Profile Of Abuse Research Articles

Addressing Elder Abuse: The Waterloo Restorative Justice Approach to Elder Abuse Project

The Community Care Access Centre (CCAC) of Waterloo Region, in partnership with a number of other social service agencies, designed and implemented a restorative justice model applicable to older adults who have been abused by an individual in a position of trust. The project was very successful in building partnerships, as many community agencies came together to deal with the problem of elder abuse. The program also raised the profile of elder abuse in the community. However, despite intensive efforts, referrals to the restorative justice program were quite low. Because of this, the program moved to a new organizational model, the Elder Abuse Response Team (EART), which has retained the guiding philosophy of restorative justice but has broadened the mandate. The team has evolved into a conflict management system that has multiple points of entry for cases and multiple options for dealing with elder abuse. The team has developed a broad range of community partners who can facilitate referrals to the EART and also can help to provide an individualized response to each case. The transition to the EART has been successful, and the number of referrals has increased significantly.

Drugs of abuse identified in the National Institute of Legal Medicine Mina Minovici Bucharest 2010

In the last few years in Romania a modern system of drug detection has been developed in the legal medicine system, increasing the detection rate and the sensitivity of DRD detection. In this short report we will present a general profile of drug abuse in Bucharest in 2010. The study was conducted in 2010 when a total number of 208 toxicology tests were conducted in the National Institute of Legal Medicine, 105 on cadavers and 103 on living persons. As main results, in living the most frequently identified drugs of abuse were THC and opiates whilst in cadavers opiates were the most frequent, followed by benzodiazepines. Conclusions. Opiate consumption has a tendency to decrease compared with 2009. Legal highs seems to shift the pattern of drug consumption in Bucharest and surrounding areas, but a definite results can only be obtained using test results from 2011.

Physical abuse of older people reported at the Institute of Forensic Medicine in Recife, Pernambuco State, Brazil

This cross-sectional study aimed to determine the profile of physical abuse against older people who underwent forensic examination at the Institute of Forensic Medicine in Recife, Pernambuco State, Brazil. The cases, with data from 1,027 forensic reports, were described according to characteristics of the incident, victim, and aggressor. Most cases of violence were produced by mechanical energy, either with blunt objects or by empty-handed attack; the most common day of the week was Sunday, most frequently in the evening, and in the victim's home; typical cases involved mild injuries on more than one part of the victim's body. The majority of the victims were men, 60 to 69 years of age, brown (mixed-race), married or living with a partner, and retirees/pensioners. The majority of the aggressors were men, known to the victim, and attacking alone. The social transcendence of violence against older people clearly calls for investment in programs to deal with the problem in order to ensure better quality of life for the elderly.

Profiles of individuals seeking psychiatric help for psychotic symptoms linked to methamphetamine abuse – baseline results from the MAPS (methamphetamine and psychosis study)

Background: Methamphetamine psychosis (MAP) is commonly encountered in psychiatric emergency rooms (ERs) in North America, and little is known regarding the specific needs of this clientele. Aims: This study aimed at describing the psychiatric and socioeconomic profiles of individuals with co-occurring methamphetamine abuse and psychosis profiles. Method: Two hundred and ninety-five (295) individuals needing psychiatric help for MAP were assessed regarding their socioeconomic situation, their substance abuse patterns, family histories, past psychiatric diagnoses, childhood trauma, and co-occurring disorders of depression, PTSD and antisocial personality disorder. Results: Eighty-seven percent had a family history of mental illness or substance abuse and close to 70% had a previous diagnosis of a mental illness, although only 21% of a psychotic disorder. Antisocial personality disorder, depression, and post-traumatic stress disorder were highly prevalent in our sample. Cluster analyses on methamphetamine (...

