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Sample records for cooccurring gentiana verna

  1. MAO-A inhibition profiles of some benzophenone glucosides from Gentiana verna subsp. pontica

    DEFF Research Database (Denmark)

    Kaya, Duygu; Jäger, Anna; Yalçin, Funda N

    2014-01-01

    Gentiana verna L. subsp. pontica (Soltok.) Hayek, G. pyrenaica L., and G. verna L. subsp. balcanica Pritchard from Turkey were tested for their MAO-A inhibitory effects. A photometric peroxidase linked MAO-A bioassay performed on the H20 extracts prepared from the methanolic extracts of the title...

  2. Conservation Status of Two Isolated Populations of Gentiana verna (Gentianaceae) in the Czech Republic: Insights from an Allozyme Analysis

    Czech Academy of Sciences Publication Activity Database

    Kirschner, Jan; Kirschnerová, Ludmila; Bartish, Igor

    2011-01-01

    Roč. 51, č. 2 (2011), s. 177-199 ISSN 0079-2047 R&D Projects: GA MŽP SP/2D4/112/08 Institutional research plan: CEZ:AV0Z60050516 Keywords : Gentiana verna * conservation * population genetics Subject RIV: EF - Botanics Impact factor: 0.833, year: 2011

  3. Establishment of mycorrhizal symbiosis in Gentiana verna

    Czech Academy of Sciences Publication Activity Database

    Sýkorová, Zuzana; Rydlová, Jana; Vosátka, Miroslav

    2003-01-01

    Roč. 38, - (2003), s. 177-189 ISSN 0015-5551 R&D Projects: GA AV ČR KSK6005114 Keywords : Gentians reintroduction * nurse plant effect * Paris type of arbuscular mycorrhiza Subject RIV: EF - Botanics Impact factor: 1.057, year: 2003

  4. Ficaria verna Huds. extracts and their β-cyclodextrin supramolecular systems

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    Hădărugă Nicoleta G

    2012-03-01

    Full Text Available Abstract Background Obtaining new pharmaceutical materials with enhanced properties by using natural compounds and environment-friendly methods is a continuous goal for scientists. Ficaria verna Huds. is a widespread perennial plant with applications in the treat of haemorrhoids and to cure piles; it has also anti-inflammatory, astringent, and antibiotic properties. The goal of the present study is the obtaining and characterization of new F. verna extract/β-cyclodextrin complexes by using only natural compounds, solvents, and environment-friendly methods in order to increase the quality and acceptability versus toxicity indicator. Thus, the flavonoid content (as quercetin of Ficaria verna Huds. flowers and leaves from the West side of Romania was determined and correlated with their antioxidant activity. Further, the possibility of obtaining β-cyclodextrin supramolecular systems was studied. Results F. verna flowers and leaves extracts were obtained by semi-continuous solid-liquid extraction. The raw concentrated extract was spectrophotometrically analyzed in order to quantify the flavonoids from plant parts and to evaluate the antioxidant activity of these extracts. The F. verna extracts were used for obtaining β-cyclodextrin complexes; these were analyzed by scanning electron microscopy and Karl Fischer water titration; spectrophotometry was used in order to quantifying the flavonoids and evaluates the antioxidant activity. A higher concentration of flavonoids of 0.5% was determined in complexes obtained by crystallisation method, while only a half of this value was calculated for kneading method. The antioxidant activity of these complexes was correlated with the flavonoid content and this parameter reveals possible controlled release properties. Conclusions The flavonoid content of F. verna Huds. from the West side of Romania (Banat county is approximately the same in flowers and leaves, being situated at a medium value among other

  5. Voorkomen en standplaats van Veronica praecox All. en V. verna L. in Nederland

    NARCIS (Netherlands)

    Weeda, E.J.

    1979-01-01

    A few years ago, Veronica praecox en V. verna were supposed to be extinct in the Netherlands, being recorded for the last time in 1935 and 1947, respectively. In 1974 both were refound, however. Formerly, V. praecox occurred on arable land in the Yssel valley in the surroundings of Deventer and at

  6. Dammarane triterpenoids from the roots of Gentiana rigescens.

    Science.gov (United States)

    Xu, Min; Wang, Dong; Zhang, Ying-Jun; Yang, Chong-Ren

    2007-05-01

    Six new minor dammarane triterpenoids were isolated from the roots of Gentiana rigescens. These include one aglycone, gentirigenic acid (1), and five glycosides, gentirigeosides A-E (2-6). Their structures were elucidated through detailed spectroscopic analyses, including 1D and 2D NMR techniques, and enzymatic hydrolysis. Antifungal testing of these compounds showed that the glycosides gentirigeosides A (2), C (4), and E (6) had antifungal activity against the plant pathogen Glomerella cingulata.

  7. [Chemical and pharmacological research for Sect. Aptera (gentiana)].

    Science.gov (United States)

    Mu, Zhenqiang; Yu, Yang; Gao, Hao; Jiao, Weihua; Yao, Xinsheng

    2009-08-01

    Sect. Aptera (Gentiana L.) is the plant origin of Traditional Chinese Medicine (TCM) "Qinjiao", which is used to treat rheumatism and pains with a long history. The plants of Sect. Aptera mainly contain iridoids, triterpenes and steroids, and possess anti-inflammatory, analgesia, stomach invigorate and bacteria inhibitory effects, etc. Herein, we reviewed the advances of chemical and pharmacological investigations of Sect. Aptera for further research.

  8. [Enrichment process of gentiopicroside from the leaves of Gentiana macropylla with macroporous resin].

    Science.gov (United States)

    Zhao, Yong; Zhang, Ru; Sun, Wen-ji

    2007-12-01

    To select the best type of macroporous resin for enriching gentiopicroside from the leaves of Gentiana macropylla, and study its optimal conditions and parameters. Adsorption and desorption characteristics of gentiopieroside were carried out on the resins. HPLC was used to determine the content of gentiopieroside. The better resin D-101 was chosen, and the optimal parameters were obtained. The process is feasible to enrich gentiopicroside from the leaves of Gentiana macropylla Pall.

  9. [Quality standard study on Tibetan medicine Gentianae Urnulae Herba].

    Science.gov (United States)

    Zong, Liu-liu; Luo, Gui-fa; Wu, Li-hong; Wang, Zheng-tao; Chou, Gui-xin; Liu, Hai-qing

    2015-10-01

    Gentianae Urnulae Herba, dried whole herb of Gentiana urnula,is a commonly used Tibetan medicine. However, only the character identification is used as quality control standard officially at present. As a part of project for the Chinese Pharmacopoeia (2015 edition), the quality standard of this species was established in this study. The tests of water content, total ash, acid-insoluble ash and ethanol-soluble extractives of the crude drugs were carried out following the methods recorded in appendix of Chinese Pharmacopeia (2010 edition, volume 1). The TLC identification method was established by using gentiournoside A as reference substance, and a mixture of ethyl acetate-methanol-water-formic acid(7:1. 5:1: 0. 2) as the developing solvent system on silica gel G TLC plate. The content of gentiournoside A was assayed by HPLC on an Agilent Zorbax SB-C18 (4.6 mm x 250 mm,5 μm) column, using acetonitrile-water (0.1% phosphoric acid) (26:74) as the mobile phase at a flow rate of 1.0 mL x min(-1). The column temperature is at 30 degrees C and the detection wavelength is at 240 nm. As a result, gentiournoside A and the other constituents were separated and presented the same fluorescence light comparing with the reference substance on TLC detected under the UV light(366 nm). The methodology validation for the assay of gentiournoside A showed that it was in a good linear correlation in the range of 0.009 95-0.398 g x L(-1) with the regression equation of Y = 1 467.1X +41.407(r = 0.999 9), and the average recovery was 98. 3% (RSD 2.2%). The mass fractions of gentiournoside A, water content, ethanol-soluble extractives of 15 batches samples were varied in the ranges of 0.175% -1.83%, 8.60% - 9.93% and 29.2% - 35.2%, respectively. Total ash and acid-insoluble ash were 10.2% - 17.2% and 5.26% - 10.8% detected from 10 batches samples. The recommended standards of quantitative indexes are that the mass fractions of gentiournoside A and extractives are not less than 0.80% and 26

  10. Dlouhodobé sledování změn populace Gentiana verna v národní přírodní památce Rovná

    Czech Academy of Sciences Publication Activity Database

    Kirschnerová, Ludmila; Moravcová, Lenka; Rauch, Ota

    2011-01-01

    Roč. 2011, č. 30 (2011), s. 91-114 ISSN 1211-3603 R&D Projects: GA MŽP SP/2D4/112/08 Institutional research plan: CEZ:AV0Z60050516 Institutional support: RVO:67985939 Keywords : protected species * monitoring * Gentianaceae Subject RIV: EF - Botanics

  11. Effects of gentiana scabra bage on expression of hepatic type I, III collagen proteins in Paragonimus skrjabini rats with liver fibrosis.

    Science.gov (United States)

    Qu, Zhao-Xia; Li, Fang; Ma, Chao-Dong; Liu, Jun; Li, Shu-De; Wang, Wen-Lin

    2015-01-01

    To explore the effects of gentiana scabra bage on the expression of hepatic collagen proteins in Paragonimus skrjabini rats with liver fibrosis. Immunohistochemical technique was used to observe the changes of content of hepatic type I, III collagen proteins in Paragonimus skrjabini rats with liver fibrosis before and after the gentiana scabra bage treatmeat. Comparing with the model group, changes of hepatic type I and type III collagen proteins in gentiana scabra bage treated group were significantly weakened. Gentiana scabra bage treatment can reduce the content of hepatic type III and type I collagen protein significantly in Paragonimus skrjabini rats with liver fibrosis, thereby, playing the role against hepatic fibrosis. Copyright © 2015 Hainan Medical College. Production and hosting by Elsevier B.V. All rights reserved.

  12. Flower color preferences of insects and livestock: effects on Gentiana lutea reproductive success

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    Mar Sobral

    2016-03-01

    Full Text Available Angiosperms diversification was primarily driven by pollinator agents, but non-pollinator agents also promoted floral evolution. Gentiana lutea shows pollinator driven flower color variation in NW Spain. We test whether insect herbivores and livestock, which frequently feed in G.lutea, play a role in G. lutea flower color variation, by answering the following questions: (i Do insect herbivores and grazing livestock show flower color preferences when feeding on G. lutea? (ii Do mutualists (pollinators and antagonists (seed predators, insect herbivores and livestock jointly affect G. lutea reproductive success? Insect herbivores fed more often on yellow flowering individuals but they did not affect seed production, whereas livestock affected seed production but did not show clear color preferences. Our data indicate that flower color variation of G. lutea is not affected by insect herbivores or grazing livestock.

  13. Review: hepatoprotective and microbiological studies of three genera: Equisetum, Lycopodium, and Gentiana

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    Maria SUCIU

    2012-11-01

    Full Text Available Liver injury treatments are among the most important of today’s research domains, because with every passing year there is a more acute need for liver transplants. Many of the everyday drugs that people use, and all the toxic influences and unhealthy food lead to some form of liver disorder. That is why today’s attention is drawn to the potentials of a few miracle plants that have the ability to reduce or cure liver damage. Equisetum, Lycopodium and Gentiana genera species are well known homeopathic plants in the Northern Hemisphere. Their properties are used in many disorders, and in the recent studies they are tested for their microbiological and hepatic curative actions.

  14. Extraction optimization, characterization and antioxidant activity of polysaccharide from Gentiana scabra bge.

    Science.gov (United States)

    Cheng, Zhenyu; Zhang, Yuewei; Song, Haiyan; Zhou, Hongli; Zhong, Fangli; Hu, Haobin; Feng, Yu

    2016-12-01

    In this study, optimization of smashing tissue extraction (STE), preliminary chemical characterization and antioxidant activity in vitro of crude polysaccharides (CPS) from Gentiana scabra bge (G. scabra) were investigated. The optimal extraction conditions were determined as follows: sample particle size of 80mesh, solid/liquid ratio of 1:34, extraction voltage of 157.09V and extraction time of 130.38s. Under these conditions, the extraction yield of CPS had reached 15.03±0.14% (n=3). Chemical composition analysis indicated CPS was mainly composed of mannose, rhamnose, galacturonic acid, glcose, galactose, arabinose and fucose in a molar ratio of 1.00:9.89:51.59:35.37:38.06:99.13:21.34, respectively. The average molecular weight of CPS was estimated to be 3.8×10 4 Da. In addition, the potential antioxidant activity of CPS extracted by STE were demonstrated by DPPH radical scavenging assay, superoxide anion radical scavenging assay, hydroxyl radical scavenging assay and ferric reducing power assay. Overall, this study provided an effective extraction technique for G. scabra polysaccharides which would be explored as a promising natural antioxidant agent applied in functional foods or medicines. Copyright © 2016 Elsevier B.V. All rights reserved.

  15. Efficient methods for isolating five phytochemicals from Gentiana macrophylla using high-performance countercurrent chromatography.

    Science.gov (United States)

    Rho, Taewoong; Jung, Mila; Lee, Min Won; Chin, Young-Won; Yoon, Kee Dong

    2016-12-01

    Efficient high-performance countercurrent chromatography methods were developed to isolate five typical compounds from the extracts of Gentiana macrophylla. n-Butanol-soluble extract of G. macrophylla contained three hydrophilic iridoids, loganic acid (1), swertiamarin (2) and gentiopicroside (3), and a chromene derivative, macrophylloside D (4) which were successfully isolated by flow rate gradient (1.5 mL/min in 0-60 min, 5.0 mL/min in 60-120 min), and consecutive flow rate gradient HPCCC using n-butanol/0.1% aqueous trifluoroacetic acid (1:1, v/v, normal phase mode) system. The yields of 1-4 were 22, 16, 122, and 6 mg, respectively, with purities over 97% in a flow rate gradient high-performance countercurrent chromatography, and consecutive flow rate gradient high-performance countercurrent chromatography gave 1, 2, 3 (54, 41, 348 mg, respectively, purities over 97%) and 4 (13 mg, purity at 95%) from 750 mg of sample. The main compound in methylene chloride soluble extract, 2-methoxyanofinic acid, was successfully separated by n-hexane/ethyl acetate/methanol/water (4:6:4:6, v/v/v/v, flow-rate: 4 mL/min, reversed phase mode) condition. The structures of five isolates were elucidated by 1 H, 13 C NMR and ESI-Q-TOF-MS spectroscopic data which were compared with previously reported values. © 2016 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

  16. Antioxidant and immunological activities of polysaccharides from Gentiana scabra Bunge roots.

    Science.gov (United States)

    Wang, Zhanyong; Wang, Chenyu; Su, Tingting; Zhang, Jing

    2014-11-04

    Two polysaccharide fractions, GSP I-a and GSP II-b, were isolated from Gentiana scabra Bunge roots. Both GSP I-a and GSP II-b comprised seven monosaccharides: fructose, mannose, rhamnose, galacturonic acid, glucose, galactose, and fucose. Ultraviolet and infrared analyses show that GSP I-a and GSP II-b are proteoglycans. In vitro evaluation of the antioxidant activity suggests that GSP I-a and GSP II-b scavenge 1,1-diphenyl-2-picrylhydrazyl radicals. However, the scavenging activity of the latter is stronger than that of the former. GSP I-a and GSP II-b have relatively low reducing powers and scavenging activities toward superoxide anions and hydroxyls. GSP I-a and GSP II-b significantly increase lymphocyte proliferation when lipopolysaccharide is used as a mitogen for lymphocytes, but only GSP I-a can significantly increase lymphocyte proliferation within the test-dosage range when concanavalin A is used as a mitogen. Copyright © 2014 Elsevier Ltd. All rights reserved.

  17. Optimization of Gentisides Extraction from Gentiana rigescens Franch. ex Hemsl. by Response Surface Methodology

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    Bowen Chu

    2015-01-01

    Full Text Available Gentisides are a class of chemical compounds which is considered as potential therapeutic substance for treatment of neurodegenerative disorders. The heat reflux extraction conditions were optimized for seven kinds of gentisides from the root and rhizome of Gentiana rigescens Franch. ex Hemsl. by employing response surface method. Based on univariate test, a Box-Behnken design (BBD was applied to the survey of relationships between response value (gentisides yield and independent variables which were chosen from various extraction processes, including extraction temperature, extraction time, and solvent-material ratio. The optimized conditions for this extraction are as follows: extraction time of 3.40 h, extraction temperature of 74.33°C, and ratio of solvent to raw material of 10.21 : 1 mL/g. Verification assay revealed that the predicted value (99.24% of extraction parameters from this model was mainly conformed to the experimentally observed values (98.61±0.61.

  18. De Novo Assembly and Characterization of the Transcriptome of the Chinese Medicinal Herb, Gentiana rigescens

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    Xiaodong Zhang

    2015-05-01

    Full Text Available Gentiana rigescens is an important medicinal herb in China. The main validated medicinal component gentiopicroside is synthesized in shoots, but is mainly found in the plant’s roots. The gentiopicroside biosynthetic pathway and its regulatory control remain to be elucidated. Genome resources of gentian are limited. Next-generation sequencing (NGS technologies can aid in supplying global gene expression profiles. In this study we present sequence and transcript abundance data for the root and leaf transcriptome of G. rigescens, obtained using the Illumina Hiseq2000. Over fifty million clean reads were obtained from leaf and root libraries. This yields 76,717 unigenes with an average length of 753 bp. Among these, 33,855 unigenes were identified as putative homologs of annotated sequences in public protein and nucleotide databases. Digital abundance analysis identified 3306 unigenes differentially enriched between leaf and root. Unigenes found in both tissues were categorized according to their putative functional categories. Of the differentially expressed genes, over 130 were annotated as related to terpenoid biosynthesis. This work is the first study of global transcriptome analyses in gentian. These sequences and putative functional data comprise a resource for future investigation of terpenoid biosynthesis in Gentianaceae species and annotation of the gentiopicroside biosynthetic pathway and its regulatory mechanisms.

  19. Identifying genetic signatures of selection in a non-model species, alpine gentian (Gentiana nivalis L.), using a landscape genetic approach

    DEFF Research Database (Denmark)

    Bothwell, H.; Bisbing, S.; Therkildsen, Nina Overgaard

    2013-01-01

    loci, we compared outlier locus detection methods with a recently-developed landscape genetic approach. We analyzed 157 loci from samples of the alpine herb Gentiana nivalis collected across the European Alps. Principle coordinates of neighbor matrices (PCNM), eigenvectors that quantify multi...

  20. Genetic Variation of the Endangered Gentiana lutea L. var. aurantiaca (Gentianaceae in Populations from the Northwest Iberian Peninsula

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    Oscar González-López

    2014-06-01

    Full Text Available Gentiana lutea L. (G. lutea L. is an endangered plant, patchily distributed along the mountains of Central and Southern Europe. In this study, inter-simple sequence repeat (ISSR markers were used to investigate the genetic variation in this species within and among populations of G. lutea L. var. aurantiaca of the Cantabrian Mountains (Northwest Iberian Peninsula. Samples of G. lutea L. collected at different locations of the Pyrenees and samples of G. lutea L. subsp. vardjanii of the Dolomites Alps were also analyzed for comparison. Using nine ISSR primers, 106 bands were generated, and 89.6% of those were polymorphic. The populations from the Northwest Iberian Peninsula were clustered in three different groups, with a significant correlation between genetic and geographic distances. Gentiana lutea L. var. aurantiaca showed 19.8% private loci and demonstrated a remarkable level of genetic variation, both among populations and within populations; those populations with the highest level of isolation show the lowest genetic variation within populations. The low number of individuals, as well as the observed genetic structure of the analyzed populations makes it necessary to protect them to ensure their survival before they are too small to persist naturally.

  1. Differences in pollination success between local and foreign flower color phenotypes: a translocation experiment with Gentiana lutea (Gentianaceae

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    Javier A. Guitián

    2017-02-01

    Full Text Available Background The adaptive maintenance of flower color variation is frequently attributed to pollinators partly because they preferentially visit certain flower phenotypes. We tested whether Gentiana lutea—which shows a flower color variation (from orange to yellow in the Cantabrian Mountains range (north of Spain—is locally adapted to the pollinator community. Methods We transplanted orange-flowering individuals to a population with yellow-flowering individuals and vice versa, in order to assess whether there is a pollination advantage in the local morph by comparing its visitation rate with the foreign morph. Results Our reciprocal transplant experiment did not show clear local morph advantage in overall visitation rate: local orange flowers received more visits than foreign yellow flowers in the orange population, while both local and foreign flowers received the same visits in the yellow population; thus, there is no evidence of local adaptation in Gentiana lutea to the pollinator assemblage. However, some floral visitor groups (such as Bombus pratorum, B. soroensis ancaricus and B. lapidarius decipiens consistently preferred the local morph to the foreign morph whereas others (such as Bombus terrestris consistently preferred the foreign morph. Discussion We concluded that there is no evidence of local adaptation to the pollinator community in each of the two G. lutea populations studied. The consequences for local adaptation to pollinator on G. lutea flower color would depend on the variation along the Cantabrian Mountains range in morph frequency and pollinator community composition.

  2. The Herbal Bitter Drug Gentiana lutea Modulates Lipid Synthesis in Human Keratinocytes In Vitro and In Vivo

    Science.gov (United States)

    Haarhaus, Birgit; Seiwerth, Jasmin; Cawelius, Anja; Schwabe, Kay; Quirin, Karl-Werner; Schempp, Christoph M.

    2017-01-01

    Gentiana lutea is a herbal bitter drug that is used to enhance gastrointestinal motility and secretion. Recently we have shown that amarogentin, a characteristic bitter compound of Gentiana lutea extract (GE), binds to the bitter taste receptors TAS2R1 and TAS2R38 in human keratinocytes, and stimulates the synthesis of epidermal barrier proteins. Here, we wondered if GE also modulates lipid synthesis in human keratinocytes. To address this issue, human primary keratinocytes were incubated for 6 days with GE. Nile Red labeling revealed that GE significantly increased lipid synthesis in keratinocytes. Similarly, gas chromatography with flame ionization detector indicated that GE increases the amount of triglycerides in keratinocytes. GE induced the expression of epidermal ceramide synthase 3, but not sphingomyelinase. Lipid synthesis, as well as ceramide synthase 3 expression, could be specifically blocked by inhibitors of the p38 MAPK and PPARγ signaling pathway. To assess if GE also modulates lipid synthesis in vivo, we performed a proof of concept half side comparison on the volar forearms of 33 volunteers. In comparison to placebo, GE significantly increased the lipid content of the treated skin areas, as measured with a sebumeter. Thus, GE enhances lipid synthesis in human keratinocytes that is essential for building an intact epidermal barrier. Therefore, GE might be used to improve skin disorders with an impaired epidermal barrier, e.g., very dry skin and atopic eczema. PMID:28829355

  3. Trichotillomania and co-occurring anxiety.

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    Grant, Jon E; Redden, Sarah A; Leppink, Eric W; Chamberlain, Samuel R

    2017-01-01

    Trichotillomania appears to be a fairly common disorder, with high rates of co-occurring anxiety disorders. Many individuals with trichotillomania also report that pulling worsens during periods of increased anxiety. Even with these clinical links to anxiety, little research has explored whether trichotillomania with co-occurring anxiety is a meaningful subtype. One hundred sixty-five adults with trichotillomania were examined on a variety of clinical measures including symptom severity, functioning, and comorbidity. Participants also underwent cognitive testing assessing motor inhibition and cognitive flexibility. Clinical features and cognitive functioning were compared between those with current co-occurring anxiety disorders (i.e. social anxiety, generalized anxiety disorder, panic disorder, and anxiety disorder NOS) (n=38) and those with no anxiety disorder (n=127). Participants with trichotillomania and co-occurring anxiety reported significantly worse hair pulling symptoms, were more likely to have co-occurring depression, and were more likely to have a first-degree relative with obsessive compulsive disorder. Those with anxiety disorders also exhibited significantly worse motor inhibitory performance on a task of motor inhibition (stop-signal task). This study suggests that anxiety disorders affect the clinical presentation of hair pulling behavior. Further research is needed to validate our findings and to consider whether treatments should be specially tailored differently for adults with trichotillomania who have co-occurring anxiety disorders, or more pronounced cognitive impairment. Copyright © 2016 Elsevier Inc. All rights reserved.

  4. Corología de tres táxones de interés en el macizo del Castro Valnera: Eriophorum vaginatum L., Gentiana acaulis L. y Gentiana boryi Boiss. [Chorology of three interesting plants from Castro Valnera (Cantabrian Mountains, N Spain.

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    Juan Antonio Alejandre Sáez

    2013-05-01

    Full Text Available RESUMEN: Se ofrece una visión actualizada de la situación en el macizo del Castro Valnera de tres especies de alto interés regional: Eriophorum vaginatum L., Gentiana acaulis L. y Gentiana boryi Boiss. Se comentan datos sobre la historia de su descubrimiento en ese macizo. Se recogen y enumeran para cada uno de ellos los datos de recolecciones, citas bibliográficas y de campo. Con el conjunto de todas ellas se elaboran varios mapas. Finalmente, se aportan comentarios que contribuyen al conocimiento de su comportamiento ecológico y se apuntan algunas pautas y criterios a tener en cuenta para su protección. ABSTRACT: Chorology of three interesting plants from Castro Valnera (Cantabrian Mountains, N Spain. An updated view of the situation within the Castro Valnera mountain range of three species of high regional interest is provided: Eriophorum vaginatum L., Gentiana acaulis L. y Gentiana boryi Boiss. The history data of their discovery within that mountain range is discussed. Collections data and field citations are gathered and listed for each of them and several maps are drawn with the whole of them. Finally, comments that contribute to the knowledge of their environmental performance are provided, as well as some guidelines and criteria to be considered for their protection.

  5. [Preparative separation of gentiopicrin from Radix Gentianae by high-speed counter-current chromatography with macroporous resin].

    Science.gov (United States)

    Xu, You-Wei; Qi, Yan; Han, Xu; Xu, Li-Na; Xu, Qi-Wei; Peng, Jin-Yong

    2007-12-01

    To develop a method for the preparative separation of gentiopicrin from Radix Gentianae by high-speed counter-current chromatography (HSCCC). The crude alcohol extracts were eluted on a macroporous resin column and then purified by high speed counter-current chromatography (HSCCC). A two-phase solvent system composed of ethyl acetate: n-butanol: water (2 : 1 : 3) was used, and the lower phase was used as the mobile phase at a flow rate of 1.5 mL x min(-1), while the apparatus rotated at 800 r x min(-1) and the eluate was detected at 254 nm. 136 mg gentiopicrin with purity of 99.6% determined by HPLC were obtained from 300 mg crude extraction only in one-step separation and less than 200 minutes. The established method is simple, high efficiency and suitable for large-scale separation of gentiopicrin.

  6. [Determination of polysaccharides content of Gentiana farreri from different producing areas based on anthrone-sulfuric acid method].

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    Lin, Li; Wang, Yan; Wang, Fu-Xing; He, Jia-Yan; Zhang, Hang-Lin

    2014-07-01

    Study a method for the detemination of the content of polysaccharides in Gentiana farreri, and analysis of the content of polysaccharides from different producing areas. The results showed that using the anthrone-sulfuric acid method, simple operation, accurate result. Sample was measured at 620 nm absorbance after anthrone-sulfuric acid color, at this wavelength, solution absorption and glucose showed a good linear relationship; The linearity was in the range of 0.01-0.07 g x L(-1) (r = 0.996 7). The recovery rate was 99.41%, with RSD of 2.0%. Considering the experimental conditions, to determine the solid-liquid ratio 1:60, extracting time 50 min, concentration of ethanol 80%. The mass fraction of polysaccharides was the highest to reached 0.743% in G. farreri from Gansu Xiahe. This experiment has laid a good foundation for further study on G. farreri.

  7. The correlations between phenotypical characthers in selected families by Gentiana lutea L. and the chemical compounds of underground organs

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    Horea BARBU

    2008-05-01

    Full Text Available The ground organs of Gentiana lutea L. contain active principles, which have certain properties recommended for anorexia or convalescence.Along the year we tried to show cast the existent correlations between the main morphological characters and the productivity elements, such as the concentration in active principles. It is proved that the development of a character influence either the development of positive correlation or negative correlation [7].Having in mind that the phonotypical expression is influenced by the phases of vegetation, a very important thing to know is the morph chemical characteristics of specie in different phases of vegetation. The superior quality of the raw materials obtained by different sowing methods defined during our research, will decrease the crop from our country wild flora [10].

  8. Co-occurring mycotoxins in animal feeds

    African Journals Online (AJOL)

    STORAGESEVER

    2008-07-04

    Jul 4, 2008 ... Co-occurring mycotoxins in animal feeds. Phakamile T. Mngadi1, Roshini Govinden2, and Bharti Odhav1*. 1Department of Biotechnology, M.L. Sultan Campus, Durban University of Technology, P.O. Box 1334, Durban 4000,. South Africa. 2Medical Research Council, PO Box 70380, Over port 4091, ...

  9. Rapid identification and quantitative analysis of chemical constituents of Gentiana veitchiorum by UHPLC-PDA-QTOF-MS

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    Shan Li

    Full Text Available ABSTRACT Gentiana veitchiorum Hemsl., Gentianaceae, a traditional Tibetan medicine, was used for the treatment of liver jaundice with damp-heat pathogen, as well as for headache and chronic pharyngitis. A rapid ultra-performance liquid chromatography, photodiode array detector, quadrupole time-of-flight mass spectrometry method was developed for the fast and accurate identification and quantification of the chemical constituents of G. veitchiorum. In fact, eighteen compounds were detected and identified on the basis of their mass spectra, fragment characteristics and comparison with published data. Especially, the MS fragmentation pathways of iridoid glycosides and flavone C-glycosides were illustrated. Five compounds among them were quantified by UHPLC-PDA, including swertiamarin, gentiopicroside, sweroside, isoorientin, and isovitexin. The proposed method was then validated based on the analyses of linearity, accuracy, precision, and recovery. The overall recoveries for the five analytes ranged from 96.54% to 100.81%, with RSD from 1.05% to 1.82%. In addition, ten batches of G. veitchiorum from different areas were also analyzed. The developed method was rapid and reliable for both identification and quantification of the chemical constituents of G. veitchiorum, especially for simultaneous qualitative and quantitative analysis of iridoid glycosides and flavone C-glycosides.

