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FASD: the current situation in the UK FASD:英国目前的情况
IF 0.9 Q4 PSYCHOLOGY, CLINICAL Pub Date : 2019-02-18 DOI: 10.1108/ADD-02-2019-040
Raja A. S. Mukherjee
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引用次数: 3
Responding to FASD: what social and community service professionals do in the absence of diagnostic services and practice standards 对FASD的回应:在缺乏诊断服务和实践标准的情况下,社会和社区服务专业人员该怎么做
IF 0.9 Q4 PSYCHOLOGY, CLINICAL Pub Date : 2019-02-18 DOI: 10.1108/ADD-05-2018-0007
K. Bagley
PurposeThe purpose of this paper is to ascertain the experiences and practices of social and community service professionals working with Fetal Alcohol Spectrum Disorder (FASD) or suspected FASD in New Zealand.Design/methodology/approachThe research examined professionals’ empirical experience of working with FASD or suspected FASD. In total, 21 participants working in practice settings relevant to dual diagnosis were interviewed, with each interview being of 1–2 h duration. The interview data were transcribed and coded using the constant-comparative method in order to derive themes.FindingsParticipants identified a number of barriers to understanding or working with FASD: the limited knowledge of FASD and the absence of FASD from training contexts, difficulty obtaining institutional support and the challenge of working without a diagnosis. Participants also articulated a range of strategies for approaching FASD within the identified barriers of their practice contexts, specifically: working with alternative diagnoses, focussing on adjusting expectations, adopting a strengths-based approach, actively advocating for clients when working with other sectors and systems and focussing on prevention education.Originality/valueThis research expands the knowledge base for social and community service practice in contexts where FASD maybe a factor contributing to poor health and well-being outcomes for clients. It clarifies the challenges that professionals face when encountering FASD or suspected FASD in their work, reveals key gaps in individual and systemic knowledge about FASD and provides new insight into what professionals do to address these challenges. It also adds to the body of research concerning FASD in the Australasian context more broadly.
目的本文的目的是确定新西兰社会和社区服务专业人员处理胎儿酒精谱系障碍(FASD)或疑似FASD的经验和做法。设计/方法/方法该研究考察了专业人员与FASD或疑似FASD合作的经验。共采访了21名在双重诊断相关实践环境中工作的参与者,每次采访持续时间为1-2小时。访谈数据采用恒常比较方法进行转录和编码,以便得出主题。研究发现,参与者确定了理解或使用FASD的一些障碍:FASD知识有限,培训环境中缺乏FASD,难以获得机构支持,以及在没有诊断的情况下工作的挑战。与会者还阐述了在其实践背景中确定的障碍范围内处理FASD的一系列策略,特别是:与替代诊断合作,注重调整期望,采用基于优势的方法,在与其他部门和系统合作时积极倡导客户,并注重预防教育。原创性/价值本研究扩展了社会和社区服务实践的知识基础,在这些背景下,FASD可能是导致客户健康状况不佳和福祉结果的一个因素。它阐明了专业人员在工作中遇到FASD或疑似FASD时所面临的挑战,揭示了个人和系统对FASD知识的主要差距,并为专业人员如何应对这些挑战提供了新的见解。它也增加了有关FASD在澳大利亚范围内更广泛的研究机构。
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引用次数: 6
Stigma as a dominant discourse in fetal alcohol spectrum disorder 柱头作为胎儿酒精谱系障碍的主导话语
IF 0.9 Q4 PSYCHOLOGY, CLINICAL Pub Date : 2019-02-18 DOI: 10.1108/ADD-05-2018-0005
Peter W. Choate, D. Badry
PurposeThe purpose of this paper is to conduct a scoping review of the literature to explore the many ways stigma affects people with FASD and to highlight the disciplines and places where discourse on FASD and stigma is taking place.Design/methodology/approachSearches were conducted in PubMed, ERIC, Family & Society Studies Worldwide, Families Studies Abstracts and Google Scholar between 2008 and 2018. Search terms focused on stigma, shame and the connection to FASD with a view to looking across social and medical science literature.FindingsSearches identified 39 full text manuscripts, 13 of which were included in the scoping review. Stigma toward people with FASD exists in multiple professional forums across disciplines. The relationship between mother’s use of alcohol and the lasting impact on the child is a focus in the articles identified from a public health perspective. The review showed there was limited cross-disciplinary discussion evident. In total 13 articles were selected for inclusion in this review.Research limitations/implicationsNegative discourses predominate with little attention being paid to possible areas of success as well as cases of lower FASD impacts. There is a significant void in work focusing on positive outcomes for people with FASD. Such discourse would support a better understanding of pathways to more positive outcomes.Originality/valueThis paper highlights the issue of FASD and stigma through identification of relevant literature and expands the conversation to offer insights into the challenging terrain that individuals with FASD must navigate. The issue of stigma is not linked only to individuals with FASD but also their support systems. It is critical to recognize the multiple attributions of stigma to FASD in order to effectively take up conversations across and between disciplines to promote new discourses focused on de-stigmatization.
