Drug Use,Self-Efficacy,and Coping Skills Among People with Concurrent Substance Abuse and Personality Disorders: Implications for Relapse Prevention

ABSTRACT

This study investigated drug use antecedents, abstinence self-efficacy and coping skills among people with concurrent substance abuse and personality disorders. Fifty inpatients with recent polydrug abuse were divided into two groups based upon the presence (PD) or absence (NPD) of a personality disorder. The PD group reported more often using drugs when experiencing unpleasant emotions, physical discomfort, and conflict with others. They also reported lower self-efficacy for situations involving physical discomfort and interpersonal conflict, more use of a self-blaming coping style, and lower levels of interpersonal competence. Implications for treatment are discussed in light of these findings.     

Sexual victimization and substance abuse in psychiatrically hospitalized adolescents

This article investigates the relationship between substance abuse and sexual abuse in a population of 260 psychiatrically hospitalized adolescents. Seven hypotheses are set forth to test a model that uses parental alcohol abuse, sexual abuse status, and gender as exogenous variables, perceived benefit of alcohol or drugs as an endogenous mediating variable, and substance abuse as the dependent variable. Using these variables, a path model was constructed and revised based on empirical testing. The revised model achieved an adjusted R2 of .38, thus explaining 38 percent of the variance in this sample's abuse of alcohol or drugs. The model suggests that within clinical populations, sexually abused adolescents should be screened for substance abuse, and attention should be given to parental alcohol abuse as well as the degree to which adolescents perceive benefits from their alcohol or drug use.     

UN: Treatment not accessible,especially in prisons,globally

Last week, the United Nations Office on Drugs and Crime (UNODC) released a report revealing that the adverse health consequences of drug use are more severe and widespread than previously thought. About 35 million people globally are estimated to need treatment for drug use disorders, according to the World Drug Report 2019, released June 26. The number of opioid users is now 53 million, up 56% from previous estimates. Opioids are responsible for two‐thirds of the 585,000 drug use deaths in 2017. Across the world, 11 million people injected drugs in 2017; 1.4 million of them have HIV and 5.6 million have hepatitis C.     

Free Symbolic Play and Assessment of the Nature of Child Sexual Abuse

ABSTRACT

This article highlights the potential value of free symbolic play to the field of sexual abuse. The following two points are argued: (1) free symbolic play is a modality well suited to the expression, reworking and mastery of psychic trauma and therefore offers sexually abused children a channel for communication; (2) free symbolic play is a potential source of information to mental health professionals when attempting to understand the context of a child's experience of sexual abuse. Preliminary guidelines are suggested regarding the appropriate use of free symbolic play to gain information about possible sexual abuse. In addition, a case study is presented illustrating application. Furthermore, the potential impact of research comparing the free symbolic play of sexually abused and nonabused children is considered.     

Partner Abuse Among Women Whose Children Have Been Sexually Abused: An Exploratory Study

ABSTRACT

To explore partner abuse among women in families in which a child has disclosed sexual abuse, 102 mothers completed a measure of partner abuse and the Coping Responses Inventory. Results suggest that, like women in the general population, mothers of children who have been sexually abused have often experienced partner abuse. As expected, physical abuse in a current relationship was found to be related to the use of avoidance strategies in dealing with the sexual abuse disclosure. The implications for practitioners and for future research are discussed.     

The Relationship Between Child Sexual Abuse and Alexithymic Symptoms in a Population of Recovering Adult Substance Abusers

ABSTRACT

Recovering substance abusers with a history of childhood sexual abuse (n = 69) or no history of childhood sexual abuse (n = 68) completed the Toronto Alexithymia Scale (TAS) and a background survey assessing demographic data and (In the case of sexually abused respondents) parameters of the childhood abuse experienced. The sexually abused group scored significantly higher than the non-abused group on the TAS. Within the abused group, measured alexithymic symptomatology was found to be related positively to the duration of the abuse. Alexithymia was significantly higher when the sexual abuse first occurred after the victim had reached the age of 12, when a perpetrator of the sexual abuse was a father or stepfather, and when the abuse involved oral, vaginal, and/or anal penetration. Results were interpreted as indicating that the development of alexithymic symptoms may represent another defense victims may employ to insulate themselves from painful affect, along with dissociative symptoms and substance abuse, which have been shown previously to characterize adult survivors of child sexual abuse.     

