Network therapy for substance abuse: A clinical trial.

Describes an effective treatment for addicted patients in office practice. In network therapy, the therapist draws on family and peer support in the office setting to secure abstinence and aid in relapse prevention. This approach complements individual therapy and can draw on self-help groups and other modalities as well. Assessment of a series of 60 patients treated for alcohol and drug dependence demonstrates the mode of operation and the outcome of this approach. 46 experienced major or full improvement, and those using disulfiram under observation of a network member showed the best outcome. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Spirituality and the treatment of the dually diagnosed: an investigation of patient and staff attitudes

Spirituality is a neglected area of study and research in the treatment of addictions. The role of spirituality in the treatment of the dually diagnosed has received particularly scant attention. One hundred and one patients on an in-patient dual-diagnosis unit, as well as the 31 members of the nursing staff who treat them were surveyed. Patients and staff were questioned about their spiritual beliefs and what was the role of spirituality in the patients' recovery from addiction. Staff were questioned about their own spirituality and what they think the patients' level of spirituality is. In addition the staff were asked what they think the patients' view of spiritually is. Results indicate that the patients and staff are equally spiritually oriented. The patients view spirituality as essential to their recovery and value spiritual programming in their treatment more than some concrete items. The nursing staff underestimated both the patients' level of spirituality and this importance placed on spiritual issues. The authors suggest that more attention should be given by staff to spirituality in the treatment of this population.     

Empirical assessment of the self-medication hypothesis among dually diagnosed inpatients

The aim of this study was to empirically determine the expected effects of drugs of abuse on the psychiatric symptoms of individuals dependent on alcohol and other drugs to assess the validity of the self-medication hypothesis, defined as motivation of patients to seek a specific drug for relief of a particular set of symptoms. Eight-three inpatients in a large metropolitan hospital with an axis I diagnosis of one drug dependence and an axis II diagnosis of personality disorder completed the Hopkins Symptom Checklist-Revised (HSCL-90-R) and the Neuropsychological Impairment Scale (NIS). They also reported the effect of their drug of choice on each of the symptoms included in both tests. Heroin addicts reported that heroin improved some of their psychiatric symptoms and all of their cognitive dysfunctions. Both cocaine and alcohol users reported that their drug of choice worsened their psychiatric and cognitive symptoms. No relationship was found between frequency or severity of symptoms and drug choice. We concluded that attempts at self-medication may have occurred among heroin addicts, but were unlikely among alcoholics and cocaine addicts. We found no evidence in support of the self-medication hypothesis as a necessary reinforcer of continued drug use.     

Measurement of the oxygen isotopic composition of nitrate in seawater and freshwater using the denitrifier method

We report a novel method for measurement of the oxygen isotopic composition (18O/16O) of nitrate (NO3-) from both seawater and freshwater. The denitrifier method, based on the isotope ratio analysis of nitrous oxide generated from sample nitrate by cultured denitrifying bacteria, has been described elsewhere for its use in nitrogen isotope ratio (15N/14N) analysis of nitrate. (1) Here, we address the additional issues associated with 18O/16O analysis of nitrate by this approach, which include (1) the oxygen isotopic difference between the nitrate sample and the N20 analyte due to isotopic fractionation associated with the loss of oxygen atoms from nitrate and (2) the exchange of oxygen atoms with water during the conversion of nitrate to N2O. Experiments with 18O-labeled water indicate that water exchange contributes less than 10%, and frequently less than 3%, of the oxygen atoms in the N20 product for Pseudomonas aureofaciens. In addition, both oxygen isotope fractionation and oxygen atom exchange are consistent within a given batch of analyses. The analysis of appropriate isotopic reference materials can thus be used to correct the measured 18O/16O ratios of samples for both effects. This is the first method tested for 18O/16O analysis of nitrate in seawater. Benefits of this method, relative to published freshwater methods, include higher sensitivity (tested down to 10 nmol and 1 microM NO3-), lack of interference by other solutes, and ease of sample preparation.     

Introducing cognitive-behavioral training into a self-help drug treatment program.

