A social stress model of substance abuse.

The social stress model provides a framework for detecting protective factors that may contribute to adolescents" resiliency when confronted with compelling influences to engage in substance abuse. Parameters of the model were tested in 2 urban high school samples (N?=?124) of Black (78%), White (16%), and Hispanic (6%) adolescents aged 12–14 years. Pretest and posttest measures, designed to detect the relative influence of stress, social networks, social competencies, and community resources on levels of students" usage, were completed at the beginning and end of the school year. The parameters of the model, estimated using LISREL7, indicated that the pathway from family characteristics to usage and from assertion to usage were significant. The paths from the remaining hypothesized variables were not significant. Implications for the design of prevention programs that facilitate youths" resiliency are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Perinatal loss: considerations in social work practice

The death of a fetus or newborn infant prompts a grief response which has numerous unique aspects. Pregnancy losses are similar in many respects to other losses, but raise additional issues which require attention and consideration. This article addresses these issues, and offers guidance to social workers who are working with persons following this special type of loss. Parental communication, sibling needs and follow-up programs are also reviewed, along with caregiver issues.     

An overview of problem-solving and social skills approaches in substance abuse treatment.

Reviews the research on problem solving (PS) and social skills (SSKs) approaches to treating substance abuse. Populations at high risk for substance abuse have been described as having deficits in these areas. Research shows 2 ways in which poor PS and SSKs can be related to drug use: (1) Deficiencies can lead to failures in interpersonal areas that can precipitate substance use and (2) individuals with deficits may find themselves unable to negotiate their way out of situations that carry a high risk of drug use. PS and SSKs training in substance abuse treatment are designed to give clients new skills that will allow them to maintain their abstinence. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Immigrant policy: issues for social work practice

Immigrants make up a significant segment of U.S. society. Immigration to the United States has been characterized by steady growth, dramatic changes in ethnic composition, and declining socioeconomic levels. The challenge for social work is to respond to the social services needs of immigrants by designing appropriate programs that will contribute to the social and economic integration of immigrants. This article provides an overview of the major policy issues relevant to social work practice with immigrants and describes the recent U.S. immigrant population. It discusses current federal policy that affects service provision to immigrants, defines immigrant eligibility for social services, outlines the major areas of need among immigrants, and considers implications for social work practice.     

Perceptions of social work intervention with bereaved clients: some implications for hospital social work practice

During infection of a mammalian host, African trypanosomes are in constant contact with the host's immune system. These protozoan parasites are infamous for their ability to evade the immune responses by periodically switching their major variant surface glycoprotein (VSG), a phenomenon called antigenic variation. Antigenic variation, however, is likely to be only one of several mechanisms enabling these organisms to thrive in the face of the immune defenses. The ability to grow in high levels of interferon-gamma (IFN-gamma) and to avoid complement-mediated destruction may also facilitate the parasite's survival. In this review we summarize (i) the activation of trypanosome genes for three different VSGs during antigenic variation, (ii) the secretion of a trypanosome protein that induces host CD8 T cells to produce IFN-gamma, and (iii) the evidence for trypanosome protein similar to a surface protease of Leishmania that plays a role in resistance to complement-mediated lysis.     

Intervening in adolescent substance abuse

Violence towards health professionals is defined as any incident in which a health professional experiences abuse, threat, fear or the application of force arising out of the course of his or her work, whether or not they are on duty. It emerges that no single theory can adequately explain the phenomenon, and perceptions about incidence and prevalence are distorted by the media. There is consistent and variable reporting but a high incidence and prevalence undoubtedly exists within health care. Health professionals and less experienced nurses in particular have been found to be most at risk. A strategic approach is needed to the development and implementation of workplace-specific solutions. Health professionals have a right to expect that violence at work is minimized but it would be unrealistic to expect it to be eradicated.     

Munchausen's syndrome and substance abuse

The syndrome of factitious disorders with physical symptoms was named "Munchausen's syndrome" by Richard Asher (1951). The present article contains an interesting case report of a patient who has a history of Munchausen's syndrome, substance abuse, and genuine physical illness. A review of the literature supports a strong association of substance abuse in patients with Munchausen's syndrome. Also important for clinicians to remember is that patients with Munchausen's syndrome often have true physical illnesses which need appropriate treatment. The patient described here has successfully begun treatment with methadone maintenance, but further study will be needed regarding methadone maintenance's role in the management of Munchausen's syndrome.     

Usefulness of the MAC scale in differentiating adolescents in normal, psychiatric, and substance abuse settings.

Performed discriminant function analyses on the MacAndrew (MAC) scale scores of 443 adolescents from 3 different samples (residential substance abusers, psychiatric inpatients, and high school students). Results indicated that the highest degree of discrimination occurred between substance abusers and normals. The considerable overlap observed in the MAC scores of substance abusers and psychiatric inpatients suggests that the MAC may be sensitive to characteristics common to both groups. Such characteristics may include high sensation seeking and delinquent-prone activity. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Contemporary trends in substance abuse.

A clinical consensus has evolved as to the specific areas to be addressed in a comprehensive clinical interview with substance abusers. Knowledge of specific psychopathology and associated comorbidities among addicts will refine this assessment. There are several reasonably reliable and valid objective psychological tests that can be used to provide supplementary information for diagnostic and treatment decisions. Etiological theories, including the disease concept, family systems theory, psychodynamic formulations, and behavioral approaches, have generated treatment interventions of clinical utility. Recent research suggests that psychotherapy, combined with traditional approaches, results in increased therapeutic benefits that were heretofore considered unlikely. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Future trends in substance abuse.

Argues that as illicit drugs with increased abuse liability come into vogue, a broader segment of the population will be at risk for becoming addicted. Consequently, the attendant effects of abuse, including acquired immune deficiency syndrome (AIDS) and human immunodeficiency virus (HIV) infection, will grow proportionately. Health care providers will need to become more astute and creative to provide effective rehabilitation for addicted individuals. (0 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Handwriting in assessing treatment for substance abuse

Analysis of Mathematics and Language Arts scores for 11,438 fourth- and 8,972 seventh-grade students in compensatory education programs on the performance assessments for the Iowa Test of Basic Skills indicated the students performed poorly, particularly in mathematics.     

Group treatment for substance abuse in schizophrenia

OBJECTIVES: A review of the relevant research suggests a need to develop an appropriate, effective, and replicable treatment to help individuals with schizophrenia and substance abuse problems. This pilot study describes a biweekly group specifically designed to help the individual with both schizophrenia and substance abuse. The components of the group were support, psychoeducation, and skills training. Attention was also paid to the stage of recovery. METHOD: Eighteen subjects attended the group and were assessed pregroup. Thirteen subjects completed a 1-year follow-up, and 5 subjects were assessed between 3 and 6 months. RESULTS: At the follow-up assessment, 8 subjects (44%) were abstinent. CONCLUSIONS: This type of treatment appears to be effective for reducing substance abuse in this population.     

Dentistry, stress, and substance abuse

Dentists have to deal with many significant stressors in their personal and professional lives. It is important for dentists to learn to cope and deal with these stressors and their effects. This paper reviews the nature and causes of addictions, the relationship between addiction and stress, and methods to organize and reduce stress in work environments.     

Assessment of substance abuse in psychotherapy clients: The effectiveness of the MMPI-2 substance abuse scales.

The Minnesota Multiphasic Personality Inventory—2 (MMPI—2) contains 3 scales, the MacAndrew Alcoholism Scale—Revised (MAC—R), the Addiction Potential Scale (APS), and the Addiction Acknowledgement Scale (AAS), that were developed to identify alcohol and drug abusing individuals. The current study was designed to measure the effectiveness of these scales at detecting substance abuse problems in a community-based mental health sample. MAC—R, APS, and AAS scores were obtained from 64 therapists who identified 68 substance abusing and 392 nonabusing psychotherapy clients. The results indicated that mean scores on all 3 scales were higher for the substance abusers than for nonabusers. Furthermore, discriminant analysis found all 3 scales to be effective screening tools. The AAS was the best single predictor, and a combination of the AAS and MAC—R provided the best overall discrimination. The implications of early substance abuse detection on treatment effectiveness are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Cost-effectiveness of inpatient substance abuse treatment

OBJECTIVE: To identify the characteristics of cost-effective inpatient substance abuse treatment programs. DATA SOURCES/STUDY SETTING: A survey of program directors and cost and discharge data for study of 38,863 patients treated in 98 Veterans Affairs treatment programs. STUDY DESIGN: We used random-effects regression to find the effect of program and patient characteristics on cost and readmission rates. A treatment was defined as successful if the patient was not readmitted for psychiatric or substance abuse care within six months. PRINCIPAL FINDINGS: Treatment was more expensive when the program was smaller, or had a longer intended length of stay (LOS) or a higher ratio of staff to patients. Readmission was less likely when the program was smaller or had longer intended LOS; the staff to patient ratio had no significant effect. The average treatment cost $3,754 with a 75.0% chance of being effective, a cost-effectiveness ratio of $5,007 per treatment success. A 28-day treatment program was $860 more costly and 3.3% more effective than a 21-day program, an incremental cost-effectiveness of $26,450 per treatment success. Patient characteristics did not affect readmission rates in the same way they affected costs. Patients with a history of prior treatment were more likely to be readmitted but their subsequent stays were less costly. CONCLUSIONS: A 21-day limit on intended LOS would increase the cost-effectiveness of treatment programs. Consolidation of small programs would reduce cost, but would also reduce access to treatment. Reduction of the staff to patient ratio would increase the cost-effectiveness of the most intensively staffed programs.     

Ideology trumps social science.

Comments on the L. B. Silverstein and C. F. Auerbach (see record 1999-05337-001) examination of the essentialist perspective on fathering, family structure, and child development. The author examines the evidence on which they rely. (PsycINFO Database Record (c) 2010 APA, all rights reserved)