Elder Abuse in Residential Settings in Sweden

ABSTRACT

To investigate frequencies and types of elder abuse occurring in residential settings in two municipal areas of Sweden, nursing staff were asked to answer a questionnaire; 499 responded. The findings indicated that elder abuse involving the staff did occur. Eleven percent of the staff knew of situations of elder abuse and two percent admitted that they themselves had been abusive towards an elderly resident. Psychological and physical abuse related to caring activities were most common. In the specific situations reported, the abusers were mostly characterised as hot-tempered, exhausted, and burned out. The abused people were often mentally and/or physically handicapped and generally over 80 years old. Feelings such as powerlessness, anger towards the abuser, and compassion for the abused person were reported. To cope with the situation, they talked to each other or to the manager. They recommended more education and support as the main preventive strategy.     

Substance Abuse Among Puerto Rican and Dominican Gang Members in a Small City Setting

SUMMARY

Joining a gang increases an adolescent's risk for substance abuse. To better understand the contextual development of drug use behavior, this retrospective ethnographic study describes a sample of 76 young small-city mainland Puerto-Rican and Dominican males who joined gangs when they were younger. Data is presented and discussed on the drug abuse behavior including their drug using progression and the context in which such use occurs. The young average age of onset 11.2 (sd = 2.6) combined with the rapid progression to more dangerous drugs, which generally occurs within six years, demonstrates the elevated risk associated with small city gang membership. Differences in the patterns of drug use were also found between the English and Spanish speaking groups. The authors discuss the implications of the study findings on the development of interventions. Recommendations address future research possibilities on drug abuse within Latino gangs.     

Impact of Drugs and Alcohol on the Brain Through the Life Cycle

Abstract

This article discusses the impact of alcohol and other drugs on the brain during five stages of the life cycle: perinatal (pregnancy-2 years), childhood (2-12 years), adolescence (13-21), adulthood (22-50), and senior (50+). Alcohol and psychotropic drugs act through specific chemicals in the brain called neurotransmitters. Neurotransmitters have two main functions in the brain: mediate electrical transmission (synaptic activity) and promote growth (trophic activity). The trophic activity results in a neuron increasing its size and the complexity of its branches (dendrites). The ability of drugs and alcohol to influence neuronal growth (neuroplasticity) has unique consequences in children, adults, and seniors. Knowledge of such biological principles as developmental critical period, age-related cortical shrinkage and steroid-induced neuronal growth is presented in the context of alcohol and other drug abuse. A few suggestions are made for developing new treatment strategies based on the inherent dynamics of the brain during the life cycle.     

Awareness of Elder Abuse Among Community Health and Social Care Staff in Northern Ireland: An Exploratory Study

ABSTRACT

This article reports on one of the first surveys of multi-disciplinary staff awareness of elder abuse in this region of the United Kingdom (UK). Forty staff from eight professional groups in the Southern Health and Services Board area were surveyed about their knowledge of elder abuse, the types of help they thought they could offer the abused and the abuser, and the level of abuse in their current caseload. Thirty-five per cent of respondents had cases of physical, psychological, financial, and sexual abuse as well as care-giver neglect of people aged 65 and over in their caseloads. The findings suggest that while staff had differing levels of awareness of elder abuse, further training is necessary.     

Betrayed and Broken: A Study of the Experiences of Victims of Child Sexual Abuse in the Ga Community in Accra,Ghana

ABSTRACT

Child sexual abuse is increasingly becoming an issue of concern in most societies across the globe, including Ghana. This is a phenomenological study that sought to describe the lived experiences of victims of child sexual abuse in Ghana, using the Ga community as a case study. Purposive and snowball sampling techniques were used to identify 17 sexually abused children in the Ga Community. Using the interpretative phenomenological analysis (IPA), four main themes described the experiences of the victims: (a) forced sex (b) incest (c) joleying and (d) transactional sex. The findings illustrate the different circumstances in which children were sexually abused in the community studied. It also presents socio-cultural factors that normalizes the sexual abuse of children in the Ga Community. These findings underline the need for effective preventive programs and community interventions to protect children and support victims of child sexual abuse.     

