A Retrospective Cohort Study on the increasing trend of suicide ideations and risks in an opioid-dependent population of Puerto Rico 2015-2018

Background: The rate of suicide attempts among people with substance abuse disorders in the U.S. is six times higher than in the general population. The prevalence of suicidal ideations and attempts continues to increase in Puerto Rico, with a significant incidence in substance-abusing populations. Methods: This retrospective cohort study evaluate the suicide profile of 4,347 opioid-dependent participants in ASSMCA's methadone center in San Juan, PR, from 2015 to 2018 using questions related to suicidal ideation and attempts included in the admission questionnaire. Results: Participants reporting suicide ideation increase from 8.5% in 2015 to 17.0% in 2018. In 2015 only 7.0% claimed to have had a history of a suicide attempt, increasing to 12.4% in 2018. Discussion: Our data support the need for screening for suicide risk among substance-abusing populations to identify targeted interventions. The identification of high-risk populations for suicide can help during rehabilitation and finding the adequate resources needed.

An Exploratory Study in Gambling Recovery Communities: A Comparison Between ‘‘Pure’’ and Substance-Abusing Gamblers

Most of the available literature has shown that gambling disorder (GD) is often associated with several psychiatric conditions. Comorbidities with mood disorders, impulsiveness, personality traits, and impairments in cognitive function have also been frequently investigated. However, it is currently uncommon to study this disorder in individuals without comorbid substance abuse; therefore, the primary aim of our study was to compare the psychological profile of individuals with GD with and without substance use disorder. A total of 60 participants (100% male), including 20 individuals with GD, 20 substance-dependent gamblers (SDGs), and 20 healthy controls (HCs), were assessed with several clinical measures to investigate impulsivity, hostility, mood, and personality traits, as well as with cognitive tasks (i.e., decision-making tasks). Our results showed differences in both experimental groups compared with the HC group in mood disorders, impulsivity, and hostility traits. The ‘‘pure’’ GD group differed from the SDG group only in characteristics related to mood disorders (e.g., State-Trait Anxiety Inventory-Y2, Beck Depression Inventory-II, and assault dimension), whereas greater impairment in decision making processes related to risky choices was shown in the SDG group. This study suggests the importance of studying pure GD to clarify the underlying mechanisms without the neurotoxic effects of the substances. This could provide an important contribution to the treatment and understanding of this complex disorder.

Intergenerational Transmission of Violence Among Substance-Abusing Chinese Parents: Roles of Detachment and Social Support

Despite a large population of registered people with drug addiction, child protection in substance-abusing families is a neglected issue in China. The present study aims to investigate the association between parents’ childhood abuse history and the risk of abusing their own children in substance-abusing Chinese families and also to examine the mediating role of detachment and moderating role of social support during the intergenerational transmission of abuse. A total of 173 men and 116 women were selected using cluster sampling from two compulsory drug rehabilitation centers in Jiangsu Province. Results indicated that one’s childhood abuse history was positively associated with the current perpetration of child abuse for both fathers and mothers. Detachment mediated the linkage between a history of childhood maltreatment and perpetration of child abuse in all types of abuse for both men and women except for women’s sexual abuse. Social support from family members buffered the intergenerational transmission of child abuse for fathers but not for mothers. Child maltreatment in substance-abusing families is an urgent issue that needs measures to prevent the intergenerational transmission of violence in China. Intervention programs could involve helping parents cope with their childhood abuse history through rebuilding secure attachment and facilitating social support for their parenting practices, especially for fathers.

Intervention Programs For Children of Substance Abusing Parents: Realist Review and Program Evaluation Study