  10. Quantitative and Qualitative Characterization of Gentiana rigescens Franch (Gentianaceae on Different Parts and Cultivations Years by HPLC and FTIR Spectroscopy

    Directory of Open Access Journals (Sweden)

    Lu-Ming Qi

    2017-01-01

    Full Text Available Gentiana rigescens Franch (Gentianaceae is a famous medicinal plant for treatments of rheumatism, convulsion, and jaundice. Comprehensive investigation of different parts and cultivation years of this plant has not yet been conducted. This study presents the quantitative and qualitative characterization of iridoid glycosides from G. rigescens performed by HPLC and FTIR spectroscopy techniques. The accumulations of loganic acid, swertiamarin, gentiopicroside, and sweroside were determined. Results indicated that their content and distribution in different parts and cultivation years exhibit great variations. Gentiopicroside was identified as the most abundant compound among iridoid glycosides and its highest level was observed in the root of 2-year-old plant. With respect to qualitative variation of metabolic profile, the 1800–800 cm−1 band of FTIR spectra successfully discriminated different parts and cultivation years with the aid of PLS-DA. In addition, combined with PLSR, the feasibility of FTIR spectroscopy for determination of gentiopicroside was investigated by selecting characteristic wavelengths (1800–800 cm−1, which presented a good performance with a residual predictive deviation (RPD of 3.646. Our results suggested that HPLC and FTIR techniques can complement each other and could be simultaneously applied for comparing and analyzing different parts and cultivation years of G. rigescens.

  11. ADAPTATION OF THE OBTAINED in vitro Gentiana lutea L. PLANTS TO ex vitro AND in situ CONDITIONS

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    О. Yu.

    2015-12-01

    Full Text Available The objective of the research was to develop the technology of introduction of the obtained by microclonal propagation Gentiana lutea L. plants into conditions in situ. Methods of cultivation of plant objects in vitro were used. There were chosen optimal conditions for rooting G. lutea shoots obtained through microclonal propagation in vitro: МS/2 medium with twice decreased concentration of NH4NO3 without vitamins and sucrose supplemented with 3 g/l of mannite and 0.05 mg/l kinetin, and agar (4 mg/l in combination with perlite (16 g/l used as a maintaining substrate; or the nutrient medium (MS/2 without vitamins and smaller concentration of N4NO3 with gradual decrease of carbohydrates from 10 g/l to 2 g/l, and further rooting experimental shoots in tap water. Rooted plants were adapted to conditions ex vitro through planting them into flowerpots with soil and gradual changing hothouse regime for exposed one. The share of adapted to in situ conditions plants (21% after a year of planting proves the suggested method to be efficient and promising. There was suggested this technology is the most efficient ones for revival of disturbed G. lutea populations that includes repatriation of rooted and adapted to ex vitro conditions plants obtained through microclonal propagation in vitro.

  12. Nonprenylated Xanthones from Gentiana lutea, Frasera caroliniensis, and Centaurium erythraea as Novel Inhibitors of Vascular Smooth Muscle Cell Proliferation

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    Birgit Waltenberger

    2015-11-01

    Full Text Available Aberrant proliferation of vascular smooth muscle cells (VSMC plays a major role in restenosis, the pathological renarrowing of the blood vessel lumen after surgical treatment of stenosis. Since available anti-proliferative pharmaceuticals produce unfavorable side effects, there is high demand for the identification of novel VSMC proliferation inhibitors. A natural product screening approach using a resazurin conversion assay enabled the identification of gentisin (1 from Gentiana lutea as a novel inhibitor of VSMC proliferation with an IC50 value of 7.84 µM. Aiming to identify further anti-proliferative compounds, 13 additional nonprenylated xanthones, isolated from different plant species, were also tested. While some compounds showed no or moderate activity at 30 µM, 1-hydroxy-2,3,4,5-tetramethoxyxanthone (4, swerchirin (6, and methylswertianin (7 showed IC50 values between 10.2 and 12.5 µM. The anti-proliferative effect of 1, 4, 6, and 7 was confirmed by the quantification of DNA synthesis (BrdU incorporation in VSMC. Cell death quantification (determined by LDH release in the culture medium revealed that the compounds are not cytotoxic in the investigated concentration range. In conclusion, nonprenylated xanthones are identified as novel, non-toxic VSMC proliferation inhibitors, which might contribute to the development of new therapeutic applications to combat restenosis.

  13. Species diversity, vegetation pattern and conservation of Gentiana macrophylla Pall. communities in Dongling mountain meadow, Beijing, China

    International Nuclear Information System (INIS)

    Sadia, S.; Zhang, J.T.; Bai, X.; Shedayi, A.A.; Tariq, A.

    2017-01-01

    Gentiana macrophylla, native to mountainous areas of Central and Southern Asia, is most popular remedy for rheumatism and pains in Traditional Chinese Medicine with an extensive demand in local market. Our study aimed to classify G. macrophylla communities and to find out the impact of topographic and soil factors on their diversity and distribution in Dongling mountain meadow, Beijing, China. Seventy five samples in 15 transects separated by 50m distance in altitude along an elevation gradient (1592-2298m) were established by quadrate method. TWINSAPN and CCA were used for classification and ordination, respectively. Six diversity indices (Species richness, Shannon-Weiner heterogeneity, Simpson’s index, Hill’s index, Pielou evenness and McIntosh evenness) were used to analyze the pattern of species diversity and polynomial regression analysis was used to establish their relationship with environmental variables. TWINSPAN classified G. macrophylla communities into 8 types and CCA indicated that soil pH, soil temperature, soil type, disturbance, total N, total K, Mg and Zn were significantly related to these communities. Elevation was the most significant factor that affecting the diversity and distribution of G. macrophylla communities. Significant effect of environment, topography and disturbance to meadow communities of G. macrophylla highly suggests some important measures such as uprooting restriction, tourism limitation in meadow area, monitoring of functional diversity, fertilization, irrigation, cloning and cultivation to protect and conserve it and its communities to be used in medicine industry. (author)

  14. Co-Occuring Directions Sketching for Approximate Matrix Multiply

    OpenAIRE

    Mroueh, Youssef; Marcheret, Etienne; Goel, Vaibhava

    2016-01-01

    We introduce co-occurring directions sketching, a deterministic algorithm for approximate matrix product (AMM), in the streaming model. We show that co-occuring directions achieves a better error bound for AMM than other randomized and deterministic approaches for AMM. Co-occurring directions gives a $1 + \\epsilon$ -approximation of the optimal low rank approximation of a matrix product. Empirically our algorithm outperforms competing methods for AMM, for a small sketch size. We validate empi...

  15. Red Anthocyanins and Yellow Carotenoids Form the Color of Orange-Flower Gentian (Gentiana lutea L. var. aurantiaca)

    Science.gov (United States)

    Gómez Gómez, Lourdes; Veiga, Tania; Ni, Xiuzhen; Farré, Gemma; Capell, Teresa; Guitián, Javier; Guitián, Pablo; Sandmann, Gerhard; Christou, Paul

    2016-01-01

    Flower color is an important characteristic that determines the commercial value of ornamental plants. Gentian flowers occur in a limited range of colors because this species is not widely cultivated as a cut flower. Gentiana lutea L. var. aurantiaca (abbr, aurantiaca) is characterized by its orange flowers, but the specific pigments responsible for this coloration are unknown. We therefore investigated the carotenoid and flavonoid composition of petals during flower development in the orange-flowered gentian variety of aurantiaca and the yellow-flowered variety of G. lutea L. var. lutea (abbr, lutea). We observed minor varietal differences in the concentration of carotenoids at the early and final stages, but only aurantiaca petals accumulated pelargonidin glycosides, whereas these compounds were not found in lutea petals. We cloned and sequenced the anthocyanin biosynthetic gene fragments from petals, and analyzed the expression of these genes in the petals of both varieties to determine the molecular mechanisms responsible for the differences in petal color. Comparisons of deduced amino acid sequences encoded by the isolated anthocyanin cDNA fragments indicated that chalcone synthase (CHS), chalcone isomerase (CHI), anthocyanidin synthase 1 (ANS1) and ANS2 are identical in both aurantiaca and lutea varieties whereas minor amino acid differences of the deduced flavonone 3-hydroxylase (F3H) and dihydroflavonol 4-reductase (DFR) between both varieties were observed. The aurantiaca petals expressed substantially higher levels of transcripts representing CHS, F3H, DFR, ANS and UDP-glucose:flavonoid-3-O-glucosyltransferase genes, compared to lutea petals. Pelargonidin glycoside synthesis in aurantiaca petals therefore appears to reflect the higher steady-state levels of pelargonidin synthesis transcripts. Moreover, possible changes in the substrate specificity of DFR enzymes may represent additional mechanisms for producing red pelargonidin glycosides in petals of

  16. The impact of climatic variations on the reproductive success of Gentiana lutea L. in a Mediterranean mountain area.

    Science.gov (United States)

    Cuena-Lombraña, Alba; Fois, Mauro; Fenu, Giuseppe; Cogoni, Donatella; Bacchetta, Gianluigi

    2018-03-30

    Increases in temperature have been predicted and reported for the Mediterranean mountain ranges due to global warming and this phenomenon is expected to have profound consequences on biodiversity and ecosystem functioning. We hereby present the case of Gentiana lutea L. subsp. lutea, a rhizomatous long-lived plant living in Central-Southern Europe, which is at the edge of its ecological and distributional range in Sardinia. Concretely, we analysed the reproductive success experienced during three phenological cycles (2013/2014, 2014/2015 and 2015/2016) in four representative populations, with particular attention to the phenological cycle of 2014/2015, which has been recorded as one of the warmest periods of the last decades. The Smirnov-Grubbs test was used to evaluate differences in temperature and precipitation regimes among historical data and the analysed years, while the Kruskal-Wallis followed by the Wilcoxon test was used to measure differences between anthesis and reproductive performances among cycles and populations. In addition, generalised linear models were carried out to check relationships between climate variables and reproductive performance. Significant differences among climate variables and analysed cycles were highlighted, especially for maximum and mean temperatures. Such variations determined a non-flowering stage in two of the four analysed populations in 2014/2015 and significant differences of further five reproductive traits among cycles. These results confirmed that in current unstable climatic conditions, which are particularly evident in seasonal climates, reproductive success can be a sensitive and easily observable indicator of climatic anomalies. Considering the importance of this issue and the ease and cost-effectiveness of reproductive success monitoring, we argue that research in this sense can be a supporting tool for the enhancement of future crucial targets such as biodiversity conservation and the mitigation of global

  17. Red Anthocyanins and Yellow Carotenoids Form the Color of Orange-Flower Gentian (Gentiana lutea L. var. aurantiaca.

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    Judit Berman

    Full Text Available Flower color is an important characteristic that determines the commercial value of ornamental plants. Gentian flowers occur in a limited range of colors because this species is not widely cultivated as a cut flower. Gentiana lutea L. var. aurantiaca (abbr, aurantiaca is characterized by its orange flowers, but the specific pigments responsible for this coloration are unknown. We therefore investigated the carotenoid and flavonoid composition of petals during flower development in the orange-flowered gentian variety of aurantiaca and the yellow-flowered variety of G. lutea L. var. lutea (abbr, lutea. We observed minor varietal differences in the concentration of carotenoids at the early and final stages, but only aurantiaca petals accumulated pelargonidin glycosides, whereas these compounds were not found in lutea petals. We cloned and sequenced the anthocyanin biosynthetic gene fragments from petals, and analyzed the expression of these genes in the petals of both varieties to determine the molecular mechanisms responsible for the differences in petal color. Comparisons of deduced amino acid sequences encoded by the isolated anthocyanin cDNA fragments indicated that chalcone synthase (CHS, chalcone isomerase (CHI, anthocyanidin synthase 1 (ANS1 and ANS2 are identical in both aurantiaca and lutea varieties whereas minor amino acid differences of the deduced flavonone 3-hydroxylase (F3H and dihydroflavonol 4-reductase (DFR between both varieties were observed. The aurantiaca petals expressed substantially higher levels of transcripts representing CHS, F3H, DFR, ANS and UDP-glucose:flavonoid-3-O-glucosyltransferase genes, compared to lutea petals. Pelargonidin glycoside synthesis in aurantiaca petals therefore appears to reflect the higher steady-state levels of pelargonidin synthesis transcripts. Moreover, possible changes in the substrate specificity of DFR enzymes may represent additional mechanisms for producing red pelargonidin glycosides in

  18. Preparative Separation and Purification of Four Glycosides from Gentianae radix by High-Speed Counter-Current Chromatography and Comparison of Their Anti-NO Production Effects

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    Bao Chen

    2017-11-01

    Full Text Available Secoiridoid and iridoid glycosides are the main active components of Gentianae radix. In this work, one iridoid and three secoiridoid glycosides from Gentianae radix have been purified by high-speed counter-current chromatography in two runs using different solvent systems. Ethyl acetate–n-butanol–water (2:1:3, v/v/v was the optimum solvent system to purify ca. 4.36 mg of loganic acid, 3.05 mg of swertiamarin, and 35.66 mg of gentiopicroside with 98.1%, 97.2% and 98.6% purities, respectively, while 31.15 mg of trifloroside with 98.9% purity was separated using hexane–ethyl acetate–methanol–water (1:3:1:3, v/v/v/v. The structures of the glycosides were identified by mass spectrometry and NMR. After separation, the anti-nitric oxide production effects of the compounds on lipopolysaccharide-induced BV-2 murine microglial cells were also evaluated. All of the compounds inhibited the production of nitric oxide in lipopolysaccharide-induced BV-2 cells with high cell viabilities in a concentration-dependent manner, which demonstrated that were able to be used as a nitric oxide inhibitor.

  19. Co-occurring psychiatric disorders and alcoholism.

    Science.gov (United States)

    Stephen Rich, J; Martin, Peter R

    2014-01-01

    Alcohol use disorder (AUD), a term that comprises both alcohol abuse and alcohol dependence, is a highly prevalent psychiatric disorder. Over 50% of treated AUD patients also suffer from other psychiatric disorder(s). Detailed study has revealed disorders across multiple psychiatric domains with rates of co-occurrence far greater than chance, suggesting a synergistic relationship. The basis of this synergy is explored along with its multiple forms, including behavioral and neurobiologic. Specific topics include the predisposition to both AUD and co-occurring psychopathology, the vulnerability to environmental risk factors that exacerbate these predispositions, and the nature of reinforcement in acute intoxication. Co-occurrence can also modify and exacerbate the neuroadaptations underpinning chronic dependence and relapse, the manifestations of acute and protracted withdrawal, emergence of medical and psychiatric complications, and ultimately the potential for relapse. The outcomes of co-occurrence as well as the unique impact it has on proper treatment are also discussed. Throughout, the significance of recognizing co-occurrence is emphasized since, both neurobiologically and clinically, the synergies between co-occurring disorders yield a result far more complex than a mere sum of the component disorders. © 2014 Elsevier B.V. All rights reserved.

  20. [Data fusion and multi-components quantitative analysis for identification and quality evaluation of Gentiana rigescens from different geographical origins].

    Science.gov (United States)

    Wang, Qin-Qin; Shen, Tao; Zuo, Zhi-Tian; Huang, Heng-Yu; Wang, Yuan-Zhong

    2018-03-01

    The accumulation of secondary metabolites of traditional Chinese medicine (TCM) is closely related to its origins. The identification of origins and multi-components quantitative evaluation are of great significance to ensure the quality of medicinal materials. In this study, the identification of Gentiana rigescens from different geographical origins was conducted by data fusion of Fourier transform infrared (FTIR) spectroscopy and high performance liquid chromatography (HPLC) in combination of partial least squares discriminant analysis; meanwhile quantitative analysis of index components was conducted to provide an accurate and comprehensive identification and quality evaluation strategy for selecting the best production areas of G. rigescens. In this study, the FTIR and HPLC information of 169 G. rigescens samples from Yunnan, Sichuan, Guangxi and Guizhou Provinces were collected. The raw infrared spectra were pre-treated by multiplicative scatter correction, standard normal variate (SNV) and Savitzky-Golay (SG) derivative. Then the performances of FTIR, HPLC, and low-level data fusion and mid-level data fusion for identification were compared, and the contents of gentiopicroside, swertiamarin, loganic acid and sweroside were determined by HPLC. The results showed that the FTIR spectra of G. rigescens from different geographical origins were different, and the best pre-treatment method was SNV+SG-derivative (second derivative, 15 as the window parameter, and 2 as the polynomial order). The results showed that the accuracy rate of low- and mid-level data fusion (96.43%) in prediction set was higher than that of FTIR and HPLC (94.64%) in prediction set. In addition, the accuracy of low-level data fusion (100%) in the training set was higher than that of mid-level data fusion (99.12%) in training set. The contents of the iridoid glycosides in Yunnan were the highest among different provinces. The average content of gentiopicroside, as a bioactive marker in Chinese

  1. The complete chloroplast genome sequence of Gentiana lawrencei var. farreri (Gentianaceae) and comparative analysis with its congeneric species.

    Science.gov (United States)

    Fu, Peng-Cheng; Zhang, Yan-Zhao; Geng, Hui-Min; Chen, Shi-Long

    2016-01-01

    The chloroplast (cp) genome is useful in plant systematics, genetic diversity analysis, molecular identification and divergence dating. The genus Gentiana contains 362 species, but there are only two valuable complete cp genomes. The purpose of this study is to report the characterization of complete cp genome of G. lawrencei var. farreri , which is endemic to the Qinghai-Tibetan Plateau (QTP). Using high throughput sequencing technology, we got the complete nucleotide sequence of the G. lawrencei var. farreri cp genome. The comparison analysis including genome difference and gene divergence was performed with its congeneric species G. straminea . The simple sequence repeats (SSRs) and phylogenetics were studied as well. The cp genome of G. lawrencei var. farreri is a circular molecule of 138,750 bp, containing a pair of 24,653 bp inverted repeats which are separated by small and large single-copy regions of 11,365 and 78,082 bp, respectively. The cp genome contains 130 known genes, including 85 protein coding genes (PCGs), eight ribosomal RNA genes and 37 tRNA genes. Comparative analyses indicated that G. lawrencei var. farreri is 10,241 bp shorter than its congeneric species G. straminea. Four large gaps were detected that are responsible for 85% of the total sequence loss. Further detailed analyses revealed that 10 PCGs were included in the four gaps that encode nine NADH dehydrogenase subunits. The cp gene content, order and orientation are similar to those of its congeneric species, but with some variation among the PCGs. Three genes, ndhB , ndhF and clpP , have high nonsynonymous to synonymous values. There are 34 SSRs in the G. lawrencei var. farreri cp genome, of which 25 are mononucleotide repeats: no dinucleotide repeats were detected. Comparison with the G. straminea cp genome indicated that five SSRs have length polymorphisms and 23 SSRs are species-specific. The phylogenetic analysis of 48 PCGs from 12 Gentianales taxa cp genomes clearly identified

  2. Self-Stigma, Identity, and Co-Occurring Disorders.

    Science.gov (United States)

    Al-Khouja, Maya A; Corrigan, Patrick W

    2017-01-01

    A four stage regressive model that links public stigma to self-stigma is applied to mental illness and substance use disorder. We assess this four stage model in those with co-occurring disorders versus those who have mental illness or substance use disorder alone. 366 people who self-identified as having either a mental illness or co-occurring mental illness with substance use disorder were recruited from MTurk and completed measures on identity and self-stigma. Higher group identity predicted lower selfstigma in those with mental illness while this effect was not present for participants with co-occurring disorders. Limitations include that this study only looked at mental illness identity for those with both mental illness and substance use disorder; sample limitations are also discussed. Those with co-occurring disorders may identify more with certain groups over others.

  3. Treatment of co-occurring psychotic and substance use disorders.

    Science.gov (United States)

    Mueser, Kim T; Gingerich, Susan

    2013-01-01

    People with psychotic disorders and other serious mental illnesses, such as schizophrenia, bipolar disorder, and severe major depression, have high rates of co-occurring substance use disorder, which can wreak havoc in their lives. In this article the authors describe strategies for assessing substance use problems in people with serious mental illnesses, and then address the treatment of these co-occurring disorders. The authors review principles of treatment of co-occurring disorders, including integration of mental health and substance abuse services, adopting a low-stress and harm-reduction approach, enhancing motivation, using cognitive-behavioral therapy strategies to teach more effective interpersonal and coping skills, supporting functional recovery, and engaging the social network. The authors include a section on how social workers may play a key role in assessment, treatment, or referral for co-occurring disorders in a variety of settings. Throughout the article the authors emphasize that belief in the possibility of recovery from co-occurring disorders and instilling hope in clients, their family members, and other treatment providers, are vital to the effective treatment of co-occurring disorders.

  4. Differential dormancy of co-occurring copepods

    Science.gov (United States)

    Ohman, Mark D.; Drits, Aleksandr V.; Elizabeth Clarke, M.; Plourde, Stéphane

    1998-08-01

    Four species of planktonic calanoid copepods that co-occur in the California Current System ( Eucalanus californicus Johnson, Rhincalanus nasutus Giesbrecht, Calanus pacificus californicus Brodsky, and Metridia pacifica Brodsky) were investigated for evidence of seasonal dormancy in the San Diego Trough. Indices used to differentiate actively growing from dormant animals included developmental stage structure and vertical distribution; activity of aerobic metabolic enzymes (Citrate Synthase and the Electron Transfer System complex); investment in depot lipids (wax esters and triacylglycerols); in situ grazing activity from gut fluorescence; and egg production rates in simulated in situ conditions. None of the 4 species exhibited a canonical calanoid pattern of winter dormancy - i.e., synchronous developmental arrest as copepodid stage V, descent into deep waters, reduced metabolism, and lack of winter reproduction. Instead, Calanus pacificus californicus has a biphasic life history in this region, with an actively reproducing segment of the population in surface waters overlying a deep dormant segment in winter. Eucalanus californicus is dormant as both adult females and copepodid V's, although winter females respond relatively rapidly to elevated food and temperature conditions; they begin feeding and producing eggs within 2-3 days. Rhincalanus nasutus appears to enter dormancy as adult females, although the evidence is equivocal. Metridia pacifica shows no evidence of dormancy, with sustained active feeding, diel vertical migration behavior, and elevated activity of metabolic enzymes in December as well as in June. The four species also differ markedly in water content, classes of storage lipids, and specific activity of Citrate Synthase. These results suggest that copepod dormancy traits and structural composition reflect diverse adaptations to regional environmental conditions rather than a uniform, canonical series of traits that remain invariant among taxa

  5. [Co-occuring mood and substance use disorders].

    Science.gov (United States)

    Adida, M; Kaladjian, A; Fakra, E; Belzeaux, R; Azorin, J M

    2014-12-01

    Mood and substance use disorders commonly co-occur, yet there is little evidence-based research to guide the pharmacologic management of these comorbid disorders. The authors review the existing empirical findings including current clinical pharmacotherapy practices for treating co-occurring mood and substance use disorders and call into question current clinical practices. The specific mood disorders reviewed are bipolar and major depressive disorders (either one co-occurring with a substance use disorder). The authors also highlight knowledge gaps that may serve as a basis for future research. Findings from the relatively small amount of available data indicate that pharmacotherapy for managing mood symptoms might be effective in patients with substance dependence, although results have not been consistent across all studies. In most studies, medications for managing mood symptoms did not appear to have an impact on the substance use disorder. Research has only begun to address optimal pharmacologic management of co-occurring disorders. In addition, current clinical treatment for drug dependence often exclude new pharmacotherapies approved by the French Haute Autorité de Santé for treating certain types of addiction. With new data becoming available, it appears that we need to revisit current practice in the pharmacological management of co-occurring mood and substance use disorders. Copyright © 2014 L’Encéphale. Published by Elsevier Masson SAS.. All rights reserved.

  6. Traditional Chinese medicine herbal extracts of Cibotium barometz, Gentiana scabra, Dioscorea batatas, Cassia tora, and Taxillus chinensis inhibit SARS-CoV replication.

    Science.gov (United States)

    Wen, Chih-Chun; Shyur, Lie-Fen; Jan, Jia-Tsrong; Liang, Po-Huang; Kuo, Chih-Jung; Arulselvan, Palanisamy; Wu, Jin-Bin; Kuo, Sheng-Chu; Yang, Ning-Sun

    2011-10-01

    Development of anti-severe acute respiratory syndrome associated coronavirus (SARS-CoV) agents is pivotal to prevent the reemergence of the life-threatening disease, SARS. In this study, more than 200 extracts from Chinese medicinal herbs were evaluated for anti-SARS-CoV activities using a cell-based assay that measured SARS-CoV-induced cytopathogenic effect (CPE) in vitro on Vero E6 cells. Six herbal extracts, one each from Gentianae Radix ( lóng dǎn; the dried rhizome of Gentiana scabra), Dioscoreae Rhizoma ( shān yào; the tuber of Dioscorea batatas), Cassiae Semen ( jué míng zǐ; the dried seed of Cassia tora) and Loranthi Ramus ( sāng jì shēng; the dried stem, with leaf of Taxillus chinensis) (designated as GSH, DBM, CTH and TCH, respectively), and two from Rhizoma Cibotii ( gǒu jǐ; the dried rhizome of Cibotium barometz) (designated as CBE and CBM), were found to be potent inhibitors of SARS-CoV at concentrations between 25 and 200 μg/ml. The concentrations of the six extracts needed to inhibit 50% of Vero E6 cell proliferation (CC50) and 50% of viral replication (EC50) were determined. The resulting selective index values (SI = CC50/EC50) of the most effective extracts CBE, GSH, DBM, CTH and TCH were > 59.4, > 57.5, > 62.1, > 59.4, and > 92.9, respectively. Among these extracts, CBM and DBM also showed significant inhibition of SARS-CoV 3CL protease activity with IC50 values of 39 μg/ml and 44 μg/ml, respectively. Our findings suggest that these six herbal extracts may have potential as candidates for future development of anti-SARS therapeutics.AbbreviationsSARS,severe acute respiratory syndromeCoV,coronavirusCPE,cytopathogenic effectTCM,traditional Chinese medicine.

  7. Traditional Chinese medicine herbal extracts of Cibotium barometz, Gentiana scabra, Dioscorea batatas, Cassia tora, and Taxillus chinensis inhibit SARS-CoV replication

    Directory of Open Access Journals (Sweden)

    Chih-Chun Wen

    2011-10-01

    Full Text Available Development of anti-severe acute respiratory syndrome associated coronavirus (SARS-CoV agents is pivotal to prevent the reemergence of the life-threatening disease, SARS. In this study, more than 200 extracts from Chinese medicinal herbs were evaluated for anti-SARS-CoV activities using a cell-based assay that measured SARS-CoV-induced cytopathogenic effect (CPE in vitro on Vero E6 cells. Six herbal extracts, one each from Gentianae Radix (龍膽 lóng dǎn; the dried rhizome of Gentiana scabra, Dioscoreae Rhizoma (山藥 shān yào; the tuber of Dioscorea batatas, Cassiae Semen (決明子 jué míng zǐ; the dried seed of Cassia tora and Loranthi Ramus (桑寄生 sāng jì shēng; the dried stem, with leaf of Taxillus chinensis (designated as GSH, DBM, CTH and TCH, respectively, and two from Rhizoma Cibotii (狗脊 gǒu jǐ; the dried rhizome of Cibotium barometz (designated as CBE and CBM, were found to be potent inhibitors of SARS-CoV at concentrations between 25 and 200 μg/ml. The concentrations of the six extracts needed to inhibit 50% of Vero E6 cell proliferation (CC50 and 50% of viral replication (EC50 were determined. The resulting selective index values (SI=CC50/EC50 of the most effective extracts CBE, GSH, DBM, CTH and TCH were>59.4,> 57.5,> 62.1,> 59.4, and>92.9, respectively. Among these extracts, CBM and DBM also showed significant inhibition of SARS-CoV 3CL protease activity with IC50 values of 39 μg/ml and 44 μg/ml, respectively. Our findings suggest that these six herbal extracts may have potential as candidates for future development of anti-SARS therapeutics.

  8. Comprehensive Quality Assessment Based Specific Chemical Profiles for Geographic and Tissue Variation in Gentiana rigescens Using HPLC and FTIR Method Combined with Principal Component Analysis

    Directory of Open Access Journals (Sweden)

    Jie Li

    2017-12-01

    Full Text Available Roots, stems, leaves, and flowers of Longdan (Gentiana rigescens Franch. ex Hemsl were collected from six geographic origins of Yunnan Province (n = 240 to implement the quality assessment based on contents of gentiopicroside, loganic acid, sweroside and swertiamarin and chemical profile using HPLC-DAD and FTIR method combined with principal component analysis (PCA. The content of gentiopicroside (major iridoid glycoside was the highest in G. rigescens, regardless of tissue and geographic origin. The level of swertiamarin was the lowest, even unable to be detected in samples from Kunming and Qujing. Significant correlations (p < 0.05 between gentiopicroside, loganic acid, sweroside, and swertiamarin were found at inter- or intra-tissues, which were highly depended on geographic origins, indicating the influence of environmental conditions on the conversion and transport of secondary metabolites in G. rigescens. Furthermore, samples were reasonably classified as three clusters along large producing areas where have similar climate conditions, characterized by carbohydrates, phenols, benzoates, terpenoids, aliphatic alcohols, aromatic hydrocarbons, and so forth. The present work provided global information on the chemical profile and contents of major iridoid glycosides in G. rigescens originated from six different origins, which is helpful for controlling quality of herbal medicines systematically.

  9. Optimization of ultrasonic extraction by response surface methodology combined with ultrafast liquid chromatography–ultraviolet method for determination of four iridoids in Gentiana rigescens

    Directory of Open Access Journals (Sweden)

    Yu Pan

    2015-09-01

    Full Text Available Gentiana rigescens is a rich source of iridoids and is commonly used as a folk medicine for treatment of hepatitis and cholecystitis for over 1000 years. A rapid ultrafast liquid chromatography–ultraviolet method was developed for simultaneous determination of four major iridoid glycosides in G. rigescens. Response surface methodology based on the Box–Behnken design was applied to optimize the extraction conditions of iridoid glycosides. Using the Shim-Pack XR-ODS III, four iridoid glycosides were efficiently separated with an acetonitrile:0.1% formic acid aqueous solution gradient at a flow rate of 0.25 mL/min for 8 minutes. All the regression equations revealed a good linear relationship (R2 > 0.9995. The intraday and interday variations were <1.95%. The recoveries ranged from 99.7% to 103.2%. The optimal extraction conditions were as follows: methanol concentration, 82%; the ratio of liquid to solid material, 68:1 (mL/g; and extraction time, 32 minutes. The yield of the four iridoid glycosides under the optimal process was found to be 63.08 mg/g, which was consistent with the predicted yield. In addition, the total content of 50 cultivated samples from Lincang, Yunnan, China, was within the range of 33.6–113.26 mg/g, which provides a more reasonable foundation for utilization of G. rigescens.

  10. Tolerability of the combination of ginger (Zingiber officinalis), gentian (Gentiana lutea) and turmeric (Curcuma longa) in patients with cancer-associated anorexia.