Gender Differences in the Characteristics and Outcomes of Sexually Abused Preschoolers

ABSTRACT

This study examined whether sexually abused preschool boys and girls (ages 2–5) differed in terms of abuse characteristics or psychological outcomes. A retrospective chart review of 74 cases of sexually abused children (29 boys and 45 girls) treated at an urban mental health clinic in Maryland was conducted. Information was collected on: (1) demographics; (2) abuse characteristics (victim's age, type of sexual abuse, relationship to perpetrator); (3) abuse discovery pattern (accidental vs. purposeful); (4) children's symptomatology; and (5) child and familial factors. No differences were found between boys and girls in terms of the victim's age at the time of abuse, perpetrator's age, or the identity of the perpetrator. However, boys and girls experienced different forms of abuse; boys were more likely to experience fondling, oral and anal intercourse. The majority of boys and girls were abused by males, typically someone they knew (biological parent/parent figure or relative). No differences were evident in the type of disclosure; however, older children were more likely to self-disclose than younger children. Results indicated that boys exhibited more developmental delays and aggressive symptoms than girls. Clinical implications of these findings are discussed as well as recommendations for future research.     

Persistent Complications of Child Sexual Abuse: Sexually Compulsive Behaviors,Attachment, and Emotions

ABSTRACT

Child sexual abuse has the potential to cause distress for the victim across the lifespan. Romantic relationships may be particularly difficult for victims of child sexual abuse. This retrospective study examined differences in adult romantic attachment, sexually compulsive behaviors, and emotion regulation by history of child sexual abuse in a large, nonclinical sample. Those with a history of child sexual abuse reported more attachment anxiety in romantic relationships and engaged in more sexually compulsive behaviors. Overall, males displayed more sexually compulsive behaviors than females regardless of history of sexual abuse. Males with a history of sexual abuse displayed the greatest number of sexually compulsive behaviors. Surprisingly, no differences were observed in emotion regulation or attachment avoidant behaviors by history of child sexual abuse. Future research should seek to replicate current findings and examine emotion regulation difficulties experienced as a result of trauma.     

Risk factors and physical signs of child abuse in hospitalized children in Taiwan

PurposeThis study used the Criteria for Distinguishing Abuse from Accidents Chinese version (CDAA-C) to determine cases of child abuse, undetermined intent, and unintentional injury, and compared risk factors and injury profiles among hospitalized children in Taiwan.DesignA retrospective chart review study.MethodsWe selected children aged 0–3 who were hospitalized with a discharge diagnosis of injury or child maltreatment in a medical center in southern Taiwan between 2007 and 2009. The CDAA-C was used to collect children's demographics and injury types and to determine the intent of injury. Children's charts with records and notes of admission, surgery and emergency care were reviewed and analyzed.ResultsAmong 157 eligible cases, the CDAA-C identified 13 child abuse cases including additional 8 victims who were not previously coded in ICD-9-CM. Most abused children suffered from brain injuries, had ≥ 2 in jury incidents, and had a misdiagnosis in the previous visit. Abused children were younger and more likely to be born premature.ConclusionsThis study highlighted the under-diagnosis of child abuse in Taiwan. An easy-to-use standardized screening tool for child abuse in Taiwan is needed.     

Childhood Sexual Abuse and Drug Use Among Low-Income Urban Puerto Rican Women

SUMMARY

This study examines the relationship between childhood sexual abuse and adult drug use among low-income urban Puerto Rican women. Interviews were conducted with 718 women, 408 involved in drug use and a comparison group of 310 non drug-users. Results demonstrate a strong association between childhood sexual abuse and adult drug use. The impact of childhood sexual abuse was greater for women reporting greater abuse severity, abuse by a family member, and increased abuse duration. Findings support a direct effects model of childhood sexual abuse on adult drug use. The increased rates of drug use among victims of childhood sexual abuse did not appear to be mediated by other childhood maltreatment or family background factors. Implications for practice and research are discussed.     

