摘要:

AbstractThe importance of sharing infecting equipment in the transmission dynamics of HIV is well established. Comparatively less is known about the sexual behaviour of drug injectors and the risks posed to themselves and their sexual partners through the sexual transmission of HIV. Findings are reported from survey‐based interviews undertaken in 1991 which investigated the sexual behaviour of 516 drug injectors, both in and out of treatment in London. The majority of respondents (80%) were sexually active in the 6 months preceding interview. During this time, respondents had a mean of 2.1 non‐commercial opposite sex partners. Most (66%) had vaginal intercourse at least once a week, although 68% never used condoms with primary partners and 34% never used condoms with casual partners. Those having sexual intercourse most often were less likely to use condoms. Many had non‐injecting sexual partners, and 62% of respondents' primary and casual partners did not inject drugs. Confirmed saliva HIV test results show 10% of respondents to be antibody positive, with a higher rate of prevalence (14% positive) among those with no experience of treatment. This group were also more likely la report casual sexual intercourse. The average rate of partner change, the high proportion of drug injectors with non‐injecting partners and the infrequency of condom use within primary and casual relationships indicates the potential for HIV transmission between injectors and their non‐injecting sexual partners. The paper concludes by emphasizing the importance of outreach and community‐based intervention in safer sex healt

ISSN:0965-2140    

DOI:10.1111/j.1360-0443.1994.tb02785.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

AbstractTwo prominent behavioral syndromes associated with chronic cocaine use that have been described in the literature are cocaine‐induced paranoia (CIP) and cocaine‐induced compulsive foraging (CICF) for cocaine. To help to clarify the relationship between the two cocaine‐induced syndromes, the concordance and sequence of onset of the two cocaine‐induced behaviors over the course of the patients' lifetime use of cocaine and during the course of a binge was examined in 62 crack cocaine‐dependent men. Winy‐four (54.8%) reported experiencing both CIP and CICF. In 18 (29%) of the patients, only one of these cocaine‐induced behavioral syndromes was reported. Ten (16.1%) of the subjects reported neither CIP nor CICF. Patterns of cocaine or other substance use and degrees of tolerance to cocaine were not significantly different between the groups endorsing different patterns of cocaine‐induced behaviors. CIP typically preceded the onset of CICF both over the course of the patients' lifetime use of cocaine and over the course of a binge. The study results suggest varying thresholds for the expression of these behaviors in chronic cocaine‐ab

ISSN:0965-2140    

DOI:10.1111/j.1360-0443.1994.tb02786.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

AbstractDSM‐III‐R and proposed DSM‐IV schemes for the diagnosis of psychoactive substance use disorders art‐based largely mi the dependence syndrome concept. However there is an absence of empirical support for the generalizability of the dependence syndrome across substances, flits study examines how consistently proposed DSM‐IV dependence criteria function to measure dependence across seven substances: alcohol, cannabis, cocaine, stimulants, hallucinogens, sedatives and opiates. Using structured research diagnostic interviews, dependence diagnoses were determined for 295 American subjects in treatment for alcohol/drug problems. Several factor analytic techniques were used la assess whether criteria fanned single dimensions and ham consistently individual criteria measured dependence across substances. The ability and consistency of criteria to measure a continuum of severity across substances were also assessed. Only subjects who used the substance at least six times were entered in the analyses. Overall, results provide strong support fur the DSM approach for alcohol, cannabis, cocaine, stimulants, sedatives and opiates, but not for hallucinogens. Results indicate that a single strong factor adequately described the criteria for these six substances. All criteria loaded strongly and uniformly on single factors indicating that all litre good measures of dependence. Criteria provided a dimensional measure of severity based on several indices for these substances. In addition, four criteria provided relatively stable indicators of high or tow severity across these substances. Results did not support the use of dependence criteria for Hallucinogens as these criteria did not form a single factor. Results suggest that very few hallucinogen users experience an inability to cut down or control use, a key indicator of loss o

ISSN:0965-2140    

DOI:10.1111/j.1360-0443.1994.tb02787.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