    Science.gov (United States)

    Sanatani, Michael; Younus, Jawaid; Stitt, Larry; Malik, Nazish

    2015-03-01

    Anorexia is a common symptom for patients with advanced cancer. Gentian, ginger, and turmeric have traditionally been used to stimulate appetite. We tested these agents in combination, in a pilot study to assess tolerability in patients indicating 4/10 or worse anorexia on the Edmonton Symptom Assessment System, and who were not currently on chemotherapy. We collected exploratory data on the patient's appetite using a visual analogue scale. Between 2009 and 2012, 17 patients were enrolled in arm 1 (turmeric 1 g and ginger 1 g orally twice daily, and gentiana lutea tincture 1 mL three times a day, for 14 days). The three patients enrolled in arm 2 received the same doses of ginger and turmeric but no gentian. All patients completed a daily appetite diary and a weekly symptom assessment. In arm 1, seven patients (41%) completed treatment. Seven patients (41%) stopped early because of unacceptable toxicity or patient-initiated discontinuation, and 3 stopped because of other reasons. All patients in arm 2 stopped taking the study medication within few days of starting the treatment, leading the study committee to recommend stopping the trial. The most common adverse effects attributed to study drugs were nausea (6 patients), vomiting (3), fatigue (3), diarrhea (2) and bloating (2). There was no statistically significant effect seen on appetite. At the doses used in this study, the combination of ginger, turmeric, and gentian is not tolerated well in cancer patients. Future studies should use fewer agents or lower doses.

  11. Skin picking disorder with co-occurring body dysmorphic disorder

    DEFF Research Database (Denmark)

    Grant, Jon E; Redden, Sarah A; Leppink, Eric W

    2015-01-01

    There is clinical overlap between skin picking disorder (SPD) and body dysmorphic disorder (BDD), but little research has examined clinical and cognitive correlates of the two disorders when they co-occur. Of 55 participants with SPD recruited for a neurocognitive study and two pharmacological...

  12. Integration of independent component analysis with near-infrared spectroscopy for analysis of bioactive components in the medicinal plant Gentiana scabra Bunge

    Directory of Open Access Journals (Sweden)

    Yung-Kun Chuang

    2014-09-01

    Full Text Available Independent component (IC analysis was applied to near-infrared spectroscopy for analysis of gentiopicroside and swertiamarin; the two bioactive components of Gentiana scabra Bunge. ICs that are highly correlated with the two bioactive components were selected for the analysis of tissue cultures, shoots and roots, which were found to distribute in three different positions within the domain [two-dimensional (2D and 3D] constructed by the ICs. This setup could be used for quantitative determination of respective contents of gentiopicroside and swertiamarin within the plants. For gentiopicroside, the spectral calibration model based on the second derivative spectra produced the best effect in the wavelength ranges of 600–700 nm, 1600–1700 nm, and 2000–2300 nm (correlation coefficient of calibration = 0.847, standard error of calibration = 0.865%, and standard error of validation = 0.909%. For swertiamarin, a spectral calibration model based on the first derivative spectra produced the best effect in the wavelength ranges of 600–800 nm and 2200–2300 nm (correlation coefficient of calibration = 0.948, standard error of calibration = 0.168%, and standard error of validation = 0.216%. Both models showed a satisfactory predictability. This study successfully established qualitative and quantitative correlations for gentiopicroside and swertiamarin with near-infrared spectra, enabling rapid and accurate inspection on the bioactive components of G. scabra Bunge at different growth stages.

  13. Effect of light, temperature and different pretreatments on seed germination of gentiana boissieri schott et kotschy ex boiss. (gentianaceae) and endemic to turkey

    International Nuclear Information System (INIS)

    Erken, S.

    2017-01-01

    This study was undertaken with the aim of determining the germination characteristics of Gentiana boissieri (Gentianaceae), an endemic species. The effects of light, temperature and different pretreatments on the germination of seeds collected from nature were investigated. Two different experiments were run to determine germination characteristics of seeds and the final germination percentage (FGP), mean germination time (MGT) and germination index (GI). The first experiment involved twenty different treatments including soaking in water, soaking in gibberellic acid (GA3), dry stratification, moist cold stratification, moist warm stratification + moist cold stratification, moist cold stratification + soaking in GA3 and control. The germination test was carried out at +20 degree C in dark. The highest final germination percentages were obtained from the treatments of soaking in 500, 750, 1000 ppm GA3, soaking in 250, 500 ppm GA3 + 4 weeks of moist cold stratification (89.00; 95.00; 93.50; 91.33; 94.00%, respectively). In the control group with no pretreatment, the final germination percentage of seeds was found to be 13.50%. In the second experiment, seeds treated with 750 ppm GA3 pretreatment, providing highest germination rate in the first experiment, were germinated under dark and light conditions (12/12 h; dark/light) at 15, 20, 25 and 10/20 degree C. At the end of 28 days under four different temperatures, it was found that light significantly increased the final germination percentage and the highest final germination percentages were found at 15 and 20 degree C (87.00; 89.50%, respectively). (author)

  14. Peers and Co-Occurring Research-Supported Interventions.

    Science.gov (United States)

    Harrison, Jennifer; Cousins, Linwood; Spybrook, Jessaca; Curtis, Amy

    2017-01-01

    Adults with co-occurring mental illness and substance use disorders have poor outcomes in important quality of life areas, including hospitalization, incarceration, employment, and community housing. Integrated dual disorder treatment (IDDT) is a research-supported intervention for individuals with co-occurring disorders associated with improvements in outcome measures when implemented with high fidelity. Research-supported intervention IDDT was not designed with peer services, provided by people with lived experience with mental illness, but the practice has been altered to include peers. IDDT fidelity data were evaluated from 20 teams that also reported on peer services on their team in one state over a 7 year period, and paired with their fidelity data for the most recent review to analyze the relationship between peers and IDDT fidelity. Analysis of variance was utilized to determine a dose effect peers on fidelity. Of these IDDT teams, 85% of teams incorporated a peer and 40% of teams had a full-time peer. Having a full-time peer (M = 4.22, SD = .41) was associated with significantly higher fidelity compared to teams with a part-time (M = 3.68, SD = .56) or no peer (M = 3.21, SD = .18, F(2, 17) = 5.88, p = .01). Peers on IDDT teams are associated with higher fidelity, leading to important possibilities about the incorporation of those with lived experience into research-supported interventions. Implications for team composition, implementation measurement, policy, and funding are discussed.

  15. Consequences of Co-Occurring Attention-Deficit/Hyperactivity Disorder on Children's Language Impairments

    Science.gov (United States)

    Redmond, Sean M.; Ash, Andrea C.; Hogan, Tiffany P.

    2015-01-01

    Purpose: Co-occurring attention-deficit/hyperactivity disorder (ADHD) and communication disorders represent a frequently encountered challenge for school-based practitioners. The purpose of the present study was to examine in more detail the clinical phenomenology of co-occurring ADHD and language impairments (LIs). Method: Measures of nonword…

  16. A Qualitative Analysis of the MAYSI-2: Screening for Co-Occurring Disorders in Adolescents

    Science.gov (United States)

    James, William H.; Randolph, Dwight E.

    2015-01-01

    This study investigated the use of the Massachusetts Youth Screening Instrument (MAYSI-2) to screen for co-occurring disorders in an adolescent outpatient treatment program and to provide a preliminary assessment of those needs. The MAYSI-2 identified youth with co-occurring disorders and the results support existing recommendations for distinct…

  17. Factors influencing service use among homeless youths with co-occurring disorders.

    Science.gov (United States)

    Kozloff, Nicole; Cheung, Amy H; Ross, Lori E; Winer, Heather; Ierfino, Diana; Bullock, Heather; Bennett, Kathryn J

    2013-09-01

    Given high rates of co-occurring mental and substance use disorders among homeless youths and poorly understood facilitators of and barriers to service use, this study explored factors influencing service use among homeless youths with co-occurring disorders. Focus groups were conducted with 23 youths age 18 to 26 with co-occurring disorders. Group discussion was audio-recorded and transcribed verbatim, and transcripts were examined with thematic content analysis. The factors identified as influencing service use were grouped into three broad categories: individual (motivation, support, and therapeutic relationship), program (flexibility and comprehensiveness of services and availability of harm reduction services), and systemic (stigma and accessibility). Multilevel factors appear to influence service use among homeless youths with co-occurring disorders. Given the lack of evidence to support specific treatments in this population, these findings may be used to guide the development of thoughtfully designed interventions to engage homeless youths with co-occurring disorders.

  18. Co-occurring nonnative woody shrubs have additive and non-additive soil legacies

    DEFF Research Database (Denmark)

    Kuebbing, Sara E.; Patterson, Courtney M.; Classen, Aimee Taylor

    2016-01-01

    species compared to the impacts of nonnative species when they co-occur, and in particular predicting when impacts of co-occurring nonnative species will be non-additive. Understanding non-additivity is important for management decisions because the management of only one co-occurring invader....... Whether co-occurring nonnative plants alter soil properties additively or non-additively relative to their effects on soils when they grow in monoculture is rarely addressed. We use a greenhouse plant-soil feedback experiment to test for non-additive soil impacts of two common invasive nonnative woody...... in soils conditioned by either shrub singly. This result indicates that when these two nonnative shrubs co-occur, their influence on soils disproportionally favors persistence of the nonnative L. sinense relative to this native herbaceous community, and could provide an explanation of why native species...

  19. Predictors of Co-occurring Neurodevelopmental Disabilities in Children With Autism Spectrum Disorders.

    Science.gov (United States)

    Zauche, Lauren Head; Darcy Mahoney, Ashley E; Higgins, Melinda K

    Co-occurring neurodevelopmental disabilities (including cognitive and language delays and attention deficit hyperactivity disorder) affect over half of children with ASD and may affect later behavioral, language, and cognitive outcomes beyond the ASD diagnosis. However, no studies have examined predictors of co-occurring neurodevelopmental disabilities in children with ASD. This study investigated whether maternal sociodemographic, perinatal and neonatal factors are associated with co-occurring disabilities. This study involved a retrospective analysis of medical records for children diagnosed with ASD between 2009 and 2010 at an Autism Center in the southeast United States. Logistic regression was used to identify predictors of co-occurring neurodevelopmental disabilities. Of the 385 children in the sample, 61% had a co-occurring neurodevelopmental disability. Children whose mothers had less education (OR: 0.905), had never been married (OR: 1.803), or had bleeding during pregnancy (OR: 2.233) were more likely to have a co-occurring neurodevelopmental disability. Both preterm birth and African American race were associated with bleeding during pregnancy. Several maternal and perinatal risk factors for ASD were found to put children at risk for further diagnoses of co-occurring neurodevelopmental disabilities. While prematurity, a well-established risk factor for ASD, as well as maternal ethnicity was not found to increase the risk of a co-occurring disability, this study suggests that bleeding during pregnancy may moderate these relationships. Understanding maternal, perinatal, and neonatal risk factors may inform healthcare provider screening for ASD and co-occurring neurodevelopmental disabilities by helping providers recognize infants who present with multiple risk factors. Copyright © 2017 Elsevier Inc. All rights reserved.

  20. Back Pain and Co-occurring Conditions: Findings from a Nationally Representative Sample.

    Science.gov (United States)

    Badley, Elizabeth M; Millstone, Dov B; Perruccio, Anthony V

    2018-02-16

    Cross-sectional population-level health survey. To describe the frequency of co-occurring conditions with back pain; to identify risk factors for back pain controlling for co-occurring conditions; and to examine the association between back pain and individual co-occurring conditions. Back pain shares risk factors with a range of other conditions. Most studies have considered risk factors for back pain without taking into account the potential influence of co-occurring conditions. Analysis of the 2013 Canadian Community Health Survey (n = 61,854, age. ≥ 15 years). Back pain status and co-occurring conditions were determined from questions about long term health conditions diagnosed by a health profession. Multivariable log-Poisson regression analysis was used to assess the adjusted association of back pain with demographic and lifestyle characteristics and co-occurring conditions. The population prevalence of reported back pain was 19.3%. Most (71%) reported at least one co-occurring condition. Most frequently reported were arthritis (35%), high blood pressure (26%), migraine (18%), and mood disorders (14%). Following the addition of co-occurring condition count to the regression model, being female and being overweight/obese were no longer significantly associated with back pain, and the associations with ages 45-54 years and older, low income, smoking and being physical inactive were significantly attenuated. The highest prevalence ratio, 3.32 (95% CI: 3.06-3.59), was for 3+ co-occurring conditions. In multi-variable regression all but a few individual chronic conditions remained significant associated with back pain. Established risk factors for back pain may be largely a reflection of shared risk factors with co-occurring conditions. The high frequency of co-occurring conditions likely reflects diverse mechanisms related to heterogeneity of back pain. The extent of association of co-occurring conditions with back pain has implications for clinical

  1. Substance Use and Mental Health Stigma in Veterans With Co-Occurring Disorders.

    Science.gov (United States)

    Harnish, Autumn; Corrigan, Patrick; Byrne, Thomas; Pinals, Debra A; Rodrigues, Stephanie; Smelson, David

    2016-01-01

    This pilot study examined whether substance use or mental illness was more stigmatizing among individuals with co-occurring mental health and substance abuse problems. This study included 48 individuals with co-occurring substance use and mental health problems enrolled in a Substance Abuse and Mental Health Services funded treatment program. Subjects received a baseline assessment that included addiction, mental health, and stigma measures. The sample consisted primarily of White males with an average age of 38 years. Substance abuse was found to be more stigmatizing than mental illness, F(1, 47) = 14.213, p co-occurring disorders with a greater focus on substance abuse.

  2. Autism and Obesity: Co-Occurring Conditions or Drug Side Effects

    Science.gov (United States)

    2015-10-01

    AWARD NUMBER: W81XWH-14-1-0374 TITLE: Autism and Obesity: Co-Occurring Conditions or Drug Side Effects? PRINCIPAL INVESTIGATOR: Zohreh...SUBTITLE Autism and Obesity: Co-Occurring Conditions or Drug Side Effects? 5a. CONTRACT NUMBER 5b. GRANT NUMBER W81XWH-14-1-0374 5c. PROGRAM ELEMENT...project is to better understand the relationship between autism and obesity. It is not clear if obesity is co-occurring with autism or is related to

  3. cooccur: Probabilistic Species Co-Occurrence Analysis in R

    Directory of Open Access Journals (Sweden)

    Daniel M. Griffith

    2016-02-01

    Full Text Available The observation that species may be positively or negatively associated with each other is at least as old as the debate surrounding the nature of community structure which began in the early 1900's with Gleason and Clements. Since then investigating species co-occurrence patterns has taken a central role in understanding the causes and consequences of evolution, history, coexistence mechanisms, competition, and environment for community structure and assembly. This is because co-occurrence among species is a measurable metric in community datasets that, in the context of phylogeny, geography, traits, and environment, can sometimes indicate the degree of competition, displacement, and phylogenetic repulsion as weighed against biotic and environmental effects promoting correlated species distributions. Historically, a multitude of different co-occurrence metrics have been developed and most have depended on data randomization procedures to produce null distributions for significance testing. Here we improve upon and present an R implementation of a recently published model that is metric-free, distribution-free, and randomization-free. The R package, cooccur, is highly accessible, easily integrates into common analyses, and handles large datasets with high performance. In the article we develop the package's functionality and demonstrate aspects of co-occurrence analysis using three sample datasets.

  4. CooVar: Co-occurring variant analyzer

    Directory of Open Access Journals (Sweden)

    Vergara Ismael A

    2012-11-01

    Full Text Available Abstract Background Evaluating the impact of genomic variations (GV on protein-coding transcripts is an important step in identifying variants of functional significance. Currently available programs for variant annotation depend on external databases or annotate multiple variants affecting the same transcript independently, which limits program use to organisms available in these databases or results in potentially incorrect or incomplete annotations. Findings We have developed CooVar (Co-occurring Variant Analyzer, a database-independent program for assessing the impact of GVs on protein-coding transcripts. CooVar takes GVs, reference genome sequence, and protein-coding exons as input and provides annotated GVs and transcripts as output. Other than similar programs, CooVar considers the combined impact of all GVs affecting the same transcript, generating biologically more accurate annotations. CooVar is operated from the command-line and supports standard file formats VCF, GFF/GTF, and GVF, which makes it easy to integrate into existing computational pipelines. We have extensively tested CooVar on worm and human data sets and demonstrate that it generates correct annotations in only a short amount of time. Conclusions CooVar is an easy-to-use and lightweight variant annotation tool that considers the combined impact of GVs on protein-coding transcripts. CooVar is freely available at http://genome.sfu.ca/projects/coovar/.

  5. PTSD Care Among Veterans With and Without Co-Occurring Substance Use Disorders.

    Science.gov (United States)

    Mansfield, Alyssa J; Greenbaum, Mark A; Schaper, Kim M; Banducci, Anne N; Rosen, Craig S

    2017-06-01

    This study examined whether a co-occurring substance use disorder contributed to disparities in receipt of Veterans Health Administration (VHA) posttraumatic stress disorder (PTSD) specialty care or psychotherapy. Logistic regression, controlling for sociodemographic characteristics, was used to examine predictors of PTSD care among 424,211 veterans with confirmed PTSD (two or more PTSD diagnosis encounters) who accessed care in a VHA facility between fiscal years 2009 and 2010. Overall, 16% of veterans had PTSD and a co-occurring substance use disorder diagnosis. In adjusted analyses, veterans with a co-occurring substance use disorder were more likely than veterans with PTSD alone to receive any outpatient PTSD specialty care and complete eight or more sessions of outpatient psychotherapy within 14 weeks, but they were less likely to be treated in inpatient PTSD specialty units. Co-occurring substance use disorders did not appear to hinder receipt of outpatient specialty PTSD treatment or of sufficient psychotherapy among VHA-enrolled veterans.

  6. Changes in the probability of co-occurring extreme climate events

    Science.gov (United States)

    Diffenbaugh, N. S.

    2017-12-01

    Extreme climate events such as floods, droughts, heatwaves, and severe storms exert acute stresses on natural and human systems. When multiple extreme events co-occur, either in space or time, the impacts can be substantially compounded. A diverse set of human interests - including supply chains, agricultural commodities markets, reinsurance, and deployment of humanitarian aid - have historically relied on the rarity of extreme events to provide a geographic hedge against the compounded impacts of co-occuring extremes. However, changes in the frequency of extreme events in recent decades imply that the probability of co-occuring extremes is also changing, and is likely to continue to change in the future in response to additional global warming. This presentation will review the evidence for historical changes in extreme climate events and the response of extreme events to continued global warming, and will provide some perspective on methods for quantifying changes in the probability of co-occurring extremes in the past and future.

  7. The AC-OK Cooccurring Screen: Reliability, Convergent Validity, Sensitivity, and Specificity

    Directory of Open Access Journals (Sweden)

    Andrew L. Cherry

    2013-01-01

    Full Text Available The principal barriers to universal screening for the cooccurring disorders of mental illness and substance abuse are training, time, cost, and a reliable and valid screen. Although many of the barriers to universal screening still remain intact, the lack of a cooccurring screen that is effective and can be administered in a cost efficient way is no longer an obstacle. This study examined the reliability, factor structure, and convergent validity of the 15-item AC-OK Cooccurring Screen. A total of 2,968 AC-OK Cooccurring Screens administrated to individuals who called or went to one of the nine participating mental health and substance abuse treatment facilities were administrated and analyzed. Principal axis factor (PAF analysis was used in the confirmatory factor analysis to identify the common variance among the items in the scales while excluding unique variance. Cronbach's Alpha was used to establish internal consistency (reliability of each subscale. Finally, the findings from the AC-OK Cooccurring Screen were compared to individual scores on two standardized reference measures, the addiction severity index and the Client assessment record (a measure of mental health status to determine sensitivity and specificity. This analysis of the AC-OK Cooccurring Screen found the subscales to have excellent reliability, very good convergent validity, excellent sensitivity, and sufficient specificity to be highly useful in screening for cooccurring disorders in behavioral health settings. In this study, the AC-OK Cooccurring Screen had a Cronbach's Alpha of .92 on the substance abuse subscale and a Cronbach's Alpha of .80 on the mental health subscale.

  8. The AC-OK Cooccurring Screen: Reliability, Convergent Validity, Sensitivity, and Specificity.

    Science.gov (United States)

    Cherry, Andrew L; Dillon, Mary E

    2013-01-01

    The principal barriers to universal screening for the cooccurring disorders of mental illness and substance abuse are training, time, cost, and a reliable and valid screen. Although many of the barriers to universal screening still remain intact, the lack of a cooccurring screen that is effective and can be administered in a cost efficient way is no longer an obstacle. This study examined the reliability, factor structure, and convergent validity of the 15-item AC-OK Cooccurring Screen. A total of 2,968 AC-OK Cooccurring Screens administrated to individuals who called or went to one of the nine participating mental health and substance abuse treatment facilities were administrated and analyzed. Principal axis factor (PAF) analysis was used in the confirmatory factor analysis to identify the common variance among the items in the scales while excluding unique variance. Cronbach's Alpha was used to establish internal consistency (reliability) of each subscale. Finally, the findings from the AC-OK Cooccurring Screen were compared to individual scores on two standardized reference measures, the addiction severity index and the Client assessment record (a measure of mental health status) to determine sensitivity and specificity. This analysis of the AC-OK Cooccurring Screen found the subscales to have excellent reliability, very good convergent validity, excellent sensitivity, and sufficient specificity to be highly useful in screening for cooccurring disorders in behavioral health settings. In this study, the AC-OK Cooccurring Screen had a Cronbach's Alpha of .92 on the substance abuse subscale and a Cronbach's Alpha of .80 on the mental health subscale.

  9. Hospitalizations and hospital charges for co-occurring substance use and mental disorders.

    Science.gov (United States)

    Ding, Kele; Yang, Jingzhen; Cheng, Gang; Schiltz, Trisha; Summers, Karen M; Skinstad, Anne Helene

    2011-06-01

    Most published studies have examined co-occurring disorders among mental health patients. Our objective was to compare the length of stay and hospital charges between hospitalized patients with alcohol- or substance-related disorders with and without co-occurring disorders. We analyzed nationally representative hospital discharge data (Nationwide Inpatient Sample, 2003-2007) and examined factors associated with length of stay and hospital charges. Forty-four percent of patients who were hospitalized with alcohol- or substance-related disorders were diagnosed with co-occurring mental disorders, representing 979,421 such disorders nationwide between 2003 and 2007. Females, those of White race, those who paid with insurance, and those who stayed in large, rural, nonteaching, and Midwest region hospitals had a high prevalence of co-occurring disorders. Co-occurring disorders were associated with longer hospital stays, but there were mixed results with hospital charges per discharge. An increase in co-occurring disorders among hospitalized patients with substance-related disorder may be due to the improvement in diagnosis and clinical attention. Published by Elsevier Inc.

  10. Co-occurring mood disorders among hospitalized patients and risk for subsequent medical hospitalization.

    Science.gov (United States)

    Daratha, Kenn B; Barbosa-Leiker, Celestina; H Burley, Mason; Short, Robert; Layton, Matthew E; McPherson, Sterling; Dyck, Dennis G; McFarland, Bentson H; Tuttle, Katherine R

    2012-01-01

    The objective was to determine if patients hospitalized with a primary medical diagnosis and any co-occurring serious mental illness (SMI) were more likely than patients without any co-occurring SMI diagnosis to experience a subsequent medical hospitalization. This was a longitudinal cohort study of 925,705 adult persons (aged 18+ years). Patients hospitalized in Washington State from 2004 to 2008 were followed through 2009 (for an average of 43 months). Compared to patients hospitalized for medical conditions without co-occurring SMI, patients with co-occurring dysthymia, bipolar and major depressive disorders were at an elevated risk for long-term subsequent hospitalization. Patients in the combined co-occurring mood disorders cohort were more likely (hazard ratio=1.13; 99% confidence interval=1.10-1.16; Pdisorders that increased risk for subsequent hospitalization was also observed. Hospitalized patients with co-occurring mood disorders are at high risk for repeat hospitalization for a medical reason. This high-risk population, including those with substance abuse, should be a focus of research efforts to identify and address ambulatory-care-sensitive conditions amenable to strategies that decrease complications and illness leading to subsequent hospitalizations. Copyright © 2012 Elsevier Inc. All rights reserved.

  11. Autism spectrum disorders and health care expenditures: the effects of co-occurring conditions.

    Science.gov (United States)

    Peacock, Georgina; Amendah, Djesika; Ouyang, Lijing; Grosse, Scott D

    2012-01-01

    Children with autism spectrum disorders (ASDs) often have co-occurring conditions, but little is known on the effect of those conditions on their medical care cost. Medical expenditures attributable to ASDs among Medicaid-enrolled children were calculated, and the effects of 3 commonly co-occurring conditions--intellectual disability (ID), attention deficit/hyperactivity disorder (ADHD), and epilepsy-on those expenditures were analyzed. Using MarketScan Medicaid Multi-State Databases (2003-2005) and the International Classification of Disease, Ninth Revision, children with ASD were identified. Children without ASD formed the comparison group. The 3 co-occurring conditions were identified among both the ASD and the comparison groups. Annual mean, median, and 95th percentile of total expenditures were calculated for children with ASD and the co-occurring conditions and compared with those of children without ASD. Multivariate analyses established the influence of each of those co-occurring conditions on the average expenditures for children with and without ASD. In 2005, 47% of children with ASD had at least 1 selected co-occurring condition; attention deficit/hyperactivity disorder was the most common, at 30%. The mean medical expenditures for children with ASD were 6 times higher than those of the comparison group. Children with ASD and ID incurred expenditures 2.7 times higher than did children with ASD and no co-occurring condition. Medicaid-enrolled children with ASD incurred higher medical costs than did Medicaid-enrolled children without ASD. Among Medicaid-enrolled children with ASD, cost varied substantially based on the presence of another neurodevelopmental disorder. In particular, children with ID had much higher costs than did other children with ASD.

  12. Inherited and Environmental Influences on a Childhood Co-Occurring Symptom Phenotype: Evidence From an Adoption Study

    OpenAIRE

    Roos, Leslie E.; Fisher, Philip A.; Shaw, Daniel S.; Kim, Hyoun K.; Neiderhiser, Jenae M.; Reiss, David; Natsuaki, Misaki N.; Leve, Leslie D.

    2015-01-01

    Risk factors for the childhood development of co-occurring internalizing and externalizing symptoms are not well understood, despite a high prevalence and poor clinical outcomes associated with this co-occurring phenotype. We examined inherited and environmental risk factors for co-occurring symptoms in a sample of children adopted at birth and their birth mothers and adoptive mothers (N = 293). Inherited risk factors (i.e., birth mothers’ processing speed and internalizing symptoms) and envi...

  13. Co-occurring mental illness, substance use disorders, and antisocial personality disorder among clients of forensic mental health services.

    Science.gov (United States)

    Ogloff, James R P; Talevski, Diana; Lemphers, Anthea; Wood, Melisa; Simmons, Melanie

    2015-03-01

    Despite the number of studies investigating co-occurring disorders, and more recently, co-occurring disorders and criminal offending, few studies have considered samples from forensic mental health services. The present study was conducted to investigate the relationship between mental illness, substance use disorders, antisocial personality disorder, and offending. The prevalence of co-occurring disorders was investigated in 130 male offenders who had contact with the statewide forensic mental health service in Victoria, Australia. Offense histories and severity of offending were compared among participants diagnosed with a single mental illness (or no mental illness), co-occurring mental illness and substance use, and co-occurring disorders plus antisocial personality disorder. The majority of participants had co-occurring mental and substance use disorders; a significant minority met the criteria for antisocial personality disorder. Participants with co-occurring mental illness and substance use disorders, and those who had an additional diagnosis of antisocial personality disorder, were responsible for more serious and frequent offending than those with mental illness alone. Forensic mental health services must take into account the effect that co-occurring disorders have on clients' functioning and offending. Those who work with people with psychiatric disabilities and co-occurring substance use disorders must ensure that the substance disorders are addressed to help ensure recovery from the mental illness and to reduce the likelihood of offending. (PsycINFO Database Record (c) 2015 APA, all rights reserved).

  14. cooccurNet: an R package for co-occurrence network construction and analysis.

    Science.gov (United States)

    Zou, Yuanqiang; Wu, Zhiqiang; Deng, Lizong; Wu, Aiping; Wu, Fan; Li, Kenli; Jiang, Taijiao; Peng, Yousong

    2017-06-15

    Previously, we developed a computational model to identify genomic co-occurrence networks that was applied to capture the coevolution patterns within genomes of influenza viruses. To facilitate easy public use of this model, an R package 'cooccurNet' is presented here. 'cooccurNet' includes functionalities of construction and analysis of residues (e.g. nucleotides, amino acids and SNPs) co-occurrence network. In addition, a new method for measuring residues coevolution, defined as residue co-occurrence score (RCOS), is proposed and implemented in 'cooccurNet' based on the co-occurrence network. 'cooccurNet' is publicly available on CRAN repositories under the GPL-3 Open Source License ( http://cran.r-project.org/package=cooccurNet ). taijiao@ibms.pumc.edu.cn or pys2013@hnu.edu.cn. Supplementary data are available at Bioinformatics online. © The Author 2017. Published by Oxford University Press. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com

  15. Current status of co-occurring mood and substance use disorders: a new therapeutic target.

    Science.gov (United States)

    Pettinati, Helen M; O'Brien, Charles P; Dundon, William D

    2013-01-01

    Mood and substance use disorders commonly co-occur, yet there is little evidence-based research to guide the pharmacologic management of these comorbid disorders. The authors review the existing empirical findings, some of which may call into question current clinical pharmacotherapy practices for treating co-occurring mood and substance use disorders. The authors also highlight knowledge gaps that can serve as a basis for future research. The specific mood disorders reviewed are bipolar and major depressive disorders (either one co-occurring with a substance use disorder). Overall, findings from the relatively small amount of available data indicate that pharmacotherapy for managing mood symptoms can be effective in patients with substance dependence, although results have not been consistent across all studies. Also, in most studies, medications for managing mood symptoms did not appear to have an impact on the substance use disorder. In a recent trial for comorbid major depression and alcohol dependence, combination treatment with a medication for depression and another for alcohol dependence was found to reduce depressive symptoms and excessive drinking simultaneously. However, research has only begun to address optimal pharmacologic management of co-occurring disorders. In addition, current clinical treatment for alcohol and drug dependence often excludes new pharmacotherapies approved by the U.S. Food and Drug Administration for treating certain types of addiction. With new data becoming available, it appears that we need to revisit current practice in the pharmacological management of co-occurring mood and substance use disorders.

  16. CDCOCA: A statistical method to define complexity dependence of co-occuring chromosomal aberrations

    Directory of Open Access Journals (Sweden)

    Cai Haoyang

    2011-03-01

    Full Text Available Abstract Background Copy number alterations (CNA play a key role in cancer development and progression. Since more than one CNA can be detected in most tumors, frequently co-occurring genetic CNA may point to cooperating cancer related genes. Existing methods for co-occurrence evaluation so far have not considered the overall heterogeneity of CNA per tumor, resulting in a preferential detection of frequent changes with limited specificity for each association due to the high genetic instability of many samples. Method We hypothesize that in cancer some linkage-independent CNA may display a non-random co-occurrence, and that these CNA could be of pathogenetic relevance for the respective cancer. We also hypothesize that the statistical relevance of co-occurring CNA may depend on the sample specific CNA complexity. We verify our hypotheses with a simulation based algorithm CDCOCA (complexity dependence of co-occurring chromosomal aberrations. Results Application of CDCOCA to example data sets identified co-occurring CNA from low complex background which otherwise went unnoticed. Identification of cancer associated genes in these co-occurring changes can provide insights of cooperative genes involved in oncogenesis. Conclusions We have developed a method to detect associations of regional copy number abnormalities in cancer data. Along with finding statistically relevant CNA co-occurrences, our algorithm points towards a generally low specificity for co-occurrence of regional imbalances in CNA rich samples, which may have negative impact on pathway modeling approaches relying on frequent CNA events.