目的本文的目的是对文献进行范围审查,以探索耻辱感影响FASD患者的多种方式,并强调FASD和耻辱感的学科和地方正在发生。在2008年至2018年期间,在PubMed, ERIC, Family & Society Studies Worldwide, Families Studies Abstracts和谷歌Scholar中进行了搜索。搜索词集中在耻辱、羞耻和与FASD的联系上,以查看整个社会和医学科学文献。搜索发现了39份全文手稿,其中13份被纳入了范围审查。对FASD患者的污名存在于多个专业论坛中。从公共卫生角度确定的文章的重点是母亲使用酒精与对儿童的持久影响之间的关系。该综述显示,明显存在有限的跨学科讨论。总共有13篇文章被纳入本综述。研究局限/影响负面话语占主导地位,很少关注可能的成功领域以及较低FASD影响的案例。在关注FASD患者的积极结果的工作中存在显著的空白。这种讨论将有助于更好地理解通往更积极结果的途径。原创性/价值本文通过对相关文献的识别,强调了FASD和耻辱的问题,并扩大了对话,以提供对FASD患者必须驾驭的具有挑战性的地形的见解。耻辱感问题不仅与FASD患者有关,还与他们的支持系统有关。为了有效地跨学科和跨学科进行对话,促进以去污名化为重点的新话语,认识到污名化对FASD的多重归因至关重要。
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引用次数: 22
Exploring the experiences of birth mothers whose children have been diagnosed with fetal alcohol spectrum disorders: a qualitative study 探索孩子被诊断为胎儿酒精谱系障碍的生母的经历:一项定性研究
IF 0.9 Q4 PSYCHOLOGY, CLINICAL Pub Date : 2019-01-11 DOI: 10.1108/ADD-10-2018-0014
Robyn Thomas, R. Mukherjee
PurposeFetal alcohol spectrum disorder (FASD) is an umbrella term for a range of conditions that may occur in an individual whose mother drank alcohol during pregnancy. There has been little research into the experience of birth mothers of children with FASD and no published work of this kind in the UK. This is in contrast to a number of studies that have been conducted on foster/adoptive parents. In light of the recent publication in the UK of a mixed methods study on adoptive carers, it is timely to conduct research on birth mothers in the UK. The purpose of this paper is to explore the experiences of birth mothers following a diagnosis of FASD in their children.Design/methodology/approachAn interpretive phenomenological analytical approach was used to generate themes from individual semi-structured interviews of five women who are birth mothers of children with FASD.FindingsFour superordinate main themes and various subthemes were identified. To blame or not to blame captures the tension the mothers experience when considering the cause of their child’s condition. Life is a series of battles which describes the struggles the women experience on a crusade with a renewed sense of purpose that captures the process of transformation that occurs, which helps describe the internal and external factors that help the mothers cope.Originality/valueFASD is often described in the literature as being completely preventable with the implication that it is the mother’s fault because they drank alcohol during pregnancy. However, a statement like this fails to portray the complexities of the phenomenon of women drinking during pregnancy. Life is difficult for the women for a number of different reasons, yet a sense of hope is present. The mothers have a renewed sense of purpose to do the best they can for their child and to raise awareness of FASD. Understanding their experiences can help service providers better meet the needs of parents and children affected by FASD.