AbstractPsychiatric research increasingly emphasizes the diagnosis of symptoms and syndromes on a longitudinal basis. This study tests the reliability of lifetime DSM‐IV diagnoses of alcohol, cannabis, cocaine and opiate dependence. The CIDI‐SAM was administered at intervals not less than six months apart to a multi‐site sample of 201 clinical respondents. The reliability of lifetime diagnosis of the syndromes, of the criteria which constitute the syndromes, and of the ages of onset reported for the criteria and for the dependence syndromes as a whole, were studied and the effects of patient characteristics suspected to degrade reliability were examined. There was generally good agreement, statistically, at both the syndrome and criterion level between the two interviews. Lifetime diagnoses for three of the drugs–alcohol, cannabis and opiates–were made at or near levels of agreement generally considered excellent under less strict testing conditions, and cocaine dependence was only marginally below this level. Most criteria showed good reliability and all delivered about equal results when averaged across the four substances, although a relationship between reliability and centrality of the symptom to the individual drug abuse pattern was found. Age of onset was almost uniformly highly reliable. Most patient characteristics bore no detectable relationship to reliability, although patients with multiple drug use patterns may warrant more careful probing by interviewers. Overall, these data indicate that lifetime symptoms and diagnoses can be queried reliably, although they must be reported with less confidence than current slate

ISSN:0965-2140    

DOI:10.1111/j.1360-0443.1994.tb02788.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

AbstractAccording to DSM‐III‐R a positive diagnosis of alcohol dependence requires the presence of at least three of nine symptoms of a core dependence syndrome. In this study the presence of the nine symptoms according to degree of the severity of dependence is examined in 99 patients (mild, n=23; moderate, n = 26; and severe, n = 50). It is shown that although the cut‐off point far a positive diagnosis of dependence is the presence of “any three” out of nine DSM‐III‐R criteria, specific symptoms (“excessive drinking”, “desire or efforts to control drinking”, and “drinking despite major problems”) have a high probability of occurrence across the dependence seventy range (mild, moderate or severe). Conversely, other symptoms appear prominently only in the more were cases (“much time devoted to alcohol”, “important activities given up”, and “drinking to relieve withdrawal”). The results suggest that in the DSM‐III‐R criteria for alcohol dependence name symptoms are mare frequently associated with the diagnosis, white other symptoms are associated with s

ISSN:0965-2140    

DOI:10.1111/j.1360-0443.1994.tb02789.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

AbstractProblem drinkers (99 males, 41 females) wishing to qmt or cut down without professional help received a 60‐minute session during which they lucre‐ assessed and given at random one of these materials: Guidelines, a two‐page. pamphlet outlining specific methods for achieving abstinence or moderate drinking; Manual, a 30‐page booklet describing the methods in the Guidelines; or General Information, a package about alcohol effects. At 12 months following ‐up, subjects in the Guidelines and Manual conditions showed significantly greater reductions of heavy days (of 5 + drinks) than subjects in General Information (70% vs. 24%); in addition, significantly fewer subjects in the Guidelines and the Manual conditions expressed need for professional assistance will their drinking (25% vs. 46% in General Information). No main effect of condition or gender was observed on rates of moderate drinking. At 12 months follow‐up, 31% of the men and 43% of the women were rated as moderate drinkers. It was concluded that drinkers intending to cut damn on their own derive greater benefit (in terms of their alcohol use) from materials containing specific instructions to develop moderate drinking than from those providing general information on alcohol effects. Clinical and research implications of the findings ar

ISSN:0965-2140    

DOI:10.1111/j.1360-0443.1994.tb02790.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