  17. CDCOCA: a statistical method to define complexity dependence of co-occuring chromosomal aberrations.

    Science.gov (United States)

    Kumar, Nitin; Rehrauer, Hubert; Cai, Haoyang; Baudis, Michael

    2011-03-03

    Copy number alterations (CNA) play a key role in cancer development and progression. Since more than one CNA can be detected in most tumors, frequently co-occurring genetic CNA may point to cooperating cancer related genes. Existing methods for co-occurrence evaluation so far have not considered the overall heterogeneity of CNA per tumor, resulting in a preferential detection of frequent changes with limited specificity for each association due to the high genetic instability of many samples. We hypothesize that in cancer some linkage-independent CNA may display a non-random co-occurrence, and that these CNA could be of pathogenetic relevance for the respective cancer. We also hypothesize that the statistical relevance of co-occurring CNA may depend on the sample specific CNA complexity. We verify our hypotheses with a simulation based algorithm CDCOCA (complexity dependence of co-occurring chromosomal aberrations). Application of CDCOCA to example data sets identified co-occurring CNA from low complex background which otherwise went unnoticed. Identification of cancer associated genes in these co-occurring changes can provide insights of cooperative genes involved in oncogenesis. We have developed a method to detect associations of regional copy number abnormalities in cancer data. Along with finding statistically relevant CNA co-occurrences, our algorithm points towards a generally low specificity for co-occurrence of regional imbalances in CNA rich samples, which may have negative impact on pathway modeling approaches relying on frequent CNA events.

  18. Gender Differences in Perceived Unmet Treatment Needs Among Persons With and Without Co-occurring Disorders.

    Science.gov (United States)

    Manuel, Jennifer I; Stebbins, Mary B; Wu, Elwin

    2018-01-01

    This study examined gender differences in perceived unmet treatment needs among persons with and without co-occurring substance use disorders and serious mental health conditions. Data were drawn from the 2008-2013 National Survey on Drug Use and Health (unweighted N = 37,187) to test the hypothesis that the relationships between diagnosis and perceived unmet treatment needs differ as a function of gender. Compared to individuals with a substance use disorder or severe mental illness, those with co-occurring disorders were more likely to report perceived unmet needs for substance abuse and mental health treatment. Gender significantly moderated the relationship between diagnosis and unmet needs, suggesting that men with co-occurring disorders might be more adversely affected. Findings highlight the need for better understanding of gender-diagnosis differences with respect to unmet needs for substance abuse and mental health care.

  19. Barriers to serving clients with co-occurring disorders in a transformed mental health system.

    Science.gov (United States)

    Padwa, Howard; Guerrero, Erick G; Braslow, Joel T; Fenwick, Karissa M

    2015-05-01

    The publication of the President's New Freedom Commission Report in 2003 led to hope and anticipation that system transformation would address barriers that have impeded the delivery of integrated services for clients with co-occurring mental health and substance use disorders. Have problems been resolved? This study analyzed providers' perspectives on serving clients with co-occurring disorders in a large mental health system that has undergone transformation. Six focus groups were conducted with providers at specialty mental health treatment organizations that received funding to transform services. Using content analysis, the authors identified major themes of the focus group discussions. Participants reported several barriers within the mental health system and challenges associated with collaborating with specialty substance abuse treatment providers that impede the delivery of integrated care. In spite of efforts to improve co-occurring disorder service delivery in a transformed mental health system, barriers that have historically impeded integrated treatment persist.

  20. Contingency Management for Patients with Cooccurring Disorders: Evaluation of a Case Study and Recommendations for Practitioners

    Directory of Open Access Journals (Sweden)

    Claire E. Adams

    2012-01-01

    Full Text Available Research indicates that contingency management (CM has potential to improve a number of outcomes (e.g. substance use, treatment attendance, quality of life among individuals with substance use and cooccurring disorders. However, multiple factors must be considered on a case-by-case basis in order to promote optimal treatment effects. The present study describes an individualized CM protocol for a US Veteran with substance dependence and cooccurring severe mental illness. CM targeted attendance at outpatient appointments and appropriate use of hospital resources. Effects of CM were assessed by comparing the 3-month baseline and CM periods. The CM intervention marginally reduced unnecessary hospital admissions, resulting in cost savings to the medical center of over $5,000 in three months for this individual. However, CM did not affect outpatient attendance. Several complications arose, highlighting challenges in using CM in populations with substance use and cooccurring disorders. Practical suggestions are offered for maximizing the effects of CM.

  1. Overprotective parenting and child anxiety: the role of co-occurring child behavior problems.

    Science.gov (United States)

    Gere, Martina K; Villabø, Marianne A; Torgersen, Svenn; Kendall, Philip C

    2012-08-01

    The relationship between overprotective parenting and child anxiety has been examined repeatedly because theories emphasize its role in the maintenance of child anxiety. No study has yet tested whether this relationship is unique to child anxiety, by controlling for commonly co-occurring behavior problems within the same children. The current study examined 190 children (age 7-13, 118 [corrected] boys) referred to mental health clinics and their parents. Results revealed that significant correlations between overprotective parenting and child anxiety symptoms disappear after controlling for co-occurring child behavior symptoms. It appears that overprotection is not uniquely related to child anxiety. Furthermore, overprotective parenting was significantly and uniquely related to child behavior symptoms. Researchers and practitioners need to consider co-occurring child behavior problems when working with the parents of anxious children. Copyright © 2012 Elsevier Ltd. All rights reserved.

  2. The Role of Co-occurring Emotions and Personality Traits in Anger Expression

    Science.gov (United States)

    Mill, Aire; Kööts-Ausmees, Liisi; Allik, Jüri; Realo, Anu

    2018-01-01

    The main aim of the current study was to examine the role of co-occurring emotions and their interactive effects with the Big Five personality traits in anger expression. Everyday anger expression (“anger-in” and “anger-out” behavior) was studied with the experience-sampling method in a group of 110 participants for 14 consecutive days on 7 random occasions per day. Our results showed that the simultaneously co-occurring emotions that buffer against anger expression are sadness, surprise, disgust, disappointment, and irritation for anger-in behavior, and fear, sadness and disappointment for anger-out reactions. While previous studies have shown that differentiating one's current affect into discrete emotion categories buffers against anger expression (Pond et al., 2012), our study further demonstrated the existence of specific interactive effects between the experience of momentary emotions and personality traits that lead to higher levels of either suppression or expression of anger behavior (or both). For example, the interaction between the trait Openness and co-occurring surprise, in predicting anger-in behavior, indicates that less open people hold their anger back more, and more open people use less anger-in behavior. Co-occurring disgust increases anger-out reactions in people low in Conscientiousness, but decreases anger-out reactions in people high in Conscientiousness. People high in Neuroticism are less likely to engage in anger-in behavior when experiencing disgust, surprise, or irritation alongside anger, but show more anger out in the case of co-occurring contempt. The results of the current study help to further clarify the interactions between the basic personality traits and the experience of momentary co-occurring emotions in determining anger behavior. PMID:29479333

  3. Preparation of Mental Health Clinicians to Work with Children with Co-Occurring Autism Spectrum Disorders and Mental Health Needs

    Science.gov (United States)

    Williams, Marian E.; Haranin, Emily C.

    2016-01-01

    Up to 70% of children with autism spectrum disorders (ASD) have a co-occurring mental health disorder; however, many clinicians feel unprepared to serve children with complex co-occurring conditions. This study surveyed 64 mental health clinicians working in 21 publically-funded mental health agencies in a large urban setting to explore their…

  4. Developing and Implementing a Comprehensive Approach to Serving Women with Co-Occurring Disorders and Histories of Trauma

    Science.gov (United States)

    Huntington, Nicholas; Moses, Dawn Jahn; Veysey, Bonita M.

    2005-01-01

    The Substance Abuse and Mental Health Services Administration (SAMHSA) funded the Women, Co-Occurring Disorders and Violence Study to generate empirical knowledge on how to improve services for women who are trauma survivors and have co-occurring mental health and substance use disorders. We first review the literature on the pervasiveness of…

  5. Cultural, social and intrapersonal factors associated with clusters of co-occurring health-related behaviours among adolescents

    NARCIS (Netherlands)

    Klein Velderman, Mariska; Dusseldorp, Elise; van Nieuwenhuijzen, Maroesjka; Junger, Marianne; Paulussen, Theo G. W. M.; Reijneveld, Sijmen A.

    BACKGROUND: Adverse health-related behaviours (HRBs) have been shown to co-occur in adolescents. Evidence lacks on factors associated with these co-occurring HRBs. The Theory of Triadic Influence (TTI) offers a route to categorize these determinants according to type (social, cultural and

  6. Cultural, social and intrapersonal factors associated with clusters of co-occurring health-related behaviours among adolescents

    NARCIS (Netherlands)

    Klein Velderman, M.; Dusseldorp, E.; Nieuwenhuijzen, M. van; Paulussen, T.W.G.M.; Junger, M.; Reijneveld, S.A.

    2015-01-01

    Adverse health-related behaviours (HRBs) have been shown to co-occur in adolescents. Evidence lacks on factors associated with these co-occurring HRBs. The Theory of Triadic Influence (TTI) offers a route to categorize these determinants according to type (social, cultural and intrapersonal) and

  7. Cultural, social and intrapersonal factors associated with clusters of co-occurring health-related behaviours among adolescents

    NARCIS (Netherlands)

    Klein Velderman, Mariska; Dusseldorp, Elise; van Nieuwenhuijzen, Maroesjka; Junger, Marianne; Paulussen, Theo G.W.M.; Reijneveld, Sijmen A.

    2015-01-01

    Background: Adverse health-related behaviours (HRBs) have been shown to co-occur in adolescents. Evidence lacks on factors associated with these co-occurring HRBs. The Theory of Triadic Influence (TTI) offers a route to categorize these determinants according to type (social, cultural and

  8. Co-occurring prescription opioid use problems and posttraumatic stress disorder symptom severity.

    Science.gov (United States)

    Meier, Andrea; Lambert-Harris, Chantal; McGovern, Mark P; Xie, Haiyi; An, Melissa; McLeman, Bethany

    2014-07-01

    Prescription opioids are the most rapidly growing category of abused substances, and result in significant morbidity, mortality and healthcare costs. Co-occurring with psychiatric disorders, persons with prescription opioid problems have negative treatment outcomes. Data are needed on the prevalence of co-occurring prescription opioid abuse and specific disorders, such as posttraumatic stress disorder (PTSD), to better inform clinical practice. To determine prevalence rates of current co-occurring prescription opioid use problems and PTSD symptom severity among patients in community addiction treatment settings. We abstracted administrative and chart information on 573 new admissions to three addictive treatment agencies during 2011. Systematic data were collected on PTSD symptoms, substance use, and patient demographics. Prescription opioid use was significantly associated with co-occurring PTSD symptom severity (OR: 1.42, p co-occurring PTSD symptoms and prescription opioid use problem were nearly three times greater among females versus males (OR: 2.63, p co-occurring PTSD symptom severity. Being female or younger increase the likelihood of this co-morbidity. Further research is needed to confirm these finding, particularly using more rigorous diagnostic procedures. These data suggest that patients with prescription opioid use problems should be carefully evaluated for PTSD symptoms.

  9. Adolescent Co-Occurring Disorders Treatment: Clinicians' Attitudes, Values, and Knowledge

    Science.gov (United States)

    Denby, Ramona W.; Brinson, Jesse A.; Ayala, Jessica

    2011-01-01

    This study examined community-based clinicians' (N = 294) attitudes, background/experiences, values, and knowledge relating to issues of co-occurring disorders, which occur at a high rate among adolescents involved in the juvenile justice system. Study results reveal that clinicians self-rate their clinical values and attitudes at or above the…

  10. Predictors of Competitive Employment among Consumers with Co-Occurring Mental and Substance Use Disorders

    Science.gov (United States)

    Biegel, David E.; Stevenson, Lauren D.; Beimers, David; Ronis, Robert J.; Boyle, Patrick

    2010-01-01

    Objectives: This study examines consumer and agency level predictors of competitive employment for consumers with co-occurring disorders. Methods: The study sample included 191 consumers from mental health agencies receiving Integrated Dual Diagnosis Treatment services, including a subgroup which was referred for Supported Employment Services.…

  11. Co-Occurring Psychiatric and Substance Dependence Disorders as Predictors of Parolee Time to Rearrest

    Science.gov (United States)

    Wood, Steven R.

    2011-01-01

    An estimated 500,000-plus people are on parole each year, many with serious co-occurring psychiatric and substance use disorders. Using cross sectional, self-report data this study examined the relationships between parolee time to rearrest, serious mental illnesses, and substance dependency (n = 1,121). Regression analyses indicated that after…

  12. Modified Therapeutic Community Treatment for Offenders with Co-Occurring Disorders: Mental Health Outcomes

    Science.gov (United States)

    Sullivan, Christopher J.; Sacks, Stanley; McKendrick, Karen; Banks, Steven; Sacks, Joann Y.; Stommel, Joseph

    2007-01-01

    This paper examines outcomes 12 months post-prison release for offenders with co-occurring disorders (n = 185) randomly assigned to either a mental health control treatment (C) or a modified therapeutic community (E). Significant between-group differences were not found for mental health measures, although improvements were observed for each…

  13. A review of treatment options for co-occurring methamphetamine use disorders and depression.

    Science.gov (United States)

    Hellem, Tracy L; Lundberg, Kelly J; Renshaw, Perry F

    2015-01-01

    Co-occurring methamphetamine use and depression interferes with treatment outcomes. Female methamphetamine users are known to have higher rates of depression than male methamphetamine users, although this is also true for the general population. There are limited treatment options for the management of depression among methamphetamine users. In this integrative review, we summarize data on treatment strategies for co-occurring depression and methamphetamine use disorders. English-language articles were identified from PsychINFO, CINAHL, PubMed, and Medline as well as from reference lists of key articles. Search terms included "methamphetamine," "depression," and "treatment." Research articles describing psychological (n = 3), pharmacological (n = 6), nutritional supplement (n = 1), and psychological combined with pharmacological (n = 3) approaches for the treatment of methamphetamine use or withdrawal and/or depression are included in this review. Psychological and combination of psychological with pharmacological approaches have not been shown to be effective in treating these co-occurring conditions. Antidepressants have been determined to be ineffective and/or to introduce side effects. Gender differences with response to treatment were examined in only one of the published studies. There is a large gap in knowledge regarding treatment of co-occurring methamphetamine use disorders and depression. Considering that female methamphetamine users experience higher rates of depression than men, a focus on gender-specific treatment approaches is warranted.

  14. Treatment of co-occurring anxiety disorders and substance use disorders.

    Science.gov (United States)

    McHugh, R Kathryn

    2015-01-01

    Anxiety disorders commonly co-occur with substance use disorders both in the general population and in treatment-seeking samples. This co-occurrence is associated with greater symptom severity, higher levels of disability, and poorer course of illness relative to either disorder alone. Little research has been conducted, however, on the treatment of these co-occurring disorders. This gap may not only leave anxiety untreated or undertreated but also increase the risk for relapse and poor substance use outcomes. The aim of this article is to review the current state of the literature on treating co-occurring anxiety and substance use disorders. In addition to presenting a brief overview of the epidemiology of this co-occurrence, the article discusses the challenges in assessing anxiety in the context of a substance use disorder, the evidence for various treatment approaches, and recent advances and future directions in this understudied area. Also highlighted is the need for future research to identify optimal behavioral and pharmacologic treatments for co-occurring anxiety and substance use disorders.

  15. Case-Series Evaluating a Transdiagnostic Cognitive-Behavioural Treatment for Co-occurring Anxiety Disorders.

    Science.gov (United States)

    McManus, Freda; Clark, Gavin; Muse, Kate; Shafran, Roz

    2015-11-01

    Patients with anxiety disorder diagnoses commonly have more than one anxiety diagnosis. While cognitive-behavioural interventions have proven efficacy in treating single anxiety disorder diagnoses, there has been little investigation of their efficacy in treating co-occurring anxiety disorders. To evaluate the efficacy of a transdiagnostic cognitive-behavioural intervention for treating co-occurring anxiety disorders. An A-B single case study design (N = 6) was used to evaluate the efficacy of a 12 to 13-session modular transdiagnostic cognitive-behavioural intervention for treating co-occurring anxiety disorders across patients with at least two of the following diagnoses: GAD, Social Phobia, Panic Disorder and/or OCD. Five of the six participants completed treatment. At posttreatment assessment the five treatment completers achieved diagnostic and symptomatic change, with three participants being diagnosis free. All participants who completed treatment no longer met criteria for any DSM-IV-TR Axis-I diagnosis at the 3-month follow-up assessment, and demonstrated reliable and clinically-significant improvements in symptoms. Across the participants, statistically significant improvements from pre to postintervention were found on measures of anxiety, depression and general well-being, and all improvements were maintained at 3-month follow-up. Results suggest that transdiagnostic cognitive behavioural interventions can be of benefit to patients with co-occurring anxiety disorders.

  16. Access to Treatment for Adolescents with Substance Use and Co-Occurring Disorders: Challenges and Opportunities

    Science.gov (United States)

    Sterling, Stacy; Weisner, Constance; Hinman, Agatha; Parthasarathy, Sujaya

    2010-01-01

    Objective: To review the research on economic and systemic barriers faced by adolescents needing treatment for alcohol and drug problems, particularly those with co-occurring conditions. Method: We reviewed the literature on adolescent access to alcohol and drug services, including early intervention, and integrated and specialty mental health…

  17. A One Year Prospective Study of Neurogenic Stuttering Following Stroke: Incidence and Co-Occurring Disorders

    Science.gov (United States)

    Theys, C.; van Wieringen, A.; Sunaert, S.; Thijs, V.; De Nil, L. F.

    2011-01-01

    In this prospective study, data on incidence, stuttering characteristics, co-occurring speech disorders, and recovery of neurogenic stuttering in a large sample of stroke participants were assessed. Following stroke onset, 17 of 319 participants (5.3%; 95% CI, 3.2-8.3) met the criteria for neurogenic stuttering. Stuttering persisted in at least…

  18. Family Integrated Transitions: A Promising Program for Juvenile Offenders with Co-Occurring Disorders

    Science.gov (United States)

    Trupin, Eric J.; Kerns, Suzanne E. U.; Walker, Sarah Cusworth; DeRobertis, Megan T.; Stewart, David G.

    2011-01-01

    This study evaluates the impact of the Family Integrated Transitions (FIT) program on juvenile recidivism. FIT is a family-based intervention for youths with co-occurring substance use and mental health disorders transitioning to home from incarceration. We used administrative data to compare 36-month recidivism rates for youths receiving FIT (N =…

  19. Severity of Victimization and Co-Occurring Mental Health Disorders among Substance Using Adolescents

    Science.gov (United States)

    Sabri, Bushra

    2012-01-01

    Background: Co-occurring mental health disorders are widespread among substance using adolescents. Severity of victimization may be an important factor in explaining co-occurrence of mental health problems among adolescents with substance misuse problems. Purpose: The purpose of this study was to evaluate whether severe victimization experiences…

  20. Helping Homeless Individuals with Co-Occurring Disorders: The Four Components

    Science.gov (United States)

    Sun, An-Pyng

    2012-01-01

    Homeless individuals with co-occurring disorders (CODs) of severe mental illness and substance use disorder are one of the most vulnerable populations. This article provides practitioners with a framework and strategies for helping this client population. Four components emerged from a literature review: (1) ensuring an effective transition for…

  1. Strategies for Developing Treatment Programs for People with Co-Occurring Substance Abuse and Mental Disorders.

    Science.gov (United States)

    Substance Abuse and Mental Health Services Administration (DHHS/PHS), Rockville, MD.

    Increasingly, people receiving public-supported health care are seeking help for and/or presenting with both substance abuse and mental disorders. People with these co-occurring disorders often require help from many different care systems. Consequently, no single system of care is adequately prepared to help people with both mental and substance…

  2. Priorities for Advancing Research on Youth with Autism Spectrum Disorder and Co-Occurring Anxiety

    Science.gov (United States)

    Vasa, Roma A.; Keefer, Amy; Reaven, Judy; South, Mikle; White, Susan W.

    2018-01-01

    Research on anxiety disorders in youth with autism spectrum disorder (ASD) has burgeoned in the past two decades. Yet, critical gaps exist with respect to measuring and treating anxiety in this population. This study used the nominal group technique to identify the most important research priorities on co-occurring anxiety in ASD. An international…

  3. Sex Differences in Co-Occurring Conditions of Children with Autism Spectrum Disorders

    Science.gov (United States)

    Stacy, Maria E.; Zablotsky, Benjamin; Yarger, Heather A.; Zimmerman, Andrew; Makia, Barraw; Lee, Li-Ching

    2014-01-01

    This study investigated differences in co-occurring diagnoses made in females compared to males with autism spectrum disorders in 913 children (746 males and 167 females) living in the United States with a current autism spectrum disorder diagnosis identified via caregiver-reported data from the National Survey of Children's Health 2007. The…

  4. Drugs, Guns, and Disadvantaged Youths: Co-Occurring Behavior and the Code of the Street

    Science.gov (United States)

    Allen, Andrea N.; Lo, Celia C.

    2012-01-01

    Guided by Anderson's theory of the code of the street, this study explored social mechanisms linking individual-level disadvantage factors with the adoption of beliefs grounded in the code of the street and with drug trafficking and gun carrying--the co-occurring behavior shaping violence among young men in urban areas. Secondary data were…

  5. Physiological strategies of co-occurring oaks in a water- and nutrient-limited ecosystem

    Science.gov (United States)

    Heidi Renninger; Nicholas Carlo; Kenneth L. Clark; Karina V.R. Schafer

    2014-01-01

    Oak species are well suited to water-limited conditions by either avoiding water stress through deep rooting or tolerating water stress through tight stomatal control. In co-occurring species where resources are limited, species may either partition resources in space and/or time or exhibit differing efficiencies in the use of limited resources. Therefore, this study...

  6. Nutrient Foraging Traits in 10 Co-occurring Plant Species of Contrasting Life Forms

    Science.gov (United States)

    Juliet C. Einsmann; Robert H. Jones; Mou Pu; Robert J. Mitchell

    1999-01-01

    1 Responses to spatial heterogeneity of soil nutrients were tested in 10 plant species that differ in life form and successional status, but which co-occur in the South Carolina coastal plain. The morphological responses of the root system were tested by assessing scale (represented by root mass and root length densities), precision (preferential...

  7. Dynamics of leaf water relations components in co-occurring iso- and anisohydric conifer species

    Science.gov (United States)

    Frederick Meinzer; David Woodruff; Danielle Marias; Katherine McCulloh; Sanna Sevanto

    2014-01-01

    Because iso- and anisohydric species differ in stomatal regulation of the rate and magnitude of fluctuations in shoot water potential, they may be expected to show differences in the plasticity of their shoot water relations components, but explicit comparisons of this nature have rarely been made. We subjected excised shoots of co-occurring anisohydric Juniperus...

  8. Parenting of men with co-occurring intimate partner violence and substance abuse.

    Science.gov (United States)

    Stover, Carla Smith; Easton, Caroline J; McMahon, Thomas J

    2013-07-01

    No studies to date have compared parenting behaviors of men with co-occurring intimate partner violence (IPV) and substance abuse (SA) with community controls. This study was designed to document mediators of differences in parenting behavior of fathers and the emotional-behavioral problems of their children for men with co-occurring SA and IPV. The self-reported parenting (negative, positive and coparenting behaviors) and the child emotional-behavioral problems of 43 fathers with children aged 2 to 6 years with a recent history of SA + IPV were compared to a sample of 43 community control fathers with the same socioeconomic and cultural backgrounds. Fathers completed measures on their parenting behavior with a target child, coparenting behavior with the child's mother, emotion regulation, romantic attachment, psychiatric symptoms, and the behavior of the target child. Men with co-occurring SA + IPV had significantly less positive coparenting and more negative parenting behaviors than community control fathers. Negative parenting and coparenting were mediated by the fathers' avoidant attachment problems. SA + IPV fathers also reported more emotional and behavioral problems in their children. These poor child outcome differences between groups were mediated by the negative parenting behaviors of the fathers. These results suggest areas of potential focus in interventions with fathers who have co-occurring SA + IPV issues. Focus on attachment difficulties with his coparent, which may include affect regulation, coping with emotions, and communication skills training related to coparenting, may yield significant changes in parenting behaviors and ultimately child functioning.

  9. Long-term sobriety strategies for men with co-occurring disorders.

    Science.gov (United States)

    Luciano, Alison; Bryan, Elisabeth L; Carpenter-Song, Elizabeth A; Woods, Mary; Armstrong, Katherine; Drake, Robert E

    2014-01-01

    Roughly half of people with severe mental disorders also experience a co-occurring substance use disorder, and recovery from both is a critical objective for health care services. While understanding of abstinence initiation has grown, the strategies people with co-occurring disorders use to maintain sobriety are largely unknown. This article reports strategies for relapse prevention as described by men with co-occurring disorders who achieved one or more years of sobriety. We analyzed semi-structured interviews conducted with a sample of 12 men with co-occurring psychosis and substance use disorder who achieved and maintained sobriety for at least one year, supplemented with demographic and diagnostic clinical record data. These men were participating in residential or outpatient treatment at a private, nonprofit integrated treatment clinic. The 12 men were primarily Caucasian (91.7%) and unmarried (100%), and their ages ranged from 23 to 42 years. The two most common psychiatric disorders were schizoaffective disorder (n = 4, 33.3%) and bipolar disorder (n = 4, 33.3%), while the two most commonly misused substances were alcohol and cannabis. Qualitative analyses showed that participants maintained sobriety for at least one year by building a supportive community, engaging in productive activities, and carefully monitoring their own attitudes toward substances, mental health, and responsibility. Alcoholics Anonymous might act as a catalyst for building skills. People with co-occurring disorders who achieve sobriety use a variety of self-management strategies to prevent relapse-seeking support, activities, and a healthy mindset. The findings suggest a relapse prevention model that focuses on social networks, role functioning, and self-monitoring and conceptualizes self-care as critical to extending periods of wellness.

  10. Co-occurring nonnative woody shrubs have additive and non-additive soil legacies.

    Science.gov (United States)

    Kuebbing, Sara E; Patterson, Courtney M; Classen, Aimée T; Simberloff, Daniel

    2016-09-01

    To maximize limited conservation funds and prioritize management projects that are likely to succeed, accurate assessment of invasive nonnative species impacts is essential. A common challenge to prioritization is a limited knowledge of the difference between the impacts of a single nonnative species compared to the impacts of nonnative species when they co-occur, and in particular predicting when impacts of co-occurring nonnative species will be non-additive. Understanding non-additivity is important for management decisions because the management of only one co-occurring invader will not necessarily lead to a predictable reduction in the impact or growth of the other nonnative plant. Nonnative plants are frequently associated with changes in soil biotic and abiotic characteristics, which lead to plant-soil interactions that influence the performance of other species grown in those soils. Whether co-occurring nonnative plants alter soil properties additively or non-additively relative to their effects on soils when they grow in monoculture is rarely addressed. We use a greenhouse plant-soil feedback experiment to test for non-additive soil impacts of two common invasive nonnative woody shrubs, Lonicera maackii and Ligustrum sinense, in deciduous forests of the southeastern United States. We measured the performance of each nonnative shrub, a native herbaceous community, and a nonnative woody vine in soils conditioned by each shrub singly or together in polyculture. Soils conditioned by both nonnative shrubs had non-additive impacts on native and nonnative performance. Root mass of the native herbaceous community was 1.5 times lower and the root mass of the nonnative L. sinense was 1.8 times higher in soils conditioned by both L. maackii and L. sinense than expected based upon growth in soils conditioned by either shrub singly. This result indicates that when these two nonnative shrubs co-occur, their influence on soils disproportionally favors persistence

  11. A cognitive behavioral therapy for co-occurring substance use and posttraumatic stress disorders.

    Science.gov (United States)

    McGovern, Mark P; Lambert-Harris, Chantal; Acquilano, Stephanie; Xie, Haiyi; Alterman, Arthur I; Weiss, Roger D

    2009-10-01

    Co-occurring posttraumatic stress disorder (PTSD) is prevalent in addiction treatment programs and a risk factor for negative outcomes. Although interventions have been developed to address substance use and PTSD, treatment options are needed that are effective, well tolerated by patients, and potentially integrated with existing program services. This paper describes a cognitive behavioral therapy (CBT) for PTSD that was adapted from a treatment for persons with severe mental illnesses and PTSD in community mental health settings. The new adaptation is for patients in community addiction treatment with co-occurring PTSD and substance use disorders. In this study, 5 community therapists delivered the CBT for PTSD. Outcome data are available on 11 patients who were assessed at baseline, post-CBT treatment, and at a 3-month follow-up post-treatment. Primary outcomes were substance use, PTSD severity, and retention, of which all were favorable for patients receiving the CBT for PTSD.

  12. A Review of Impact of Tobacco Use on Patients with Co-occurring Psychiatric Disorders.

    Science.gov (United States)

    Pal, Arghya; Balhara, Yatan Pal Singh

    2016-01-01

    Consumption of tobacco has been a worldwide problem over the past few decades due to the highly prevalent tobacco-attributable complications. Tobacco use has also been found to be more prevalent in patients with psychiatric disorders. Therefore, we conducted this review about the impact of tobacco use on co-occurring psychiatric disorders. Various facets of this interaction between tobacco use among those with co-occurring psychiatric disorders have been explored. It has been found that people with psychiatric disorders have a higher chance of currently smoking tobacco and lesser chance of cessation. Tobacco use and mental disorders continue to share a complex relationship that has been further evolving after the change in the pattern of tobacco use and also the advent of newer modalities of treatment. However, at the same time, it is believed that cessation of smoking may lead to improvement in the symptoms of mental illness.

  13. Risk of future offense among probationers with co-occurring substance use and mental health disorders.

    Science.gov (United States)

    Balyakina, Elizabeth; Mann, Christopher; Ellison, Michael; Sivernell, Ron; Fulda, Kimberly G; Sarai, Simrat Kaur; Cardarelli, Roberto

    2014-04-01

    The criminal justice system is the primary service delivery system for many adults with drug and alcohol dependence, mental health, and other health service needs. The purpose of this study was to examine the relationship between risk of future offense, mental health status and co-occurring disorders in a large substance abuse diversion probationer population. A purposive sample of 2,077 probationers completed an assessment to screen for mental health disorders, substance use disorders, risk of future crime and violence, and several demographic characteristics. Probationers who screened positive for co-occurring substance use and mental health disorders were significantly more likely to be at higher risk of future crime and violence compared to probationers who screened positive for only substance use, only a mental health disorder, or no substance use or mental health disorder. Implications for substance use and mental health service delivery are discussed, and recommendations are made for further research.

