Self-reported Substance Abuse Research Articles

Retraction of "Home visiting impacts during the pandemic: Evidence from a randomized controlled trial of Child First" by Xia et al. (2023).

Reports the retraction of "Home visiting impacts during the pandemic: Evidence from a randomized controlled trial of child first" by Samantha Xia, Mervett Hefyan, Meghan P. McCormick, Maya Goldberg, Emily Swinth and Sharon Huang (Journal of Family Psychology, 2023[Aug], Vol 37[5], 569-580). This article is being retracted at the request of the publisher, and the editor and all authors of the original article consented. The MDRC study team identified two caregivers who were enrolled at baseline but were, themselves, minors. (The following abstract of the original article appeared in record 2023-81526-001.) Existing research has found that home visiting programs for families with young children can improve children's development and strengthen caregiver and family well-being. However, the pandemic created numerous challenges for home visiting programs, forcing them to deliver services online or in a hybrid format to respond to pandemic-related challenges. Questions remain about the impacts of these programs when delivered at-scale via a hybrid model, especially during this uniquely challenging time. The present study reports 12-month impacts from a randomized controlled trial of Child First-an evidence-based home visiting program that provides psychotherapeutic, parent-child intervention (children ages 0-5) embedded in a coordinated system of care-when implemented as a hybrid service. This study estimates impacts within four domains: families' receipt of services, caregiver psychological well-being and parenting, child behavior, and family economic well-being. After randomly assigning families (N = 226) to receive Child First or typical community services, the research team surveyed caregivers (N = 183) about a year after study enrollment. Results from regression models with site fixed effects revealed suggestive evidence that Child First reduced caregivers' job loss, residential mobility, and self-reported substance abuse, and increased receipt of virtual services during the pandemic. There were null impacts on caregivers' psychological well-being, families' involvement with the child welfare system, children's behaviors, and other indicators of economic well-being. Implications for future research and policy are discussed. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Prenatal Substance Abuse and Pregnancy Outcomes Among African American Women

Subjects in this prospective observational study were 467 nulliparous women, ages 16-35, recruited at the prenatal clinics of a university hospital and a public hospital. Using a purposive sampling approach, and entry questionnaire and a series of psychosocial instruments were administered throughout the pregnancy course to assess stress, anxiety, body image, self-esteem, pregnancy symptoms, locus of control, and partner's interaction. Several pregnancy outcome measures were determined after delivery. Brazelton neonatal behavioral assessments were performed two days after birth of infants delivered to the maternal subjects. Self-reported substance abuse data were obtained from the entry questionnaire and the medical intake records, with usage characterized in terms of occurrence prior to and/or during pregnancy. Illicit drug users during pregnancy had lower self-esteem, greater stress, more pregnancy symptoms, a more negative pre-pregnancy body image and less favorable interactions with their partners. T test results show that infants of smokers had smaller head circumferences, shorter body length, and less optimal Brazelton orientation performance. Infants of illicit drug users had smaller head circumferences and shorter body lengths.

Rate and correlates of tobacco treatment during a primary care visit for a largely urban and African American sample of smokers

IntroductionEvidence-based treatments for tobacco use are under-utilized and primary care visits may be an opportune time to address this gap. This study examined the rate at which primary care visits included tobacco use treatment and examined patient demographics, smoking characteristics, attitudes about tobacco use treatments, and comorbidities as correlates of treatment provision. MethodsThis prospective study assessed demographics, smoking characteristics, attitudes about tobacco use treatments, and comorbidities via interview prior to a primary care visit among 105 patients. One week following the appointment, 85 patients were reassessed for the tobacco use treatments they received during their appointment (i.e., asked about their tobacco use, advised to quit, and provided with a referral to a tobacco use treatment program or an FDA-approved tobacco use medication). Results93% of patients were asked about their tobacco use, 74% were advised to quit, 37% were provided with a referral for tobacco use treatment, and 27% received an FDA-approved medication (16% NRT, 11% varenicline or bupropion). Patients with higher quit motivation and who endorsed that medications can reduce cravings were more likely to report receiving tobacco use medication. Patients with a self-reported substance abuse history were less likely to report receiving tobacco use medications. ConclusionsThe provision of tobacco use medications within primary care remains low. Strategies to increase patient quit motivation and help patients understand that tobacco use medications can mitigate cravings may increase use. Strategies may also be needed to ensure that patients with comorbid substance abuse still receive tobacco use treatments.

