951 resultados para Substance Abuse and Addiction


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ABSTRACT


Background

Predominant polarity (PP) is a proposed course specifier for bipolar disorder, which was not incorporated in the DSM-5 as a descriptor for the nosology of bipolar disorder (BD). Here we perform a systematic review of original studies about PP. 

Methods
A computerized search of MEDLINE/Pubmed, EMBASE and Web of Science databases from inception to October 6th, 2013 was performed with keywords, including ‘bipolar disorder’, ‘polarity’ and ‘predominant polarity’.

Results
A total of 19 studies met inclusion criteria. A unifying definition and conceptualization for PP is lacking. A PP is found in approximately half of BD patients. Most studies that included type I BD patients found the manic PP to be more prevalent, while studies that included type II BD participants found a higher prevalence of depressive PP. The depressive PP has been consistently associated with a depressive onset of illness, a delayed diagnosis of BD, type II BD and higher rates of suicidal acts. The manic PP is associated with a younger onset of illness, a first episode manic/psychotic and a higher rate of substance abuse. Evidence suggests that PP may influence responses to acute treatment for bipolar depression. Furthermore, evidences indicate that PP should be considered for the selection of maintenance treatments for BD.

Limitations
There are few prospective studies on PP. There were disparate definitions for PP across studies.

Conclusions
The concept of PP provides relevant information for clinicians. Future studies should investigate the genetic and biological underpinnings of PP.

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Although most conceptualizations of social anxiety emphasise that socially anxious individuals are overtly shy, and utilise avoidant behavioural strategies (e.g., risk-aversion, passivity, and submissiveness), there is tentative support for the existence of an approach-motivated subtype, characterised by risk taking and a greater propensity for substance misuse. It is likely that this subtype may help explain the reported co-occurrence of substance misuse and social anxiety. The current study sought to test via latent class analysis whether an approach-motivated social anxiety subtype could be identified within a community sample. A self-report questionnaire was completed by 351 participants (age: 18-74 years). Two distinct social anxiety subgroups were identified: one characterised by prototypical SAD symptomatology (i.e., behavioural inhibition and risk-avoidance), the second by elevated levels of rash impulsiveness, reward sensitivity, risk-taking and co-occurring substance use problems. The current findings provides support for the existence of a distinct approach-motivated social anxiety subtype and indicates that impulsivity may be critical to understanding the comorbid substance use symptomatology of these individuals.

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 Introduction and Aims: The aim of this study was to investigate patterns of supplement use among male university students, who have been identified as high consumers of these substances.

Design and Methods: An online survey investigating supplement use was conducted over four weeks. Participants were sent a link to the survey via email and through posts on the online homepages of units from the School of Exercise and Nutrition Sciences at Deakin University.

Results: Sixty-one males completed the survey (median age 21 years). All participants had used at least one supplement in their lifetime, with most having used legal supplements; the most commonly used supplement was sports drinks (80%), followed by protein (80%), and vitamins and minerals (80%). Although no participants reported use of anabolic-androgenic steroids, 18% would consider using them in the future. Motivations for use differed according to substance; for instance, vitamins and minerals were used for general health purposes while creatine was used to gain muscle. Friends were a common source of information about supplements (57%), followed by online (36%) and a supplement store staff member (22%). Participants reported few negative side effects from supplement use.

Discussion and Conclusions: Supplement use is common among this group, and some indicate intentions to use more serious substances such as steroids. This study presents valuable findings about supplement use habits and patterns among male university students. However, more research is needed among this population to determine whether body image and exercise habits can influence supplement use.

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 Intimate partner violence (IPV) is endemic in societies around the world and detrimental to women's wellbeing. Abused women are frequent users of health services. Despite the recent World Health Organization guidelines on IPV and sexual violence, we need more evidence on effective responses to women in health care settings. Developing robust evidence with potential to inform policy and clinical practice requires greater clarity and consistency across studies in the selection and use of outcomes to evaluate interventions. Drawing on systematic reviews and individual trials aimed at reducing abuse and improving women's health, we discuss critical issues in respect of outcomes. We discuss primary, secondary, intermediate and proxy outcomes and measures used to evaluate interventions for women who experience IPV. We offer recommendations about which outcomes to assess and approaches to doing so within the context of trials in health care settings. © 2014 Elsevier Ltd. All rights reserved.

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This study used the Resilient Families baseline survey to examine associations between the connectedness of parents within the school and parents' rules regarding their children's use of alcohol, prior participation in parenting education, and parents' demographic characteristics. The study involved parents of Year 7 students (mean age 12 years) at secondary schools in Melbourne, Australia (N = 1,238; 2004). Most parents (54%) had no connections with parents of other children in their child's school year. Allowing children to have sips of alcohol or drinks on special occasions was reported by 23% and 6% of parents, respectively, but neither was significantly associated with parental connectedness. Copyright © 2014 Informa Healthcare USA, Inc.

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Identifying specific aspects of peer social norms that influence adolescent substance use may assist international prevention efforts. This study examines two aggregated measures of social norms in the school setting and their predictive association with substance (alcohol, tobacco and marijuana) use 2 years later in a large cross-national population-based cohort of adolescents. The primary hypothesis is that in Grade 7 both "injunctive" school norms (where students associate substance use with "coolness") and "descriptive" norms (where student substance use is common) will predict Grade 9 substance use. Data come from the International Youth Development Study, including 2,248 students (51.2% female) in the US and Australia attending 121 schools in Grade 7. Independent variables included injunctive norms (aggregating measures of school-wide coolness ratings of each substance use) and descriptive norms (aggregating the prevalence of school substance use) in Grade 7. Dependent variables included binge drinking and current use of alcohol, tobacco and marijuana in Grade 9. Associations between each type of school-wide social norm and substance use behaviors in Grade 9 were tested using multilevel logistic regression, adjusting for covariates. In unadjusted models, both injunctive and descriptive norms each significantly predicted subsequent substance use. In fully adjusted models, injunctive norms were no longer significantly associated with Grade 9 use, but descriptive norms remained significantly associated with tobacco and marijuana use in the expected direction. The findings identify descriptive social norms in the school context as a particularly important area to address in adolescent substance use prevention efforts.

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There is a range of risk factors that may make young people of any ethnicity more likely to engage in antisocial behaviours. These factors include the young person’s own attitudes; relationships within the family; and growing up in communities where there is widespread violence, alcohol and other substance abuse, poverty, poor health and poor-quality housing. Indigenous young people face the additional challenges ofdispossession, discontinuity of culture and intergenerational trauma.A strong connection to culture—coupled with high self-esteem, a strong sense of autonomy, and with living in cohesive, functioning families and communities—can be protective factors that result in Indigenous young people choosing productive life pathways.Mentoring is a relationship intervention strategy that can assist in building some of these protective factors. A growing body of research demonstrates that mentoring can have powerful and lasting positive effects in improving behavioural, academic and vocational outcomes for at-risk youth and, to a more limited extent, in reducing contact with juvenile justice systems.In an Indigenous context, mentoring is a particularly promising initiative because it fits well with Indigenous teaching and learning styles and can help to build strong collective ties within a community.Mentoring programs can involve adult or peer mentors and can be implemented in a range of ways, such as one-on-one or in groups.Although positive results can be achieved with single-intervention mentoring for at risk youth, integrating mentoring into broader programs produces a greater level of positive change.The way the mentoring program is run and the nature of the relationship between mentor and mentee are crucial in determining the outcomes of youth mentoring programs.

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To investigate alcohol consumption, substance use and risky and harmful behaviour among young people attending 'schoolies' week in Victoria.

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Alcohol has consistently been demonstrated to increase levels of aggression and violence, particularly in late night licensed venues. Since 2005, the City of Geelong in Australia has implemented a substantial number of interventions to reduce alcohol related violence, including a liquor accord, increased police surveillance, ID scanners, CCTV, a radio network and an alcohol industry sponsored social marketing campaign. The aim of the current study is to assess the individual and collective impact of community interventions on indicators of alcohol-related assaults in the Geelong region. This paper reports stage one findings from the Dealing with Alcohol-related problems in the Night-time Economy project (DANTE) and specifically examines assault rate data from both emergency department presentations, ICD-10 classification codes, and police records of assaults. None of the interventions were associated with reductions in alcohol-related as-sault or intoxication in Geelong, either individually or when combined. However, the alcohol industry sponsored social marketing campaign ‘Just Think’ was associated with an increase in assault rates. Community level interventions appeared to have had little effect on assault rates during high alcohol times. It is also possible that social marketing campaigns without practical strategies are associated with increased assault rates. The findings also raise questions about whether interventions should be targeted at reducing whole-of-community alcohol consumption.

