Journal of Dual Diagnosis最新文献

Objective: Black individuals in the United States have high rates of obesity and cigarette smoking, both of which increase health risks. One factor that has demonstrated significant relations to cigarette smoking outcomes is anxiety sensitivity. Yet, work examining these relations among Black individuals with obesity who smoke is nonexistent. Therefore, the present study examined the role of anxiety sensitivity in relation to several smoking outcomes among Black individuals with obesity who smoke. Methods: Participants were 161 Black adults with obesity who endorsed daily combustible cigarette smoking (M_age = 47.1 years, SD = 14.19, age range 19-73 years; 65.2% female). Results: Results indicated that greater levels of anxiety sensitivity were statistically significantly and positively related to increased cigarette dependence, severity of problems when trying to quit, perceived barriers to smoking cessation, and smoking abstinence expectancies, including negative mood, somatic symptoms, and harmful consequences. Importantly, findings were observed above and beyond the variance accounted for by age, sex, education, income, perceived physical health, average number of cigarettes smoked per day, hazardous drinking, and cannabis use. Conclusions: These findings suggest that Black individuals with obesity who smoke and exhibit higher levels of anxiety sensitivity may be at increased risk for processes known to sustain smoking behavior and impede quitting success.

Objective: There are high rates of unemployment among individuals with substance use disorders (SUDs) and unemployment can increase the risk of relapse. Additionally, SUD relapse can increase the chance of job loss. However, there is a dearth of research related to the feasibility and acceptability of employment counseling strategies for individuals with SUDs.

Methods: This study is a secondary sub-group analysis of data attained from a pre-post trial (no control group) of the Conversing with Others intervention, a direct skills teaching (DST) approach designed to enhance confidence with workplace conversational skills. The brief, small-group intervention was administered to 68 participants with SUDs among which 43 (63.2%) had dual diagnoses in community agency settings.

Results: From pre- to post-intervention, participants reported greater confidence with and increased knowledge of having a conversation with others in the workplace. Furthermore, participants reported high levels of overall satisfaction with the quality of the intervention.

Conclusions: Securing employment can positively impact the lives of people with SUDs and foster recovery. Brief, targeted soft skills training for enhancing workplace conversational confidence and knowledge may be feasible and acceptable to implement among individuals with SUDs and dual diagnoses in community settings. Findings also have implications for mental health practitioners, multidisciplinary practice, policy makers, and researchers.

Objective: This study examined the associations between COVID-19 related stress and alcohol use outcomes, and the role of impulsive personality traits in moderating these associations. Participants: Participants were college students from a large public university in the southwestern United States (n = 425; 74.9% female) and a private mid-size institution in the southeastern United States (N = 114; 74.6% female). Methods: Students completed self-report assessments during fall 2020. Hierarchical multiple regression models were conducted. Results: Main effects of COVID-19 related stress, negative urgency, and sensation seeking on both alcohol consumption and alcohol use disorder (AUD) symptoms emerged. The association between COVID-19 related stress and AUD symptoms was greater among students with higher negative urgency. Conclusions: The association between COVID-19 related stress and drinking is evident across the undergraduate student body. Findings demonstrate that students higher in negative urgency may be particularly vulnerable to AUD pathology during periods of heightened stress.

Objective: Intimate partner violence is highly prevalent, with approximately one in two women reporting experiences of intimate partner violence (IPV) at some point in their lifetime. Posttraumatic stress disorder (PTSD) is etiologically tied to trauma-including experiences of IPV-and is associated with drug use-related harm. Women of color experience higher rates of IPV, PTSD, and drug use-related harm compared to their white counterparts; however, a dearth of research has been conducted on the relation between PTSD symptoms and drug use-related harm among women of color experiencing IPV. Moreover, little research has identified factors that may ameliorate the association between PTSD symptoms and drug use-related harm. To advance this research, this study investigated the role of ethnic-racial identity as a moderator in the relation between PTSD symptoms and drug use-related harm.

Method: Participants were 103 women of color currently experiencing IPV who were recruited from the community. Regression analyses examined whether ethnic-racial identity facets of affirmation, exploration, and resolution attenuated the relation between PTSD symptoms and drug use-related harm.

Results: The affirmation component of ethnic-racial identity moderated the relation between PTSD symptoms and drug use-related harm (B = -0.02, p = .02), such that PTSD symptoms were significantly associated with drug use-related harm at higher (b = 0.10, p < .001), but not lower (b = 0.01, p = .52), levels of ethnic-racial identity affirmation. No moderating effects were detected for ethnic-racial identity exploration and resolution.

Conclusion: Results of this study suggest that bolstering the ethnic-racial identity facet of affirmation among women of color who experience IPV may attenuate the relation between PTSD symptoms and drug use-related harm.

Background: The COVID-19 pandemic prompted a rapid expansion of telehealth services in patients with substance use disorders (SUD) and comorbid mental health conditions (dual diagnosis). However, evidence on the effectiveness and utilization of hybrid care (combining in-person and telehealth modalities) in this population remains limited.

Objective: This study aims to analyze the use of a hybrid treatment (telehealth and in-person treatment) among patients with dual pathology across three distinct periods-before, during, and after COVID-19-related public health measures-and to assess the impact of hybrid care on treatment dropout rates.