Illicit drugs in wastewater of the city of Zagreb (Croatia) – Estimation of drug abuse in a transition country

A comprehensive study of various psychoactive substances and their metabolites was performed in the wastewater treatment plant of the city of Zagreb (780 000 inhabitants) using liquid chromatography/tandem mass spectrometry (LC–MS–MS). The estimation of drug abuse for five different illicit drugs, including heroin, cocaine, marijuana, amphetamine and ecstasy, was made on the basis of their representative excretion rates, which were determined over a period of 8 months. Marijuana (1000 kg/year), heroin (75 kg/year) and cocaine (47 kg/year) were found to be the most frequently consumed illicit drugs, while the consumption of amphetamine-type drugs was much lower (1–3 kg/year). A comparison with other reports indicated that drug abuse profiles in transition countries might be different from those reported for Western Europe, in particular with respect to the comparatively increased consumption of heroin. Enhanced consumption of stimulating drugs (cocaine and ectasy) was systematically detected during weekends.

A study on substance abuse among school going male adolescents of Doiwala Block, District Dehradun

Adolescent boys are recognized as a vulnerable group to substance abuse. The present study has the objective to study the biosocial profile and habit pattern of substance abusers. The study was conducted on 511 male adolescents, students of 10 th to 12 th class from the four intermediate schools of the Doiwala block of Dehradun district. 46.9% students accepted substance abuse. In 75.5% cases, friends were providing the substances. 80.2% substance abusers expressed their desire to quit the habit. The study is indicative of need for developing a supportive environment involving both parents and teachers so that adolescent can decide and sustain with the right choices for healthy life.

PW01-118 - Personality traits and response inhibition in pedophile sexual abusers, pedophile internet abusers and controls - preliminary results

ObjectivesRecent research about pedophilia suggested an association between pedophilia, neurocognitive disturbance and specific personality profiles. Especially neuropsychological functions associated with the prefrontal and motor processing loops showed to be impaired in pedophilia. But in most studies about pedophilia subjects were recruited from high security forensic hospitals. The results might therefore be influenced by selection bias. To overcome this bias we conducted a study that aimed to compare neurocognitive disturbance and specific personality profiles of pedophile sexual abusers, pedophile internet abusers and controls.MethodsWe included until now 5 male pedophile sexual abusers, 4 male pedophile internet abusers and 6 male control subjects. Subjects were matched for age and IQ. Personality profiles were assessed by SKID and MMPI. Response inhibition was tested in a classical Go/NoGo task.ResultsAssessments of personality profiles showed similar sub threshold profiles for the controls and the group of internet abusers while subjects from security forensic hospital setting fulfilled criteria of personality disorders. Accordingly showed the Go/NoGo task higher rates of failed response inhibition in the group of paedophilic subjects from high security forensic hospital setting and lower rates for pedophile internet abusers and/or controls.ConclusionsOur preliminary data suggests that results of recent studies about neurocognitive disturbance and neuroimaging correlates of paedophilia might be influenced by selection bias and might rather reflect impairment of personality and social interaction in a broader sense. Future research about paedophilia should consequently aim to disentangle personality impairment from sexual orientation.

Different profile of substance abuse in relation to predominant polarity in bipolar disorder: The Vitoria long-term follow-up study

Background There is a need for comparisons of long-term outcomes in bipolar disorder patients with predominantly manic symptoms vs. predominantly depressive symptoms, especially the course of comorbid alcohol/substance abuse. Method A naturalistic sample of bipolar I patients ( n = 120) was followed prospectively for up to 10 years. At baseline, number and polarity of past episodes were used to classify patients as predominantly manic or predominantly depressive if there were more manic or more depressive episodes, respectively. 25 patients were excluded from the analyses. Outcomes including episodes, hospitalisations and suicide attempts were recorded at bimonthly visits. Mixed effects models compared the course of alcohol and other substance abuse in predominantly manic vs. depressive patients. Results Of the 95 patients analyzed, 44 (46.3%) had predominantly manic episodes and 51 (53.7%) had predominantly depressive episodes. At baseline, the predominantly depressive group had more history of suicide attempts (45.1% vs. 20.5%; p = 0.021) and more family history of affective disorders (64.7% vs. 38.6%; p = 0.020), but they had fewer previous hospitalisations than the manic group (mean 0.38 vs. 0.50; p = 0.025). During the 10-year follow-up, the predominantly depressive group was associated with more episodes ( p = 0.001), more hospitalisations ( p = 0.004) and more suicide attempts ( p = 0.002). At baseline, there were no differences between the manic and depressive groups in the frequency of alcohol abuse (43.2% and 35.3%, p = 0.565) or other substance abuse (13.6% and 9.8%, p = 0.794). During the 10-year follow-up, the frequency of alcohol and other substance abuse decreased significantly in the manic group only, after controlling by age at onset and civil (marital) status. Conclusion Long-term clinical outcomes differ between predominantly manic vs. depressive bipolar patients, with the predominantly depressive group having a worse prognosis and maintained alcohol and other substance abuse. These differences should be considered when designing treatment approaches for bipolar patients with comorbid alcohol/substance abuse.