Distinguishing prisoners who think about suicide from those who attempt suicide.

Many people who consider suicide do not translate these intentions into action. Although prisoners constitute a particularly high-risk group for suicide, little is known about the factors that distinguish those who think about suicide from those who attempt suicide. Participants were 1326 adult offenders (1203 men) randomly selected from 15 Belgian prisons, representing 14% of the national prison population. Multivariate regression analysis compared prisoners who attempted suicide (n = 277) with those who thought about suicide but never made an attempt (n = 312) on a range of established risk factors. Among the 589 participants reporting a lifetime history of suicidal ideation (44% of the total sample), almost half (47%) had made a suicide attempt. Relative to those who only thought about suicide, participants who attempted suicide were more likely to be violent offenders (aOR 2.33, 95% CI 1.49-3.62) and have a history of non-suicidal self-injury (aOR 3.19, 95% CI 2.09-4.86). The presence of self-reported mental disorder diagnosis (aOR = 2.84, 95% CI 1.91-4.24) and illicit substance abuse (aOR = 2.01, 95% CI 1.24-3.28) also independently differentiated prisoners who attempted v. considered suicide. This study provides preliminary evidence that behavioural and mental health factors are implicated in the transition from thoughts to acts of suicide in prisoners. Prospective studies are warranted to explore whether these risk factors predict progression from ideation to action over time.

274 Occurrence of Psychiatric Illness and Problematic Substance Use among Frostbite Patients in an Urban Verified Burn Center

High concordance rates of frostbite injury, substance abuse, and psychiatric illnesses among patients receiving specialized burn treatment have been acknowledged in both scientific literature and clinical lore. Despite this, no recent study has been conducted documenting this phenomenon, and there are no published protocols to guide management of psychiatric comorbidities. Review of the literature shows the last such study was published in 1997. Although understood to be a problem, the challenge of effectively addressing psychosocial factors related to frostbite injury and care has received little attention. To explore the frequency of identified psychiatric diagnoses among patients, this study examined a limited time course (2012-2018) of both inpatient and outpatient clinical records of adult patients treated at an urban verified Regional Burn Center for frostbite injury. A total of 39 patients met inclusion criteria. The patient population was predominately male (77%), with a mean age of 42.5 years (range 22-74 years). Twenty-two patients (56%) were admitted to the burn center and 17 patients (44%) were treated as outpatients. Of the 39 patients reviewed, 65% self-reported substance abuse and/or a preexisting psychiatric illness. Consistent with previous findings, high rates of preexisting psychiatric illness and substance abuse were identified. Results highlight the importance of initial psychiatric and substance abuse screening for identified frostbite patients. If further indicated by screening, full utilization of available social work, psychological, and/or psychiatric services for clinical assessment and treatment recommendations (both while hospitalized and post discharge) is strongly recommended. This study supports a routine psychology and/or psychiatry consult for frostbite patients due to high concordance rates of substance abuse and psychiatric illness.

Substance Abuse and its Associated Factors among Pregnant Women: A Cross-Sectional Study in the Southeast of Iran.

BackgroundThe data on the prevalence of substance abuse in Iranian pregnant women is scarce in the current literature. This study investigated the prevalence of and the factors associated with substance abuse among pregnant women, and compared self-reported use with urine test results.MethodsThis cross-sectional study included data for 2000 pregnant women admitted to a tertiary care hospital in the southeast of Iran. Data were collected on socio-demographic characteristics and the patterns of substance use. Multivariate logistic regression analysis was used to identify factors associated with opiate use. A subsample (200 women) was randomly selected to provide urine samples for toxicological screening.FindingsThe lifetime prevalence of substance abuse and tobacco smoking was 15% and 31%, respectively. Overall, 3.3% of the participants reported using at least one substance during the previous month. One third of pregnant women reported using substances as a home remedy for treatment of pregnancy related health problems. Overall, 23% of the urine screening tests were positive. The agreement between self-reported substance abuse and the results of the urine tests was poor. Factors associated with opiates use in pregnant women were age at the first pregnancy of less than 20 years, living in rural areas, unwanted pregnancy, lack of healthcare during pregnancy, and having a spouse and/or first-degree family member with substance abuse.ConclusionThis study showed a high prevalence of substance abuse among the studied women. Thus, a multidisciplinary approach to provide preventive educational programs during pregnancy, and interviews and urinary screening of all pregnant women is recommended.