Methods: A retrospective observational study was conducted using electronic health records (EHR) from 6,365 outpatients diagnosed with SUD and comorbid mental disorders, between March 2018 and September 2023. Patients were classified by treatment modality (in-person vs. hybrid) and period of care. Bivariate statistics and Cox regression analyses were performed to identify predictors of treatment dropout, accounting for demographic and clinical variables.

Results: Hybrid care utilization increased significantly during the pandemic and remained elevated post-pandemic. Women and patients with opioid use disorder were more likely to receive hybrid care. Patients receiving hybrid therapy had significantly lower dropout rates and longer treatment durations. Also, patients in coordinated care (addiction and mental health centers) show lower rates of dropout. Cox regression confirmed that hybrid care was the strongest predictor of reduced treatment dropout across all periods.

Conclusions: Hybrid care models enhance treatment retention among dual diagnosis patients, underscoring the need to maintain and optimize telehealth options for this high-risk group even beyond pandemic-related restrictions.

Objective: This study examined differences in self-stigma between patients with cannabis-induced first-episode psychosis (C-FEP, n = 10) and non-cannabis-induced first-episode psychosis (NC-FEP, n = 10).

Methods: We used three core measures: the Self-Stigma of Mental Illness Scale (SSMIS), the Rosenberg Self-Esteem Scale (RSES), and qualitative interviews.

Results: Despite similar levels of stereotype awareness, C-FEP patients showed significantly lower stereotype concurrence (p < .01) and self-application (p < .05) than NC-FEP patients. C-FEP patients attributed their symptoms to cannabis use rather than inherent vulnerability, potentially buffering against internalized stigma, but expressed greater disclosure concerns. Self-esteem was higher in the C-FEP group (p < .05).

Conclusions: These findings suggest that causal attribution influences self-stigma manifestation, with important implications for tailored stigma interventions in early psychosis.

Objective: Cognitive impairment is common among patients with alcohol use disorder of which relapse is a common feature. This study investigates the prevalence of cognitive impairment in patients with alcohol use disorder and also explores the relationship between cognitive impairment and craving.

Methods: In this cross-sectional study, we assessed 30 male patients with alcohol use disorder in an inpatient deaddiction unit between June to August 2023. The patients were between 29 and 60 years of age. The patients included for the study did not have any active alcohol withdrawal symptoms, medical or other psychiatric disorders affecting cognition or intellectual disability. Their cognitive functions were tested using Montreal Cognitive Assessment (MoCA) and Frontal Assessment Battery (FAB). Craving for alcohol was assessed by Visual Analogue Scale. We used Independent T test and ANOVA to compare means. Pearson correlation test was used to compare quantitative variables.

Results: Global cognitive impairment (MoCA < 26) was seen in 86.7% of participants while 30% had frontal executive dysfunction (FAB < 12). Craving was found to be positively correlated with the amount of alcohol consumed and negatively correlated with the Montreal Cognitive Assessment (MoCA) score.

Conclusions: Our findings support the relationship between cognitive impairment and craving in alcohol use disorder. Majority of the patients in the study (86.7%) exhibited global cognitive dysfunction as measured by MoCA test. Furthermore, patients with global cognitive impairment had significantly higher subjective craving scores as measured by VAS.

Objective: Psychiatric and substance use disorders commonly co-occur, yet treatment is often siloed. To improve treatment utilization for individuals with co-occurring disorders in the psychiatric setting it important to understand current practices. This study analyzed adults seen by community-based psychiatric emergency services with co-occurring disorders to identify: (1) reason for visit; (2) prevalence of suicidality and past attempts; (3) whether suicidality predicted future psychiatric emergency department (ED) presentation.

Methods: Retrospective chart review of patients seen by the Boston Emergency Services Team with first encounters between 2017-2021 (N = 352).

Results: The sample had an average age of 38 years old, 66% male, 57% White. Thirty-eight percent of patients reported suicidal ideation (SI), of whom 25% described SI involving overdose. Sixty patients had attempted suicide, 35 by overdose. In a Cox Regression model, suicidality in the first visit did not predict future psychiatric ED use.

Conclusions: The high co-occurrence of SUDs with suicidality indicates the importance of screening and intervention in specialty mental health and addiction treatment settings.

Objective: The current study aimed to systematically review the prevalence of comorbid Cannabis Use Disorder (CUD) in individuals with Anxiety and Related Disorders (ARDs).

Method: PubMed, PsycInfo, and Web of Science were searched electronically to identify studies comprised of participants 18+ years, diagnosed with a current ARD via clinician interview and experiencing comorbid CUD (interview or validated screener). Of the 1646 articles identified, 11 were included.

Results: Across general population samples (n = 7), approximately 1 in 30 to 1 in 5 individuals with an ARD had comorbid CUD (lifetime prevalence: 3.3%-21.6%; current prevalence: 4.3%-20.0%). Among veteran samples with PTSD (n = 4), comorbid CUD was reported in approximately 1 in 25 to 1 in 3 individuals for current prevalence (4.1%-34.0%), and about 1 in 9 for lifetime prevalence (11.3%-12.5%).

Conclusion: Preliminary evidence suggests that individuals with ARDs may be susceptible to developing comorbid CUD. Current comorbidity rates may be higher among veterans with PTSD compared to adults in general population samples; however, due to the limited number of eligible studies and methodological heterogeneity, further research is needed to confirm this difference. Given the recent global increase in cannabis legalization, understanding ARD-CUD comorbidity in high-risk populations is essential to inform treatment and improve outcomes.