Childhood abuse uncovered in a palliative care audit

This article aims to highlight potentially high levels of childhood sexual abuse within Cancer and Palliative Care Service users. During a routine audit, data was collated to quantify a perceived high level of disclosure of pre-existing psychological trauma within the palliative care caseload of a Macmillan Children and Families Therapist. Families comprised adults (generally parents or step-parents), one of whom was terminally ill or recently deceased who had direct responsibility for children and young people aged under 20 years old. Each family had at least two members using the service for advice, emotional support or counselling. A childhood sexual abuse rate of 33% for women and 10% for men was revealed. Of 59 families, 49% had one or more members who had experienced childhood sexual abuse. In addition a further 9% of adults had experienced severe physical and emotional abuse in childhood. Many families had faced multiple trauma. Palliative care clinicians have access to detailed personal and family history during a highly vulnerable transition. While confidentiality is paramount it is essential to develop better data collection methods and raise the profile of childhood sexual abuse as a major contributing factor to morbidity. A whole family assessment is crucial to ensure child protection and emotional care for children facing the loss and subsequently bereaved of a parent or a carer. Clinicians must be able to offer a range of approaches which provide distressed patients with a history of childhood abuse some sense of emotional containment at the end of life, a challenge which cannot be overstated.

A Profile of Substance Abuse, Gender, Crime, and Drug Policy in the United States and Canada

The climate of domestic drug policy in the United States as it pertains to both women and men at the beginning of the 21st century is the criminalization mode of regulation—a mode that is based on the model of addiction as a crime and one that is used to prohibit the use of illegal drugs. In Canada, drug policy is based mainly on the harm reduction model, a policy or program directed towards decreasing the adverse health, social, and economic consequences of drug abuse without requiring abstinence from such use. Using a comparative perspective, several issues are examined in this article: the prevalence of substance abuse between the two countries, the significance of gender and substance abuse, drug costs relative to both countries, the prevalence of crime and substance abuse, and domestic drug control policies.

Elderly in America: A Descriptive Study of Elder Abuse Examining National Incident-Based Reporting System (NIBRS) Data, 2000–2005

Elder abuse is the newest form of intrafamilial violence to garner the attention of the public, policy makers, health officials, researchers, and the criminal justice system. Despite evidence that elder abuse is a growing problem, there is little known about the phenomenon because of persistent limitations in the extant empirical work. The present study examined a large cross-national sample of reported incidents (n = 87,422) collected as part of the National Incident-Based Reporting System (NIBRS), 2000–2005. Addressing limitations in prior works, this research employed a criminal justice oriented definition of elder abuse examining victim, offender, and incident characteristics using chi-square tests and logistic regression to establish baseline findings from a more comprehensive sample of data than previously existed. Results render a baseline profile of victims and abusers and suggest that gender differences prevail throughout elder abuse. This work both corroborates and contrasts past findings of elder abuse research, providing new insights and much needed baseline data.

Drug abuse profile – patient delay, diagnosis delay and drug resistance pattern – among addict patients with tuberculosis

