ISSN:1055-0496    

DOI:10.1111/j.1521-0391.1992.tb00001.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

Prevention efforts in alcohol and drug abuse have typically focused on the general population. However, most individuals who abuse addictive drugs either terminate consumption voluntarily or do not progress to a clinical diagnosis of psychoactive substance use disorder (PSUD). Because PSUD has such adverse effects on costs to society, prevention research and practice should emphasize the development and implementation of interventions for individuals who are at high risk for this disorder. This article proposes a conceptual framework for better understanding of the etiology of PSUD and for implementing prevention efforts that are targeted to specific vulnerabilities of an individual. These vulnerabilities are discussed with respect to their spatial organization (i.e., manifestations across multiple levels of biobehavioral organization) and temporal organization (i.e., manifestations across an individual's life span).

ISSN:1055-0496    

DOI:10.1111/j.1521-0391.1992.tb00002.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

Psychoactive substance abuse and psychoactive substance dependence among adolescents are considered to be high‐risk factors for attempted and completed suicide. The typical adolescent at risk for suicide in the United States is a Caucasian male who is likely to be intoxicated and is likely to commit suicide with a firearm without ever seeking treatment. Psychopathologies such as depression and conduct disorder and personality disorders accompanied by precipitating events are frequently present. This review will examine the association between substance abuse and/or substance dependence and suicidal behavior from an epidemiological perspective. Clinical implications and research directions will be offered in conclusio

ISSN:1055-0496    

DOI:10.1111/j.1521-0391.1992.tb00003.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

Thirty‐five chronic cocaine users were offered carbamazepine in an open clinical trial as an adjunct to outpatient treatment for cocaine dependence. Nine patients refused ongoing carbamazepine treatment, 13 decreased their cocaine use from 65/100 days pretreatment to 2.8/100 days with treatment (2,562 days at risk), and 13 had a reduction from 78.1/100 days pretreatment to 35.1/100 days with treatment (2,790 total days at risk). The 9 carbamazepine refusers had virtually no change in their cocaine use. The degree of patient compliance with carbamazepine intake correlated directly with decreased cocaine use and with lowered craving intensity, frequency, and duratio

ISSN:1055-0496    

DOI:10.1111/j.1521-0391.1992.tb00004.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

This 6‐month follow‐up study of 43 of 72 patients who entered a 6‐week randomized clinical trial of pharmacotherapy for cocaine dependence found that self‐reported cocaine abstinence during the 6 months was significantly greater in patients treated with desipramine (44%) than in those treated with lithium (19%) or placebo (27%). The placebo group had more occurrences of depression (36% vs. 6%) and daily alcohol abuse (36% vs. 15%) than the medicated groups. The ability to abstain from cocaine use during the clinical trial was the strongest predictor of continued abstinence during the follow‐up, which showed that 53% remained abstinent after

ISSN:1055-0496    

DOI:10.1111/j.1521-0391.1992.tb00005.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

Proposed DSM‐IV revisions to psychoactive substance dependence include emphasizing the physiological symptoms of tolerance and withdrawal by requiring the presence of either symptom to diagnose psychoactive substance dependence or by subtyping the diagnosis according to presence or absence of physiological symptoms. This article is an empirical evaluation of the tolerance and withdrawal criteria in a sample of 399 cocaine abusers. The required use of tolerance or withdrawal to make a dependence diagnosis had a comparatively small impact on rates of diagnosis because most of the subjects who meet DSM‐III‐R criteria for dependence report tolerance as one of their symptoms. In contrast, withdrawal or withdrawal avoidance are reported by a much smaller number. Compared with other DSM‐III‐R dependence syndrome criteria, tolerance and withdrawal showed no superiority in test‐retest agreement, concurrent validity, or predicti

ISSN:1055-0496    

DOI:10.1111/j.1521-0391.1992.tb00006.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

Medical students at The University of Calgary were surveyed about their experiences with and attitudes toward alcohol abuse using the Children of Alcoholics Screening Test (CAST), the Codependency Assessment Inventory (CDAI), the CAGE's four questions, and the Substance Abuse Attitude Survey (SAAS). Nineteen percent of the 110 respondents showed strong evidence that they were the offspring of alcoholics (CAST ≥ 6), 22% reported strong codependency traits (CDAI ≥ 30), and 22% showed evidence of alcohol problems (CAGE ≥ 2). Among the five subscales of the SAAS, three showed a significant amount of variance determined by the personal variables investi

ISSN:1055-0496    

DOI:10.1111/j.1521-0391.1992.tb00007.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

The psychological factors that predispose an individual to substance abuse are the same factors involved in relapse, a major threat to recovery from a reliance on substances. Modified Dynamic Group Therapy (MDGT) is a group therapeutic approach that is sufficiently supportive and structured to provide the safety and comfort that such patients require, but unstructured enough to allow a natural unfolding of their vulnerabilities and characterological defenses that need to be identified and modified. MDGT targets and focuses on four areas of self‐regulation vulnerabilities involving difficulties with feeling life (affects), self‐esteem, relationships, and self‐care, and the defensive, characterological traits that compensate for, while they also reveal, these vulnerabi

ISSN:1055-0496    

DOI:10.1111/j.1521-0391.1992.tb00008.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

Implementing appropriate treatment of patients with dual diagnosis is one of the most vexing conundrums in contemporary psychiatry. Surprisingly, however, there have been few reports of the use of case management in treating this patient group, despite its apparent face‐value applicability to this difficult clinical population. The authors report their experience in applying case management to a group of “depressed” and/or “negative‐symptom” schizophrenic patients with substance abuse problems. They found most problematic areas were confidentiality, treatment compliance, and the necessity and timing of abstinence. Discussion of these issues is illustrated with c

ISSN:1055-0496    

DOI:10.1111/j.1521-0391.1992.tb00009.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

Alcohol abuse or dependence may complicate medical and surgical treatment. Two cases involving patients with head and neck cancer are presented to illustrate 1) continued drinking despite adverse medical consequences and 2) the need for careful assessment and appropriate intervention with alcohol‐dependent patient

ISSN:1055-0496    

DOI:10.1111/j.1521-0391.1992.tb00010.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY