Abuse Treatment Research Articles

Evaluating an Integrated APS–Elder Advocate Intervention Model in the State of Maine

Despite recommendations to include a distinct intervention phase in Adult Protective Services (APS), most APS programs close cases following investigation/substantiation phases without engaging in a defined intervention phase. This study implements and evaluates a novel APS service planning/intervention model in the state of Maine. Using an experimental efficacy trial design with stratified random sampling at the level of Maine APS offices, this study compares standard APS care with an enhanced/integrated APS intervention model involving “elder advocates”. Advocates were trained in motivational interviewing, supported decision-making, teaming, restorative justice, and goal attainment scaling to develop capacity to work with both the older adult victim and perpetrator and to strengthen the family and social systems surrounding the victim-perpetrator dyad. This presentation will present results on the efficacy of this integrated APS/elder advocate model and discuss the challenges and successes in conducting elder abuse intervention research in collaboration with APS and APS clients. Part of a symposium sponsored by Abuse, Neglect and Exploitation of Elderly People Interest Group.

Alcohol-related mortality and all-cause mortality following bereavement in two successive generations.

Background and aimBereavement affects the health of the bereaved both emotionally and physically. Bereavement resulting from alcohol-related death of the previous generation (parents-first generation) may increase the risk of alcohol abuse and consequently alcohol-related mortality as well as all-cause mortality in the next generation (offspring-second generation). Furthermore, these associations can be bi-directional. However, there is no conclusive evidence of these effects, and studies exploring these intergenerational effects are rare. This study investigates these associations.MethodsA longitudinal data were constructed by linking participants from the Adolescent Health and Lifestyle Surveys (AHLS) from 1979 to 1997 with census and registry-based data from Statistics Finland containing the socioeconomic status of the survey participants and their parents (N = 78610) to investigate these associations. Multivariate Cox proportional hazards models were used to calculate hazard ratios with 95% confidence intervals to determine the effect of bereavement with alcohol-related mortality and all-cause mortality.ResultsThe findings suggest that bereavement following the death of an offspring increases the risk of both alcohol-related and all-cause mortality among both parents. The magnitude of the risk of mortality following the death of an offspring is higher for mothers than for fathers. There were no clear associations of a parent’s death with an offspring’s alcohol-related or all-cause mortality. However, generally, a father’s death seems to be protective of the risk of mortality among the offspring while a mother’s alcohol-related death slightly increased the risk of alcohol-related mortality among their offspring.ConclusionsThese findings emphasise the role of bereavement, particularly resulting from the death of an offspring, on alcohol-related and all-cause mortality and therefore inequalities in mortality. Furthermore, the findings highlighting the need for alcohol abuse intervention and emotional support for bereaved persons following the death of an offspring.

How Resilience Promotes Mental Health of Patients With DSM-5 Substance Use Disorder? The Mediation Roles of Positive Affect, Self-Esteem, and Perceived Social Support.

Objectives: The existing studies found that resilience is a salient trait that can significantly affect people's psychological well-being with substance use disorders (SUDs). However, few studies examined how the mechanisms are connected between resilience and mental health among patients with Diagnostic and Statistical Manual of Mental Disorders—fifth edition SUD. This study investigated the mediation effects of positive affect, perceived social support, and self-esteem on the effect of resilience on perceived stress and life satisfaction in SUD patients.Design: A total of 415 patients diagnosed with Diagnostic and Statistical Manual of Mental Disorders—fifth edition SUD from the south of China joined the research.Outcome Measures: The study applied Connor–Davidson Resilience Scale, Positive and Negative Affect Scale, Multidimensional Scale of Perceived Social Support, Rosenberg Self-Esteem Scale, and Satisfaction with Life Scale to measure patients' resilience, positive affect, self-esteem, perceived social support, perceived stress, and life satisfaction.Results: Structural equation model analysis revealed that positive affect and self-esteem partially mediate the relationship between resilience and perceived stress. In contrast, positive affect and perceived social support partially mediate the relationship between resilience and life satisfaction.Conclusion: The findings provide insights for evidence-based substance abuse intervention that positive affect, self-esteem, and perceived social support can conditional the effects of resilience on promoting the mental health of SUD patients.

Increasing collaboration and translation in epidemiology and intervention research.

Epidemiologic research serves as an important foundation for intervention research. In this way, it can contribute to vast improvements in public health. However, to fully capitalize on what is learned through epidemiology, collaborations must ensure the translation of epidemiologic findings into both treatment and prevention interventions. This commentary suggests some ways in which epidemiology can inform intervention research and how intervention research can be backtranslated so that epidemiological studies are designed to better inform intervention design. The commentary does this by using as examples the original contributions in this special section on the intergenerational transmission of cannabis use. These studies identify several ways in which epidemiology can inform intervention and discuss mechanisms of risk transmission from one generation to the next, such as parental monitoring, parent norms around substance use or parenting strategies, poor inhibitory control, or perceptions of harm from substance use. Targeting these mechanisms could be important for effective intervention. The papers further explore factors that might mitigate or amplify the association between parental and offspring use of cannabis, such as active coping or harsh parenting. Finally, to ensure bridging between substance abuse epidemiology and intervention research, this article considers research training practices. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Polysubstance Use Common in SUD Patients

Polysubstance Use Common in SUD Patients

Estimation of the Development of Depression and PTSD in Children Exposed to Sexual Abuse and Development of Decision Support Systems by Using Artificial Intelligence

ABSTRACT The most common diagnoses after childhood sexual abuse are Post-Traumatic Stress Disorder and depression. The aim of this study is to design a decision support system to help psychiatry physicians in the treatment of childhood sexual abuse. Computer aided decision support system (CADSS) based on ANN, which predicts the development of PTSD and Major Depressive Disorder, using different parameters of the act of abuse and patients was designed. The data of 149 girls and 21 boys who were victims of sexual abuse were included in the study. In the designed CADDS, the gender of the victim, the type of sexual abuse, the age of exposure, the duration until reporting, the time of abuse, the proximity of the abuser to the victim, number of sexual abuse, whether the child is exposed to threats and violence during the abuse, the person who reported the event, and the intelligence level of the victim are used as input parameters. The average accuracy values for all three designed systems were calculated as 99.2%. It has been shown that the system designed by using these data can be used safely in the psychiatric assessment process, in order to differentiate psychiatric diagnoses in the early post-abuse period.

The nature of domestic and family violence reported to child protection prenatally

• First Australian study to examine the nature of violence in prenatal reports. • Violence experienced within families reported prenatally was severe. • Violence prevention efforts are a key pillar of child protection repsonses. Up to 70% of prenatal child protection reports include notifier concerns about current or previous domestic and family violence within families, far more than identified using only fixed-field administrative data. The nature of this violence remains unknown. A qualitative case file review was carried out to examine the nature of violence recorded in the narratives of 91 prenatal child protection reports from a single Australian jurisdiction in 2014. Concerns raised to child protection were coded, and similar codes categorised to identify the main ways in which violence was recorded within the reports. Five themes emerged: the nature of the violence; violence in the context of relationships; violence resulting in police and court intervention; co-occurring experiences of violence within families; and incidents or patterns of violence that lacked detailed description. Violence experienced within families was severe, including allegations of attempted murder, and pervasive, occurring in multiple ways within families and across the population. Findings suggest violence prevention and service responses are a key pillar of any approach to the early intervention and prevention of child abuse and neglect, and that improved understandings of the emergence and patterns of violence experienced are critical in developing targeted interventions.

The Dual Use of Religious-Faith in Intimate Partner Abuse Perpetration: Perspectives of Latino Men in a Parish-based Intervention Program

Little is known about the role that religious-faith plays in the lives of men who have acted abusively against an intimate partner. Studies report mixed findings about the relationship between religious-faith and intimate partner violence/abuse (IPV/A) perpetration. This study explored the perceptions of Latino men involved in a parish-based partner abuse intervention program (PAIP). Two focus groups were conducted with members of the PAIP (N=18). Two major themes emerged. Participants reported using religious-faith as a mechanism for ending violence. However, participants also reported past misuse of religion in order to gain control over intimate partners. These apparently conflicting roles of religion were further elucidated in several sub-themes. Religious-faith is complex. This study offers insight into how faith may serve as both a risk and protective factor for IPV/A perpetration. Implications for how intervention programs may address participants’ religious-faith during treatment and how religio-spiritual abuse is measured are discussed.

Marijuana use and repeated attempted suicide among senior high school students in Ghana: Evidence from the WHO Global School-Based Student Health Survey, 2012

BackgroundThe association between substance use including marijuana use and attempted suicide has been well documented. However, little is known about marijuana use and its association with attempted suicide repetition among...

Simulation in Addiction Education

Addiction and substance use disorders are complex medical conditions with a number of effective treatment options. Providing health care professionals with high-quality training to treat addiction and substance use disorders is an essential component of health care education. High-fidelity simulation has been a successful teaching method in training providers across various health care disciplines and specialties. Some such disciplines include dentistry, nursing, and numerous medical specialties. In recent years, high-fidelity simulation has proven to be a significantly effective teaching tool in psychiatry and specifically in the treatment of addiction and substance abuse. High-fidelity simulation recreates real-life medical scenarios in a safe learning environment and results in improved medical care and better patient outcomes. This commentary introduces basic concepts of simulation-based education followed by a focus on high-fidelity manikin-based simulation and its use across various disciplines including addiction. It concludes with a discussion of the benefits and potential of manikin simulation in addiction treatment.

Telehealth treatment engagement with Latinx populations during the COVID-19 pandemic

Telehealth treatment engagement with Latinx populations during the COVID-19 pandemic

Economic evaluations of interventions for opioid overdose and abuse

Economic evaluations of interventions for opioid overdose and abuse

Economic evaluations of interventions for opioid overdose and abuse

Economic evaluations of interventions for opioid overdose and abuse

“We Must Not Let These Stores That Trade on Human Misery Proliferate”: Black Activism, Spatial Justice, and Liquor Stores in South Central Los Angeles, 1984–94

Abstract This article offers a new way of exploring African American protest in Los Angeles in the 1980s and 1990s. It moves beyond reductive explanations of an inevitable economic and cultural conflict between African Americans and Koreans to examine the role of urban space and understanding of “spatial justice” in fostering anger and resentment. Activists in Black Los Angeles had for a long time targeted liquor stores as a form of neighborhood blight in South Central. The article considers three organizational approaches to protesting liquor stores: 1) The South Central Organizing Committee, a coalition of local Black churches, whose morality politics understood liquor stores as representing neighborhood blight and enabling local crime; 2) The Brotherhood Crusade, an organization steeped in Black nationalist thinking, which emphasized economic independence and community ownership in conjunction with xenophobic leanings toward Korean shopkeepers; 3) The Community Coalition for Substance Abuse Prevention and Treatment, which looked to deescalate racial tensions by refocusing the “problem” of liquor stores and their damaging effects on local quality of life as a public-health issue. Rethinking the controversy and tragedy caused by the death of Latasha Harlins as a conflict over contested spaces, rather than interracial hostility, helps us to understand the ways African Americans claimed space and connected social justice to physical spaces in the post-civil rights era despite differing tactics and objectives. Exploring these organizations leads to the conclusion that scholars need to take greater care to consider the role of space and the built environment when examining urban social movements.

Some Impediments to Child Sexual Abuse Interventions and Corresponding Social Work Implications: Reflections on the Zimbabwean Victim Friendly System

Child sexual abuse is a multifaceted children’s rights issue and a global problem of considerable extent. It has adverse effects for child survivors and their ecological environments. Using qualitative data from a multiple-case study research project, the current paper discusses some of the impediments hindering effective service provision within the institutional arrangements that respond to child sexual abuse cases in Zimbabwe. The Victim Friendly System is a confluence of multisectoral and multistakeholder professionals from different governmental and nongovernmental organizations that offer integrated and coordinated services targeting primary, secondary and tertiary levels of child sexual abuse prevention and mitigation. While the Victim Friendly System has made significant strides in providing better service delivery outcomes to direct and indirect victims of child sexual abuse, there remains some service provision gaps that hinder its effectiveness. These impediments include limited coverage of services due to an urban bias, services remaining largely unknown to the public owing to poor visibility, and the cost burden associated with accessing services. The authors argue that these gaps constrain children’s access to muchneeded intervention. This constitutes rights violations for CSA survivors. The paper ends by discussing corresponding implications for social work practice.

Classic Psychedelics as a Psychotherapeutic Aid in the Treatment of Stimulant Use Disorder: a Case Report

Despite nascent research supporting the efficacy of classic psychedelics as a psychotherapeutic aid for the treatment of substance abuse, to date, there is limited published research exploring their use in the treatment of stimulant use disorder and dual diagnosis. A 22-year-old male with a history of mood disorder and polysubstance use presented to a private Australian mental health clinic. While undergoing psychological treatment for mood and stimulant use disorder, this patient reported significant benefit from his use of classic psychedelics. Following consumption of 3.5 grams of psilocybin-containing mushrooms, he decided to seek out psychotherapy for the first time. Throughout treatment, subjective reports of his classic psychedelic use, which among others, included two occasions of having consumed 200 μg of lysergic acid diethylamide and 100 mg of dimethyltryptamine, were recorded and a psychometric tool used to capture mystical experiences was administered. As treatment progressed, the patient reported being better able to consolidate his therapeutic gains through the integration of insights obtained through his use of classic psychedelics, ultimately remaining abstinent from all stimulant drugs. The results of this case report suggest that classic psychedelics may be effective psychotherapeutic aids to be used in traditional substance abuse treatment programs. It is hoped that this case report will inform future research in this field.

Elder Abuse Detection and Intervention: Challenges for Professionals and Strategies for Engagement From a Canadian Specialist Service.

Elder abuse (EA) is of increasing relevance in the context of an aging society, and this has implications for detection and intervention for several types of healthcare providers, including forensic nurses. Knowledge related to EA is important as victims are likely to interact with providers, because of either existing health problems or the consequences of abuse. This article provides a brief overview of EA, followed by an outline of current detection and intervention efforts used by healthcare providers in community and hospital settings. In addition, knowledge about help-seeking and barriers to disclosure are discussed to inform healthcare provider interactions with older adults where EA is suspected or disclosed. To illustrate challenges faced by healthcare providers in this area, two cases of EA involving case management by a forensic nurse in a specialist service in Canada are presented.

Sexual dream and family relationships in frequent sexual dreamers and healthy volunteers.

Early life family relationships affect the sexuality in adulthood, and these influences might be reflected in sexual dreams. The present study was designed to investigate the exact associations between family relationships and sexual dream experience. We therefore invited 62 frequent sexual dreamers (dreamers) and 104 healthy volunteers (controls) to answer the Sexual Dream Experience Questionnaire (SDEQ) and the Family Relationship Questionnaire (FRQ). Compared to controls, dreamers scored higher on all SDEQ factors and sexual dream frequency, higher on FRQ Paternal Abuse, and lower on FRQ General Attachment and Maternal Freedom Release. In controls, Paternal Abuse was associated with Joyfulness, Maternal Dominance with Aversion, and Maternal Abuse with dream frequency (–). In dreamers, Paternal Abuse was associated with Aversion, Bizarreness and dream frequency, and Maternal Freedom Release with Aversion (–). In conclusion, there were pronounced associations between sexual dreams and family relationships in frequent sexual dreamers. Paternal Abuse in particular was associated with sexual dream experience. Adverse family relationships might induce frequent sexual dream occurrence, and family therapy or early intervention of Paternal Abuse might alleviate the negative sexual dream experience.

Impact of Substance Use and Abuse on Opioid Demand in Lower Extremity Fracture Surgery.

To describe the perioperative opioid demand in a large population of patients undergoing lower extremity fracture fixation and to evaluate mental disorders such as substance abuse as risk factors for increased use. Retrospective, observational. National insurance claims database. Twenty-three four hundred forty-one patients grouped by mental disorders such as depression, psychoses, alcohol abuse, tobacco abuse, drug abuse, and preoperative opioid filling undergoing operative treatment of lower extremity fractures (femoral shaft through ankle) between 2007 and 2017. Operative treatment of lower extremity fractures. The primary outcome was filled opioid prescription volume converted to oxycodone 5-mg pill equivalents. Secondary outcomes included the number of filled prescriptions and the risk of obtaining 2 or more opioid prescriptions. Of 23,441 patients, 16,618 (70.9%), 8862 (37.8%), and 18,084 (77.1%) filled opioid prescriptions within 1-month preop to 90-day postop, 3-month postop to 1-year postop, and 1-month preop to 1-year postop, respectively. On average, patients filled 104, 69, and 173 oxycodone 5-mg pills at those time intervals. Alcohol, tobacco, drug abuse, and preoperative opioid filling were associated with increased perioperative opioid demand. Psychoses had a small effect on opioid demand, and depression had no significant impact. This study reports the rate and volume of opioid prescription filling in patients undergoing lower extremity fracture surgery. Substance use and abuse were the main risk factors for increased perioperative opioid prescription filling. Providers should recognize these risk factors for increased use and be judicious when prescribing opioids. Enhanced patient education, increased nonopioid pain management strategies, and referral for substance use and abuse treatment may be helpful for these patients. Level III. See Instructions for Authors for a complete description of levels of evidence. Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.

Elder Abuse Assessment Tools and Interventions for use in the Home Environment: a Scoping Review.

Background and AimCaregivers in the home environment have an important role in timely detecting and responding to abuse. The aim of this review was to provide insight into both the existing tools for the assessment of and interventions for elder abuse by formal and informal caregivers in the home environment, and to categorize them according to a public health perspective, into primary, secondary, tertiary or quaternary prevention.MethodsWe selected the assessment tools and interventions that can be used by caregivers in the home environment included in previous reviews by Gallione et al (2017) and Fearing et al (2017). To identify published studies after these reviews, a search was performed using PubMed, Cochrane Database, CINAHL and Web of Science.ResultsIn total, fifteen assessment tools and twelve interventions were included. The number of assessment tools for elder abuse for use in the home environment is increasing; however, tools must be validated over different cultures and risk groups. In addition, the tools lack attention for the needs of vulnerable older persons such as persons with dementia. Existing interventions for caregivers in the home environment lack evidence for addressing elder abuse and do not address potential adverse effects (quaternary prevention).ConclusionAssessment tools for elder abuse need further testing for validity and reliability for use by caregivers in the home environment. For interventions, meaningful outcome measures are needed. Important to note is that quaternary prevention requires more attention. This argues for taking into account perspectives of (abused) older persons and caregivers in the development of assessment tools and interventions protocols.