AbstractTwo measures of alcohol consumption were used to predict groups of alcohol problems in 21 general population studies from 11 countries to determine (a) if quantity of drinking per occasion or frequency of drinking per month constituted significant “risk” for alcohol problems, having controlled for each as well as individual‐level and aggregate‐level variables winch might confound these relationships and (b) if these associations mere homogeneous across studies. A two‐tiered analysis assessed these relationships within each study by modeling age, sex, quantity per occasion and frequency per month as predictors of alcohol problems. Mela‐analysis combined test statistics to determine if they were homogeneous across studies. The meta‐analysis was repealed, blocking for per capita consumption of alcohol (a trait of nations thought to measure drinking norms) and the female rate of suicide (a trail of nations thought to measure societal‐level stress). When only individual‐level variables were controlled (age and sex), both quantity and frequency were risk factors for each drinking problem. However, except in the case of the association of quantity with alcohol treatment, the magnitude of these risks were heterogeneous across studies. When blocking for the societal‐level traits, each had more relevance for some, but not all, of the relationships between consumption and problems. Particularly striking was the welt‐documented finding that per capita consumption of alcohol significantly distinguished the relationships of frequency of drinking and health problems (while the female suicide rate did not) and the previously undocumented finding that the female suicide rate significantly distinguished the relationships of both quantity and frequency with treatment (while the per capita consumption of alcohol did not). These findings suggest that the impact of norms and the impact of societal stress in groups have different but significant consequences for the relationships of co

ISSN:0965-2140    

DOI:10.1111/j.1360-0443.1994.tb02791.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

AbstractTwo versions of a school‐based alcohol prevention programme for 7th grade students were evaluated against a non‐treated comparison condition. Both programme versions were based on a social‐cognitive theory approach to alcohol prevention, and differed in the level of role‐specifications for participating teachers and peer leaders. Twelve schools with 955 students m Bergen, Norway, participated in the study. Four schools were randomly assigned to each of the three conditions, and the programme was implemented during 10 class periods over 2 months in Spring, 1992. Pre‐ and post‐test surveys were conducted, assessing alcohol use, as welt as cognitive variables related to alcohol use in a specific context (intentions, attitudes, norms and self‐efficacy expectations). Results showed that the highly role‐specified (HRS) version had a higher degree of student involvement than the less role‐specified (LRS) version, indicating that the HRS programme was more successful in engaging students in alcohol prevention activities. A significant difference in programme effectiveness was found, as measured by an overall programme effect across all dependent variables. This effect was explained by significantly more positive outcomes in the HRS version compared to both the LRS and the non‐treated conditions, while the LRS version did not differ significantly from the no

ISSN:0965-2140    

DOI:10.1111/j.1360-0443.1994.tb02792.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

AbstractThis paper examines the connection between medical research and temperance from the point of view of the Anglican temperance movement in three periods: (1) 1830–55, when Anglican clergymen resisted teetotalism in favour of mideration, in keeping with accepted medical opinion; (2) 1855–73, when a miniority of Anglican teetotal clergymen attempted unsuccesfully to convert the Anglican Church to teetotalism and prohibition, as the medical profession in theory, but not always in practice, disoruaged excessive therapeutic reliance on alcohol; and (3) 1873–1914, when the prestigious Church of England Temperance Society, with a dual basis, promoted teetotalism among the majority but affirmed the legitimacy of moderate drinking among the British medical and social

ISSN:0965-2140    

DOI:10.1111/j.1360-0443.1994.tb02793.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

Women and Substance AbuseEDITH S. LISANSKY GOMBERG&TED D. NMRENBERG (Eds)The Facts about Drug Use: coping with drugs and alcohol in your family, at work, in your communityBARRY STIMMEL and the Editors of ConsumerSubstance Abuse Treatment. A Family Systems PerspectiveEDITH M. FREEMAN (Ed.)The Recovery BookA. J. MOONEY, A. E1SENBERG&H. EISENBERGPsychoactive Drugs and Harm Reduction: From Faith to ScienceN. HEATHER, A. WODAK, E. NADEL‐MANN&P. O'HARE (Eds)Women Drug Users: An Ethnography of a Female Injecting CommunityAVRIL TAYLORDrink in Canada: Historical EssaysCHKRYL KRASNICK WALSH (Ed

ISSN:0965-2140    

DOI:10.1111/j.1360-0443.1994.tb02794.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY