摘要:

The author reviews countertransference in relation to the psychodynamics of substance abusers. The contemporary view of countertransference acknowledges the importance of reciprocal cycles of interaction between patients and therapists. These cycles can now be viewed as a pathway for change for the substance‐abusing patient. The six phenomena that are fused with countertransference (i.e., parallel process, codependence, denial, enabling, burnout, and family of origin) are discussed in detai

ISSN:1055-0496    

DOI:10.1111/j.1521-0391.1992.tb00024.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

This study evaluates a screening tool, based on the acronym “A‐I‐D‐S,” for assessment of risk of HIV infection. Patients were asked if they were afraid they had been exposed to AIDS, had everusedintravenousdrugs or received blood products, had anydiagnosticfeatures of HIV infection, and had engaged in any high‐risksexualbehaviors. The rating of risk based on the A‐I‐D‐S study questionnaire correlated significantly with assessments of risk by the treating physician and based on chart review. The A‐I‐D‐S mnemonic proved to be rapid and accurate for assessing

ISSN:1055-0496    

DOI:10.1111/j.1521-0391.1992.tb00025.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

The authors assessed the characteristics of disadvantaged, dually diagnosed schizophrenic individuals, antecedents of their substance abuse, and their treatment outcome. Forty hospitalized inpatients were evaluated. When daily users were compared with less frequent users, differences were found in measures of parental substance abuse. Frequency of drug use did not discriminate between the two groups on admission or discharge. However, treatment response, as measured by Brief Psychiatric Rating Scale scores, improved significantly in both groups.

ISSN:1055-0496    

DOI:10.1111/j.1521-0391.1992.tb00026.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

The authors investigated the association between age at menarche and age at onset of substance use with frequency of alcohol consumption in mid‐adolescence; age at first DSM‐III‐R diagnosis of psychoactive substance use disorder (PSUD); severity of physical health, substance use, and psychosocial problems; and psychiatric disorders in female adolescents. Twenty‐eight PSUD female adolescents (age 14–18 years) were studied. Chronological age at first substance use, and not age at menarche, was associated with the four variables mentioned above. These findings indicate that substance use in this population is encompassed within significant psychiatric disturbance that most commonly precedes the onse

ISSN:1055-0496    

DOI:10.1111/j.1521-0391.1992.tb00027.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

This article presents a training curriculum in substance abuse that can be incorporated within an existing psychiatry residency training program. This set of training experiences is currently in place in the psychiatry residency program at the University of Minnesota. It includes a series of basic psychopathology lectures; focused lectures on the interview of the chemically dependent patient; a full‐time, core clinical rotation in alcohol and drug abuse; a didactic graduate seminar; a longitudinal outpatient management experience; advanced electives; research opportunities; resident presentations and teaching experience; and the possibility of a chemical dependency fellowship progra

ISSN:1055-0496    

DOI:10.1111/j.1521-0391.1992.tb00028.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

Craving, which ranges from a sustained desire for drugs persisting for weeks to an acute desire passing within minutes, has been described as an important clinical precipitant of relapse in cocaine and opioid abusers and may be a useful surrogate outcome for developing new drug abuse pharmacotherapies. Whereas craving for opioids frequently has been conceptualized as the negative reinforcer of protracted withdrawal or “drug hunger,” craving for cocaine has been conceptualized as the positive reinforcer of remembered euphoria. Medications can reduce both sustained cocaine craving and acute craving induced by a single dose of cocaine, and reductions in both types of craving are correlated with reductions in cocaine use. Furthermore, high levels of craving during treatment or during cue‐induced challenges predict poor treatment response and later relapse to cocaine abuse in those who have attained absti

ISSN:1055-0496    

DOI:10.1111/j.1521-0391.1992.tb00029.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

The Addiction Severity Index (ASI), an instrument used in the evaluation of program effectiveness in the alcohol and drug dependency field, has been expanded and modified for use in patients with gambling problems. The Gambling Severity Index component of the modified ASI was tested for validity using a sample of 119 inpatient pathological gamblers. The ASI modification retains the reliability and validity of the original instrument while adding gambling‐specific items for evaluation of gambling treatment programs in which there are significant numbers of substance‐abusing patie

ISSN:1055-0496    

DOI:10.1111/j.1521-0391.1992.tb00030.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

The authors performed three studies to determine if drug abusers preferring three different psychoactive substances (alcohol, cannabis, or cocaine) differed on subjective experience of their drug of preference as measured by modified versions of the Adjective Checklist (ACL; Gough and Heilbrun, 1983). In addition, the subject's stimulus sensitivity was measured by the Vando Reducer‐Augmenter (RA) scale. In all three studies, responses to the modified ACL (MACL and MACL‐18) differentiated drug of preference in over 80% of the cases. This suggests that subjects perceive a unique subjective experience from their drug of choice, which may constitute a basis for their drug preference. In the second and third studies, alcohol‐preferring subjects scored significantly lower on the RA scale than those who preferred either cannabis or cocaine, suggesting that they were more sensitive to stimuli. The results are discussed within the contexts of the optimum arousal and self‐medication theories of drug ad

ISSN:1055-0496    

DOI:10.1111/j.1521-0391.1992.tb00031.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

The author explores the nature of the relationship between attention‐deficit hyperactivity disorder (ADHD) and psychoactive substance use disorder (PSUD). Researchers of ADHD in children and adolescents have posited that the development of conduct disorder and antisocial personality disorder is an unavoidable step in the path to PSUD. Some investigators of adult substance abusers do not subscribe to this opinion, and others give considerable weight to the self‐medication theory. The choice of cocaine as a preferred drug for self‐medication by adults with attention deficit disorder has been specifically reported. The author presents a critical review of this issue as well as methodological, nosological, and interpretive problems, and intervention implica

ISSN:1055-0496    

DOI:10.1111/j.1521-0391.1992.tb00032.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

The authors examine the utility of a fluorescence polarization immunoassay (the ADx Cocaine Metabolite Assay) for the determination of benzoylecgonine in 41 patients (28 women and 13 men) admitted to an inpatient substance abuse treatment unit following recent cocaine use. The assay remained positive (i.e., exceeded 300 ng/ml) in urine for a mean of 84.4 hours from the last reported use. There was no difference by gender or route of administration either for grams used or hours of positivity. Cocaine use in the week prior to admission was the only significant predictor of hours of positivity; age, gender, and weight did not contribute significantly to the variance. The implications of these findings for both cocaine pharmacokinetics and for treatment of cocaine abuse are discussed.

ISSN:1055-0496    

DOI:10.1111/j.1521-0391.1992.tb00033.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY