Personal Social Networks of Women with Co-Occurring Substance Use and Mental Disorders

ABSTRACT

There has been relatively little examination of the social network resources of women with substance use disorder, and even fewer explorations of women with co-occurring mental disorders, such as anxiety, depression, and posttraumatic stress disorder. This study explores the nature of co-occurring mental disorders, social network characteristics and perceived social support in 136 women with substance use disorders. Respondents reported small personal networks that contained both supportive and non-supportive people. Relatives did provide social support, but those who used alcohol/drugs were viewed as tending to interact negatively. Women with dual disorders perceived less concrete, emotional, and sobriety support from some network relationships than the women with substance use disorders only. Implications for research and practice are presented.     

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.     

Comparing the effectiveness of behavioral interventions in adults with co-occurring tobacco and substance use disorders: a systematic review of literature

ABSTRACT

This systematic literature review compares the e?ectiveness of various behavioral interventions delivered to persons with co-occurring tobacco and substance use disorders. It examines ?ndings of six randomized trials and three secondary analyses from randomized trials. Based on the ?ndings of this literature review, support is given to the following: (1) The consequences of tobacco use and smoking are deadly, costly, and can have an inhibitory e?ect on the progress of people in substance abuse treatment, (2) tobacco cessation options are a preventive intervention that can be easily incorporated into a treatment facility’s standard of practice and should be made available within the context of all substance abuse treatment facilities, and (3) concurrently treating tobacco use disorder and substance use disorder(s) is an e?ort that will help meet the social work profession’s Grand Challenge to ‘Close the Health Gap.’     

Building Trauma Informed Practice: Appreciating the Impact of Trauma in the Lives of Women with Substance Abuse and Mental Health Problems

ABSTRACT

This paper examines the lifetime interpersonal abuse experienced by a substance abuse treatment sample of 1,955 women with co-occurring disorders. Substantial rates of intimate and community-based interpersonal abuse and other life stressors are documented. Regression analysis shows that while trauma severity is significantly related to trauma distress, its impact on psychological symptom distress and drug severity is quite modest. The implementation of a trauma informed approach featuring trauma-specific treatment, service integration and consumer empowerment is described as a promising practice model for assisting women seeking help in substance abuse treatment programs.     

Predictors of Burden of Family Caregivers of Women with Substance Use Disorders or Co-Occurring Substance and Mental Disorders

ABSTRACT

This study examined the impact of having a female family member with a substance use or co-occurring disorders on family caregivers. Predictors of subjective burden (worry, stigma, and displeasure) and objective burden (family disruption) on caregivers and on types of burden were explored. Subjects were 82 women receiving substance abuse treatment and their family member providing most social support. Behavioral problems of the recipient and lack of social support for caregivers predicted higher levels of family member burden, with different types of social support predicting different types of burden. Having a dual disorder did not predict family member burden. Implications of findings for treatment are discussed.     

Concept of ‘personality disorder’ and its relationship to social work

Abstract

Inherently difficult to define and apply in a valid and reliable way, the concept of ‘personality disorder’ is, nonetheless, a very important psychological construct in the assessment and treatment of clients. This paper discusses the nature and limitations of personality disorder diagnoses. It also refers to data suggesting a paucity of formal training and research on personality disorders, and mental health in general, within Australian social work. The authors call for greater research, analysis and debate by social work educators and the profession on these issues.     

Women's Experience of Co-Occurring Substance Abuse and Mental Health Conditions

ABSTRACT

This study explored the relationship between gender and co-occurring substance abuse and mental health conditions among a sample of 754 consumers of behavioral health services in the southwest U.S. Logistic regression was used to determine factors that would predict women's unique experience of dual diagnosis. Women were almost seven times more likely than men in this sample to have a diagnosis of posttraumatic stress disorder in conjunction with substance abuse. Women were also significantly more likely to experience anxiety and mood disorders and to have been married. Implications of these findings for social work practice are suggested.     

An Evidence-Based Approach to Managing Suicidal Behavior in Patients with BPD

SUMMARY

This review will suggest an evidence-based approach to managing suicidal patients with borderline personality disorder (BPD). Many principles currently used in practice have little basis in empirical data. And some approaches used to manage chronic suicidality, particularly the emphasis on “safety,” may actually be counter-productive.     

Neuroscience in Social Work Practice and Education

Abstract

In the past two decades, advances in neuroscience research have revolutionized the scientific community's understanding of branehavior connections. Social work is now taking note of this trend. Specialists in substance abuse, addiction, and co-occurring diagnoses are beginning to relinquish long-held beliefs in mind-body dualism in favor of a truly integrated biopsychosocial understanding. This article identifies challenges related to social work and argues that neurobiological knowledge is essential for a biopsychosocial understanding of substance abuse and addiction, other mental disorders, co-occurring conditions, and human behavior. It gives examples of drawing on neurobiological knowledge for practice applications. These include educating users, families, and providers about neurobiological aspects of substance abuse (psychoeducation); using neuroscience research on mental illness and addiction to develop integrated approaches for dually diagnosed persons; and considering a range of medication options to alleviate cravings and reduce relapse.     

Pilot study of a personality-based approach to assessing eating disorder and Obsessive Compulsive Disorder symptom risk in college men and women

Abstract

Objective: To conduct a pilot test of the validity of using empirically derived personality types to characterize eating disorder (ED) risk in college students and resolve discrepancies regarding the role of perfectionism and obsessive-compulsive disorder (OCD) symptoms.

Participants: Man and woman undergraduate students (N?=?169) at a small, private university. Data were collected from February to May 2016 and 2018. Methods: Participants completed self-report measures of personality (perfectionism, impulsivity, and effortful control) and psychopathology (EDs, OCD). Results: Our analyses replicated three validated personality types: overcontrolled, undercontrolled, and resilient. Analysis of variances demonstrated perfectionism, ED, and OCD symptoms were significantly elevated in the overcontrolled subtype. There was no interaction by sex. Conclusions: These findings suggest that personality types may be useful for classifying ED risk and OCD symptoms in college students across sexes. Further study and relevance to prevention and intervention efforts to reduce the burden of EDs on college campuses will be discussed.     

Multiple Co-occurring Behaviours among Gamblers in Treatment: Implications and Assessment

A substantial portion of gamblers in treatment may have co-occurring mental health disorders including substance use disorders, especially alcohol dependency, personality disorders, affective disorders, anxiety disorders and impulse control disorders. Co-occurring mental health disorders affect treatment seeking, the treatment process and its outcome, quality of life and functioning in many mental health disorders. Participants in this study were 78 adults enrolled in state-supported out-patient services for pathological gambling and current Gamblers Anonymous attendees. The majority of participants (76.6%) had co-occurring behaviours; 55.8% had multiple co-occurring behaviours. Participants with multiple co-occurring behaviours were more likely to report that a co-occurring behaviour increased the severity of their gambling symptoms. A dose/response relationship between number of co-occurring behaviours and severity of gambling problems was found. Co-occurring behaviours can interact with gambling behaviour. Brief, validated screening instruments are available for screening and diagnosing co-occurring behaviours among gamblers presenting for treatment.     

Peer Substance Use Associated With the Co-occurrence of Borderline Personality Disorder Features and Drug Use Problems in College Students

Abstract

Objective: To determine if the substance use patterns of one's close friends and romantic partners would be a significant contributor to the co-occurrence of borderline personality disorder (BPD) features and drug use problems above and beyond impulsivity and negative emotionality. Participants: Participants were 2,202 undergraduates who attended a large southeastern university between 2003 and 2006. Methods: All subjects completed measures assessing the presence of BPD symptoms, drug use problems, general personality traits, and the proportion of their friends and partners who had used illicit drugs within the past 12 months. Results: The illicit drug use patterns of one's friends and romantic partners was a significant contributor to the co-occurrence of BPD features and drug use problems even when controlling for levels of impulsivity and negative emotionality. Conclusions: These findings suggest possible additional avenues for treatment focusing on helping students with BPD and drug use problems modify their social group.     

Risk Factors for Suicide in Taiwanese College Students

Objective: The authors investigated the personality characteristics, psychopathology, parenting style, and family function among Taiwanese college students with high, moderate, and low suicidal risks. Participants: The sample included 2,919 first-year college students (1,414 men, 1,505 women) from a university in Taipei, Taiwan. Methods: A self-administered questionnaire assessed domains covering demographics, personality, psychopathology, frequency of substance use, parenting style, family functioning, and suicidal behaviors. The authors used mixed models for data analysis. Results: The authors observed a positive linear trend between increased suicidal tendency and levels of neuroticism, harm avoidance, novelty seeking, psychopathology, and parenting styles of low affection, overprotection, and authoritarian controlling. Use of tobacco and alcohol and impaired family adaptation and cohesion were associated with high and moderate suicidal risks. Conclusions: Personality, psychopathology, substance use, and familial factors are important correlates of suicidal risks among college students in Taiwan. Optimal suicide prevention strategies in the college setting should incorporate the multiple facets of suicidal risks.     

Heavy Episodic Drinking in College Students: Associations With Features of Psychopathy and Antisocial Personality Disorder

Abstract

Objective: This study extends the college heavy episodic drinking literature by examining the associations between features of psychopathy and antisocial personality disorder (ASPD), on the one hand, and heavy episodic drinking and associated problem behaviors, on the other. Participants: Participants were 159 (85 male, 74 female) undergraduates from a private university. Methods: Participants completed self-report measures assessing alcohol use, frequency, and consequences of heavy episodic drinking, and personality pathology. Results: It was found that psychopathy, independent of ASPD, was related to the prediction of heavy episodic drinking frequency and problems associated with alcohol use. It was also found that the relation between traits of psychopathy and heavy episodic drinking are limited largely to the impulsive and antisocial aspects of this condition. Conclusion: These findings point to the need for further investigation of the association between psychopathy and ASPD traits and heavy episodic drinking behaviors in college students.     

Psychological Distress as an Indicator of Co-Occurring Psychopathology among Treatment-Seeking Disordered Gamblers

Disordered gamblers frequently present with concurrent anxiety, depressive, personality, and substance use disorders, which may complicate treatment. Although there is a need for a thorough assessment, some questionnaires may prove lengthy for clients and clinicians. Thus, there is a need for brief screens for identifying co-occurring psychopathology. The present study sought to examine whether a brief, self-report measure of psychological distress could indicate the presence of co-occurring psychopathology among an outpatient sample of disordered gamblers. At intake, 69 participants completed self-report measures of distress and gambling symptomatology, a personality inventory, and a structured interview for the diagnostic criteria for disordered gambling. Gamblers with greater elevations of psychological distress evidenced greater severity of gambling pathology. Clinically significant elevations were present for symptoms of depression, deviancy, and anxiety, but not substance abuse. Greater scores of psychological distress significantly predicted elevations of depression, deviancy, and anxiety. Sensitivity and specificity were evaluated and the findings supported that an average psychological distress score of 16 corresponded with the presence of co-occurring psychopathology. Clinicians treating disordered gamblers should consider screening for co-occurring psychopathology with brief, self-report measures of psychological distress.     

Dual Relationships: The Challenges for Social Workers in Recovery

ABSTRACT

Over the last ten years there is increasing focus in social work literature about non-sexual dual relationships. This has included consideration of different types of dual relationships that occur primarily during or after the establishment of professional social worker-client relationship. However, the specific concerns facing social workers who are themselves in recovery from substance use disorders remain absent from these discussions. This article identifies challenges facing social workers in recovery from substance use disorders who also work with clients dealing with these disorders. Recommended actions and policies that can assist professionals and agencies in balancing personal and practice issues are presented.     

Co-Occurring Disorders Among Female Jail Detainees: Implications for Service Delivery

ABSTRACT

The increase in the numbers of women incarcerated in prisons and jails has given rise to questions about their mental health and substance abuse treatment needs. This study used DSM-IV criteria to describe both lifetime and current diagnoses for substance use disorders, major depressive disorder, posttraumatic stress disorder and generalized anxiety disorder in a sample of 198 female jail detainees. Women were asked about readiness for treatment and AODA and mental health service use. Findings underscore the view that female jail detainees have complicated diagnostic histories and that the jail setting can provide opportunities for assessment and services.     

The Seven Challenges: An Effective Treatment for Adolescents with Co-Occurring Substance Abuse and Mental Health Problems

ABSTRACT

Recent developments in the provision of the substance abuse treatment for adolescents has included a focus on age appropriate treatment with consideration for adolescents' relatively low level of motivation for treatment and high incidence of co-occurring substance use and mental health problems. This study examines 3- and 6-month substance use and mental health outcomes for youth (n = 36) participating in The Seven Challenges Program. Results indicate significant reductions in both substance use and mental-health-related measures at 3 months with all measures except substance abuse frequency continuing to improve at the most distal 6-month assessment. The Seven Challenges treatment model is presented along with a discussion of the findings.     

Disregulated Alcohol-Related Behavior Among College Drinkers: Associations With Protective Behaviors,Personality, and Drinking Motives

Abstract

Objective: This study investigated the psychometric properties of the Disregulated Alcohol-Related Behaviors Inventory (DARBI), a measure of harmful alcohol-related behavior, and the relationship between protective behavior use and scores on the DARBI and several other measures. Participants: Participants were 281 undergraduate volunteers (60% female) enrolled in introductory psychology sections in Summer and Fall 2007. Methods: Participants completed the DARBI along with paper-and-pencil self-report measures of broad personality domains, trait resilience, protective behavior use, and drinking motivations and consequences. Results: The DARBI's internal consistency was good (alpha = .85). DARBI scores correlated negatively with conscientiousness scores but positively with neuroticism, the Michigan Alcohol Screening Test (MAST), Rutgers Alcohol Problem Index (RAPI), and positive-reinforcement motives scores. The self-reported use of protective behaviors related negatively to DARBI, MAST, RAPI, and enhancement motives scores. Protective behavior use was unrelated to broad personality domains. Conclusions: The DARBI may prove a useful tool in campus interventions. Further research should determine the dispositional and situational determinants of protective behavior use.