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