Describes the mechanics of introducing cognitive-behavioral training into a self-help drug treatment program. Issues that emerged in developing such a paradigm in an outpatient clinic treatment program for cocaine users included incorporating coping techniques into a therapeutic community (TC) milieu, professional leadership vs self-help, and theoretical incompatibilities between 12-step programs and psychological models emphasizing self-control. Although cognitive-behavioral training shares the TC emphasis on self-help, a systematic approach was needed for it to achieve acceptance within the intense cohesiveness of the TC. Examples of applicable behavioral skills training included overcoming social anxieties, dealing with nonverbal experience, and anger management. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Intercontinental transport of air pollution: will emerging science lead to a new hemispheric treaty?

We examine the emergence of InterContinental Transport (ICT) of air pollution on the agendas of the air quality and climate communities and consider the potential for a new treaty on hemispheric air pollution. ICT is the flow of air pollutants from a source continent (e.g., North America) to a receptor continent (e.g., Europe). ICT of air pollutants occurs through two mechanisms: (i) episodic advection and (ii) increasing the global background, which enhances surface concentrations. We outline the current scientific evidence for ICT of aerosols and ozone, both of which contribute to air pollution and radiative forcing. The growing body of scientific evidence for ICT suggests that a hemispheric-scale treaty to reduce air pollutant concentrations may be appropriate to address climate and air quality concerns simultaneously. Such a treaty could pave the way for future climate agreements.     

Validation of a scale for network therapy: a technique for systematic use of peer and family support in addition treatment

The feasibility of employing triple-quantum-filtered (TQF) or double-quantum-filtered (DQF) 23Na NMR spectra to monitor intracellular Na (Nain) content in isolated rat hearts perfused in the absence of a chemical-shift reagent (SR) was investigated. This necessitated characterization of the following: first, the pool of Nain represented by the intracellular TQF (TQFin) spectrum; second, the maximum extent to which altered transverse relaxation times affect TQFin spectral amplitudes; and finally, the situations for which the SR-free method can reliably be applied. The rates of increase in peak amplitudes of both intracellular TQF spectra, adjusted for changes in both fast (T2f) and slow (T2s) transverse relaxation times, and intracellular single-quantum (SQin) spectra were identical during no-flow ischemia, indicating that TQFin and SQin spectra represent the same Nain population. Addition of an Na/K ATPase inhibitor, ouabain (>/=500 microM), and no-flow ischemia induced similar rates of increase of Nain content. However, the Nain level for which the T2 values started to increase was lower for ischemic (<140% of preischemic values) than for ouabain-exposed (>165%) hearts, which is consistent with the known earlier onset of intracellular swelling in ischemic hearts. Exposure of hearts to hyperosmotic perfusate (200 mM sucrose) increased [Nain], due to a decreased cell volume and an unchanged Nain content, but caused a decrease in T2 values, a trend opposite to that observed with exposure of hearts to ouabain or ischemia. T2 values therefore consistently correlated only with cell volume, not with Nain content or concentration, indicating an important role for intracellular macromolecule concentration in modulating transverse relaxation behavior. The combined effect of ischemia-induced increases in T2 values and their inhomogeneous broadened forms was an approximately 6% overestimation of Nain content from amplitudes of SR-aided TQFin spectra, indicating negligible effect of transverse relaxation-dependent alterations on TQFin spectral amplitudes. Thus, Nain content may be reliably determined from SR-free TQF spectra when the contribution from extracellular Na does not appreciably vary, such as during constant pressure perfusion. Following complete reduction in perfusion pressure, both SR-free TQF and DQF spectra respond to increases in Nain content. However, SR-free DQF NMR provides an estimate of Nain content much closer to that provided by the SR-aided method, due to the appreciable decrease of the extracellular DQF signal resulting from destructive interference between second- and third-rank tensors.     

Interpersonal knowledge and individual and group effectiveness.

"Measures of discrepancy between an objective group preference hierarchy structure of members and an individual estimate of this preference hierarchy structure were obtained for members of infantry rifle squads who had scored high and low on a criterion field problem." It was found that the appointed leaders, popular individuals, and members of effective groups were better able to estimate the preference hierarchy structure than were non-leaders, less popular individuals, and members of ineffective groups. (PsycINFO Database Record (c) 2010 APA, all rights reserved)