Substance abuse is a pervasive issue affecting Canadian families, and a substantial number of children are impacted by alcohol or drug abusing parents. Children exposed to parental substance misuse are at increased risk for negative psychological, emotional, developmental, and behavioural outcomes, and a substantial proportion will go on to experience substance use issues later in life. Early intervention is key to providing support for these children and ultimately disrupting the family cycle of addiction. However, few family-based programs for children of substance abusing families are reported in the literature and information on program theory is lacking. A 2-study dissertation was conducted in order to address these gaps. First, a realist review study was undertaken to systematically review existing evaluations of family-based interventions aimed at improving psychosocial outcomes for children of substance abusing parents. A systematic search of academic and grey literature uncovered over 30 documents spanning 7 different intervention programs. Data were extracted on contexts, mechanisms, and outcomes for each program. Four demi-regularities, or patterns of program functioning, were found to account for the effectiveness of programs included in this review: 1) opportunities for positive parent-child interactions, 2) supportive peer-to-peer relationships, 3) the power of knowledge, and 4) engaging hard to reach families using strategies that are responsive to socio-economic needs and matching services to client lived experience. Second, a program evaluation of the Renascent Children’s Program was conducted in order to determine effective implementation and program outcomes for participating children and parents. A repeated measures, mixed methods design was used with 19 families (26 parents and 26 children) who enrolled in the program over a 16 month period. Results indicate that the Children’s Program yields significant improvements in child emotional and depressive symptoms, child conduct behaviours, parenting skills, parent emotion regulation, family functioning, and family communication. High levels of implementation fidelity were also found. These two dissertation studies shed light on theoretical process of family-based interventions for children of substance abusing parents and provide preliminary evidence of effectiveness of the Children’s Program.

Intervention Programs For Children of Substance Abusing Parents: Realist Review and Program Evaluation Study

Substance abuse is a pervasive issue affecting Canadian families, and a substantial number of children are impacted by alcohol or drug abusing parents. Children exposed to parental substance misuse are at increased risk for negative psychological, emotional, developmental, and behavioural outcomes, and a substantial proportion will go on to experience substance use issues later in life. Early intervention is key to providing support for these children and ultimately disrupting the family cycle of addiction. However, few family-based programs for children of substance abusing families are reported in the literature and information on program theory is lacking. A 2-study dissertation was conducted in order to address these gaps. First, a realist review study was undertaken to systematically review existing evaluations of family-based interventions aimed at improving psychosocial outcomes for children of substance abusing parents. A systematic search of academic and grey literature uncovered over 30 documents spanning 7 different intervention programs. Data were extracted on contexts, mechanisms, and outcomes for each program. Four demi-regularities, or patterns of program functioning, were found to account for the effectiveness of programs included in this review: 1) opportunities for positive parent-child interactions, 2) supportive peer-to-peer relationships, 3) the power of knowledge, and 4) engaging hard to reach families using strategies that are responsive to socio-economic needs and matching services to client lived experience. Second, a program evaluation of the Renascent Children’s Program was conducted in order to determine effective implementation and program outcomes for participating children and parents. A repeated measures, mixed methods design was used with 19 families (26 parents and 26 children) who enrolled in the program over a 16 month period. Results indicate that the Children’s Program yields significant improvements in child emotional and depressive symptoms, child conduct behaviours, parenting skills, parent emotion regulation, family functioning, and family communication. High levels of implementation fidelity were also found. These two dissertation studies shed light on theoretical process of family-based interventions for children of substance abusing parents and provide preliminary evidence of effectiveness of the Children’s Program.

A realistic review of family-based interventions for children of substance abusing parents.

Background Millions of children across North America and Europe live in families with alcohol or drug abusing parents. These children are at risk for a number of negative social, emotional and developmental outcomes, including an increased likelihood of developing a substance use disorder later in life. Family-based intervention programs for children with substance abusing parents can yield positive outcomes. This study is a realist review of evaluations of family-based interventions aimed at improving psychosocial outcomes for children of substance abusing parents (COSAPs). The primary objectives were to uncover patterns of contextual factors and mechanisms that generate program outcomes, and advance program theory in this field. Methods Realist review methodology was chosen as the most appropriate method of systematic review because it is a theory-driven approach that seeks to explore mechanisms underlying program effectiveness (or lack thereof). A systematic and comprehensive search of academic and grey literature uncovered 32 documents spanning 7 different intervention programs. Data was extracted from the included documents using abstraction templates designed to code for contexts, mechanisms and outcomes of each program. Two candidate program theories of family addiction were used to guide data analysis: the family disease model and the family prevention model. Data analysis was undertaken by a research team using an iterative process of comparison and checking with original documents to determine patterns within the data. Results Programs originating in both the family disease model and the family prevention model were uncovered, along with hybrid programs that successfully included components from each candidate program theory. Four demi-regularities were found to account for the effectiveness of programs included in this review: (1) opportunities for positive parent-child interactions, (2) supportive peer-to-peer relationships, (3) the power of knowledge, and (4) engaging hard to reach families using strategies that are responsive to socio-economic needs and matching services to client lived experience. Conclusions This review yielded new findings that had not otherwise been explored in COSAP program research and are discussed in order to help expand program theory. Implications for practice and evaluation are further discussed.