  14. Differences between older and younger adults in residential treatment for co-occurring disorders.

    Science.gov (United States)

    Morse, Siobhan A; Watson, Cayce; MacMaster, Samuel A; Bride, Brian E

    2015-01-01

    The purpose of this study was to examine differences between older and younger adults who received integrated treatment for co-occurring substance use and mental disorders, including differences on demographic and baseline characteristics (e.g., substance use, readiness for change, mental health symptoms, and severity of problems associated with substance use), as well as predictors of retention in treatment. This study included 1400 adults who received integrated substance abuse and mental health treatment services at one of two private residential facilities offering residential and outpatient services. Initial analyses consisted of basic descriptive and bivariate analyses to examine differences between older (≥ 50 years old) and younger (co-occurring substance use and mental health disorders by documenting that age-based differences exist in general and in the factors that are associated with the length of stay in residential treatment.

  15. Evaluation of Co-occurring Terms in Clinical Documents Using Latent Semantic Indexing.

    Science.gov (United States)

    Han, Choonghyun; Yoo, Sooyoung; Choi, Jinwook

    2011-03-01

    Measurement of similarities between documents is typically influenced by the sparseness of the term-document matrix employed. Latent semantic indexing (LSI) may improve the results of this type of analysis. In this study, LSI was utilized in an attempt to reduce the term vector space of clinical documents and newspaper editorials. After applying LSI, document similarities were revealed more clearly in clinical documents than editorials. Clinical documents which can be characterized with co-occurring medical terms, various expressions for the same concepts, abbreviations, and typographical errors showed increased improvement with regards to a correlation between co-occurring terms and document similarities. Our results showed that LSI can be used effectively to measure similarities in clinical documents. In addition, correlation between the co-occurrence of terms and similarities realized in this study is an important positive feature associated with LSI.

  16. Emotion recognition deficits in eating disorders are explained by co-occurring alexithymia

    Science.gov (United States)

    Brewer, Rebecca; Cook, Richard; Cardi, Valentina; Treasure, Janet; Bird, Geoffrey

    2015-01-01

    Previous research has yielded inconsistent findings regarding the ability of individuals with eating disorders (EDs) to recognize facial emotion, making the clinical features of this population hard to determine. This study tested the hypothesis that where observed, emotion recognition deficits exhibited by patients with EDs are due to alexithymia, a co-occurring condition also associated with emotion recognition difficulties. Ability to recognize facial emotion was investigated in a sample of individuals with EDs and varying degrees of co-occurring alexithymia, and an alexithymia-matched control group. Alexithymia, but not ED symptomology, was predictive of individuals' emotion recognition ability, inferred from tolerance to high-frequency visual noise. This relationship was specific to emotion recognition, as neither alexithymia nor ED symptomology was associated with ability to recognize facial identity. These findings suggest that emotion recognition difficulties exhibited by patients with ED are attributable to alexithymia, and may not be a feature of EDs per se. PMID:26064585

  17. Autism Spectrum Disorder and Co-occurring Substance Use Disorder – A Systematic Review

    Directory of Open Access Journals (Sweden)

    Espen Ajo Arnevik

    2016-01-01

    Full Text Available Objective Patients with co-occurring autism spectrum disorders (ASD and substance use disorder (SUD require special attention from clinical services. Screening for this co-occurrence is not generally an integral part of routine clinical assessments, and failure to identify and understand this group of patients may contribute to a worsening of their symptoms and/or an increase in drug abuse. Thus, there is a need to review the evidence base on patients with co-occurring ASD and SUD in order to enhance clinical practice and future research. Methods We reviewed all identified papers on patients with co-occurring ASD and SUD. The focus of the review was on epidemiology, patient characteristics, function of drug use, and the effect of current interventions. Results A total of 18 papers were included in the analysis. Eleven papers were based on epidemiological studies, although only one study reported the prevalence of ASD in an SUD population. Two papers explored the role of personality, three papers studied subgroups of individuals serving prison for violent or sexual crimes, and one paper explored the function of drugs in the ASD patient group. There were no studies testing specific treatment interventions. Conclusions In most of the treatment settings studied, there were relatively few patients with co-occurring ASD and SUD, but due to differences in study samples it was difficult to establish a general prevalence rate. The one consistent finding was the lack of focused treatment studies. There is clearly a need for research on interventions that take account of the special needs of this patient group.

  18. Treatments for co-occurring depression and substance use in young people: a systematic review.

    Science.gov (United States)

    Deady, Mark; Teesson, Maree; Kay-Lambkin, Frances J

    2014-01-01

    Depression and problematic substance use represent two of the major social and health problems facing young people internationally. Frequently, these conditions co-occur and this co-occurrence is associated with greater functional impact, poorer treatment outcomes, and increased costs to both society and the individual. This review aims to identify peer-reviewed published trials of interventions for co-occurring substance use and depression delivered to young people, describe these interventions, and critique the methodological quality of the studies. Eleven electronic databases were searched. The reference lists of relevant review papers were searched manually for additional studies not identified by the electronic database search. Initially, 1,976 studies were identified, of which 22 were classified as trial studies of youth-based treatment interventions for co-occurring substance use and depression. Ten of these studies met criteria for review. The majority (60%) utilized a pharmacotherapy component, but found it to be generally no better than placebo when both groups received adjunct counselling. METHODological quality of studies varied. There is a dearth of trials of interventions for co-occurring depression and substance use disorders in young people. The limited data available is promising regarding the overall effectiveness of a psychological counselling approach. Given the importance of early intervention, and the difficulties faced when engaging youth in treatment, there is a need for further focused effort amongst this group. This may require more innovative techniques in intervention design and implementation. Recent advances in Internet- and mobile phone-based therapies present a potential avenue for further research.

  19. Investigating the nature of co-occurring depression and anxiety: Comparing diagnostic and dimensional research approaches.

    Science.gov (United States)

    Kircanski, Katharina; LeMoult, Joelle; Ordaz, Sarah; Gotlib, Ian H

    2017-07-01

    Although approximately half of adults diagnosed with a depressive or anxiety disorder exhibit their simultaneous co-occurrence, traditional research has centered on single-target diagnoses, overlooking comorbidities within samples. In this article, we review and extend the literature that directly investigates co-occurring depression and anxiety, with the goal of shifting the focus from co-occurring diagnoses to symptom dimensions. First, we review studies that have directly compared psychobiological features (neural, neuroendocrine, autonomic) across depression, anxiety, and their co-occurrence, defined either categorically or dimensionally. Second, we analyze adults' diurnal cortisol secretion to examine the independent and interactive relations of continuously-assessed depressive and anxiety symptoms to neuroendocrine function. Previous findings on the psychobiology of diagnostic co-occurrence are mixed. While nascent, evidence from dimensionally focused studies suggests that co-occurring levels of depressive and anxiety symptoms can interact with one another, as reflected in a distinct psychobiological profile for individuals with high levels of both symptom dimensions. Results of our analyses support this formulation: we found that depressive and anxiety symptom dimensions interacted consistently in their relation to the measures of diurnal cortisol. The illustrative sample was relatively small and included only women; future research should examine generalizability of these findings. A dimensional approach to investigating the psychobiology of co-occurring depression and anxiety affords both conceptual and practical advantages. Simultaneously assessing depressive and anxiety symptom dimensions can efficiently capture their unique, shared, and interactive features, thereby identifying targets for intervention across a wide range of symptom presentations. Published by Elsevier B.V.

  20. Adolescents in speciality mental health services (BUP): time trends, referral problems, and co-occuring conditions

    OpenAIRE

    Reigstad, Bjørn Steinar

    2007-01-01

    Traditionally, research on mental health problems among children and adolescents has focused mainly on prevalences and predictors of stability and changes in these disorders. Less is known about associated conditions as referral problems, and cooccurring conditions as pain and sleep disturbances, and psychosocial adversities like abuse and neglect. The purpose of this study is to focus on these less investigated problems and conditions which might be highly significant in day-to-day clinical ...

  1. CDCOCA: A statistical method to define complexity dependence of co-occuring chromosomal aberrations

    OpenAIRE

    Kumar, Nitin; Rehrauer, Hubert; Cai, Haoyang; Baudis, Michael

    2011-01-01

    Abstract Background Copy number alterations (CNA) play a key role in cancer development and progression. Since more than one CNA can be detected in most tumors, frequently co-occurring genetic CNA may point to cooperating cancer related genes. Existing methods for co-occurrence evaluation so far have not considered the overall heterogeneity of CNA per tumor, resulting in a preferential detection of frequent changes with limited specificity for each association due to the high genetic instabil...

  2. AFSC/RACE/FBEP/Ryer: Growth and distributional correlates of behavior in three co-occurring juvenile flatfishes

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — This dataset is from laboratory experiments that explored anti-predator behavior and intrinsic growth in three co-occurring juvenile flatfish species (English sole...

  3. Profiles Associated Respectively with Substance Dependence Only, Mental Disorders Only and Co-occurring Disorders.

    Science.gov (United States)

    Fleury, Marie-Josée; Grenier, Guy; Bamvita, Jean-Marie; Caron, Jean

    2015-09-01

    This study sought to identify profiles associated with substance dependence only, mental disorders only and co-occurring disorder respectively, using a broad range of socio-demographic, socio-economic, health beliefs, clinical and health services utilization variables concurrently. Based on a broad analytic framework, 423 participants diagnosed with substance dependence only, mental disorders only or co-occurring disorders within a 12-months period were studied. The study used comparison analysis, and a multinomial logistic regression model. Participants with dependence only and mental disorders only were in contrast in terms of gender, age, marital status, self-perception of physical health, perception of the physical conditions of their neighbourhood, impulsiveness, psychological distress and visit with a family physician in previous 12-months, while those with co-occurring disorders were in an intermediary position between the other two groups. Public authorities should especially promote strategies that could increase the capacity of family physicians to take care of individuals with substance dependence only.

  4. Bipolar disorder and co-occurring cannabis use disorders: characteristics, co-morbidities and clinical correlates.

    Science.gov (United States)

    Lev-Ran, Shaul; Le Foll, Bernard; McKenzie, Kwame; George, Tony P; Rehm, Jürgen

    2013-10-30

    This study examines rates of co-morbid mental disorders and indicators of the course of illness among individuals with bipolar disorder and cannabis use disorders (CUD). Data were drawn from the National Epidemiological Survey of Alcohol and Related Conditions (NESARC Wave 1, 2001-2002), a nationally representative sample of adults living in the United States. Among individuals with lifetime prevalence of bipolar disorder (N=1905) rates of CUD in the past 12 months were 7.2%, compared to 1.2% in the general population. Logistic regression models adjusting for sociodemographic variables indicated that individuals with bipolar disorder and co-occurring CUD were at increased risk for nicotine dependence (Adjusted Odds Ratio (AOR)=3.8), alcohol (AOR=6.6) and drug (AOR=11.9) use disorders, as well as antisocial personality disorder (AOR=2.8) compared to those without CUD. Among individuals with co-occurring CUD, age of onset of bipolar disorder was significantly lower and median number of manic, hypomanic and depressive episodes per year was significantly greater compared to individuals without CUD. Co-occurring CUD is associated with significant co-morbidities and a more severe course of illness among individuals with bipolar disorder. Comprehensive evaluation of patients with bipolar disorder should include a systematic assessment of CUD. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

  5. Psychiatric Disorders Among Patients Seeking Treatment for Co-Occurring Chronic Pain and Opioid Use Disorder.

    Science.gov (United States)

    Barry, Declan T; Cutter, Christopher J; Beitel, Mark; Kerns, Robert D; Liong, Christopher; Schottenfeld, Richard S

    2016-10-01

    Psychiatric comorbidities complicate treatment of patients with chronic pain and opioid use disorder, but the prevalence of specific comorbid psychiatric disorders in this population has not been systematically investigated. 170 consecutive participants entering a treatment research program for co-occurring chronic pain and opioid use disorder between March 2009 and July 2013 were evaluated with the Structured Clinical Interview for DSM-IV-TR Axis I Disorders (SCID-I/P) and the Diagnostic Interview for DSM-IV Personality Disorders (DIPD-IV). The prevalence of any lifetime (and current) comorbid Axis I disorder was 91% (75%); 52% met criteria for lifetime anxiety disorder (48% current), 57% for lifetime mood disorder (48% current), and 78% for lifetime nonopioid substance use disorder (34% current). Common current anxiety diagnoses were posttraumatic stress disorder (21%), generalized anxiety disorder (16%), and panic disorder without agoraphobia (16%). Common current mood diagnoses were major depressive disorder (40%) and dysthymia (11%). A majority of patients had a personality disorder (52%). High rates and persistence of co-occurring psychiatric disorders, including anxiety or mood disorders, may explain in part the difficulty providers have treating patients with co-occurring opioid use disorder and chronic pain and suggest possible targets for improving treatment. ClinicalTrials.gov identifiers: buprenorphine/naloxone treatment (NCT00634803), opioid treatment program-based methadone maintenance treatment (NCT00727675). © Copyright 2016 Physicians Postgraduate Press, Inc.

  6. Reproductive coercion and co-occurring intimate partner violence in obstetrics and gynecology patients.

    Science.gov (United States)

    Clark, Lindsay E; Allen, Rebecca H; Goyal, Vinita; Raker, Christina; Gottlieb, Amy S

    2014-01-01

    Reproductive coercion is male behavior to control contraception and pregnancy outcomes of female partners. We examined the prevalence of reproductive coercion and co-occurring intimate partner violence among women presenting for routine care at a large, urban obstetrics and gynecology clinic. Women aged 18-44 years completed a self-administered, anonymous survey. Reproductive coercion was defined as a positive response to at least 1 of 14 questions derived from previously published studies. Women who experienced reproductive coercion were also assessed for intimate partner violence in the relationship where reproductive coercion occurred. Of 641 women who completed the survey, 16% reported reproductive coercion currently or in the past. Among women who experienced reproductive coercion, 32% reported that intimate partner violence occurred in the same relationship. Single women were more likely to experience reproductive coercion as well as co-occurring intimate partner violence. Reproductive coercion with co-occurring intimate partner violence is prevalent among women seeking general obstetrics and gynecology care. Health care providers should routinely assess reproductive-age women for reproductive coercion and intimate partner violence and tailor their family planning discussions and recommendations accordingly. Copyright © 2014 Mosby, Inc. All rights reserved.

  7. Impulsivity-related traits distinguish women with co-occurring bulimia nervosa in a psychiatric sample.

    Science.gov (United States)

    Reas, Deborah L; Pedersen, Geir; Rø, Øyvind

    2016-12-01

    This study investigated impulsivity-related personality traits using the Revised NEO Personality Inventory (NEO PI-R) in women diagnosed with co-occurring bulmia nervosa and borderline personality disorder (BN-BPD), borderline personality disorder (BPD no-BN), or major depressive disorder (MDD-only). The sample included 672 adult female admissions to a psychiatric day hospital treatment program. The NEO PI-R facets of impulsiveness (N5), excitement-seeking (E5), self-discipline (C5), and deliberation (C6) provided a proxy assessment of impulsivity-related traits tapping negative urgency, sensation-seeking, lack of perseverance, and lack of premeditation/planning. After adjusting for age, BN-BPD displayed significantly higher levels of negative urgency and lack of premeditation than BPD without co-occurring BN. Women with BN-BPD also had significantly higher levels of impulsivity traits than MDD across domains, except for lack of perseverance. Impulsivity-related traits of negative urgency and lack of premeditation significantly differentiated women with versus without co-occurring BN among women with borderline personality disorder. Lower levels of impulsivity-related traits in women with MDD indicated that effects were not simply attributable to any form of psychopathology. Of the impulsivity traits, negative urgency demonstrated the strongest effect, providing further evidence of the important relationship between negative urgency and the expression of bulimic symptomology. © 2016 Wiley Periodicals, Inc. (Int J Eat Disord 2016; 49:1093-1096). © 2016 Wiley Periodicals, Inc.

  8. Incarceration associated with homelessness, mental disorder, and co-occurring substance abuse.

    Science.gov (United States)

    McNiel, Dale E; Binder, Renée L; Robinson, Jo C

    2005-07-01

    This study assessed relationships between homelessness, mental disorder, and incarceration. Using archival databases that included all 12,934 individuals who entered the San Francisco County Jail system during the first six months of 2000, the authors assessed clinical and behavioral characteristics associated with homelessness and incarceration. In 16 percent of the episodes of incarceration, the inmates were homeless, and in 18 percent of the episodes, the inmates had a diagnosis of a mental disorder; 30 percent of the inmates who were homeless had a diagnosis of a mental disorder during one or more episodes. Seventy-eight percent of the homeless inmates with a severe mental disorder had co-occurring substance-related disorders. Inmates with dual diagnoses were more likely to be homeless and to be charged with violent crimes than other inmates. Multiple regression analyses showed that inmates who were homeless and had co-occurring severe mental disorders and substance-related disorders were held in jail longer than other inmates who had been charged with similar crimes. People who were homeless and who were identified as having mental disorders, although representing only a small proportion of the total population, accounted for a substantial proportion of persons who were incarcerated in the criminal justice system in this study's urban setting. The increased duration of incarceration associated with homelessness and co-occurring severe mental disorders and substance-related disorders suggests that jails are de facto assuming responsibility for a population whose needs span multiple service delivery systems.

  9. Pathological gambling, co-occurring disorders, clinical presentation, and treatment outcomes at a university-based counseling clinic.

    Science.gov (United States)

    Soberay, Adam; Faragher, J Michael; Barbash, Melissa; Brookover, Amanda; Grimsley, Paul

    2014-03-01

    It is the intent of this study to examine the relationship between the number of co-occurring disorders in a sample of pathological gamblers and variables associated with clinical presentation and treatment outcomes. Participants were given screening tools for four common psychological disorders: the hands depression screen, the Mood Disorder Questionnaire, the Carroll-Davidson generalized anxiety disorder screen, and the Sprint-4 PTSD Screen. The number of co-occurring disorders, as indicated by the results of these screening instruments, was compared to severity of gambling problems at outset of treatment, as measured by the NORC diagnostic screen for gambling problems-self administered. The number of co-occurring disorders was also compared to psychosocial functioning at the outset of treatment, as well as level of improvement in psychosocial functioning through treatment. Psychosocial functioning was measured using the Outcome Questionnaire 45 (OQ-45). The number of co-occurring disorders was compared to participant satisfaction with the therapeutic relationship as measured by the working alliance inventory-short form. Results suggest that co-occurring disorders are commonplace among treatment seeking pathological gamblers. Over 86 % of the sample screened positively for at least one of the four targeted psychological disorders. Furthermore, the number of co-occurring disorders was found to be positively related to severity of gambling problems at outset of treatment and negatively related to level of psychosocial functioning at outset of treatment. However, the number of co-occurring disorders was not found to be significantly related to level of improvement in psychosocial functioning through treatment. Overall, those that attended at least six sessions reported significantly improved psychosocial functioning by the end of their sixth session. Finally, the number of co-occurring disorders was not found to be significantly related to participants' reported

  10. Differences between patients with schizophrenia with and without co-occurring methamphetamine use disorders in a Taiwanese public psychiatric hospital.

    Science.gov (United States)

    Lin, Ching-Hua; Huang, Yu-Hui; Wu, Hung-Chi; Chen, Cheng-Chung

    2014-11-01

    This study aimed to examine the factors related to and the outcomes of schizophrenic patients with co-occurring methamphetamine use disorders (MUDs). All schizophrenic patients discharged from a psychiatric hospital between January 1, 2006, and December 31, 2006, were monitored. This study compared the important demographic and clinical variables between patients with co-occurring MUDs and those without, and postdischarge measured time to rehospitalization during a 1-year period. Seven hundred fifty-six patients were included in this study. Of these patients, 88 (11.6%) reported the use of methamphetamine. Univariate analyses indicated that male sex, low educational level, discharge against medical advice, missed first appointment after discharge, co-occurring other illicit substance use disorder, age (younger), diazepam equivalents prescribed at discharge (higher), number of previous admissions within the past 5 years (higher), and length of hospital stay (longer) were predictive of patients with co-occurring MUDs. There were also significant differences in time to rehospitalization between these two groups during the follow-up periods. Many factors can be identified in schizophrenic patients with co-occurring MUDs. Furthermore, schizophrenic patients with co-occurring MUDs were more likely to be rehospitalized. Future studies in many different mental health systems are needed before these findings can be generalized.

  11. Inherited and environmental influences on a childhood co-occurring symptom phenotype: Evidence from an adoption study.

    Science.gov (United States)

    Roos, Leslie E; Fisher, Philip A; Shaw, Daniel S; Kim, Hyoun K; Neiderhiser, Jenae M; Reiss, David; Natsuaki, Misake N; Leve, Leslie D

    2016-02-01

    Risk factors for the childhood development of co-occurring internalizing and externalizing symptoms are not well understood, despite a high prevalence and poor clinical outcomes associated with this co-occurring phenotype. We examined inherited and environmental risk factors for co-occurring symptoms in a sample of children adopted at birth and their birth mothers and adoptive mothers (N = 293). Inherited risk factors (i.e., birth mothers' processing speed and internalizing symptoms) and environmental risk factors (i.e., adoptive mothers' processing speed, internalizing symptoms, and uninvolved parenting) were examined as predictors for the development of internalizing-only, externalizing-only, or co-occurring symptoms using structural equation modeling. Results suggested a unique pattern of predictive factors for the co-occurring phenotype, with risk conferred by adoptive mothers' uninvolved parenting, birth mothers' slower processing speed, and the birth mothers' slower processing speed in tandem with adoptive mothers' higher internalizing symptoms. Additional analyses indicated that when co-occurring-symptom children were incorporated into internalizing and externalizing symptom groups, differential risk factors for externalizing and internalizing symptoms emerged. The findings suggest that spurious results may be found when children with co-occurring symptoms are not examined as a unique phenotypic group.

  12. Co-Occurring Disorders: A Challenge for Mexican Community-Based Residential Care Facilities for Substance Use.

    Science.gov (United States)

    Marín-Navarrete, Rodrigo; Medina-Mora, María Elena; Horigian, Viviana E; Salloum, Ihsan M; Villalobos-Gallegos, Luis; Fernández-Mondragón, José

    2016-01-01

    In Mexico, specialized treatment services for people with co-occurring disorders are limited within public health services, while private options are deemed too costly. More than 2,000 community-based residential care facilities have risen as an alternative and are the main source of treatment for individuals with substance use disorders; however, suboptimal practices within such facilities are common. Information on the clinical characteristics of patients receiving care in these facilities is scarce and capacity to provide high-quality care for co-occurring disorders is unknown. The aims of this study were to examine the prevalence of co-occurring disorders in patients receiving treatment for substance use in these community-based residential centers and to assess whether the presence of co-occurring disorders is associated with higher severity of substance use, psychiatric symptomatology, and other health risks. This study was conducted with 601 patients receiving treatment for substance use disorders at 30 facilities located in five Mexican states, recruited in 2013 and 2014. Patients were assessed with self-report measures on substance use, service utilization, suicidality, HIV risk behaviors, psychiatric symptomatology, and psychiatric disorder diagnostic criteria. The prevalence of any co-occurring disorder in this sample was 62.6%. Antisocial personality disorder was the most prevalent (43.8%), followed by major depressive disorder (30.9%). The presence of a co-occurring disorder was associated with higher severity of psychiatric symptoms (aB = .496, SE = .050, p Co-occurring disorders are highly prevalent in community-based residential centers in Mexico and are associated with significantly increased probability of other health risks. This highlights the need to develop care standards for this population and the importance of clinical research in these settings.

  13. Patients With Co-Occurring Bipolar Disorder and Posttraumatic Stress Disorder: A Rapid Review of the Literature.

    Science.gov (United States)

    Cerimele, Joseph M; Bauer, Amy M; Fortney, John C; Bauer, Mark S

    2017-05-01

    To summarize the current literature on epidemiology, clinical correlates, and treatment of individuals with co-occurring bipolar disorder and posttraumatic stress disorder (PTSD). We conducted a focused, time-sensitive review called "rapid review" in November 2015, using keyword searches (including keywords bipolar disorder, post-traumatic stress disorder, PTSD, and others) in PubMed for studies of adults with co-occurring bipolar disorder and PTSD. Results were sorted and systematically searched. An article was excluded if it did not describe adult patients with co-occurring PTSD and bipolar disorder or did not report original data on epidemiology, clinical correlates, or treatment. Information on study characteristics including population studied and key findings were extracted onto a data collection tool. Thirty-two articles were included. Over two-thirds of articles reported epidemiology of co-occurring bipolar disorder and PTSD. Prevalence of PTSD among individuals with bipolar disorder ranged from 4% to 40%, with women and those with bipolar I versus bipolar II disorder experiencing higher prevalence of PTSD. Prevalence of bipolar disorder among individuals with PTSD ranged from 6% to 55%. Baseline PTSD or bipolar disorder was associated with incidence of the other illness. Individuals with co-occurring bipolar disorder and PTSD experienced high symptom burden and low quality of life. No studies evaluated prospective treatment of patients with co-occurring bipolar disorder and PTSD. Bipolar disorder and PTSD commonly co-occur and result in greater symptom burden than either condition alone. Few published treatment strategies exist for patients with both conditions. © Copyright 2017 Physicians Postgraduate Press, Inc.

  14. Multidisciplinary residential treatment of type 1 diabetes mellitus and co-occurring eating disorders.

    Science.gov (United States)

    Dickens, Yani L; Haynos, Ann F; Nunnemaker, Shannon; Platka-Bird, Lorraine; Dolores, John

    2015-01-01

    Research on treatment for diabetes and co-occurring eating disorders is sparse. We examined outcomes from multidisciplinary residential treatment for women with type 1 diabetes and eating disorders and the impact of treatment duration on outcomes. Participants were 29 women with type 1 diabetes and eating disorders receiving residential treatment. Repeated measures analyses of variance examined changes in blood glucose and psychological symptoms over treatment. Analyses were repeated to include treatment by duration interactions. Treatment produced significant reductions in blood glucose, eating disorder symptoms, and psychological concerns. Longer treatment duration was associated with greater improvements in psychological symptoms.

  15. A Qualitative Study of Barriers to Care for People With Co-Occurring Disorders.

    Science.gov (United States)

    Sorsa, Minna; Greacen, Tim; Lehto, Juhani; Åstedt-Kurki, Päivi

    2017-08-01

    The present qualitative study used face-to-face and telephone interviews with service providers in the Tampere area in Finland to describe the provider viewpoint on barriers to care for people with co-occurring disorders. The core barrier concerns the definition and understanding of the problems: client and professional perspectives often differ, and both can be out of step with what the care system actually proposes. Professionals need to take into account contexts with potentially multiple barriers to care. Providers in each local area should examine possible barriers and find solutions together, integrating the client perspective at each step in the process. Copyright © 2017 Elsevier Inc. All rights reserved.

  16. Assessment and Treatment of Co-occurring Eating Disorders in Privately Funded Addiction Treatment Programs

    Science.gov (United States)

    Killeen, Therese K.; Greenfield, Shelly F.; Bride, Brian E.; Cohen, Lisa; Gordon, Susan Merle; Roman, Paul M.

    2011-01-01

    Privately-funded addiction treatment programs were surveyed to increase understanding of assessment and current treatment options for patients with co-occurring substance use and eating disorders. Data were collected from face-to-face interviews with program administrators of a nationally representative sample of 345 private addiction treatment programs. Although the majority of programs reported screening for eating disorders, programs varied in screening instruments used. Sixty-seven percent reported admitting cases of low severity. Twenty-one percent of programs attempt to treat eating disorders. These results highlight the need for education of addiction treatment professionals in assessment, referral and treatment of eating disorders. PMID:21477048

  17. Decrease in Healthcare Utilization and Costs for Opioid Users Following Residential Integrated Treatment for Co-Occurring Disorders.

    Science.gov (United States)

    Morse, Siobhan; Bride, Brian E

    2017-09-07

    Opioid use results in higher healthcare utilization and costs, particularly among those with co-occurring mental health disorders. Presumably, effective treatment would result in a reduction in healthcare utilization and costs. To date, research has not examined this question. As such, the purpose of this study was to estimate and compare pre- and post-treatment healthcare utilization and costs for individuals receiving residential integrated treatment for co-occurring mental health and opioid use disorders. A single-group, repeated measures design was used to examine changes in pre- and post-treatment healthcare utilization and costs among a sample of individuals with co-occurring mental health and opioid use disorders who received residential, integrated treatment. Significant reductions in emergency rooms visits, inpatient admissions, and resulting costs were observed in the six months following treatment. Residential, integrated treatment of co-occurring mental health and opioid use disorders can significantly decrease both utilization and cost of healthcare among opioid users with co-occurring mental health disorders.

  18. A social network analysis approach to alcohol use and co-occurring addictive behavior in young adults.

    Science.gov (United States)

    Meisel, Matthew K; Clifton, Allan D; MacKillop, James; Goodie, Adam S

    2015-12-01

    The current study applied egocentric social network analysis (SNA) to investigate the prevalence of addictive behavior and co-occurring substance use in college students' networks. Specifically, we examined individuals' perceptions of the frequency of network members' co-occurring addictive behavior and investigated whether co-occurring addictive behavior is spread evenly throughout networks or is more localized in clusters. We also examined differences in network composition between individuals with varying levels of alcohol use. The study utilized an egocentric SNA approach in which respondents ("egos") enumerated 30 of their closest friends, family members, co-workers, and significant others ("alters") and the relations among alters listed. Participants were 281 undergraduates at a large university in the Southeastern United States. Robust associations were observed among the frequencies of gambling, smoking, drinking, and using marijuana by network members. We also found that alters tended to cluster together into two distinct groups: one cluster moderate-to-high on co-occurring addictive behavior and the other low on co-occurring addictive behavior. Lastly, significant differences were present when examining egos' perceptions of alters' substance use between the networks of at-risk, light, and nondrinkers. These findings provide empirical evidence of distinct clustering of addictive behavior among young adults and suggest the promise of social network-based interventions for this cohort. Copyright © 2015. Published by Elsevier Ltd.