目的胎儿酒精谱系障碍(FASD)是母亲在怀孕期间饮酒可能导致的一系列病症的总称。对患有FASD的孩子的生母的经历的研究很少,在英国也没有发表过这方面的研究。这与对寄养/收养父母进行的一些研究形成对比。鉴于英国最近发表了一项关于收养照顾者的混合方法研究,对英国的生母进行研究是及时的。本文的目的是探讨分娩母亲的经验后,诊断为FASD的孩子。设计/方法/方法:采用解释性现象学分析方法,从五名患有FASD儿童的生母的个人半结构化访谈中产生主题。发现确定了四个上级主题和各种副主题。责备或不责备抓住了母亲在考虑孩子病情的原因时所经历的紧张。生活是一系列的战斗,描述了女性在一场十字军东征中所经历的斗争,她们带着一种新的使命感,捕捉了发生的转变过程,这有助于描述帮助母亲应对的内部和外部因素。在文献中,自闭症谱系障碍通常被描述为完全可以预防的,暗示这是母亲的错,因为她们在怀孕期间饮酒。然而,这样的说法并没有描述女性在怀孕期间饮酒现象的复杂性。由于许多不同的原因,生活对女性来说很困难,但希望是存在的。母亲们有了新的目标感,要为孩子做最好的事情,并提高对FASD的认识。了解他们的经历,有助服务提供者更切合受伤残津贴影响的家长及儿童的需要。
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引用次数: 3
Behaviour and adaptive functioning in children and young people with fetal alcohol spectrum disorders: a UK study 患有胎儿酒精谱系障碍的儿童和青少年的行为和适应功能:一项英国研究
IF 0.9 Q4 PSYCHOLOGY, CLINICAL Pub Date : 2019-01-07 DOI: 10.1108/ADD-10-2018-0016
Mari Sakano, R. Mukherjee, J. Turk
PurposeThe purpose of this paper is to explore the profiles of behaviours and adaptive functioning in the UK children and young people with fetal alcohol spectrum disorders.Design/methodology/approachData of 106 participants registered from 2005 to 2015 were extracted from a clinic database. In total, 99 individuals with confirmed prenatal alcohol exposure (PAE), aged from 5 to 25 years, were analysed using scaled scores of the Vineland Adaptive Behavior Scales-Second Edition (VABS-II), and the Developmental Behaviour Checklist-Primary Carer Version (DBC-P) and Teacher Version (DBC-T). Differences due to age, gender, IQ and family structure (adopted/living with birth parents) were also explored.FindingsThe mean composite adaptive behaviour score on the VABS-II was classified as “low” at 68.2 (SD=8.5), with the socialisation domain being the most impaired. Significantly lower VABS-II composite scores were found in individuals with lower IQ’s, older ages and in males. Disruptive behaviours were the most commonly observed on the DBCs, whereas primary carers scored significantly higher than teachers across all subscales. IQ, age and gender were not associated with the total percentile scores of both DBCs. Adoption made no differences compared to living with birth parents.Research limitations/implicationsFuture studies would replicate these findings in a larger sample size including individuals without PAE and those living with birth parents.Originality/valueThis study is the first UK report that examines this issue.
目的本文的目的是探讨在英国儿童和青少年胎儿酒精谱系障碍的行为和适应功能的概况。设计/方法/方法从临床数据库中提取2005年至2015年登记的106名参与者的数据。使用Vineland适应行为量表-第二版(VABS-II)和发展行为检查表-初级护理人员版(DBC-P)和教师版(DBC-T)的评分,对99名确诊产前酒精暴露(PAE)的5至25岁个体进行了分析。研究还探讨了年龄、性别、智商和家庭结构(收养/与亲生父母生活)造成的差异。VABS-II的平均综合适应行为得分为68.2分(SD=8.5),属于“低”,其中社交领域受损最严重。在智商较低、年龄较大和男性的个体中,VABS-II综合得分明显较低。破坏性行为在dbc中最常见,而初级照顾者在所有子量表上的得分都明显高于教师。智商、年龄和性别与两种dbc的总百分位数得分无关。与与亲生父母生活在一起相比,领养没有什么不同。研究局限性/意义未来的研究将在更大的样本量中复制这些发现,包括没有PAE的个体和与亲生父母生活在一起的个体。原创性/价值这项研究是英国第一份研究这一问题的报告。
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引用次数: 6
Homework compliance among substance using male offenders of IPV 吸毒男性犯家庭作业依从性的研究
IF 0.9 Q4 PSYCHOLOGY, CLINICAL Pub Date : 2018-11-19 DOI: 10.1108/ADD-08-2018-0010
Cassandra Berbary, Camila Fernandes, Cory A. Crane, C. Easton
PurposeResearch suggests that homework compliance within cognitive behavioral therapy is associated with treatment adherence and positive treatment outcomes through generalization of learned skills. The purpose of this paper is to determine whether there were differences in aggression and substance use between participants who did and did not complete therapy homework assignments.Design/methodology/approachSecondary analyses were conducted using data from Easton et al.’s (2017) randomized controlled trial of substance abuse domestic violence (SADV) treatment among substance dependent intimate partner violence (IPV) offenders. Analyses of covariance were conducted in order to determine whether homework completion had a significant effect on aggression and substance use. Correlational