A realistic review of family-based interventions for children of substance abusing parents.

Background Millions of children across North America and Europe live in families with alcohol or drug abusing parents. These children are at risk for a number of negative social, emotional and developmental outcomes, including an increased likelihood of developing a substance use disorder later in life. Family-based intervention programs for children with substance abusing parents can yield positive outcomes. This study is a realist review of evaluations of family-based interventions aimed at improving psychosocial outcomes for children of substance abusing parents (COSAPs). The primary objectives were to uncover patterns of contextual factors and mechanisms that generate program outcomes, and advance program theory in this field. Methods Realist review methodology was chosen as the most appropriate method of systematic review because it is a theory-driven approach that seeks to explore mechanisms underlying program effectiveness (or lack thereof). A systematic and comprehensive search of academic and grey literature uncovered 32 documents spanning 7 different intervention programs. Data was extracted from the included documents using abstraction templates designed to code for contexts, mechanisms and outcomes of each program. Two candidate program theories of family addiction were used to guide data analysis: the family disease model and the family prevention model. Data analysis was undertaken by a research team using an iterative process of comparison and checking with original documents to determine patterns within the data. Results Programs originating in both the family disease model and the family prevention model were uncovered, along with hybrid programs that successfully included components from each candidate program theory. Four demi-regularities were found to account for the effectiveness of programs included in this review: (1) opportunities for positive parent-child interactions, (2) supportive peer-to-peer relationships, (3) the power of knowledge, and (4) engaging hard to reach families using strategies that are responsive to socio-economic needs and matching services to client lived experience. Conclusions This review yielded new findings that had not otherwise been explored in COSAP program research and are discussed in order to help expand program theory. Implications for practice and evaluation are further discussed.

Problems and solutions occurred for using doping substances

Doping is now a global problem that follows international sporting events worldwide. International sports federations, led by the International Olympic Committee and World Anti-Doping Agency have for the past half century attempted to stop the spread of this problem, with little effect. It was expected that, with educational programs, testing, and supportive medical treatment, this substance-abusing behavior would decrease. Unfortunately, this has not been the case. In fact, new, more powerful and undetectable doping techniques and substances are now abused by professional athletes, while sophisticated networks of distribution have developed. Professional athletes are often the role models of adolescent and young adult populations, who often mimic their behaviors, including the abuse of drugs. This review of doping within international sports is to inform the international psychiatric community and addiction treatment professionals of the historical basis of doping in sport and its spread to vulnerable athletic and non-athletic populations. Keywords: doping, harmful aspects, existing problems, control of doping, ethics of sports

NONHUMAN SYSTEMS AS A SOURCE OF INTERACTIONAL RESILIENCE AMONG UNIVERSITY STUDENTS RAISED BY ALCOHOL-ABUSING CAREGIVERS IN LESOTHO

Research on the resilience of young people who were raised by substance-abusing caregivers is limited. This study aims to explore the internal interactional processes between nonhuman systems and young adults raised by alcohol-abusing caregivers in Lesotho. Multiple in-depth interviews were conducted and a draw-and-write technique applied with 15 university students, six of whom described having interacted with diverse nonhuman systems in their environment. A grounded theory analysis generated two themes: (1) interacting with empowering messages from non-present writers (through songs and books) and inspirational speakers (through videos) and (2) interacting with imaginary friends and inanimate objects (dolls and tattoos) in order to enhance their resilience. Van Breda’s interactional resilience approach, developed from person-in-the-environment perspective, and Margaret Archer’s theory of agency were found to be useful in interpreting the findings. The implications of the study include the need for social workers’ greater focus on young people’s interactions with nonhuman systems for resilience building.