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Child sexual abuse cases often do not result in convictions; this attrition is due to factors inside and outside the control of the justice system. The aims of the current study were to: (1) establish the most important factors in contributing to the attrition of child sexual abuse; and (2) suggest ways to reduce the attrition associated with these factors. This study focused on system improvements to determine where efforts should be prioritised. The research approach consisted of in-depth interviews with 31 professionals from various disciplines (including police, judges, child welfare officers, doctors and psychologists). The interviewees represented a diverse group of professionals offering unique perspectives. Thematic analysis revealed five broad areas requiring focus for improvement and further reform: greater specialisation, facilitating the accessibility of services, making the trial process more user-friendly, overcoming misinformed beliefs and adequate representation of child sexual abuse. These areas, along with professionals’ practical recommendations, are discussed.

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Alcohol mixed with energy drinks (AmED) is a relatively new consumption trend generating increasing concern regarding potential adverse effects. Despite the political and health imperative, there has been no systematic and independent synthesis of the literature to determine whether or not AmED offers additional harms relative to alcohol. The aim of this study was to review the evidence about whether co-consumption of energy drinks and alcohol, relative to alcohol alone, alters: (i) physiological, psychological, cognitive and psychomotor outcomes; (ii) hazardous drinking practices; and (iii) risk-taking behaviour.

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Emerging evidence suggests that abuse and neglect in childhood may play a role in subsequent development of obesity. One population group particularly at risk is children and young people living in out-of-home care (OOHC). Given this population is already a vulnerable group, identifying potential mechanisms by which childhood abuse and neglect increases risk for obesity is essential. A possible explanation is that problematic eating and food-related behaviours (i.e., emotional eating, compulsive eating, overeating, binge eating, stealing or hoarding food) might mediate the association between adverse childhood experiences and obesity. Hence, the overall goal of this paper was to provide a narrative review of eating and food-related difficulties for children in care and their possible association with unhealthy and excessive weight gain. This review revealed a shortage of existing empirical papers and signalled particular need for further examination of the mediating effects of problematic eating.

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BACKGROUND: Domestic violence is a serious problem affecting the health and wellbeing of women globally. Interventions in health care settings have primarily focused on screening and referral, however, women often may not disclose abuse to health practitioners. The internet offers a confidential space in which women can assess the health of their relationships and make a plan for safety and wellbeing for themselves and their children. This randomised controlled trial is testing the effectiveness of a web-based healthy relationship tool and safety decision aid (I-DECIDE). Based broadly on the IRIS trial in the United States, it has been adapted for the Australian context where it is conducted entirely online and uses the Psychosocial Readiness Model as the basis for the intervention. METHODS/DESIGN: In this two arm, pragmatic randomised controlled trial, women who have experienced abuse or fear of a partner in the previous 6 months will be computer randomised to receive either the I-DECIDE website or a comparator website (basic relationship and safety advice). The intervention includes self-directed reflection exercises on their relationship, danger level, priority setting, and results in an individualised, tailored action plan. Primary self-reported outcomes are: self-efficacy (General Self-Efficacy Scale) immediately after completion, 6 and 12 months post-baseline; and depressive symptoms (Centre for Epidemiologic Studies Depression Scale, Revised, 6 and 12 months post-baseline). Secondary outcomes include mean number of helpful actions for safety and wellbeing, mean level of fear of partner and cost-effectiveness. DISCUSSION: This fully-automated trial will evaluate a web-based self-information, self-reflection and self-management tool for domestic violence. We hypothesise that the improvement in self-efficacy and mental health will be mediated by increased perceived support and awareness encouraging positive change. If shown to be effective, I-DECIDE could be easily incorporated into the community sector and health care settings, providing an alternative to formal services for women not ready or able to acknowledge abuse and access specialised services. TRIAL REGISTRATION: Trial registered on 15(th) December 2014 with the Australian New Zealand Clinical Trials Registry ACTRN12614001306606.

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There is a growing body of evidence suggesting a link between sport participation and violent behavior outside of the sporting context. However, there have been few studies that have investigated the basis of this relationship. The current study examined longitudinal relationships between sport participation, problem alcohol use, and various violent behaviors, and whether sport participation moderates relationships between problem alcohol use and violence. The sample comprised 2,262 young adults (55% female, age range at Time 1 = 17-24 years) from Victoria, Australia, surveyed in 2010 and 2012. When controlling for common risk factors, substance use, and past violence, sport participation was not associated with any violent behaviors 2 years later. However, sport participation moderated the relationship between problem alcohol use and fighting, whereby problem alcohol use was associated with engaging in fights 2 years later for sport participants, but not for nonparticipants. These findings suggest that it is not sport participation per se that influences later violence but the drinking norms or culture embedded within certain sporting contexts. Prevention approaches that address the drinking culture and social approval of excessive alcohol consumption within sporting contexts may reduce the incidence of violent behavior in the community.

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