analyses were conducted to determine the association between quality of homework and outcomes.FindingsParticipants (n=63) who completed at least two homework assignments had fewer days of alcohol use during treatment compared to those who did not complete any assignments, p=0.03. There was not a difference in the number of days participants engaged in violence based on homework completion. Analyses indicated that those who displayed aggression proximal to alcohol use during treatment completed significantly fewer homework assignments compared to those who did not display aggression proximal to alcohol use (p=0.04).Research limitations/implicationsThis research was limited to a sample of male substance using offenders of IPV within the US additional research utilizing a larger sample size in order to investigate differences in homework completion across treatment groups is needed. Further analysis of the barriers to and predictors of homework compliance among this population is recommended.Originality/valueThis research highlights the need for incorporation of homework and further exploration of methods and treatment modalities to ensure homework compliance among substance using male offenders of IPV.
研究表明,在认知行为治疗中,家庭作业依从性与治疗依从性和通过学习技能的泛化获得的积极治疗结果有关。本文的目的是确定在完成和未完成治疗家庭作业的参与者之间是否存在攻击和物质使用的差异。设计/方法/方法使用Easton等人(2017)对物质依赖亲密伴侣暴力(IPV)犯罪者进行药物滥用家庭暴力(SADV)治疗的随机对照试验的数据进行二次分析。为了确定作业完成是否对攻击和物质使用有显著影响,我们进行了协方差分析。进行相关分析以确定作业质量与结果之间的关联。研究结果:完成至少两项家庭作业的参与者(n=63)在治疗期间酒精使用天数少于未完成任何作业的参与者,p=0.03。根据家庭作业的完成情况,参与者参与暴力的天数没有差异。分析表明,在治疗期间表现出接近酒精使用攻击性的学生完成的家庭作业明显少于那些没有表现出接近酒精使用攻击性的学生(p=0.04)。研究局限性/意义本研究仅限于美国男性物质滥用者的样本,需要利用更大的样本量进行额外的研究,以调查不同治疗组在家庭作业完成方面的差异。建议进一步分析这一人群家庭作业依从性的障碍和预测因素。原创性/价值本研究强调了将家庭作业结合起来的必要性,并进一步探索了确保吸毒男性犯遵守家庭作业的方法和治疗方式。
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引用次数: 0
Prevalence of HIV risk behavior among male substance abusing offenders of intimate partner violence 亲密伴侣暴力男性药物滥用者艾滋病毒风险行为的流行情况
IF 0.9 Q4 PSYCHOLOGY, CLINICAL Pub Date : 2018-11-15 DOI: 10.1108/ADD-09-2018-0011
Camila Fernandes, Cassandra Berbary, Cory A. Crane, C. Easton
PurposeThe purpose of this paper is to assess the rates of HIV risk-taking behavior and sexual violence among clients with co-occurring addiction and intimate partner violence (IPV). The current study also aims to determine whether HIV risk-taking behaviors (e.g. trading sex for money or drugs, having unprotected sex with multiple partners) differ among substance using IPV offenders with and without a history of sexual aggression.Design/methodology/approachSecondary analyses were conducted from Easton et al.’s (2017) randomized controlled trial of substance use domestic violence treatment among substance using IPV offenders. Correlational analyses were conducted to assess the relationship between pre-treatment sexual aggression, HIV risk-taking behaviors, substance use and aggression. Analyses of covariance were conducted in order to determine differences in participants’ HIV risk-taking behaviors based on their history of sexual aggression while controlling for hours of contact with the female partners.FindingsIn a sample of 63 participants, males with higher rates of sexual aggression were more likely to engage in sexual risk-taking behaviors. This study encountered a correlation between pre-treatment risk-taking behavior and verbal and physical aggression, as well as a correlation between pre-treatment risk-taking behaviors and cocaine use. Results neither suggest a relationship between sexual aggression and alcohol use nor HIV risk-taking behaviors and alcohol use at pre-treatment.Research limitations/implicationsThe present study is limited by sample size and power.Originality/valueThis study is among the first of its kind to investigate HIV risk-taking behaviors among substance using offenders of IPV. This study provides support for the inclusion of treatment targeting HIV risk-taking behaviors among IPV offenders.