  19. Enhancing outcomes for persons with co-occurring disorders through skills training and peer recovery support.

    Science.gov (United States)

    O'Connell, Maria J; Flanagan, Elizabeth H; Delphin-Rittmon, Miriam E; Davidson, Larry

    2017-03-10

    "Recovery supports", often provided by persons in recovery themselves, have emerged over the last decade as important components of recovery-oriented systems of care for persons with substance use disorders. This study assesses the benefit of adding peer recovery supports to the care of adults with co-occurring psychosis and substance use. 137 adults with both disorders who had at least one prior admission within the past year were recruited during an index hospitalization into a randomized trial of standard care vs skills training with and without a peer-led social engagement program. Participants were assessed at admission and at three and nine months post-discharge on symptoms, functioning, substance use, and other factors. At three months, skills training was effective in reducing alcohol use and symptoms, with the addition of peer-led support resulting in higher levels of relatedness, self-criticism, and outpatient service use. At nine months, skills training was effective in decreasing symptoms and inpatient readmissions and increasing functioning, with the addition of peer support resulting in reduced alcohol use. Adding peer-led support may increase engagement in care over the short term and reduce substance use over the longer-term for adults with co-occurring disorders.

  20. Outcomes of Offenders With Co-Occurring Substance Use Disorders and Mental Disorders.

    Science.gov (United States)

    Wilton, Geoff; Stewart, Lynn A

    2017-07-01

    Whether a diagnosis of a mental disorder contributes to the risk of poorer correctional outcomes is controversial. This study aimed to clarify the extent to which mental and substance use disorders individually and in combination contribute to correctional outcomes in order to determine optimal treatment and promote public safety. Differences were examined between four groups of federal offenders in Canada (N=715): those with a mental disorder only, those with a substance use disorder only, those with co-occurring mental and substance use disorders, and those with no disorder. Groups were compared on profiles, criminal histories, charges while incarcerated (institutional charges), and reconvictions after release from incarceration by using chi-square tests and Cox regression analyses that controlled for risk factors. Of the four groups, those with co-occurring disorders had the most substantial criminal histories and the highest rates of institutional charges, transfers to segregation while incarcerated, and reconvictions. The group with only mental disorders had outcomes intermediate between the groups with only substance use disorders and the group with neither type of disorder. Having a substance use disorder appeared to be the key factor contributing to poorer correctional outcomes for offenders with mental disorders. Psychiatric services in correctional facilities must screen for substance use disorders and, if they are present, ensure provision of treatment to improve quality of life for this population and promote public safety.

  1. Procedural justice and the judge-probationer relationship in a co-occurring disorders court.

    Science.gov (United States)

    Mahoney, Myesa Knox

    2014-01-01

    Although a considerable amount of research has been conducted on treatment-based courts, there is little quantitative evidence that describes the relationship between the judge and the probationer. The present study examines perceptions of the judge-probationer relationship (JPR), procedural justice, and outcome satisfaction within a co-occurring disorders court (CODC) in Orange County, California. Based on interview and survey data from a sample of probationers within the CODC (n=24), this article argues that perceptions of procedural justice are linked to perceptions of relationship quality between the judge and probationer. Analysis of the data found that probationers in the CODC have very positive views of their relationships with the judge, and elements of relationship quality are significantly linked with perceptions of procedural justice. Procedural justice is also a predictor of satisfaction with outcome in this sample. The results show promise that procedural justice and the quality of the judge-probationer relationship can positively affect probationers with co-occurring disorders in specialty courts. Copyright © 2013. Published by Elsevier Ltd.

  2. Auditory stimulus timing influences perceived duration of co-occurring visual stimuli

    Directory of Open Access Journals (Sweden)

    Vincenzo eRomei

    2011-09-01

    Full Text Available There is increasing interest in multisensory influences upon sensory-specific judgements, such as when auditory stimuli affect visual perception. Here we studied whether the duration of an auditory event can objectively affect the perceived duration of a co-occurring visual event. On each trial, participants were presented with a pair of successive flashes and had to judge whether the first or second was longer. Two beeps were presented with the flashes. The order of short and long stimuli could be the same across audition and vision (audiovisual congruent or reversed, so that the longer flash was accompanied by the shorter beep and vice versa (audiovisual incongruent; or the two beeps could have the same duration as each other. Beeps and flashes could onset synchronously or asynchronously. In a further control experiment, the beep durations were much longer (tripled than the flashes. Results showed that visual duration-discrimination sensitivity (d' was significantly higher for congruent (and significantly lower for incongruent audiovisual synchronous combinations, relative to the visual only presentation. This effect was abolished when auditory and visual stimuli were presented asynchronously, or when sound durations tripled those of flashes. We conclude that the temporal properties of co-occurring auditory stimuli influence the perceived duration of visual stimuli and that this can reflect genuine changes in visual sensitivity rather than mere response bias.

  3. Clinicians' management of young children with co-occurring stuttering and speech sound disorder.

    Science.gov (United States)

    Unicomb, Rachael; Hewat, Sally; Spencer, Elizabeth; Harrison, Elisabeth

    2013-08-01

    Speech sound disorders reportedly co-occur in young children who stutter at a substantial rate. Despite this, there is a paucity of scientific research available to support a treatment approach when these disorders co-exist. Similarly, little is known about how clinicians are currently working with this caseload given that best practice for the treatment of both disorders in isolation has evolved in recent years. This study used a qualitative approach to explore current clinical management and rationales when working with children who have co-occurring stuttering and speech sound disorder. Thirteen participant SLPs engaged in semi-structured telephone interviews. Interview data were analysed based on principles derived from grounded theory. Several themes were identified including multi-faceted assessment, workplace challenges, weighing-up the evidence, and direct intervention. The core theme, clinical reasoning, highlighted the participants' main concern, that not enough is known about this caseload on which to base decisions about intervention. There was consensus that little is available in the research literature to guide decisions relating to service delivery. These findings highlight the need for further research to provide evidence-based guidelines for clinical practice with this caseload.

  4. The prevalence and geographic distribution of complex co-occurring disorders: a population study.

    Science.gov (United States)

    Somers, J M; Moniruzzaman, A; Rezansoff, S N; Brink, J; Russolillo, A

    2016-06-01

    A subset of people with co-occurring substance use and mental disorders require coordinated support from health, social welfare and justice agencies to achieve diversion from homelessness, criminal recidivism and further health and social harms. Integrated models of care are typically concentrated in large urban centres. The present study aimed to empirically measure the prevalence and distribution of complex co-occurring disorders (CCD) in a large geographic region that includes urban as well as rural and remote settings. Linked data were examined in a population of roughly 3.7 million adults. Inclusion criteria for the CCD subpopulation were: physician diagnosed substance use and mental disorders; psychiatric hospitalisation; shelter assistance; and criminal convictions. Prevalence per 100 000 was calculated in 91 small areas representing urban, rural and remote settings. 2202 individuals met our inclusion criteria for CCD. Participants had high rates of hospitalisation (8.2 admissions), criminal convictions (8.6 sentences) and social assistance payments (over $36 000 CDN) in the past 5 years. There was wide variability in the geographic distribution of people with CCD, with high prevalence rates in rural and remote settings. People with CCD are not restricted to areas with large populations or to urban settings. The highest per capita rates of CCD were observed in relatively remote locations, where mental health and substance use services are typically in limited supply. Empirically supported interventions must be adapted to meet the needs of people living outside of urban settings with high rates of CCD.

  5. Learning contextualized semantics from co-occurring terms via a Siamese architecture.

    Science.gov (United States)

    Sandouk, Ubai; Chen, Ke

    2016-04-01

    One of the biggest challenges in Multimedia information retrieval and understanding is to bridge the semantic gap by properly modeling concept semantics in context. The presence of out of vocabulary (OOV) concepts exacerbates this difficulty. To address the semantic gap issues, we formulate a problem on learning contextualized semantics from descriptive terms and propose a novel Siamese architecture to model the contextualized semantics from descriptive terms. By means of pattern aggregation and probabilistic topic models, our Siamese architecture captures contextualized semantics from the co-occurring descriptive terms via unsupervised learning, which leads to a concept embedding space of the terms in context. Furthermore, the co-occurring OOV concepts can be easily represented in the learnt concept embedding space. The main properties of the concept embedding space are demonstrated via visualization. Using various settings in semantic priming, we have carried out a thorough evaluation by comparing our approach to a number of state-of-the-art methods on six annotation corpora in different domains, i.e., MagTag5K, CAL500 and Million Song Dataset in the music domain as well as Corel5K, LabelMe and SUNDatabase in the image domain. Experimental results on semantic priming suggest that our approach outperforms those state-of-the-art methods considerably in various aspects. Copyright © 2016 Elsevier Ltd. All rights reserved.

  6. Experiences of Professional Helping Relations by Persons with Co-occurring Mental Health and Substance Use Disorders.

    Science.gov (United States)

    Brekke, E; Lien, L; Biong, S

    2018-01-01

    Recovery in co-occurring mental health and substance use disorders often involves relationships with professional helpers, yet little is known about how these are experienced by service users. The aim of this study was to explore and describe behaviour and attributes of professional helpers that support recovery, as experienced by persons with co-occurring disorders. Within a collaborative approach, in-depth individual interviews with eight persons with lived experience of co-occurring disorders were analysed using systematic text condensation. The analysis yielded four categories of recovery-supporting behaviour and attributes of professional helpers and the ability to build trust cuts across all of them: Building trust through (a) hopefulness and loving concern, (b) commitment, (c) direct honesty and expectation and (d) action and courage. Services should allow for flexibility and continuity, and training should recognise the importance of establishing trust in order to reach out to this group.

  7. Predictors of residential treatment retention among individuals with co-occurring substance abuse and mental health disorders.

    Science.gov (United States)

    Choi, Sam; Adams, Susie M; MacMaster, Samuel A; Seiters, John

    2013-01-01

    A significant number of individuals with co-occurring substance abuse and mental health disorders do not engage, stay, and/or complete residential treatment. The purpose of this study is to identify factors during the initial phase of treatment which predict retention in private residential treatment for individuals with co-occurring substance use and mental health disorders. The participants were 1,317 individuals with co-occurring substance abuse and mental health disorders receiving treatment at three residential treatment centers located in Memphis, TN, Malibu, CA, and Palm Springs, CA. Bivariate analysis and logistic regression were utilized to identify factors that predict treatment retention at 30 days. The findings indicate a variety of factors including age, gender, types of drug, Addiction Severity Index Medical and Psychiatric scores, and readiness to change. These identified factors could be incorporated into pretreatment assessments, so that programs can initiate preventive measures to decrease attrition and improve treatment outcomes.

  8. Three cases of dissociative identity disorder and co-occurring borderline personality disorder treated with dynamic deconstructive psychotherapy.

    Science.gov (United States)

    Chlebowski, Susan M; Gregory, Robert J

    2012-01-01

    Dissociative Identity Disorder (DID) is an under-researched entity and there are no clinical trials employing manual-based therapies and validated outcome measures. There is evidence that borderline personality disorder (BPD) commonly co-occurs with DID and can worsen its course. The authors report three cases of DID with co-occurring BPD that we successfully treated with a manual-based treatment, Dynamic Deconstructive Psychotherapy (DDP). Each of the three clients achieved a 34% to 79% reduction in their Dissociative Experiences Scale scores within 12 months of initiating therapy. Dynamic Deconstructive Psychotherapy was developed for treatment refractory BPD and differs in some respects from expert consensus treatment of DID. It may be a promising modality for DID complicated by co-occurring BPD.

  9. Gender differences in treatment retention among individuals with co-occurring substance abuse and mental health disorders.

    Science.gov (United States)

    Choi, Sam; Adams, Susie M; Morse, Siobhan A; MacMaster, Sam

    2015-04-01

    A significant number of individuals with co-occurring substance abuse and mental health disorders do not engage, stay, and/or complete residential treatment. Although prior research indicates that women and men differ in their substance abuse treatment experiences, our knowledge of individuals with co-occurring substance abuse and mental health disorders as well as those attending private residential treatment is limited. The purpose of this study is to examine gender differences on treatment retention for individuals with co-occurring substance abuse and mental health disorders who participate in private residential treatment. The participants were 1,317 individuals (539 women and 778 men) with co-occurring substance abuse and mental health disorders receiving treatment at three private residential treatment centers. Bivariate analyses, life tables, and Cox regression (survival analyses) were utilized to examine gender effects on treatment retention, and identify factors that predict treatment retention for men and women. This study found that women with co-occurring disorders were more likely to stay longer in treatment when compared to men. The findings indicate the factors influencing length of stay differ for each gender, and include: type of substance used prior to admission; Addiction Severity Index Composite scores; and Readiness to Change/URICA scores. Age at admission was a factor for men only. CONCLUSIONS/IMPORTANCE: These findings can be incorporated to develop and initiate program interventions to minimize early attrition and increase overall retention in private residential treatment for individuals with co-occurring substance use and mental health disorders.

  10. Difficulties in emotion regulation in treatment-seeking alcoholics with and without co-occurring mood and anxiety disorders.

    Science.gov (United States)

    Bradizza, Clara M; Brown, Whitney C; Ruszczyk, Melanie U; Dermen, Kurt H; Lucke, Joseph F; Stasiewicz, Paul R

    2018-05-01

    Emotion regulation difficulties (ERD) are known to underlie mental health conditions including anxiety and depressive disorders and alcohol use disorder (AUD). Although AUD, mood, and anxiety disorders commonly co-occur, no study has examined the association between these disorders and ERD among AUD outpatients. In the current study, emotion regulation (ER) scores of AUD individuals with no co-occurring mental health condition were compared to the ER scores of individuals who met diagnostic criteria for co-occurring mood and/or anxiety disorders. Treatment-seeking AUD individuals (N=77) completed measures of emotion regulation, alcohol use and psychological functioning prior to beginning a 12-week outpatient cognitive-behaviorally oriented alcohol treatment program. Individuals were classified as having no co-occurring mood or anxiety disorder (AUD-0, n=24), one co-occurring disorder (AUD-1, n=34), or two or more co-occurring disorders (AUD-2, n=19). Between-group differences in emotion regulation, quantity/frequency of alcohol consumption, positive and negative affect, affective drinking situations, negative mood regulation expectancies, distress tolerance, alexithymia, trait mindfulness, and psychological symptom severity were examined. Compared with the AUD-0 group, the AUD-2 group reported significantly greater ERD, psychiatric distress and alcohol consumption, more frequent drinking in response to negative affect situations, greater interference from negative emotions, and less use of mindfulness skills. The AUD-1 group differed from AUD-0 group only on the DERS lack of emotional awareness (Aware) subscale. Emotion regulation scores in the AUD-0 group were comparable to those previously reported for general community samples, whereas levels of ERD in the AUD-1 and AUD-2 were similar to those found in other clinical samples. Implications for the inclusion of ER interventions among AUD patients who might most benefit from such an intervention are discussed

  11. Online interventions for problem gamblers with and without co-occurring mental health symptoms: Protocol for a randomized controlled trial

    Directory of Open Access Journals (Sweden)

    John A. Cunningham

    2016-07-01

    Full Text Available Abstract Background Comorbidity between problem gambling and depression or anxiety is common. Further, the treatment needs of people with co-occurring gambling and mental health symptoms may be different from those of problem gamblers who do not have a co-occurring mental health concern. The current randomized controlled trial (RCT will evaluate whether there is a benefit to providing access to mental health Internet interventions (G + MH intervention in addition to an Internet intervention for problem gambling (G-only intervention in participants with gambling problems who do or do not have co-occurring mental health symptoms. Methods Potential participants will be screened using an online survey to identify participants meeting criteria for problem gambling. As part of the baseline screening process, measures of current depression and anxiety will be assessed. Eligible participants agreeing (N = 280 to take part in the study will be randomized to one of two versions of an online intervention for gamblers – an intervention that just targets gambling issues (G-only versus a website that contains interventions for depression and anxiety in addition to an intervention for gamblers (G + MH. It is predicted that problem gamblers who do not have co-occurring mental health symptoms will display no significant difference between intervention conditions at a six-month follow-up. However, for those with co-occurring mental health symptoms, it is predicted that participants receiving access to the G + MH website will display significantly reduced gambling outcomes at six-month follow-up as compared to those provided with G-only website. Discussion The trial will produce information on the best means of providing online help to gamblers with and without co-occurring mental health symptoms. Trial registration ClinicalTrials.gov NCT02800096 ; Registration date: June 14, 2016.

  12. Online interventions for problem gamblers with and without co-occurring mental health symptoms: Protocol for a randomized controlled trial.

    Science.gov (United States)

    Cunningham, John A; Hodgins, David C; Bennett, Kylie; Bennett, Anthony; Talevski, Marina; Mackenzie, Corey S; Hendershot, Christian S

    2016-07-22

    Comorbidity between problem gambling and depression or anxiety is common. Further, the treatment needs of people with co-occurring gambling and mental health symptoms may be different from those of problem gamblers who do not have a co-occurring mental health concern. The current randomized controlled trial (RCT) will evaluate whether there is a benefit to providing access to mental health Internet interventions (G + MH intervention) in addition to an Internet intervention for problem gambling (G-only intervention) in participants with gambling problems who do or do not have co-occurring mental health symptoms. Potential participants will be screened using an online survey to identify participants meeting criteria for problem gambling. As part of the baseline screening process, measures of current depression and anxiety will be assessed. Eligible participants agreeing (N = 280) to take part in the study will be randomized to one of two versions of an online intervention for gamblers - an intervention that just targets gambling issues (G-only) versus a website that contains interventions for depression and anxiety in addition to an intervention for gamblers (G + MH). It is predicted that problem gamblers who do not have co-occurring mental health symptoms will display no significant difference between intervention conditions at a six-month follow-up. However, for those with co-occurring mental health symptoms, it is predicted that participants receiving access to the G + MH website will display significantly reduced gambling outcomes at six-month follow-up as compared to those provided with G-only website. The trial will produce information on the best means of providing online help to gamblers with and without co-occurring mental health symptoms. ClinicalTrials.gov NCT02800096 ; Registration date: June 14, 2016.

  13. Risk for Suicidal Ideation and Suicide Attempts Associated with Co-occurring Depression and Conduct Disorders in Early Adolescence

    Science.gov (United States)

    Stoep, Ann Vander; Adrian, Molly; McCauley, Elizabeth; Crowell, Sheila; Stone, Andrea; Flynn, Cynthia

    2013-01-01

    This study investigates the early manifestation of co-occurring depression and conduct disorders as a predictor of heightened risk for later suicidal ideation and behavior in a community sample of 521 adolescents. Self-reported symptoms of depression and conduct disorder were evaluated in early 6th grade. Suicidal thoughts and behaviors were tracked through multiple assessments carried out over the middle school years. Compared to adolescents with depression symptoms only, conduct disorder symptoms only, or low psychopathology, those with co-occurring depression and conduct disorder symptoms had the highest risk for subsequent suicidal ideation, recurrent suicidal behaviors, and suicide attempts. PMID:21463356

  14. Co-Occurring Mental Health Problems and Peer Functioning among Youth with Attention-Deficit/Hyperactivity Disorder: A Review and Recommendations for Future Research

    Science.gov (United States)

    Becker, Stephen P.; Luebbe, Aaron M.; Langberg, Joshua M.

    2012-01-01

    It is well established that children and adolescents with attention-deficit/hyperactivity disorder (ADHD) frequently experience co-occurring mental health problems in addition to difficulties in their peer relationships. Although substantial research has focused on the extent to which peer functioning contributes to subsequent co-occurring mental…

  15. Screening for and Prevalence of HIV and Hepatitis C among an Outpatient Urban Sample of People with Serious Mental Illness and Co-Occurring Substance Abuse

    Science.gov (United States)

    Himelhoch, Seth; Goldberg, Richard; Calmes, Christine; Medoff, Deborah; Slade, Eric; Dixon, Lisa; Gallucci, Gerard; Rosenberg, Stanley

    2011-01-01

    Background: To assess rates of screening and testing of HIV and HCV among those with serious mental illness and co-occurring substance use disorders. Methods: One hundred fifty-three people with serious mental illness and co-occurring substance use disorders completed measures and were screened for HIV and HCV. Results: Six percent were HIV…

  16. Brief Report: Prevalence of Co-Occurring Epilepsy and Autism Spectrum Disorder--The U.S. National Survey of Children's Health 2011-2012

    Science.gov (United States)

    Thomas, Shiny; Hovinga, Mary E.; Rai, Dheeraj; Lee, Brian K.

    2017-01-01

    Epilepsy is reported to co-occur in individuals with autism spectrum disorder (ASD). Previous studies across the world have found prevalence estimates ranging from 4 to 38%. We examined parent-reported prevalence of co-occurring epilepsy and ASD in the most recent U.S. National Survey of Children's Health, 2011-2012. All analyses accounted for…

  17. Phylogenetic Structure of Plant Communities: Are Polyploids Distantly Related to Co-occurring Diploids?

    Directory of Open Access Journals (Sweden)

    Michelle L. Gaynor

    2018-04-01

    Full Text Available Polyploidy is widely acknowledged to have played an important role in the evolution and diversification of vascular plants. However, the influence of genome duplication on population-level dynamics and its cascading effects at the community level remain unclear. In part, this is due to persistent uncertainties over the extent of polyploid phenotypic variation, and the interactions between polyploids and co-occurring species, and highlights the need to integrate polyploid research at the population and community level. Here, we investigate how community-level patterns of phylogenetic relatedness might influence escape from minority cytotype exclusion, a classic population genetics hypothesis about polyploid establishment, and population-level species interactions. Focusing on two plant families in which polyploidy has evolved multiple times, Brassicaceae and Rosaceae, we build upon the hypothesis that the greater allelic and phenotypic diversity of polyploids allow them to successfully inhabit a different geographic range compared to their diploid progenitor and close relatives. Using a phylogenetic framework, we specifically test (1 whether polyploid species are more distantly related to diploids within the same community than co-occurring diploids are to one another, and (2 if polyploid species tend to exhibit greater ecological success than diploids, using species abundance in communities as an indicator of successful establishment. Overall, our results suggest that the effects of genome duplication on community structure are not clear-cut. We find that polyploid species tend to be more distantly related to co-occurring diploids than diploids are to each other. However, we do not find a consistent pattern of polyploid species being more abundant than diploid species, suggesting polyploids are not uniformly more ecologically successful than diploids. While polyploidy appears to have some important influences on species co-occurrence in

  18. Perceived Treatment Needs Among Women With Co-occurring Substance Use Disorders and PTSD.

    Science.gov (United States)

    Resko, Stella M; Brown, Suzanne; Mendoza, Natasha S; Crosby, Shantel; González-Prendes, Antonio

    2016-01-01

    Perception of need is a key factor that influences decisions to seek help and complete treatment for substance use and mental health problems. In the current study, we examine patterns of perceived treatment needs among women with co-occurring substance use disorders and posttraumatic stress disorder (PTSD) and explore how these patterns are associated with demographics, psychosocial variables, and treatment-related factors. Secondary data analysis of the Women and Trauma Study from the National Institute on Drug Abuse's Clinical Trial Network was conducted. The sample included 353 women with co-occurring substance use disorders and PTSD (full or subthreshold) receiving outpatient substance abuse treatment. Latent class analysis was used to examine patterns of perceived treatment need and multinomial logistic regression was used to identify characteristics associated with these patterns. The sample included women between the ages of 18 and 65 (mean = 39.2, SD = 9.3) and was 46% White, 34% African American, and 21% other races/ethnicities. A three-class model representing unique perceptions of treatment needs demonstrated the best fit (Bayesian information criterion = 2101.43; entropy = 0.76; average posterior probabilities ≤ 0.82). Class one reported elevated needs in multiple areas (38%), class two reported low needs (23%), and class three reported substance use and psychological needs (40%). Living with a substance abuser, depression symptoms, recent substance use, and treatment coercion were significantly associated with membership in class 2 (OR = .28, .84, .22, and 2.32, respectively). Other race, being married, depression symptoms, recent substance use, and criminal justice involvement were associated with membership in class 3 (OR = 2.32, 2.32, .94, .42, and 1.69, respectively). Number of treatment sessions attended was not significantly associated with class membership. Results provide insight into how women with co-occurring PTSD and substance use

  19. Integrating Permanent Supportive Housing and Co-Occurring Disorders Treatment for Individuals Who Are Homeless.

    Science.gov (United States)

    Smelson, David A; Zaykowski, Heather; Guevermont, Nathan; Siegfriedt, Julianne; Sawh, Leon; Modzelewski, David; Tsemberis, Sam; Kane, Vincent

    2016-01-01

    While permanent housing, addictions, and mental health treatment are often critical needs to achieve housing stability and community reintegration, few studies have systematically integrated them into a single comprehensive approach for people experiencing chronic homelessness. This pilot study examined the feasibility and preliminary outcomes of systematically integrating permanent supportive housing and an evidence-based co-occurring disorders intervention called Maintaining Independence and Sobriety Through Systems Integration, Outreach, and Networking (MISSION). This single-group open pilot enrolled 107 people with co-occurring disorders experiencing chronic homelessness from two Massachusetts inner-city and rural areas. Enrolled subjects were interested in receiving permanent supportive housing along with 1 year of MISSION services. Data were collected through baseline and 6- and 12-month follow-up assessments. Participants (Mage = 49.52 years, SD = 10.61) were mostly male (76.6%), Caucasian (52.3%), and unemployed (86.0%), with an average of 8.34 years (SD = 8.01) of homelessness. Self-reported lifetime problems with anxiety (75.7%) and depression (76.6%) were common, as was use of alcohol (30.8%), cannabis (31.8%), and cocaine (15.9%). Almost all participants (95.3%) were placed into permanent housing, which took on average 42.6 days from enrollment (SD = 50.09). Among those placed, nearly 80% of the clients were able to retain housing through the end of the study. Overall retention was high, with 86.0% remaining in MISSION treatment until the end of the study. While there were no significant changes in rehospitalization, service utilization, or substance use, there were modest significant mental health symptom improvements from baseline to program completion. This pilot study suggests that co-occurring disorder interventions like MISSION are feasible to integrate with permanent supportive housing despite the somewhat differing philosophies, and

  20. Divergent Adaptive Strategies by Two Co-occurring Epiphytic Orchids to Water Stress: Escape or Avoidance?

    Science.gov (United States)

    Zhang, Wei; Hu, Hong; Zhang, Shi-Bao

    2016-01-01

    Due to the fluctuating water availability in the arboreal habitat, epiphytic plants are considered vulnerable to climate change and anthropogenic disturbances. Although co-occurring taxa have been observed divergent adaptive performances in response to drought, the underlying physiological and morphological mechanisms by which epiphyte species cope with water stress remain poorly understood. In the present study, two co-occurring epiphytic orchids with different phenologies were selected to investigate their drought-resistance performances. We compared their functional traits, and monitored their physiological performances in a 25-days of drought treatment. In contrast to the deciduous species Pleione albiflora, the evergreen species Coelogyne corymbosa had different root anatomical structures and higher values for saturated water content of pseudobulbs. Moreover, plants of C. corymbosa had thicker leaves and epidermis, denser veins and stomata, and higher values for leaf mass per unit area and the time required to dry saturated leaves to 70% relative water content. However, samples from that species had lower values for net photosynthetic rate (A n), stomatal length and chlorophyll content per unit dry mass. Nevertheless, due to greater capacity for water storage and conservation, C. corymbosa maintained higher A n, stomatal conductance (g s), and instantaneous water-use efficiency during severe drought period, and their values for leaf water potential were higher after the water stress treatment. By Day 10 after irrigation was restarted, only C. corymbosa plants recovered their values for A n and g s to levels close to those calculated prior to the imposition of water stress. Our results suggest that the different performance responding to drought and re-watering in two co-occurring epiphytic orchids is related to water-related traits and these two species have divergent adaptive mechanisms. Overall, C. corymbosa demonstrates drought avoidance by enhancing water

  1. Where are patients who have co-occurring mental and physical diseases located?

    DEFF Research Database (Denmark)

    Toftegaard, Kristian L; Gustafsson, Lea Nørgreen; Uwakwe, Richard

    2015-01-01

    disease, diabetes mellitus and overweight in patients with mental disorders in European countries and Japan. In Nigeria (a low-to-middle-income country), religious guides or healers, along with general practitioners, are the most frequently contacted, and they therefore seem to be the most obvious partner......BACKGROUND: Patients with a psychiatric illness have a higher prevalence of physical diseases and thus a higher morbidity and mortality. AIM: The main aim was to investigate where patients with co-occurring physical diseases and mental disorders (psychotic spectrum or mood) in the health and social...... service system are identified most frequently before admission into psychiatry. The second aim was to compare the differences in the treatment routes taken by the patients before entry into psychiatric services in all the participating countries (Denmark, Germany, Japan, Nigeria and Switzerland...

  2. Clarifying Exercise Addiction: Differential Diagnosis, Co-occurring Disorders, and Phases of Addiction

    Directory of Open Access Journals (Sweden)

    Marilyn Freimuth

    2011-10-01

    Full Text Available This paper sets out to clarify the unique features of exercise addiction. It begins by examining how this addiction can be distinguished from compulsions and impulse control disorders both of which, like an addiction, involve excessive behavior that creates adverse effects. Assessment of exercise addiction also requires that clinicians be attuned to other forms of excessive behavior, especially eating disorders that can co-occur with exercise. Finally in an effort to clarify exercise addiction, this paper uses the four phases of addiction to examine the attributes of exercise that define it as a healthy habit distinct from an addiction. The paper ends with a discussion of the implications of these topics for effective assessment and treatment.

  3. Integrating a Co-occurring Disorders Intervention in Drug Courts: An Open Pilot Trial.

    Science.gov (United States)

    Smelson, David; Farquhar, Ian; Fisher, William; Pressman, Karen; Pinals, Debra A; Samek, Barbara; Duffy, Mary-Kate; Sawh, Leon

    2018-03-07

    Little research has focused on systematically integrating clinical treatment within existing drug court procedures. This could be particularly useful for clients with substance use disorders, who comprise those on court dockets and often have co-existing mental health issues. This article reports on the preliminary outcomes of integrating MISSION-Criminal Justice (MISSION-CJ), a co-occurring mental health and substance use wraparound intervention, within two Massachusetts drug courts. In this open pilot, clients completed intake and 6-month follow-up assessments. The participants were primarily Caucasian (86%), male (82%), had at least 2 prior arrests, and received outpatient treatment for mental health (54%), alcohol use (51%), or drug use (88%) prior to enrolling in MISSION-CJ. Six-month follow-up data suggested that participants showed statistically significant reductions in average number of nights spent in jail, alcohol use, and drug use, as well as an increase in full time employment.

  4. Helping homeless individuals with co-occurring disorders: the four components.

    Science.gov (United States)

    Sun, An-Pyng

    2012-01-01

    Homeless individuals with co-occurring disorders (CODs) of severe mental illness and substance use disorder are one of the most vulnerable populations. This article provides practitioners with a framework and strategies for helping this client population. Four components emerged from a literature review: (1) ensuring an effective transition for individuals with CODs from an institution (such as a hospital, foster care, prison, or residential program) into the community, a particularly important component for clients who were previously homeless, impoverished, or at risk of homelessness; (2) increasing the resources of homeless individuals with CODs by helping them apply for government entitlements or supported employment (3) linking homeless individuals to supportive housing, including housing first options as opposed to only treatment first options, and being flexible in meeting their housing needs; and (4) engaging homeless individuals in COD treatment, incorporating modified assertive community treatment, motivational interviewing, cognitive-behavioral therapy, contingency management, and COD specialized self-help groups.

