Mental health and substance use : dual diagnosis最新文献

This study was designed to assess relations among alcohol use, alcohol-related problems, negative-life events, depressive symptoms, and suicide proneness in a cross-sectional sample of undergraduate college students (N = 1100). Alcohol use was assumed to be causally prior to alcohol-related problems and negative life events, which were in turn modeled as occurring prior to depressive symptoms, which were in turn modeled as prior to suicide proneness. Results revealed that, as expected, suicide proneness was positively related to depressive symptoms, alcohol-related problems, negative life events, and alcohol use, and depressive symptoms were positively associated with alcohol-related problems and negative life events. Additionally, the relation between alcohol use and depressive symptoms was partially mediated by alcohol-related problems and negative life events; and the alcohol use-suicide proneness link was significantly mediated by alcohol-related problems, negative life events, and depressive symptoms. Implications are offered for the improved identification and treatment of at-risk young adults.

Individuals with comorbid internalizing psychological symptoms and substance abuse issues often have more negative outcomes and evidence a relative disparity in treatment gains compared to those with only substance abuse issues. The present study examined social mechanisms over time for individuals living in self-governed recovery homes (Oxford Houses) such as 12-step group activities and social support, which likely influence both abstinence and psychological outcomes. Participants (n = 567) from a national United States sample of Oxford Houses completed baseline and multiple follow-up self-report assessments over a one-year period. A structural equation model was utilized to evaluate predicted relationships among baseline symptoms, 12-step activities, social support, and outcome variables. Results indicated that internalizing symptoms were associated with subsequent mutual help activities, but not directly with social support. Living in an Oxford House for six months and number of 12-step meetings attended were partially mediated by social support variables in predicting abstinence outcomes, but not psychological outcomes. Environments such as Oxford Houses may be viable options for recovering individuals with comorbid internalizing psychological problems, although social support mechanisms primarily promote abstinence. Implications for future research and for Oxford House policies are discussed.

Objective: Aggressive behavior is strongly associated with both posttraumatic stress disorder (PTSD) and substance use disorders (SUD) among civilians. However, little research has examined correlates of aggression among Veterans with co-occurring PTSD and SUD.

Methods: This exploratory study examined the prevalence and correlates of recent (i.e., past 30 days) and lifetime aggressive behavior among a sample of U.S. Veterans (N=97) enrolled in a study examining integrated psychosocial treatment of co-occurring PTSD/SUD.

Results: The findings revealed high rates of recent and lifetime aggressive behaviors (39.2% and 57.7%, respectively). Participants who endorsed recent aggressive behaviors were younger, had less education, more severe PTSD numbing and hyperarousal symptoms, were more likely to report recent suicidal ideation, more frequent alcohol and marijuana use, had higher rates of physical and sexual abuse, greater combat exposure, and more severe aftermath of battle experiences. Participants who endorsed lifetime aggression were younger, reported more total PTSD symptom severity, PTSD re-experiencing severity, depression severity, and fewer post-deployment stressors compared to those who did not. Logistic regression analyses indicated that education and number of drinking days were correlated with recent aggression while depression and post-deployment stressors were correlated with lifetime aggression.

Conclusions: The findings demonstrate high rates of aggressive behaviors among Veterans with PTSD/SUD, as well as clinically relevant correlates of aggressive behaviors. Although preliminary, the findings suggest potential targets for improving assessment and treatment of Veterans with PTSD/SUD.

Polysubstance use in adolescence is a known precursor to chronic substance misuse. Identifying risk factors for polysubstance use is necessary to inform its prevention. The present study examined the association of elevated levels of multiple mental health symptoms with adolescents' engagement in polysubstance use (past month use of alcohol, cigarettes, and marijuana). In a US national sample of 8^th, 10^th, and 12^th grade students from Monitoring the Future surveys, we estimated probability of polysubstance use associated with high levels of depressive symptoms, conduct problems, or both. Depressive symptoms and conduct problems, alone and particularly in combination, were associated with drastically elevated probability of polysubstance use. Adolescents with high levels of both depressive symptoms and conduct problems had the highest probability of polysubstance use. Among 8^th and 10^th graders, probability of polysubstance use associated with co-occurring mental health problems was significantly higher for girls than boys.