Socioeconomic problems limit the access of drug users to health-care services. This descriptive cross-sectional study was carried out by making use of the medical records of new case tuberculosis (TB) patients hospitalized at Masih Daneshvari Hospital, the national referral centre in Iran, from 2003 to 2006. Demographic and personal characteristics of the patients and type of disease were collected and categorized. Of the 944 patients with confirmed TB, 143 (15.1%) were drug users, among whom 140 (97.9%) were men with just three women drug users. The mean age of the drug users group was 43.04 +/- 13.81 years. The type of drug used was opium in 100 cases (69.9%), heroin in 29 (20.3%), opium and heroin together in four (2.8%) and all three, opium, heroin and crack, in two (1.4%). For 238 high-risk patients, an HIV test was performed and HIV infection was confirmed in 33 cases. Patient delay was longer in drug users (P = 0.000) against other patients, whereas diagnosis delay was shorter (P = 0.007). Drug susceptibility tests were performed for 515 patients with positive cultures. One hundred and thirty-three (14.1%) were found to have 'any resistance' to anti-TB drugs, and 10 (1.1%) individuals had multidrug-resistant TB. Twenty-six (19.5%) of the individuals who showed resistance to first-line agents were drug users. There was no significant relation between drug resistance and drug use (P = 0.4). In conclusion, it seems that active case finding for TB and HIV in addict cases must be contained in harm reduction packages. Moreover, the manifestations of the disease should be considered seriously regardless of attributing them to drug use.

How Predictors of Prescription Drug Abuse Vary by Age

Previous studies that have identified the predictors of prescription drug abuse have either focused on a specific age group or pooled all age groups together into one sample. This approach constrains the predictors to have the same effect across age groups. In this study, we use the 2001 to 2003 National Survey on Drug Use and Health to estimate separate models across five age groups for the past year nonmedical use of prescription drugs. The results indicate that several factors (e.g., gender, race/ethnicity marital status, other substance use) have quite different correlations with prescription drug abuse across age groups. This suggests that more accurate profiles of prescription drug abusers can be obtained by estimating separate models for different age groups.

P.6.c.006 Substance abuse and addiction profile in 6600 patients admitted at a psychiatric emergency room

P.6.c.006 Substance abuse and addiction profile in 6600 patients admitted at a psychiatric emergency room

Tri-city study of Ecstasy use problems: A latent class analysis

This study used latent class analysis to examine distinctive subtypes of Ecstasy users based on 24 abuse and dependence symptoms underlying standard DSM-IV criteria. Data came from a three site, population-based, epidemiological study to examine diagnostic nosology for Ecstasy use. Subject inclusion criteria included lifetime Ecstasy use exceeding five times and once in the past year, with participants ranging in age between 16 and 47 years of age from St. Louis, Miami, U.S. and Sydney, Australia. A satisfactory model typified four latent classes representing clearly differentiated diagnostic clusters including: (1) a group of sub-threshold users endorsing few abuse and dependence symptoms (negatives), (2) a group of ‘ diagnostic orphans’ who had characteristic features of dependence for a select group of symptoms (mild dependent), (3) a ‘ transitional group’ mimicking the orphans with regard to their profile of dependence also but reporting some abuse symptoms (moderate dependent), and (4) a ‘severe dependent’ group with a distinct profile of abuse and dependence symptoms. A multinomial logistic regression model indicated that certain latent classes showed unique associations with external non-diagnostic markers. Controlling for demographic characteristics and lifetime quantity of Ecstasy pill use, criminal behavior and motivational cues for Ecstasy use were the most efficient predictors of cluster membership. This study reinforces the heuristic utility of DSM-IV criteria applied to Ecstasy but with a different collage of symptoms that produced four distinct classes of Ecstasy users.

Psychiatric morbidity among sexually abused children and adolescents

To describe the social demographic profile and identify psychiatric morbidity in sexually abused children and adolescents. A Cross-sectional descriptive survey. Nairobi Women's Hospital (NWH) Gender Violence Recovery Centre (GVRC), Hurlingham, Nairobi-Kenya. A sample of 61 sexually abused children and adolescents aged 7-17 years. Eighty two percent of the survivors were sexually abused by acquaintances such as neighbours, caregivers and parents. Ninety percent of the sampled group were females. Abuse occurred in both single and both parent families and regardless of the guardian/parental economic status. Sixty six percent of the survivors' parents were abusing psychoactive substances. Sexual abuse variables and most of the social demographic variables did not predict either presence or absence of psychiatric morbidity. Only 66% of the abuse came to the notice of the child's caregiver within the first 48 hours. On the socio demographic profile, the only factor that showed a statistical significant difference in predicting presence or absence of psychiatric morbidity was the family's way of sorting out their disagreements (p = 0.045). The prevalence of psychiatric morbidity among the subjects studied as measured by the Diagnostic Statistical Manual Text Revision (DSM IV-TR) was found to be 69%. Eight different types of DSM IV-TR diagnoses were made. Twenty nine percent of the AXIS-I DSMIV-TR diagnoses were co-morbidities (Multiple DSM IV-TR diagnoses). The psychiatric morbidity prevalence is comparable to that found in other studies. Sexual abuse occurred regardless of the social demographic variables. Family's way of sorting out disagreement predicted presence or absence of psychiatric morbidity among the study subjects. Majority (82%) of the sexual abusers were acquaintances to the study subjects. It is recommended that all children and adolescents who have been sexually abused be evaluated for psychiatric morbidity regardless of their social demographic and abuse profiles and that all parents and care givers, be sensitised on childhood sexual abuse and the fact that majority of the perpetrators are acquaintances to the subjects. Families need to be sensitised on their role on prevention and reduction of psychiatric morbidity among children and adolescents in general.