  5. Housing stability and recovery among chronically homeless persons with co-occuring disorders in Washington, DC.

    Science.gov (United States)

    Tsemberis, Sam; Kent, Douglas; Respress, Christy

    2012-01-01

    Pathways Housing First provides access to housing, support, and treatment services to clients having the most complex needs-persons who have been homeless for at least 5 years and have both a psychiatric disability and substance dependency. In a 2-year Housing and Urban Development-funded demonstration project in Washington, DC, in 2007 and 2008, we observed promising outcomes in housing retention and reductions in psychiatric symptoms, alcohol use, and demand for intensive support services. The program is designed to be fiscally self-sustaining through extant public disability benefits for housing, treatment, and support services. This approach shows strong support for first providing a permanently supported housing solution for chronically homeless and severely disabled individuals in need of housing and treatment of co-occurring disorders.

  6. Factors associated with sustained community employment among adults with autism and co-occurring intellectual disability.

    Science.gov (United States)

    Chan, Wai; Smith, Leann E; Hong, Jinkuk; Greenberg, Jan S; Lounds Taylor, Julie; Mailick, Marsha R

    2017-07-01

    Sustaining community employment is a challenge for adults with autism spectrum disorders, especially for those who have co-occurring intellectual disability, but factors contributing to this employment outcome have not been fully evaluated. This study utilized longitudinal data to explore the impact of contextual influences, family factors, and individual characteristics on sustained employment over approximately 18 months ( N = 105). Very few adults with autism spectrum disorder and intellectual disability achieved sustained employment (14.3%). The results indicated that more independent daily living skills, a higher family income, a larger maternal social network, an inclusive school environment in early childhood, and currently living in an area with a larger population size were associated with significantly greater odds of sustaining employment. Follow-up analyses suggested that managing personal care is particularly important for employment.

  7. Family therapy for schizophrenia: co-occurring psychotic and substance use disorders.

    Science.gov (United States)

    Gottlieb, Jennifer D; Mueser, Kim T; Glynn, Shirley M

    2012-05-01

    People with schizophrenia have a high prevalence of co-occurring substance use disorders, which is related to a worse course of psychiatric illness, more frequent relapses, and increased depression and suicide, compared with those with schizophrenia alone. The Family Intervention for Dual Diagnosis (FIDD) program, which includes psychoeducation and goal setting and focuses on building communication and problem-solving skills within the family, can aid in decreasing the stress related to having a close relationship with someone with a dual disorder. Here, the case of a young man with psychosis and marijuana dependence is examined. This article describes how the FIDD intervention helped him with his problematic substance use, as well as to build skills within his relationship for increased empathy and reduced interpersonal stress. © 2012 Wiley Periodicals, Inc.

  8. Housing Stability and Recovery Among Chronically Homeless Persons With Co-Occuring Disorders in Washington, DC

    Science.gov (United States)

    Kent, Douglas; Respress, Christy

    2012-01-01

    Pathways Housing First provides access to housing, support, and treatment services to clients having the most complex needs—persons who have been homeless for at least 5 years and have both a psychiatric disability and substance dependency. In a 2-year Housing and Urban Development-funded demonstration project in Washington, DC, in 2007 and 2008, we observed promising outcomes in housing retention and reductions in psychiatric symptoms, alcohol use, and demand for intensive support services. The program is designed to be fiscally self-sustaining through extant public disability benefits for housing, treatment, and support services. This approach shows strong support for first providing a permanently supported housing solution for chronically homeless and severely disabled individuals in need of housing and treatment of co-occurring disorders. PMID:22390393

  9. Effects of Trauma Intervention on HIV Sexual Risk Behaviors among Women with Co-Occurring Disorders in Substance Abuse Treatment

    Science.gov (United States)

    Amaro, Hortensia; Larson, Mary Jo; Zhang, Annie; Acevedo, Andrea; Dai, Jianyu; Matsumoto, Atsushi

    2007-01-01

    Women in substance abuse treatment often have co-occurring mental health disorders and a history of trauma; they are also at high risk for HIV infection and other sexually transmitted diseases via unprotected sex. A quasi-experimental study evaluated the effectiveness of trauma-enhanced substance abuse treatment combined with HIV/AIDS prevention…

  10. Development and Implementation of a Multisite Evaluation for the Women, Co-Occurring Disorders and Violence Study

    Science.gov (United States)

    Giard, Julienne; Hennigan, Karen; Huntington, Nicholas; Vogel, Wendy; Rinehart, Debbie; Mazelis, Ruta; Nadlicki, Terri; Veysey, Bonita M.

    2005-01-01

    In this article we describe the development and implementation of the Substance Abuse and Mental Health Services Administration's (SAMHSA's) multisite Women, Co-Occurring Disorders and Violence Study (WCDVS), highlighting some of the challenges encountered, decisions made, and lessons learned. Four themes are discussed. First, the unique…

  11. Recovery-Oriented Vocational Rehabilitation Services for Individuals with Co-Occurring Psychiatric Disabilities and Substance Use Disorders

    Science.gov (United States)

    Lusk, Stephanie L.; Koch, Lynn C.; Paul, Teresia M.

    2016-01-01

    Purpose: In this article, we examined how individuals with co-occurring psychiatric disabilities and substance use disorders encounter numerous challenges when it comes to the vocational rehabilitation (VR) process. Method: A comprehensive review of the literature demonstrated barriers to service delivery (e.g., access to services, exclusionary…

  12. The Prevalence of Traumatic Brain Injury Among People With Co-Occurring Mental Health and Substance Use Disorders.

    Science.gov (United States)

    McHugo, Gregory J; Krassenbaum, Sarah; Donley, Sachiko; Corrigan, John D; Bogner, Jennifer; Drake, Robert E

    To estimate the rate and severity of traumatic brain injury (TBI) among people with co-occurring mental health and substance use disorders and to compare demographic, diagnostic, and institutionalization differences between those who screen positive or negative. Outpatient community mental health center in Washington, District of Columbia. A total of 295 people with co-occurring mental health and substance use disorders enrolled in a prospective study of integrated treatment of substance abuse. Cross-sectional baseline assessment. The Ohio State University TBI Identification Method. Standardized measures assessed psychiatric diagnoses, symptom severity, current and lifetime substance use, and history of institutionalization. Eighty percent screened positive for TBI, and 25% reported at least 1 moderate or severe TBI. TBI was associated with current alcohol use and psychiatric symptom severity and with lifetime institutionalization and homelessness. It was more common among participants with posttraumatic stress disorder, borderline personality disorder, and antisocial personality disorder. Men (vs women) and participants with psychotic disorders (vs those with mood disorders) had an earlier age of first TBI with loss of consciousness. TBI is common among people with co-occurring mental health and substance use disorders. Repeated and serious TBIs are common in this population. Failure to detect TBI in people with co-occurring disorders who are seeking integrated treatment could lead to misdiagnosis and inappropriately targeted treatment and rehabilitation.

  13. The Interaction of Co-Occurring Mental Disorders and Recovery Management Checkups on Substance Abuse Treatment Participation and Recovery

    Science.gov (United States)

    Rush, Brian R.; Dennis, Michael L.; Scott, Christy K.; Castel, Saulo; Funk, Rodney R.

    2008-01-01

    This article examines the effectiveness of quarterly Recovery Management Checkups (RMCs) for people with substance disorders by level of co-occurring mental disorders (34% none, 27% internalizing disorders, and 39% internalizing and externalizing) across two randomized experiments with 92% to 97% follow-up. The 865 participants are 82% African…

  14. Mixing Oil and Water: Integrating Mental Health and Addiction Services to Treat People with a Co-Occurring Disorder

    Science.gov (United States)

    Cherry, Andrew L.

    2008-01-01

    Treatments for people with the co-occurring disorders of mental illness and substance use (abuse or dependence) have been evolving and improving since the mid 1980s. During this period substance abuse treatment programs reported between 50 and 75% of the people they served also had a mental health problem. At the same time, mental health programs…

  15. Motivation for Treatment and Motivation for Change in Substance-Dependent Patients with Co-Occurring Psychiatric Disorders

    NARCIS (Netherlands)

    Weert-van Oene, G.H. de; Gongora, V.; Sternberg, K. von; Jong, C.A.J. de

    2015-01-01

    The aims of this study were to examine the relationship between motivation for treatment and for change, and to explore their role in the prediction of treatment completion. The sample was composed of 560 predominantly polydrug-using inpatients with co-occurring psychiatric disorders. Motivation for

  16. Characteristics of Women Engaged in Treatment for Trauma and Co-Occurring Disorders: Findings from a National Multisite Study

    Science.gov (United States)

    Becker, Marion A.; Noether, Chanson D.; Larson, Mary Jo; Gatz, Margaret; Brown, Vivian; Heckman, Jennifer P.; Giard, Julienne

    2005-01-01

    Using data from a common cross-site protocol administered at study enrollment, in this article we examine key characteristics of 2,729 participants in the Women, Co-Occurring Disorders and Violence Study (WCDVS), including demographics, physical health, mental health, substance abuse, trauma experiences, parenting status, and past history of…

  17. Speech Abilities in Preschool Children with Speech Sound Disorder with and without Co-Occurring Language Impairment

    Science.gov (United States)

    Macrae, Toby; Tyler, Ann A.

    2014-01-01

    Purpose: The authors compared preschool children with co-occurring speech sound disorder (SSD) and language impairment (LI) to children with SSD only in their numbers and types of speech sound errors. Method: In this post hoc quasi-experimental study, independent samples t tests were used to compare the groups in the standard score from different…

  18. The Voices of Female Mental Health Professionals Working with American Indians with Co-Occurring Disorders: A Constructivist Grounded Theory

    Science.gov (United States)

    Harper, Faith G.

    2013-01-01

    The robust number of co-occurring disorders among American Indian (AI) populations within the United States constitutes a significant impact on AI communities. While this issue has been discussed in depth in academic literature, there is little discussion regarding how to treat these illnesses and no evidence-based practice. In order to identify…

  19. Risk for Suicidal Ideation and Suicide Attempts Associated with Co-Occurring Depression and Conduct Problems in Early Adolescence

    Science.gov (United States)

    Vander Stoep, Ann; Adrian, Molly; Mc Cauley, Elizabeth; Crowell, Sheila E.; Stone, Andrea; Flynn, Cynthia

    2011-01-01

    This study investigates the early manifestation of co-occurring depression and conduct problems as a predictor of heightened risk for later suicidal ideation and behavior in a community sample of 521 adolescents. Self-reported symptoms of depression and conduct problems were evaluated in early 6th grade. Suicidal thoughts and behaviors were…

  20. Hybrid Cognitive Behavioral Therapy versus Relaxation Training for Co-Occurring Anxiety and Alcohol Disorder: A Randomized Clinical Trial

    Science.gov (United States)

    Kushner, Matt G.; Maurer, Eric W.; Thuras, Paul; Donahue, Chris; Frye, Brenda; Menary, Kyle R.; Hobbs, Jennifer; Haeny, Angela M.; Van Demark, Joani

    2013-01-01

    Objective: Treatment for alcohol use disorder (AUD) is far less effective for those with a co-occurring anxiety disorder. Surprisingly, adding an independent anxiety treatment to AUD treatment does not substantially improve the poor alcohol outcomes of these patients. This may reflect the lack of attention from independent treatments to the…

  1. A Brief "DSM-IV"-Referenced Teacher Rating Scale for Monitoring Behavioral Improvement in ADHD and Co-Occurring Symptoms

    Science.gov (United States)

    Sprafkin, Joyce; Mattison, Richard E.; Gadow, Kenneth D.; Schneider, Jayne; Lavigne, John V.

    2011-01-01

    Objective: To examine the psychometric properties of the 30-item teacher's version of the Child and Adolescent Symptom Inventory Progress Monitor (CASI-PM-T), a "DSM-IV"-referenced rating scale for monitoring change in ADHD and co-occurring symptoms in youths receiving behavioral or pharmacological interventions. Method: Three separate studies…

  2. Using a Creative Intervention to Increase Self-Disclosure among Mandated Juveniles with Co-Occurring Disorders

    Science.gov (United States)

    Drew, Faith; Bitar, George W.; Gee, Robert; Graff, Chad; Springer, Paul

    2007-01-01

    Counselors providing treatment within the juvenile justice system encounter numerous challenges that are inherent in working with this population. One of the challenges includes providing treatment to adolescents who are entering the juvenile justice system with co-occurring mental health and substance use disorders. Given the challenges, creative…

  3. Self-Care Practices of Female Peer Support Specialists with Co-Occurring Mood and Substance Use Disorders

    Science.gov (United States)

    Wohlert, Beverly A.

    2014-01-01

    The purpose of this study was to better understand the self-care practices of female peer support specialists (PSS) with co-occurring mood and substance use disorders. The researcher took a qualitative grounded theory approach conducting in-depth semi-structured interviews with ten women employed at peer-run agencies in Maricopa County, Arizona.…

  4. Comparison of Younger and Older Adults' Acceptability of Treatment for Generalized Anxiety Disorder Co-Occurring with Parkinson's Disease

    Science.gov (United States)

    Lundervold, Duane A.; Ament, Patrick A.; Holt, Peter S.; Hunt, Lauren S.

    2013-01-01

    Acceptability ratings of medication or Behavioral Relaxation Training (BRT), for general anxiety disorder (GAD) co-occurring with Parkinson's Disease (PD) were obtained from younger ("n" = 79) and older ("n" = 54) adults. Participants read a case description of an older adult with PD and comorbid GAD followed by a description…

  5. Hydraulic architecture of two species differing in wood density: opposing strategies in co-occurring tropical pioneer trees

    Science.gov (United States)

    Katherine A. McCulloh; Daniel M. Johnson; Frederick C. Meinzer; Steven L. Voelker; Barbara Lachenbruch; Jean-Christophe. Domec

    2012-01-01

    Co-occurring species often have different strategies for tolerating daily cycles of water stress. One underlying parameter that can link together the suite of traits that enables a given strategy is wood density. Here we compare hydraulic traits of two pioneer species from a tropical forest in Panama that differ in wood density: Miconia argentea...

  6. A systematic review of interventions for co-occurring substance use and borderline personality disorders.

    Science.gov (United States)

    Lee, Nicole K; Cameron, Jacqui; Jenner, Linda

    2015-11-01

    The aim of this study was to undertake a systematic review on effective treatment options for co-occurring substance use and borderline personality disorders to examine effective treatments for this group. A systematic review using a narrative analysis approach was undertaken as there were too few studies within each intervention type to undertake a meta-analysis. The inclusion criteria comprised of English language studies (between 1999 and 2014) and a sample of >70% borderline personality disorder, with measurable outcomes for substance use and borderline personality disorder. All abstracts were screened (n = 376) resulting in 49 studies assessed for eligibility, with 10 studies, examining three different treatment types, included in the final review. There were four studies that examined dialectical behaviour therapy (DBT), three studies that examined dynamic deconstructive psychotherapy (DDP) and three studies that examined dual-focused schema therapy (DFST). Both DBT and DDP demonstrated reductions in substance use, suicidal/self-harm behaviours and improved treatment retention. DBT also improved global and social functioning. DFST reduced substance use and both DFST and DPP improved treatment utilisation, but no other significant positive changes were noted. Overall, there were a small number of studies with small sample sizes, so further research is required. However, in the absence of a strong evidence base, there is a critical need to respond to this group with co-occurring borderline personality disorder and substance use. Both DBT and DPP showed some benefit in reducing symptoms, with DBT the preferred option given its superior evidence base with women in particular. © 2015 Australasian Professional Society on Alcohol and other Drugs.

  7. The Economic Burden of Pathological Gambling and Co-occurring Mental Health and Substance Use Disorders.

    Science.gov (United States)

    Rodriguez-Monguio, Rosa; Brand, Evelyn; Volberg, Rachel

    Disordered gambling often co-occurs with psychiatric and substance use disorders. The study aim was to assess the healthcare costs of pathological gambling (PG) and co-occurring mental health and substance use disorders by payer. This is the first-of-its-kind economic analysis of addictive behaviors and mental health disorders. Study data were derived from the Massachusetts All-Payer Claims Data-a representative health claims database-for the period 2009 to 2013. The study analytical sample contained all medical and pharmaceutical claims for commercially insured Massachusetts residents who were aged ≥18 years, had health insurance coverage, had a diagnosis of PG, and sought care in the Commonwealth. Healthcare cost components included outpatient, inpatient, emergency room visits, and prescription drugs. Bootstrap analysis was performed to account for skewed distribution of cost data. All costs were adjusted to constant dollars. The study sample included 599 patients over the study period. The most prevalent principal diagnoses were disorders of impulse control (50%), episodic mood disorders (31%), anxiety disorders (14%), and psychoactive substance (9%). The mean annual total expenditures on health care per patient with diagnosis of pathological gambling were $7993 ± $11,847 (bias-corrected 95% confidence interval) in 2009, $10,054 ± $14,555 in 2010, $9093 ± $13,422 in 2011, and $9523 ± $14,505 in 2012. Pharmaceutical expenditures represented 16% to 22% of total healthcare expenditures. In the study period, prescription drug co-pays represented approximately 16% of the pharmaceutical expenditures. Psychiatric comorbidity and substance use disorders, and nondependent abuse of drugs are highly prevalent among pathological gamblers. These disorders pose an economic burden to patients and healthcare payers.

  8. Psychiatric, psychosocial, and physical health correlates of co-occurring cannabis use disorders and nicotine dependence.

    Science.gov (United States)

    Peters, Erica N; Schwartz, Robert P; Wang, Shuai; O'Grady, Kevin E; Blanco, Carlos

    2014-01-01

    Several gaps in the literature on individuals with co-occurring cannabis and tobacco use exist, including the extent of psychiatric, psychosocial, and physical health problems. We examine these gaps in an epidemiological study, the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC), of a large, nationally representative sample. The sample was drawn from Wave 2 NESARC respondents (N=34,653). Adults with current cannabis use disorders and nicotine dependence (CUD+ND) (n=74), CUD only (n=100), and ND only (n=3424) were compared on psychiatric disorders, psychosocial correlates (e.g., binge drinking; partner violence), and physical health correlates (e.g., medical conditions). Relative to those with CUD only, respondents with CUD+ND were significantly more likely to meet criteria for bipolar disorder, Clusters A and B personality disorders, and narcissistic personality disorder, and reported engaging in a significantly higher number of antisocial behaviors. Relative to those with ND only, respondents with CUD+ND were significantly more likely to meet criteria for bipolar disorder, anxiety disorders, and paranoid, schizotypal, narcissistic, and borderline personality disorders; were significantly more likely to report driving under the influence of alcohol and being involved in partner violence; and reported engaging in a significantly higher number of antisocial behaviors. CUD+ND was not associated with physical health correlates. Poor treatment outcomes for adults with co-occurring cannabis use disorders and nicotine dependence may be explained in part by differences in psychiatric and psychosocial problems. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  9. A review of Indian research on co-occurring cannabis use disorders& psychiatric disorders.

    Science.gov (United States)

    Singh, Shalini; Balhara, Yatan Pal Singh

    2017-08-01

    Cannabis is a widely used illicit drug and its use is often associated with co-occurring psychiatric disorders. This systematic review was aimed to provide information on the published Indian studies on co-occurring cannabis use disorders and psychiatric disorders. An electronic search of available Indian literature using relevant search terms was carried out in May 2015 and 52 articles in English language published from India were included in the current review. Studies on cannabis and associated psychotic disorders (n=16) chiefly described acute episodes with predominant positive symptoms, following cannabis use. Some studies (n=6) observed an overall increased prevalence of all psychiatric disorders and symptoms owing to cannabis use, while others (n=14) elaborated on high rates of substance use in those with psychiatric disorders. The effect of cannabis use on cognitive function was the focus of some of the Indian studies (n=7). All these studies barring one had all male subjects, and a single study described the service delivery model for those with dual diagnosis disorders in India. Most of the research used cross-sectional observational design and focussed on treatment-seeking population. A review of Indian literature on cannabis use and its association with psychiatric disorders indicates a high co-prevalence of psychotic disorders, especially in vulnerable individuals as well as high rates of co-occurrence of other psychiatric comorbidities. However, there is limited focus on exploring the aetiological association between cannabis use and psychiatric disorders; understanding the neurobiology of this association and management-related issues.

  10. Polysubstance use by psychiatry inpatients with co-occurring mental health and substance use disorders.

    Science.gov (United States)

    Timko, Christine; Ilgen, Mark; Haverfield, Marie; Shelley, Alexandra; Breland, Jessica Y

    2017-11-01

    Polysubstance use, the consumption of more than one substance over a defined period, is common and associated with psychiatric problems and poor treatment adherence and outcomes. This study examined past-month polysubstance use at intake among psychiatry inpatients with co-occurring mental health and substance use disorders, and outcomes 3 months later. Participants (n=406 psychiatry inpatients with documented mental health and substance use disorders) completed a baseline and a 3-month follow-up (84%) interview. With baseline data, a latent class analysis was conducted on substances used in the past 30days. Analyses of covariance tested for differences among classes on outcomes at 3-month follow-up. At baseline, three classes were estimated: Cannabis+Alcohol (35.1%), Alcohol (49.3%), and Polysubstance, notably, cocaine plus alcohol and marijuana (15.7%). At follow-up, the Polysubstance class had more severe alcohol and drug use, support for abstinence, and motivation for help-seeking, but less abstinence self-efficacy; it was most likely to attend 12-step groups. The Cannabis+Alcohol class was least likely to obtain outpatient substance use treatment, and had the lowest percent days abstinent. Psychiatry inpatients with co-occurring substance use and mental health disorders have varying substance use patterns that correspond to substance-related outcomes concurrently and over time. Many patients achieved abstinence for most days of the 3-month post-hospitalization period. To further increase abstinence, providers could build on polysubstance-using patients' high motivation to increase self-efficacy. In addition, because patients using mainly cannabis plus alcohol may perceive little harm from cannabis use, providers may consider modifying risk perceptions through effective education. Published by Elsevier B.V.

  11. Treating Smoking in Adults With Co-occurring Acute Psychiatric and Addictive Disorders.

    Science.gov (United States)

    Das, Smita; Hickman, Norval J; Prochaska, Judith J

    Tobacco use is undertreated in individuals with psychiatric and substance use disorders (SUDs), with concerns that quitting smoking may compromise recovery. We evaluated outcomes of a tobacco intervention among psychiatric patients with co-occurring SUDs. Data from 2 randomized tobacco treatment trials conducted in inpatient psychiatry were combined; analyses focused on the subsample with co-occurring SUDs (n = 216). Usual care provided brief advice to quit and nicotine replacement therapy during the smoke-free hospitalization. The intervention, initiated during hospitalization and continued 6 months after hospitalization, was tailored to readiness to quit smoking, and added a computer-assisted intervention at baseline, and 3 and 6 months; brief counseling; and 10 weeks of nicotine replacement therapy after hospitalization. Outcomes were 7-day point prevalence abstinence from 3 to 12 months and past 30-day reports of alcohol and illicit drug use. The sample consisted of 34% women, among which 36% were Caucasian, averaging 19 cigarettes/d prehospitalization; the groups were comparable at baseline. At 12 months, 22% of the intervention versus 11% of usual care participants were tobacco-abstinent (risk ratio 2.01, P = 0.03). Past 30-day abstinence from alcohol/drugs did not differ by group (22%); however, successful quitters were less likely than continued smokers to report past 30-day cannabis (18% vs 42%) and alcohol (22% vs 58%) use (P co-occurring SUDs was effective and did not adversely impact recovery. Quitting smoking was associated with abstinence from alcohol and cannabis at follow-up. The findings support addressing tobacco in conjunction with alcohol and other drugs in psychiatric treatment.

  12. Patterns of Co-occurring Gray Matter Concentration Loss Across the Huntington Disease Prodrome

    Directory of Open Access Journals (Sweden)

    Jennifer Ashley Ciarochi

    2016-09-01

    Full Text Available Huntington disease is caused by an abnormally expanded CAG trinucleotide repeat in the HTT gene. Age and CAG-expansion number are related to age at diagnosis, and can be used to index disease progression. However, observed onset-age variability suggests that other factors also modulate progression. Indexing prodromal (pre-diagnosis progression may highlight therapeutic targets by isolating the earliest-affected factors.We present the largest prodromal Huntington disease application of the univariate method Voxel-based Morphometry, and the first application of the multivariate method Source-based Morphometry, to respectively compare gray matter concentration and capture co-occurring gray matter concentration patterns in control and prodromal participants. Using structural MRI data from 1050 (831 prodromal, 219 control participants, we characterize control-prodromal, whole-brain gray matter concentration differences at various prodromal stages. Our results provide evidence for: (1 Regional co-occurrence and differential patterns of decline across the prodrome, with parietal and occipital differences commonly co-occurring, and frontal and temporal differences being relatively independent from one another, (2 Fronto-striatal circuits being among the earliest and most consistently affected in the prodrome (3 Delayed degradation in some movement-related regions, with increasing subcortical and occipital differences with later progression, (4 An overall superior-to-inferior gradient of gray matter concentration reduction in frontal, parietal, and temporal lobes, (5 The appropriateness of Source-based Morphometry for studying the prodromal Huntington disease population, and its enhanced sensitivity to early prodromal and regionally-concurrent differences.

  13. Comparative Genomics Unravels the Functional Roles of Co-occurring Acidophilic Bacteria in Bioleaching Heaps

    Directory of Open Access Journals (Sweden)

    Xian Zhang

    2017-05-01

    Full Text Available The spatial-temporal distribution of populations in various econiches is thought to be potentially related to individual differences in the utilization of nutrients or other resources, but their functional roles in the microbial communities remain elusive. We compared differentiation in gene repertoire and metabolic profiles, with a focus on the potential functional traits of three commonly recognized members (Acidithiobacillus caldus, Leptospirillum ferriphilum, and Sulfobacillus thermosulfidooxidans in bioleaching heaps. Comparative genomics revealed that intra-species divergence might be driven by horizontal gene transfer. These co-occurring bacteria shared a few homologous genes, which significantly suggested the genomic differences between these organisms. Notably, relatively more genes assigned to the Clusters of Orthologous Groups category [G] (carbohydrate transport and metabolism were identified in Sulfobacillus thermosulfidooxidans compared to the two other species, which probably indicated their mixotrophic capabilities that assimilate both organic and inorganic forms of carbon. Further inspection revealed distinctive metabolic capabilities involving carbon assimilation, nitrogen uptake, and iron-sulfur cycling, providing robust evidence for functional differences with respect to nutrient utilization. Therefore, we proposed that the mutual compensation of functionalities among these co-occurring organisms might provide a selective advantage for efficiently utilizing the limited resources in their habitats. Furthermore, it might be favorable to chemoautotrophs' lifestyles to form mutualistic interactions with these heterotrophic and/or mixotrophic acidophiles, whereby the latter could degrade organic compounds to effectively detoxify the environments. Collectively, the findings shed light on the genetic traits and potential metabolic activities of these organisms, and enable us to make some inferences about genomic and functional

  14. Automatic NMR-based identification of chemical reaction types in mixtures of co-occurring reactions.

    Directory of Open Access Journals (Sweden)

    Diogo A R S Latino

    Full Text Available The combination of chemoinformatics approaches with NMR techniques and the increasing availability of data allow the resolution of problems far beyond the original application of NMR in structure elucidation/verification. The diversity of applications can range from process monitoring, metabolic profiling, authentication of products, to quality control. An application related to the automatic analysis of complex mixtures concerns mixtures of chemical reactions. We encoded mixtures of chemical reactions with the difference between the (1H NMR spectra of the products and the reactants. All the signals arising from all the reactants of the co-occurring reactions were taken together (a simulated spectrum of the mixture of reactants and the same was done for products. The difference spectrum is taken as the representation of the mixture of chemical reactions. A data set of 181 chemical reactions was used, each reaction manually assigned to one of 6 types. From this dataset, we simulated mixtures where two reactions of different types would occur simultaneously. Automatic learning methods were trained to classify the reactions occurring in a mixture from the (1H NMR-based descriptor of the mixture. Unsupervised learning methods (self-organizing maps produced a reasonable clustering of the mixtures by reaction type, and allowed the correct classification of 80% and 63% of the mixtures in two independent test sets of different similarity to the training set. With random forests (RF, the percentage of correct classifications was increased to 99% and 80% for the same test sets. The RF probability associated to the predictions yielded a robust indication of their reliability. This study demonstrates the possibility of applying machine learning methods to automatically identify types of co-occurring chemical reactions from NMR data. Using no explicit structural information about the reactions participants, reaction elucidation is performed without structure

  15. Co-occurring intimate partner violence, mental health, and substance use problems: a scoping review.

    Science.gov (United States)

    Mason, Robin; O'Rinn, Susan E

    2014-01-01

    Intimate partner violence (IPV) is a pervasive, serious problem detrimental to the health of untold numbers of women. In addition to physical injuries that may be sustained, IPV has been significantly associated with mental health challenges including substance use problems. The problems are complex, highly correlated with each other, and bidirectional in nature. Although as many as 50% of women in mental health and between 25% and 50% of women in substance abuse treatment programs report IPV, frontline workers in all three sectors state they lack the training to address these co-occurring problems. To determine what frontline IPV, mental health, and substance use workers need to know in order to provide appropriate care to women experiencing co-occurring IPV, mental health and/or substance use problems. Using Scholars Portal OVID, Medline and OVID PsycINFO and combinations of significant terms, we conducted a scoping review of articles published between 2005 and 2014. An initial 4017 records were retrieved (3484 from Scholars Portal, 272 from Medline, 261 from PsycINFO). After applying inclusion and exclusion criteria, 35 articles were reviewed. Of these, 14 examined the relationships among IPV, mental health, and substance use; 7 focused on IPV and mental health; 14 looked at IPV and substance use. Although education and training frequently figured among the recommendations in the reviewed articles, specific content for proposed education or training was lacking. The most frequently occurring recommendations focused on the need to develop better collaboration, coordination, and integration across IPV, mental health and addiction treatment services.

  16. Co-occurring intimate partner violence, mental health, and substance use problems: a scoping review

    Directory of Open Access Journals (Sweden)

    Robin Mason

    2014-11-01

    Full Text Available Background: Intimate partner violence (IPV is a pervasive, serious problem detrimental to the health of untold numbers of women. In addition to physical injuries that may be sustained, IPV has been significantly associated with mental health challenges including substance use problems. The problems are complex, highly correlated with each other, and bidirectional in nature. Although as many as 50% of women in mental health and between 25% and 50% of women in substance abuse treatment programs report IPV, frontline workers in all three sectors state they lack the training to address these co-occurring problems. Objective: To determine what frontline IPV, mental health, and substance use workers need to know in order to provide appropriate care to women experiencing co-occurring IPV, mental health and/or substance use problems. Design: Using Scholars Portal OVID, Medline and OVID PsycINFO and combinations of significant terms, we conducted a scoping review of articles published between 2005 and 2014. Results: An initial 4017 records were retrieved (3484 from Scholars Portal, 272 from Medline, 261 from PsycINFO. After applying inclusion and exclusion criteria, 35 articles were reviewed. Of these, 14 examined the relationships among IPV, mental health, and substance use; 7 focused on IPV and mental health; 14 looked at IPV and substance use. Conclusions: Although education and training frequently figured among the recommendations in the reviewed articles, specific content for proposed education or training was lacking. The most frequently occurring recommendations focused on the need to develop better collaboration, coordination, and integration across IPV, mental health and addiction treatment services.