Disease profiles of detainees in the Canton of Vaud in Switzerland: gender and age differences in substance abuse, mental health and chronic health conditions.

BackgroundLiterature on the disease profile of prisoners that differentiates by age and gender remains sparse. This study aimed to describe the health of correctional inmates in terms of substance abuse problems and mental and somatic health conditions, and compare it by gender and age.MethodsThis study examined cross-sectional data from the Canton of Vaud in Switzerland on the health conditions of detainees who were in prison on January 1, 2011 or entered prison in 2011. Health conditions validated by physician examination were reported using the International Classification of Diseases (ICD) version 10. The analyses were descriptive by groups of prisoners: the entire sample (All), Men, Older adults and Women.ResultsA total of 1,664 individuals were included in the analysis. Men comprised 91.5 % of the sample and had a mean age of 33 years. The other 8.5 % were women and had an average age of 39. Older adults (i.e., age 50 and older) represented 7 % of the total sample. Overall, 80 % of inmates were non-Swiss citizens, but the proportion of Swiss prisoners was higher among the older adults (51 %) and women (29 %). Overall, 41 % of inmates self-reported substance abuse problems. Of those, 27 % were being treated by psychiatrists for behavioral disorders related to substance abuse. Chronic infectious diseases were found in 9 % of the prison population. In addition, 27 % of detainees suffered from serious mental health conditions. Gender and age had an influence on the disease profile of this sample: compared to the entire prison population, the older inmates were less likely to misuse illegal drugs and to suffer from communicable infections but exhibited more problems with alcohol and a higher burden of chronic health conditions. Female prisoners were more disposed to mental health problems (including drug abuse) and infectious diseases. In terms of chronic diseases, women suffered from the same conditions as men, but the diseases were more prevalent in women.ConclusionIt is important to understand the different disease profiles of prisoners by gender and age, as it helps identify the needs of different groups and tailor age-and gender-specific interventions.

Relationship between Self-Reported Maternal Substance Abuse and Adverse Outcomes in the Premature Newborn.

This study aims to compare neonatal and long-term outcomes among preterm newborns from women with reported versus those who did not report substance abuse. Secondary analysis of a trial of magnesium sulfate for cerebral palsy prevention. Cases were pregnant women who reported substance abuse, controls were those who denied it. Study outcomes included (1) composite neonatal morbidity, defined as any of the following: Apgar score ≤ 3 at 5 minutes, seizures, culture-proven sepsis, necrotizing enterocolitis grades 2 or 3, intraventricular hemorrhage grades 3 or 4, and/or death before discharge; (2) infant and childhood morbidity, defined as stillbirth or death by 1 year, or moderate/severe cerebral palsy by age of 2. Among 1,972 women meeting the inclusion criteria, 197 (10%) reported substance abuse. Composite neonatal, infant, and childhood morbidity rates were similar between cases and controls. However, women reporting substance abuse who delivered between 32(0/7) and 36(6/7) weeks had a higher frequency of composite infant and childhood morbidity (6.5 vs. 1.0%; adjusted odds ratio, 6.5; 95% confidence interval, 1.14-36.99). Preterm birth was associated with similar composite neonatal morbidity between cases and controls. After 32 weeks, self-reported substance abuse was associated with a sevenfold increase in the rates of stillbirth and long-term infant morbidity.

Racial/Ethnic Variations in the Influence of Parental Attachment on Adolescent Substance Abuse

This article examines whether the influence of parental attachment on adolescent substance abuse differs by race/ethnicity. We hypothesized that the effect of parental attachment would be stronger for Asian Americans than for other adolescents. Using data from the 2005 Fairfax County Communities That Care survey (N = 7,589), we found no support for our hypothesis. Results suggest that the effect of parental attachment on self-reported substance abuse differs dramatically by the race/ethnicity of the adolescent. Possible explanations for these findings are discussed.

A systematic review of evidence-based workplace prevention programmes that address substance abuse and HIV risk behaviours

The purpose of the systematic review was to determine the effectiveness of workplace substance abuse prevention programmes that also address substance-related HIV risks. A search of major electronic databases was conducted. Two authors independently applied eligibility criteria, assessed study quality, and extracted data using a standardised data extraction form. Due to the heterogeneity of study results, a qualitative approach was applied in assessing the effectiveness of the programmes. The search yielded 14 studies. All studies presented mixed results, with the majority reporting improvements in selfreported substance abuse measures. The review highlighted paucity in the availability of good quality workplace prevention programmes and none that addressed substance abuse and HIV risk behaviours in such settings. Keywords : Substance abuse, evidence-based, prevention programmes, workplace, industry

An Exploration of MSW Field Education and Impairment Prevention: What Do We Need to Know?

This paper examines the types of challenges social work students face and how practicum performance is impacted by them. Secondary data related to 125 social work students in a course in human behavior in the social environment were analyzed. More than one-fourth of students reported a parent with mental health and substance abuse problems. Students' self-reported substance abuse problems (9%), and mental health problems (16%). Sixty-two percent of students reported some problem in their family of origin. Regression analysis showed that performance during the second semester of the first-year practicum was influenced by current and early family experiences and that by the second year of the MSW program, there was no impact on field. This manuscript explores some of the possible ways that social work students overcome and manage personal challenges that impact their field placement.

Prescription Medication Abuse Among Women in an Obstetrics/Gynecology Clinic

To the Editor: In a previous study,1 we confirmed among internal medicine outpatients a relationship between the self-reported abuse of prescription medications and 2 self-report measures of borderline personality symptomatology. We found no differences in gender,2 which is in contrast to the extant literature on borderline personality suggesting that males invariably evidence higher rates of alcohol/substance misuse.3–7 In the present study, we examined the relationship between the self-reported abuse of prescription medications, borderline personality symptomatology, and alcohol abuse in an obstetrics/gynecology sample. Method. Participants were female outpatients, aged 18 years or older, seeking nonemergent care in a university-affiliated obstetrics/gynecology clinic. Exclusion criteria were psychiatric, medical, cognitive, or intellectual difficulties of a severity that would preclude the candidate’s ability to complete a survey. As patients arrived at the clinic, one researcher (J.C.) solicited each, informally assessed exclusion criteria, and invited candidates to complete a 4-page survey. The cover page of the survey contained the elements of informed consent, and completion of the survey was presumed to be implied consent (specified on the cover page). We used item 13 of the Self-Harm Inventory8 to assess prescription medication abuse (“Have you ever intentionally, or on purpose, abused prescription medication?”). To assess borderline personality symptomatology, we used the borderline personality scale of the Personality Diagnostic Questionnaire-4 (PDQ-4),9 a self-report measure that is based directly on the criteria for borderline personality in the DSM-IV. We used item 6 of the Self-Harm Inventory to determine history of alcohol abuse (“Have you ever intentionally, or on purpose, abused alcohol?”).8 Data were collected in October 2010. This project was approved by an institutional review board. Results. The 371 participants ranged in age from 18 to 61 years (mean = 26.35, SD = 7.47). Participants were primarily white (55.0%) or African American (38.8%). Most had never been married (72.8%), with the remaining individuals being married (16.8%), divorced (6.6%), separated (3.3%), or widowed (0.5%). Approximately 88% had at least completed high school, with 13.5% having completed a college degree. Most participants reported government insurance (78.4%) or private insurance (6.1%), with the remaining 15.5% reporting self-pay or no insurance. The prevalence of self-reported prescription substance abuse, borderline personality symptomatology, and alcohol abuse in this sample was 11.5%, 20.5%, and 22.4%, respectively. The correlation between the abuse of prescription medication and presence of borderline personality symptomatology per the PDQ-4 borderline personality scale was 0.36 (P < .001). Likewise, the correlation between the abuse of prescription medication and the abuse of alcohol was 0.40 (P < .001). The limitations of this study include the self-report nature of all data, including personality disorder diagnosis (eg, risk of false positives), and the somewhat atypical nature of the sample (eg, single women of low socioeconomic status). However, findings indicate that prescription substance abuse is reported by a significant minority of patients and demonstrates relationships with both borderline personality symptomatology and the abuse of alcohol. These interrelationships are important in terms of fully assessing patients who present with any 1 of these 3 syndromes.

Depressive Symptoms, Substance Abuse, and Intimate Partner Violence among Pregnant Women of Diverse Ethnicities

This study examines the relationship between self-reported depressive symptoms, substance abuse and intimate partner violence among 602 African American, Hispanic, White, Asian American, American Indian/Alaskan Native, Native Hawaiian/Pacific Islander pregnant women who are clients of the Augusta Partnership for Children, Inc., a nonprofit collaborative that works with agencies, organizations, and individuals to improve the lives of children and families in Augusta-Richmond County, Georgia. Descriptive statistics and significant relationships among selected variables using correlation and regression analyses were conducted. Findings are intended to inform strategies for community-based programs better to assist women of diverse ethnicities with addressing depression, substance abuse, and intimate partner violence during their pregnancies, with the ultimate aim of improving health and mental health outcomes for women and children.

Emerging Adulthood and Leaving Foster Care: Settings Associated with Mental Health

The present study examined the role of contextual support on mental health during the transition to adulthood within a vulnerable group, adolescents leaving foster care because of their age. Participants were 265 19- to 23-year-olds who retrospectively reported on 3 main contexts of emerging adulthood: housing security, educational achievement, and employment attainment in the first 2 years after leaving foster care. Mental health measured self-reported emotional distress, substance abuse, and deviancy at the time of interview. Growth Mixture Modeling empirically identified 3 latent trajectory classes. Stable-Engaged (41%) experienced secure housing and increasing connections to education and employment over time. Stable-Disengaged (30%) maintained housing but reported decreasing rates of education and small increases in employment. Instable-Disengaged (29%) experienced chronic housing instability, declined connection to education, and failed to attain employment. Stable-Engaged and Stable-Disengaged classes reported better mental health compared to the Instable-Disengaged class, indicating the importance of housing in transitioning to adulthood.

P02-54 - Is outpatient-based substance abuse treatment a predictor of re-offending and other outcomes among Swedish offenders subjected to psychiatric assessment?

IntroductionSubstance abuse is associated with criminal recidivism. Substance abuse treatment has been found to correlate negatively with re-offending among treatment utilizers. However, for offenders with mental health problems and substance abuse, research on how substance abuse treatment affects re-offending is sparse.ObjectivesThe study aimed to examine the relationship between self-reported outpatient-based substance abuse treatment and self-reported a) re-offending, b) substance use and c) psychiatric problems among offenders with mental health and substance use problems.MethodsData were gathered from a naturalistic follow-up study with 208 participants, subjected to a court-ordered psychiatric assessment. This analysis covers 91 individuals who were followed-up after an average study period of 17 months. Among these, 68% had been sentenced to institutional imprisonment or forensic psychiatric care.ResultsOffences, substance use and psychiatric problems declined between baseline and follow-up. However, the reduction was not associated with self-reported treatment utilization. Among participants who were sentenced to non-institutional corrections, more individuals had utilized outpatient-based treatment compared to individuals who were sentenced to imprisonment or forensic psychiatric care.ConclusionsA definitive conclusion about the effect of treatment is difficult to draw. For instance, self-reported data may not reflect actual treatment consumption. However, one interpretation is that participants naturally recovered over time. Institutional correction might also have resulted in positive outcomes equivalent to outpatient-based treatment.

S13-01 - Substance abuse treatment as a predictor of criminal recidivism among psychiatrically examined Swedish offenders

BackgroundSubstance abuse is clearly associated with criminal recidivism among offenders with and without mental disorder. Treatment for substance abuse correlates with lower rates of re-offending among participants in outpatient-based as well as institution-based substance abuse treatment programs. However, for offenders with mental disorder, research on the possible preventive effect of substance abuse treatment on criminal recidivism is sparse. This paper reports from on an ongoing naturalistic and prospective interview study on the relationship between post-release outpatient substance abuse treatment and re-offending.MethodsThe Stockholm county sample comprises 246 offenders of both genders subjected to a forensic psychiatric assessment, who screened positive for substance abuse problems. Eighty-five percent (n=210) agreed to participate in the study. Baseline data and follow-up interview data, collected immediately on release from incarceration (prison/forensic hospital) and 6 and 12 months later, include self-reported substance abuse, treatment involvement and criminality. By February 2010, data will be available from the first follow-up for 150 participants, from the second follow-up for 80 individuals and from the third follow-up for 10 subjects.Results and conclusionsThe focus of the presentation will be recidivism comparisons between substance abuse treatment utilizers and those who decline treatment. Data on ongoing levels of substance abuse, mental health problems and offending will serve as dependent variables. Additional analyses will present perceived benefit from and reasons for accepting or rejecting treatment.

Factors Associated With Departure From Supported Independent Living Programs for Persons With Serious Mental Illness

Supported housing is a viable model that offers independence and opportunity for community integration. However, previous studies have shown that not all residents can sustain long-term tenancy. This study examined the extent to which personal and housing characteristics predicted positive and negative departures from independent housing programs that provided support services to persons with serious mental illness. The sample consisted of 237 persons participating in a supported independent living program in Philadelphia. Cox proportional hazards models were used to estimate the effects of personal and housing characteristics on the probability of positive departure (to an arrangement with more autonomy) and negative departure (to an arrangement with more supervision or to homelessness). Most participants (69%) maintained continuous residence in the program for the study period, 14% experienced a positive departure, and 17% a negative departure. A self-reported past substance abuse problem increased the probability of a negative departure, and a more supportive relationship with program staff decreased the probability. A higher income increased the probability of a positive departure, whereas a higher level of social distress in the neighborhood decreased the probability. The findings suggest that long-term housing tenure was not uncommon among supported independent living residents, but some were not able to maintain independent living and were discharged to shelters, institutions, or residential settings with more supervision. Predictors of positive and negative departure identified in this study may help service providers design services to meet the various needs of persons with serious mental illness for stable independent living.

Shared Decision-Making Preferences of People With Severe Mental Illness

Shared Decision-Making Preferences of People With Severe Mental Illness

Substance Abuse and Psychological Well-being of South African Adolescents

This research aimed at identifying patterns of substance abuse among South African adolescents and exploring the relationship between psychological well-being and substance abuse. Psychological well-being was assessed with selected items of the Bar-On EQ-I and Diener's Life Satisfaction scale. Self-reported substance abuse patterns of 1 918 learners between the ages of 12 and 19 from 13 schools in Tshwane were recorded. Schools were selected to represent the population composition of the area. It was found that substance abuse (current alcohol use, excessive alcohol use, and use of illicit drugs) increased with age and that nearly twice as many males as females abused substances. Language group was found to be a determining factor with regard to current and excessive use of alcohol; however, it was not found to influence drug use. An analysis of variance showed that adolescents who used drugs had significantly lower levels of psychological well-being and life satisfaction. The same was not found for excessive use of alcohol. The results can contribute to a better understanding of substance use behaviour and to identifying adolescents who may be at risk of abuse.

Predictors of disclosure of continued cocaine use

Lack of disclosure of substance use is common in research and treatment settings and is frequently higher at follow-up than at baseline interviews. The aim of this study was to determine predictors of cocaine use disclosure at follow-up among 525 individuals who reported and tested positive for baseline use. Measurements included self-reported quantity and frequency of use, and hair analysis by radioimmune assay. Forty-two percent of individuals with biochemical evidence of continued cocaine use denied this use. In adjusted analyses, self-reported substance abuse treatment contact after enrollment was associated with lower disclosure (OR 0.63, 95% CI 0.43, 0.93). Other predictors were race, hair cocaine level, and opiates in hair. Failure to stop use after seeking treatment may result in reduced disclosure of continued use, possibly because of unwillingness to admit failure.