目的评估吸毒成瘾和亲密伴侣暴力(IPV)共存人群中HIV风险行为和性暴力的发生率。目前的研究还旨在确定在有和没有性侵犯史的IPV吸毒者中,艾滋病毒风险行为(例如,性交易金钱或毒品,与多名伴侣发生无保护的性行为)是否存在差异。设计/方法/方法从Easton等人(2017)的药物使用家庭暴力治疗药物使用IPV罪犯的随机对照试验中进行了二次分析。通过相关分析评估治疗前性侵犯、HIV风险行为、药物使用与攻击之间的关系。在控制与女性伴侣接触时间的情况下,通过协方差分析来确定参与者在性侵犯史上HIV风险行为的差异。在63名参与者的样本中,性侵犯率较高的男性更有可能从事冒险的性行为。本研究发现了治疗前的冒险行为与言语和身体攻击之间的相关性,以及治疗前的冒险行为与可卡因使用之间的相关性。结果既没有显示性侵犯与酒精使用之间的关系,也没有显示HIV风险行为与治疗前酒精使用之间的关系。研究的局限性/启示本研究受样本量和功率的限制。原创性/价值本研究是同类研究中首次调查IPV药物使用者的艾滋病毒冒险行为。本研究为在IPV罪犯中纳入针对艾滋病毒冒险行为的治疗提供了支持。
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引用次数: 0
Typology of substance using offenders of IPV: violence and substance use outcomes IPV物质使用罪犯的类型:暴力和物质使用结果
IF 0.9 Q4 PSYCHOLOGY, CLINICAL Pub Date : 2018-11-06 DOI: 10.1108/ADD-01-2018-0001
Cassandra Berbary, Cory A. Crane, C. Easton
PurposeThe purpose of this paper is to investigate whether aggression and substance use assessed during treatment differ based on risk level for substance-using male offenders of intimate partner violence (IPV).Design/methodology/approachSecondary analyses were conducted using data from Easton et al.’s (2017) study on substance-dependent IPV offenders. A cluster analysis was utilized in order to classify participants into typology groups. Analyses of covariance were conducted in order to determine group differences in aggression and substance use during treatment.FindingsThe paper provides results-related response to treatment based on offender typology. Results appear to reflect two typology groups with significant differences in psychopathy among groups. High-risk offenders demonstrated higher rates of violence throughout treatment compared to moderate- and low-risk offenders; however, no differences in substance use outcomes were found.Research limitations/implicationsA limitation of the study is the extent to which the results can be generalized beyond substance using IPV offenders. Further investigation of treatment outcomes including alternate measures is needed in order to better translate theoretical typologies to clinical settings.Practical implicationsResults provide support for differentiating treatment for substance-using male offenders of IPV based on typology as those with low/moderate risk level appear to be distinctly different and have different treatment outcomes compared to high risk level offenders.Originality/valueAlthough the relationship between risk level and treatment outcomes has been researched with Drug Court Offenders, treatment outcomes based on typology has not been evaluated among substance using male offenders of IPV.