From Behind the Shadows: A Profile of the Sexual Abuse of Older Men Residing in Nursing Homes

SUMMARY Previous research on the sexual abuse of older adults has revealed few cases of the sexual abuse of older men. The first national study of the sexual abuse of vulnerable adults in facilities, reported in this article, collected data on alleged, investigated, and substantiated cases of sexual abuse. This study revealed 26 cases reported and screened in for investigation concerning the alleged sexual abuse of older men (aged 50 and older) residing in nursing homes. Cases occurred in five states within a six month time period. Of these cases, six were confirmed upon investigation by Adult Protective Services or other regulatory agencies. Victims tended to be predominately white males with cognitive and physical deficits that limited their ability for self care. The most typical sexual abuse alleged and substantiated was fondling. Residents were more often substantiated as the abuser than other perpetrators. Sexual abuse of older men in nursing homes crosses traditional gender, cultural, and role boundaries for both victims and perpetrators.

Usefulness of multi-parameter opiates–amphetamines–cocainics analysis in hair of drug users for the evaluation of an abuse profile by means of LC–APCI-MS-MS

The report presents a segmental hair analysis for the retrospective multi-parameter evaluation of drugs of abuse including opioids, cocainics and amphetamines. The analysis was carried out with the use of liquid chromatography atmospheric pressure chemical ionization tandem mass spectrometry (LC–APCI-MS-MS). The authors have evaluated the differences in the contents of particular opiates in the hair as related to the origin of a sample taken from Polish drug users taking “Polish heroin”, and also from heroin abusers from Western European countries taking “Western heroin”. The results indicate distinct differences in the 6-MAM concentration values in the Polish and foreigners, suggesting that the foreigners take products containing high concentrations of heroin and the Polish take the poppy product “compote” characterized by its variable and low heroin content. An additional argument for a different abuse profile in the Polish and Western drug users is found in the presence of cocaine detected in hair samples originating from the latter, while cocaine is much less frequently detected in Polish drug users.

Victims and assailants’ profile of sexual abuse from an outpatient clinic. A descriptive study

Sexual abuse is a significant problem in public health as it evolves from a multifactorial social phenomenon, bringing about consequences for the victim as well as society. It is a retrospective descriptive research held in an outpatient clinic for victims of sexual abuse from January 2002 to March 2005. The study aimed to: outline clients’ profiles and typify assailants. Most clients were women, between 15 and 20 years of age, elementary educational level, single, sexually active. The assailants intimidated them at gunpoint and most of them effected vaginal sexual intercourse. There were no cases of pregnancy, HIV or STDs among the properly treated clients. Only 12% returned to all appointments and 46% completed antiretroviral treatment.

Victims and assailants’ profile of sexual abuse from an outpatient clinic. A descriptive study

Sexual abuse is a significant problem in public health as it evolves from a multifactorial social phenomenon, bringing about consequences for the victim as well as society. It is a retrospective descriptive research held in an outpatient clinic for victims of sexual abuse from January 2002 to March 2005. The study aimed to: outline clients’ profiles and typify assailants. Most clients were women, between 15 and 20 years of age, elementary educational level, single, sexually active. The assailants intimidated them at gunpoint and most of them effected vaginal sexual intercourse. There were no cases of pregnancy, HIV or STDs among the properly treated clients. Only 12% returned to all appointments and 46% completed antiretroviral treatment.