Toward an Understanding of Russian Speaking Heroin Addicts and Drug Treatment Services in Israel

Abstract

This pa per de scribes the find ings from a pur pos ive sample of 152 male and fe male Rus sian-speak ing drug ad diets who im migrated to Is rael dur ing the last ten years. Ap prox i mately one-third of the co hort was not Jew ish, in clud ing 47 per cent of the women. Forty-one per cent of the subjects re ported be ing phys i cally abused and 25 per cent of the women, com pared to 5 per cent of the men, re ported be ing sex u ally abused as a child. Al co hoi abuse was found to be dif fer ent among the par ents of male and fe male ad diets: 46% of the women com pared to 31% of the men had fa thers who drank ex ces sively; 14% of the women compared to 5% of the men had moth ers who were heavy drink ers. Also, female ad diets were more likely than male ad diets to have a mother who used il licit drugs. Treat ment re lated is sues are dis cussed along with the need for specialized, culturally sen si tiveser vice pro vision.     

Cocaine Abusing Women Who Report Sexual Abuse: Implications for Treatment

ABSTRACT

Four hundred seventy-three substance-abusing women were assessed for histories of sexual abuse. The results of bivariate analysis indicated that Sexual Abuse Survivors (SAS) had higher levels of depression, anxiety, and psychological distress. A greater number of SAS reported histories of emotional and physical abuse. They also had greater severity on ASI scales of alcohol, drug, medical, and family/social difficulty. Logistic regression analysis indicated that women who were survivors of sexual abuse were more likely to have histories of emotional and physical abuse, higher levels of addiction severity, and more family members who used drugs. Implications for research and treatment are discussed.     

Holocaust Child Survivors and Child Sexual Abuse

ABSTRACT

This study utilized a qualitative analysis of child survivors of the Holocaust who were sexually abused during World War II. The research study aimed to give this specific group of survivors a voice and to explore the impact of multiple extreme traumas, the Holocaust and childhood sexual abuse, on the survivors. Twenty-two child survivors of the Holocaust who were sexually abused during the war completed open-ended interviews. The data was qualitatively analyzed according to Tutty, Rothery, and Grinnell's (1996) guidelines. Three major themes were found: issues relating to the sexual abuse trauma, survivors' perceptions of the abuse, and survivors' general perspectives towards life. The identity of the offenders, Jewish or non-Jewish, determined the survivors' feelings towards themselves, the perpetrators, and about the worth of life.     

Posttraumatic Stress Disorder and Suicidal Ideation Among Sexually Abused Adolescent Girls: The Mediating Role of Shame

ABSTRACT

Sexual abuse is associated with a host of negative repercussions in adolescence. Yet the possible mechanisms linking sexual abuse and negative outcomes are understudied. The purpose of this study was to investigate the relationships among self-blame, shame, coping strategies, posttraumatic stress disorder, depressive symptoms, and suicidal ideation. The sample included 147 sexually abused adolescent girls between 14 and 18 years of age. A total of 66% of girls reached clinical score for posttraumatic stress disorder, and 53% reached clinical score for depressive symptoms. Close to half (46%) reported suicidal thoughts in the past 3 months. Shame was found to partially mediate the relationship between self-blame and posttraumatic stress disorder. Shame and depressive symptoms were also found to partially mediate the relationship between self-blame and suicidal ideation. Results suggest that shame is a crucial target in interventions designed for sexually abused adolescent girls.     

What All Social Workers Should Know About MDMA (Ecstasy)

ABSTRACT

This article describes the history of MDMA, its relationship to other drugs, its manufacture and how it is trafficked, and the physiological reactions and health consequences associated with its use. It also presents recommendations for drug abuse prevention and treatment. Material was drawn from government publications, professional journals, and private organization Web sites. Effective strategies for decreasing MDMA use and for minimizing deleterious effects on users exist.