目的探讨亲密伴侣暴力(IPV)男性施暴者在治疗期间的攻击和物质使用评估是否存在不同风险水平的差异。设计/方法/方法使用Easton等人(2017年)对物质依赖的IPV违法者的研究数据进行了二次分析。利用聚类分析将参与者划分为类型学组。进行协方差分析,以确定治疗期间攻击和物质使用的组间差异。研究结果基于罪犯类型提供了与结果相关的治疗响应。结果似乎反映了两个类型学组在组间的精神病有显著差异。与中度和低风险罪犯相比,高风险罪犯在整个治疗过程中表现出更高的暴力率;然而,药物使用结果没有发现差异。研究的局限性/意义研究的一个局限性是研究结果可以推广到使用IPV违法者以外的程度。需要进一步研究治疗结果,包括替代措施,以便更好地将理论类型学转化为临床环境。实践意义:低/中危险水平的男性吸毒犯与高危水平的男性吸毒犯相比,存在明显差异,治疗结果也存在差异,研究结果为基于类型区分治疗提供了支持。虽然风险水平与治疗结果之间的关系已经在毒品法庭罪犯中进行了研究,但基于类型学的治疗结果尚未在使用物质的男性IPV罪犯中进行评估。
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引用次数: 1
Introducing the recovery inspiration group: promoting hope for recovery with inspirational recovery stories 介绍康复鼓舞小组:以鼓舞人心的康复故事促进康复的希望
IF 0.9 Q4 PSYCHOLOGY, CLINICAL Pub Date : 2018-11-01 DOI: 10.1108/ADD-03-2018-0004
Kelly J. Elsegood, Lucinda A. Anderson, R. Newton
PurposeThe purpose of this paper is to undertake a preliminary evaluation of a novel intervention – Recovery Inspiration Group, which uses recovery stories to promote hope and inspiration for recovery among people with complex mental health difficulties.Design/methodology/approachThe Recovery Inspiration Group was delivered to women on a specialist personality disorder inpatient unit, who were concurrently participating in a dialectical behaviour therapy (DBT) Programme. In total, 12 service users participated in the RIG and as part of the intervention, wrote down key reflections after hearing each recovery story. A thematic analysis of these reflections formed the primary basis of the evaluation. Descriptive statistics derived from a service user feedback survey (n=6) supplemented the qualitative findings.FindingsThree themes were identified in the qualitative data, suggesting that participants had engaged with recovery-oriented reflections and experiences: recovery stories as validating and inspiring; Generalisation of DBT skills; shifting perspectives of recovery: doing better rather than being better. The survey results unanimously endorsed the RIG as a worthwhile and validating experience, which participants would recommend to other service users.Practical implicationsRecovery Inspiration Group appears to be a low-cost and easily replicable intervention with the potential to promote hope and inspiration for recovery among people with complex mental health difficulties.Originality/valueRecovery Inspiration Group is a novel approach to harnessing the wisdom of people with lived experience of mental health difficulties, to foster hope among users of mental health inpatient services.
目的对一种新型的干预方式——康复激励小组进行初步评价,该干预方式通过康复故事,在有复杂心理健康困难的人群中提升对康复的希望和激励。设计/方法/方法康复启发小组被提供给人格障碍专科住院病房的妇女,她们同时参加了辩证行为治疗(DBT)方案。总共有12名服务用户参与了RIG,作为干预的一部分,他们在听到每个恢复故事后写下了关键的感想。对这些反思的专题分析构成了评价的主要基础。来自服务用户反馈调查的描述性统计(n=6)补充了定性调查结果。定性数据中确定了三个主题,表明参与者参与了以恢复为导向的反思和经历:恢复故事是有效的和鼓舞人心的;DBT技能的概括;转变对复苏的看法:做得更好,而不是变得更好。调查结果一致认可RIG是一种有价值和有效的体验,参与者将向其他服务用户推荐。实际意义康复激励小组似乎是一种低成本和容易复制的干预措施,有可能在有复杂心理健康困难的人中促进希望和激励康复。创意/价值康复启发小组是一种新颖的方法,利用有精神健康困难生活经验的人的智慧,在精神健康住院服务的用户中培养希望。
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引用次数: 2
Initiating and maintaining a recovery process – experiences of persons with dual diagnosis 启动和维持康复过程——双重诊断患者的经验
IF 0.9 Q4 PSYCHOLOGY, CLINICAL Pub Date : 2018-08-20 DOI: 10.1108/ADD-09-2017-0016
Lisa Skogens, Ninive von Greiff, A. Topor
Purpose - The purpose of this paper is to investigate the internal and social factors that persons with experience from severe mental illness and alcohol and other drugs problems, and who have rece ...
目的-本论文的目的是调查有严重精神疾病、酒精和其他药物问题的人以及有犯罪行为的人的内部和社会因素。
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引用次数: 14
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Advances in Dual Diagnosis
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