  17. Automatic NMR-based identification of chemical reaction types in mixtures of co-occurring reactions.

    Science.gov (United States)

    Latino, Diogo A R S; Aires-de-Sousa, João

    2014-01-01

    The combination of chemoinformatics approaches with NMR techniques and the increasing availability of data allow the resolution of problems far beyond the original application of NMR in structure elucidation/verification. The diversity of applications can range from process monitoring, metabolic profiling, authentication of products, to quality control. An application related to the automatic analysis of complex mixtures concerns mixtures of chemical reactions. We encoded mixtures of chemical reactions with the difference between the (1)H NMR spectra of the products and the reactants. All the signals arising from all the reactants of the co-occurring reactions were taken together (a simulated spectrum of the mixture of reactants) and the same was done for products. The difference spectrum is taken as the representation of the mixture of chemical reactions. A data set of 181 chemical reactions was used, each reaction manually assigned to one of 6 types. From this dataset, we simulated mixtures where two reactions of different types would occur simultaneously. Automatic learning methods were trained to classify the reactions occurring in a mixture from the (1)H NMR-based descriptor of the mixture. Unsupervised learning methods (self-organizing maps) produced a reasonable clustering of the mixtures by reaction type, and allowed the correct classification of 80% and 63% of the mixtures in two independent test sets of different similarity to the training set. With random forests (RF), the percentage of correct classifications was increased to 99% and 80% for the same test sets. The RF probability associated to the predictions yielded a robust indication of their reliability. This study demonstrates the possibility of applying machine learning methods to automatically identify types of co-occurring chemical reactions from NMR data. Using no explicit structural information about the reactions participants, reaction elucidation is performed without structure elucidation of

  18. Asthma and lung cancer, after accounting for co-occurring respiratory diseases and allergic conditions: a systematic review protocol.

    Science.gov (United States)

    Denholm, Rachel; Crellin, Elizabeth; Arvind, Ashwini; Quint, Jennifer

    2017-01-16

    Asthma is one of the most frequently diagnosed respiratory diseases in the UK, and commonly co-occurs with other respiratory and allergic diseases, such as chronic obstructive pulmonary disease (COPD) and atopic dermatitis. Previous studies have shown an increased risk of lung cancer related to asthma, but the evidence is mixed when accounting for co-occurring respiratory diseases and allergic conditions. A systematic review of published data that investigate the relationship between asthma and lung cancer, accounting for co-occurring respiratory and allergic diseases, will be conducted to investigate the independent association of asthma with lung cancer. A systematic review will be conducted, and include original reports of cohort, cross-sectional and case-control studies of the association of asthma with lung cancer after accounting for co-occurring respiratory diseases. Articles published up to June 2016 will be included, and their selection will follow the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A standardised data extraction form will be developed and pretested, and descriptive analyses will be used to summarise the available literature. If appropriate, pooled effect estimates of the association between asthma and lung cancer, given adjustment for a specific co-occurring condition will be estimated using random effects models. Potential sources of heterogeneity and between study heterogeneity will also be investigated. The study will be a review of published data and does not require ethical approval. Results will be disseminated through a peer-reviewed publication. International Prospective Register for Systematic Reviews (PROSPERO) number CRD42016043341. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  19. Transcranial magnetic stimulation: potential treatment for co-occurring alcohol, traumatic brain injury and posttraumatic stress disorders.

    Science.gov (United States)

    Herrold, Amy A; Kletzel, Sandra L; Harton, Brett C; Chambers, R Andrew; Jordan, Neil; Pape, Theresa Louise-Bender

    2014-10-01

    Alcohol use disorder (AUD), mild traumatic brain injury (mTBI), and posttraumatic stress disorder (PTSD) commonly co-occur (AUD + mTBI + PTSD). These conditions have overlapping symptoms which are, in part, reflective of overlapping neuropathology. These conditions become problematic because their co-occurrence can exacerbate symptoms. Therefore, treatments must be developed that are inclusive to all three conditions. Repetitive transcranial magnetic stimulation (rTMS) is non-invasive and may be an ideal treatment for co-occurring AUD + mTBI + PTSD. There is accumulating evidence on rTMS as a treatment for people with AUD, mTBI, and PTSD each alone. However, there are no published studies to date on rTMS as a treatment for co-occurring AUD + mTBI + PTSD. This review article advances the knowledge base for rTMS as a treatment for AUD + mTBI + PTSD. This review provides background information about these co-occurring conditions as well as rTMS. The existing literature on rTMS as a treatment for people with AUD, TBI, and PTSD each alone is reviewed. Finally, neurobiological findings in support of a theoretical model are discussed to inform TMS as a treatment for co-occurring AUD + mTBI + PTSD. The peer-reviewed literature was identified by targeted literature searches using PubMed and supplemented by cross-referencing the bibliographies of relevant review articles. The existing evidence on rTMS as a treatment for these conditions in isolation, coupled with the overlapping neuropathology and symptomology of these conditions, suggests that rTMS may be well suited for the treatment of these conditions together.

  20. Domains and perceived benefits of treatment among patients with and without co-occurring disorders in inpatient substance use treatment.

    Science.gov (United States)

    Bergly, Tone H; Gråwe, Rolf W; Hagen, Roger

    2014-01-01

    Persons with substance use disorders often have comorbid psychiatric problems, and treating all problem domains is important for treatment success and recovery. This study examined reported interventions provided to patients as well as patients' reports of domains of help received, perceived areas of greatest benefit, and satisfaction with substance use disorder treatment. We also compared patients with co-occurring disorders and patients with only substance use disorders to see whether there were significant differences across groups on these measures. Patients receiving inpatient substance use treatment at clinics in Norway were recruited for the study; 85 completed a cross-sectional survey prior to discharge. Treatment personnel also completed a separate survey and gathered information from patient charts. The most frequently provided treatment interventions involved improving relationships with family and important others, applied relaxation, psychodynamic therapy, cognitive behavior therapy, and motivational interviewing. Patients reported receiving the most help in domains of relapse prevention, physical health, daily functioning, relationships with people, psychological health, and self-esteem. They benefited most from physical activities, support from co-patients, group therapy, counseling, and assessment/treatment of psychological health. Patients with co-occurring disorders were given more exposure therapy, motivational interviewing, and cognitive behavior therapy interventions than those without comorbidity. Patients with co-occurring disorders self-reported receiving more help with self-esteem and coping with psychiatric symptoms and benefiting more from interventions involving psychological health, acute help, and social situations. Patients perceived psychological and physical health as important areas for improvement. There were differences between patients with co-occurring disorders and those with substance use disorders only in several measures

  1. A qualitative study of career exploration among young adult men with psychosis and co-occurring substance use disorder.

    Science.gov (United States)

    Luciano, Alison; Carpenter-Song, Elizabeth A

    2014-01-01

    This article explores the meaning and importance of career exploration and career development in the context of integrated treatment for young adults with early psychosis and substance use disorders (i.e., co-occurring disorders). Twelve young adult men (aged 18 to 35 years) with co-occurring disorders recruited from an integrated treatment center completed a series of three semi-structured in-depth qualitative interviews. Data were transcribed verbatim and analyzed using thematic analysis. Purposive sampling ensured participants represented a range of substance abuse treatment stages. Participants had a mean age of 26 (SD = 3) and identified as White. Two-thirds of participants (n = 8, 67%) had diagnosed schizophrenia-spectrum disorders, three (25%) had bipolar disorder, and one (8%) had major depression; four (33%) also had a co-occurring anxiety disorder. The most common substance use disorders involved cannabis (n = 8, 67%), cocaine (n = 5, 42%), and alcohol (n = 5, 42%). These young adult men with co-occurring disorders described past jobs that did not align with future goals as frustrating and disempowering, rather than confidence-building. Most young adult participants began actively developing their careers in treatment through future-oriented work or school placements. They pursued ambitious career goals despite sporadic employment and education histories. Treatment engagement and satisfaction appeared to be linked with career advancement prospects. Integrating career planning into psychosocial treatment is a critical task for providers who serve young adults with co-occurring disorders. Whether integrating career planning within early intervention treatment planning will improve clinical, functional, or economic outcomes is a promising area of inquiry for rehabilitation researchers and clinicians.

  2. Cultural, social and intrapersonal factors associated with clusters of co-occurring health-related behaviours among adolescents.

    Science.gov (United States)

    Klein Velderman, Mariska; Dusseldorp, Elise; van Nieuwenhuijzen, Maroesjka; Junger, Marianne; Paulussen, Theo G W M; Reijneveld, Sijmen A

    2015-02-01

    Adverse health-related behaviours (HRBs) have been shown to co-occur in adolescents. Evidence lacks on factors associated with these co-occurring HRBs. The Theory of Triadic Influence (TTI) offers a route to categorize these determinants according to type (social, cultural and intrapersonal) and distance in the causal pathway (ultimate or distal). Our aims were to identify cultural, social and intrapersonal factors associated with co-occurring HRBs and to assess the relative importance of ultimate and distal factors for each cluster of co-occurring HRBs. Respondents concerned a random sample of 898 adolescents aged 12-18 years, stratified by age, sex and educational level of head of household. Data were collected via face-to-face computer-assisted interviewing and internet questionnaires. Analyses were performed for young (12-15 years) and late (16-18 years) adolescents regarding two and three clusters of HRB, respectively. For each cluster of HRBs (e.g. smoking, delinquency), associated factors were found. These accounted for 27 to 57% of the total variance per cluster. Factors came in particular from the intrapersonal stream of the TTI at the ultimate level and the social stream at the distal level. Associations were strongest for parenting practices, risk behaviours of friends and parents and self-control. Results of this study confirm that it is possible to identify a selection of cultural, social and intrapersonal factors associated with co-occurring HRBs among adolescents. © The Author 2014. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.

  3. Smoking cessation outcomes and predictors among individuals with co-occurring substance use and/or psychiatric disorders.

    Science.gov (United States)

    Okoli, Chizimuzo T C; Khara, Milan

    2014-01-01

    Individuals with substance use and psychiatric disorders have a high prevalence of tobacco use disorders and are disproportionately affected by tobacco-related morbidity and mortality. However, it is unclear how having co-occurring disorders affects tobacco cessation. Our aim was to examine smoking cessation outcomes and relevant predictors of smoking cessation among smokers with substance use and/or psychiatric disorders. Data from medical records of 674 participants in a tobacco treatment program within mental health and addictions services in Vancouver, Canada, were analyzed. The 26-week treatment program included an 8-week structured behavioral counseling group, an 18-week support group, and 26 weeks of no-cost pharmacotherapy. Information on demographics, tobacco use and history, type of pharmacotherapy received, nicotine dependence, importance of and confidence in quitting smoking, expired carbon monoxide level, substance use and psychiatric disorder history, and total program visits were gathered. Approximately 67% (n = 449) of participants had co-occurring substance use and psychiatric disorders, while 20% (n = 136) had substance use disorder only, 10% (n = 67) had psychiatric disorder only, and 3% (n = 22) had tobacco dependence only. Rates of tobacco cessation (i.e., 7-day point prevalence of abstinence verified by expired carbon monoxide of ≤8 ppm) by group in the 522 people who completed treatment were as follows: 38.2% for those with co-occurring disorders, 47.1% for those with tobacco dependence only, 47.1% for those with substance use disorder only, and 41.8% for those with psychiatric disorder only. Length of treatment was a significant predictor of smoking cessation for those with co-occurring disorders and substance use disorder only. In the final stratified multivariate analysis, for individuals with co-occurring disorders, having an opiate use disorder (as compared to an alcohol use disorder) and higher nicotine dependence scores at baseline

  4. Divergent Hydraulic Safety Strategies in Three Co-occurring Anacardiaceae Tree Species in a Chinese Savanna.

    Science.gov (United States)

    Zhang, Shu-Bin; Zhang, Jiao-Lin; Cao, Kun-Fang

    2016-01-01

    Vulnerability segmentation, the condition under which plant leaves are more vulnerable to drought-induced cavitation than stems, may act as a "safety valve" to protect stems from hydraulic failure. Evergreen, winter-deciduous, and drought-deciduous tree species co-occur in tropical savannas, but there have been no direct studies on the role of vulnerability segmentation and stomatal regulation in maintaining hydraulic safety in trees with these three leaf phenologies. To this end, we selected three Anacardiaceae tree species co-occurring in a Chinese savanna, evergreen Pistacia weinmanniifolia , drought-deciduous Terminthia paniculata , and winter-deciduous Lannea coromandelica , to study inter-species differentiation in leaf and stem hydraulic safety. We found that the two deciduous species had significantly higher sapwood-specific hydraulic conductivity and leaf-specific hydraulic conductance than the evergreen species. Moreover, two deciduous species were more vulnerable to stem cavitation than the evergreen species, although both drought-deciduous species and evergreen species had drought-resistance leaves. The evergreen species maintained a wide hydraulic safety margin (HSM) in stems and leaves; which was achieved by embolism resistance of both stems and leaves and isohydric stomatal control. Both deciduous species had limited HSMs in stems and leaves, being isohydric in the winter-deciduous species and anisohydric in drought-deciduous species. The difference in water potential at 50% loss of hydraulic conductivity between the leaves and the terminal stems (P50 leaf-stem ) was positive in P. weinmanniifolia and L. coromandelica , whereas, T. paniculata exhibited a lack of vulnerability segmentation. In addition, differences in hydraulic architecture were found to be closely related to other structural traits, i.e., leaf mass per area, wood density, and sapwood anatomy. Overall, the winter-deciduous species exhibits a drought-avoidance strategy that maintains

  5. Phylogenetic structure of bacterial assemblages co-occurring with Ostreopsis cf. ovata bloom.

    Science.gov (United States)

    Vanucci, Silvana; Guidi, Flavio; Pistocchi, Rossella; Long, Richard A

    2016-05-01

    Extensive blooms of the toxic epiphytic/benthic dinoflagellate Ostreopsis cf. ovata are being reported with increasing frequency and spatial distribution in temperate coastal regions including the Mediterranean. These blooms are of human and environmental health concern due to the production of isobaric palytoxin and a wide range of ovatoxins by Ostreopsis cf. ovata. Bacterial-microalgal interactions are important regulators in algal bloom dynamics and potentially toxin dynamics. This study investigated the bacterial assemblages co-occurring with O. cf. ovata (OA) and from ambient seawaters (SW) during the early and peak phases of bloom development in NW Adriatic Sea. Fractions of the bacterial assemblages co-occurring with O. cf. ovata (OA) and more closely associated to the mucilage layer (LA) embedding O. cf. ovata cells were also reported. In total, 14 bacterial phyla were detected by targeted 454 pyrosequencing of the 16S rRNA gene. The dominant bacterial phyla in the OA assemblages were Proteobacteria and Bacteroidetes; while at the class level, Alphaproteobacteria were the most abundant (83 and 66%, relative abundance, early and peak bloom phases), followed by Flavobacteria (7 and 19%, early and peak phases). Actinobacteria and Cyanobacteria were of minor importance (<5% of the relative bacterial abundance each). Gammaproteobacteria showed a notably presence in OA assemblage only at the early phase of the bloom (genus Haliea, 13%). The Alphaproteobacteria were predominately composed by the genera Ruegeria, Jannaschia and Erythrobacter which represented about half of the total phylotypes' contribution of OA at both early and peak phases of the O. cf. ovata bloom, suggesting interactions between this consortium and the microalga. Moreover, the highest contribution of Ruegeria (30% of the total phylotypes) was observed at the early phase of the bloom in LA assemblage. Microbial assemblages associated with the ambient seawaters while being also dominated by

  6. Co-occurring mental disorder and intellectual disability in a large sample of Australian prisoners.

    Science.gov (United States)

    Dias, Shannon; Ware, Robert S; Kinner, Stuart A; Lennox, Nicholas G

    2013-10-01

    Prisoners with intellectual disability who have a coexisting mental health issue often have unmet health needs and are more likely to reoffend than those with intellectual disability alone. The aims of this study were to estimate the prevalence of co-occurring mental disorder among prisoners with intellectual disability and to explore the association between intellectual disability and mental disorder. Cross-sectional study of adult prisoners within 6 weeks of release from custody in seven prisons in Queensland, Australia between August 2008 and July 2010. Intellectual disability was assessed using a practical composite screening tool. Prisoners who scored prisoners completed the HASI: 316 (24%) scored below the recommended cut off for further diagnostic assessment of intellectual disability, 181 (14%) reported attending a special school, and 56 (4%) reported that they had been diagnosed with an intellectual disability. On our composite measure, 115 (9%) participants were identified as having an intellectual disability. Among prisoners with intellectual disability, the estimated lifetime and current prevalence of co-occurring mental disorders was 52.5% (95% CI 43.3-61.5) and 37.2% (95% CI 28.8-46.5), respectively. Of those with intellectual disability, 13.5% (95% CI 8.3-21.1) reported very high psychological distress, as measured by the K10. Prisoners with intellectual disability were significantly more likely than their non-disabled peers to report a current diagnosis of depression [adjusted odds ratio (AOR) 1.8, 95% CI 1.1-3.2] or substance dependence (AOR 3.7, 95% CI 1.6-8.4], after adjusting for potentially confounding variables. Prisoners with intellectual disability were also significantly more likely than their non-disabled peers to use antipsychotic medication (AOR 1.7, 95% CI 1.0-2.8). Prisoners with an intellectual disability were more likely than their non-disabled peers to have elevated rates of psychiatric comorbidity and unmet treatment needs. There

  7. Consumers’ Experiences in Dual Focus Mutual Aid for Co-occurring Substance Use and Mental Health Disorders

    Directory of Open Access Journals (Sweden)

    Harlan Matusow

    2013-01-01

    Full Text Available Mutual aid fellowships have been shown to improve outcomes for those with co-occurring substance use and mental illness disorders. Processes associated with usefulness include helper therapy (the assumption of a helping role to foster commitment and reciprocal learning (the sharing of problems and solutions among members. The present qualitative investigation used focus groups comprised a subset of participants in Double Trouble in Recovery (DTR, a 12-step mutual aid group for those with co-occurring disorders, to gather their subjective perceptions of the groups. Participants emphasized that in linking them to others with similar problems, the DTR groups played a vital emotional role in their lives and provided a needed venue for information sharing that might have been otherwise unavailable.

  8. Free-living amoebae (FLA) co-occurring with legionellae in industrial waters☆

    Science.gov (United States)

    Scheikl, Ute; Sommer, Regina; Kirschner, Alexander; Rameder, Alexandra; Schrammel, Barbara; Zweimüller, Irene; Wesner, Wolfgang; Hinker, Manfred; Walochnik, Julia

    2014-01-01

    Legionella pneumophila is known as the causative agent of Legionnaires’ disease and free-living amoebae (FLA) can serve as vehicles for legionellae. The aim of this study was to screen industrial waters for the occurrence of FLA and their co-occurrence with legionellae. A total of 201 water samples, including 129 cooling waters and 72 process waters, and 30 cooling lubricants were included in the study. Treated waters were screened periodically, pre and post treatment. Altogether, 72.6% of the water samples were positive for FLA, acanthamoebae being most prevalent (in 23.9% of the samples) followed by Vermamoeba vermiformis (19.4%). Only one cooling lubricant was positive (Acanthamoeba genotype T4). Legionella spp. were detected in 34.8% of the water samples and in 15% in high concentrations (>1000 CFU/100 ml). Altogether, 81.4% of the Legionella-positive samples were positive for FLA by standard methods. By applying a highly sensitive nested PCR to a representative set of random samples it was revealed that Legionella spp. always co-occurred with Acanthamoeba spp. Although the addition of disinfectants did influence amoebal density and diversity, treated waters showed no difference concerning FLA in the interphases of disinfection. It appears that FLA can re-colonize treated waters within a short period of time. PMID:25062389

  9. Free-living amoebae (FLA) co-occurring with legionellae in industrial waters.

    Science.gov (United States)

    Scheikl, Ute; Sommer, Regina; Kirschner, Alexander; Rameder, Alexandra; Schrammel, Barbara; Zweimüller, Irene; Wesner, Wolfgang; Hinker, Manfred; Walochnik, Julia

    2014-08-01

    Legionella pneumophila is known as the causative agent of Legionnaires' disease and free-living amoebae (FLA) can serve as vehicles for legionellae. The aim of this study was to screen industrial waters for the occurrence of FLA and their co-occurrence with legionellae. A total of 201 water samples, including 129 cooling waters and 72 process waters, and 30 cooling lubricants were included in the study. Treated waters were screened periodically, pre and post treatment. Altogether, 72.6% of the water samples were positive for FLA, acanthamoebae being most prevalent (in 23.9% of the samples) followed by Vermamoeba vermiformis (19.4%). Only one cooling lubricant was positive (Acanthamoeba genotype T4). Legionella spp. were detected in 34.8% of the water samples and in 15% in high concentrations (>1000 CFU/100 ml). Altogether, 81.4% of the Legionella-positive samples were positive for FLA by standard methods. By applying a highly sensitive nested PCR to a representative set of random samples it was revealed that Legionella spp. always co-occurred with Acanthamoeba spp. Although the addition of disinfectants did influence amoebal density and diversity, treated waters showed no difference concerning FLA in the interphases of disinfection. It appears that FLA can re-colonize treated waters within a short period of time. Copyright © 2014 The Authors. Published by Elsevier GmbH.. All rights reserved.

  10. Effect of co-occurring disorders and intimate partner violence on substance abuse treatment outcomes.

    Science.gov (United States)

    Lipsky, Sherry; Krupski, Antoinette; Roy-Byrne, Peter; Lucenko, Barbara; Mancuso, David; Huber, Alice

    2010-04-01

    This retrospective cohort study examined risk factors for co-occurring substance use and mental disorders (COD) and the effect of COD and intimate partner violence (IPV) victimization among women and IPV-related arrest among men on 1-year substance abuse treatment outcomes. The study sample included clients admitted to Washington State publicly funded substance abuse treatment facilities in 2004-2007. COD was associated with a high substance use and IPV risk profile at admission. Having a COD decreased the odds of completing treatment by 30% among men and women and increased the risk of treatment reentry by 9% and 12% among men and women, respectively. IPV also decreased the odds of completing treatment among women and increased the risk of treatment reentry among men. Men with COD were less likely than those without COD to be arrested for substance-related crimes but more likely to be arrested for violence-related crimes in the follow-up period. Implications of these findings are discussed. Copyright 2010 Elsevier Inc. All rights reserved.

  11. Treatment of borderline personality disorder and co-occurring anxiety disorders

    Science.gov (United States)

    Valenstein, Helen R.

    2013-01-01

    Anxiety disorders are highly prevalent among individuals with borderline personality disorder, with comorbidity rates of up to 90%. Anxiety disorders have been found to reduce the likelihood of achieving remission from borderline personality disorder over time and to increase the risk of suicide and self-injury in this population. Evidence-based treatments for borderline personality disorder have not sufficiently focused on targeting anxiety disorders, and their effects on these disorders are either limited or unknown. Conversely, evidence-based treatments for anxiety disorders typically exclude suicidal, self-injuring, and seriously comorbid patients, thereby limiting their generalizability to individuals with borderline personality disorder. To address these limitations, recent research has begun to emerge focused on developing and evaluating treatments for individuals with co-occurring borderline personality disorder and anxiety disorders, specifically posttraumatic stress disorder (PTSD), with promising initial results. However, there is a need for additional research in this area, particularly studies evaluating the treatment of anxiety disorders among high-risk and complex borderline personality disorder patients. PMID:23710329

  12. Co-occurring behavioral difficulties in children with severe feeding problems: A descriptive study.

    Science.gov (United States)

    González, Melissa L; Stern, Karin

    2016-11-01

    Recent literature highlights the association between behavioral difficulties and the presence of feeding problems in children with an Autism Spectrum Disorder (ASD) relative to children with ASD without feeding problems. However, it is not clear to what extent behavior problems (outside of the meal setting) occur in children with feeding problems without comorbid ASD. The purpose is to describe co-occurring behavioral difficulties of a sample of children with severe food refusal/selectivity and examine potential predictors of behavioral difficulties outside of the meal context. The medical charts of fifty-four patients were reviewed and data were collected on the frequency of caregiver coaching and/or behavioral intervention outside of the meal context. Age, presence of developmental delay/autism, and type of feeding problem were examined as potential predictors of behavioral support. Approximately half of the sample received coaching or individualized intervention. The percentage of caregivers who received individualize coaching were similar across groups. Younger age at admission was a predictor of individual caregiver coaching. Presence of delay/ASD, age, and type of feeding problems were not significant predictors for individualized treatment programing. These data provide evidence of difficult caregiver-child interactions that occurs outside of the meal context for some children with severe feeding difficulties and suggest that this association may not be exclusive to children with ASD. Copyright © 2016 Elsevier Ltd. All rights reserved.

  13. Performance measurement for co-occurring mental health and substance use disorders

    Directory of Open Access Journals (Sweden)

    Pincus Harold A

    2009-10-01

    Full Text Available Abstract Background Co-occurring mental health and substance use disorders (COD are the norm rather than the exception. It is therefore critical that performance measures are developed to assess the quality of care for individuals with COD irrespective of whether they seek care in mental health systems or substance abuse systems or both. Methods We convened an expert panel and asked them to rate a series of structure, process, and outcomes measures for COD using a structured evaluation tool with domains for importance, usefulness, validity, and practicality. Results We chose twelve measures that demonstrated promise for future pilot testing and refinement. The criteria that we applied to select these measures included: balance across structure, process, and outcome measures, quantitative ratings from the panelists, narrative comments from the panelists, and evidence the measure had been tested in a similar form elsewhere. Conclusion To be successful performance measures need to be developed in such a way that they align with needs of administrators and providers. Policymakers need to work with all stakeholders to establish a concrete agenda for developing, piloting and implementing performance measures that include COD. Future research could begin to consider strategies that increase our ability to use administrative coding in mental health and substance use disorder systems to efficiently capture quality relevant clinical data.

  14. Co-occurring Mental Disorders in Substance Abuse Treatment: the Current Health Care Situation in Germany.

    Science.gov (United States)

    Dauber, Hanna; Braun, Barbara; Pfeiffer-Gerschel, Tim; Kraus, Ludwig; Pogarell, Oliver

    2018-01-01

    Aim of this study was to investigate the current health care situation for patients with co-occurring mental disorders in addiction treatment. Therefore, data from the German Substance Abuse Treatment System ( N  = 194,406) was analysed with regard to the prevalence of comorbid mental disorders, treatment characteristics and outcomes of patients with comorbid psychiatric diagnosis. In outpatient setting, the prevalence of comorbid diagnoses was considerably lower (4.6%) than in inpatient setting (50.7%), but mood and anxiety disorders were the most prevalent additional diagnoses in both settings. In the treatment of patients with these comorbid disorders, we found higher rates of complementary internal and external (psychiatric) treatment, more co-operations and referrals after treatment, and positive treatment process outcomes. Findings indicate that the knowledge of an additional diagnosis influences the health care provision of affected patients and can therefore be seen as the essential precondition for providing adequate and comprehensive treatment. This highlights the importance of a sufficient consideration and diagnostic assessment of mental disorders in addiction treatment to further improve the health care situation of comorbid patients.

  15. Caregiving for Relatives with Psychiatric Disorders vs. Co-Occurring Psychiatric and Substance Use Disorders.

    Science.gov (United States)

    Labrum, Travis

    2018-02-08

    Despite the high comorbidity of psychiatric and substance use disorders, extremely little research has examined the experience of caregiving for relatives with co-occurring psychiatric and substance use disorders (COD). The primary objective of the present article is to identify characteristics pertaining to care recipients, family caregivers, and the experience of providing caregiving associated with care recipients having COD vs. only having psychiatric disorders (PD). A U.S. community recruited sample of 1394 family caregivers of persons with COD or PD was employed. Chi-square and Mann-Whitney-Wilcoxon tests were conducted. Compared to caregivers of persons with only PD, caregivers of persons with COD provided slightly less caregiving but experienced significantly greater negative effects from providing care. Caregivers of persons with COD were also more likely to fear care recipients would engage in multiple problematic behaviors. Most significant differences found in providing care to recipients with COD vs. only PD persisted when examining care recipients with severe psychiatric disorders or more moderate psychiatric disorders. Additional findings and treatment implications are described.

  16. Demoralization in Patients With Substance Use and Co-Occurring Psychiatric Disorders.

    Science.gov (United States)

    De Weert, Gerdien H; Markus, Wiebren; Kissane, David W; De Jong, Cornelis A J

    2017-01-01

    In recent years, treatment of substance use disorder has rekindled emphasis on recovery which, being a gradual process, starts with remoralization. In this study, we examine the level of demoralization throughout the treatment process for patients with comorbid substance dependence and psychiatric disorders. 217 patients with co-occurring disorders and 179 community-based individuals participated in this study. Demoralization was measured twice over one month as inpatient treatment happened. In contrast with the community sample, we found high levels of demoralization in the clinical cohort, with 86% of patients having demoralization scores above threshold. During the first month there was a statistically significant reduction in demoralization scores. However, clinically relevant change appeared limited, with only 3% of patients moving from dysfunctional to functional status in this naturalistic setting without targeted intervention aimed at remoralization. Although the level of demoralization is significantly improved during the first month of treatment, patients still remain strongly demoralized. Clinically relevant improvement is limited. It could be worthwhile to set up targeted interventions aimed at remoralization. Furthermore, we advocate for the assessment of demoralization in the clinical setting to monitor patients' treatment outcomes.

  17. The Structure of Co-Occurring Bullying Experiences and Associations with Suicidal Behaviors in Korean Adolescents

    Science.gov (United States)

    Roh, Beop-Rae; Yoon, Yoewon; Kwon, Ahye; Oh, Seunga; Lee, Soyoung Irene; Ha, Kyunghee; Shin, Yun Mi; Song, Jungeun; Park, Eun Jin; Yoo, Heejung; Hong, Hyun Ju

    2015-01-01

    Objective This study had two main goals: to examine the structure of co-occurring peer bullying experiences among adolescents in South Korea from the perspective of victims and to determine the effects of bullying on suicidal behavior, including suicidal ideation and suicide attempts, among adolescents. Method This study used data gathered from 4,410 treatment-seeking adolescents at their initial visits to 31 local mental health centers in Gyeonggi Province, South Korea. The structure of peer bullying was examined using latent class analysis (LCA) to classify participants’ relevant experiences. Then, a binomial logistic regression adjusted by propensity scores was conducted to identify relationships between experiences of being bullied and suicidal behaviors. Results The LCA of experiences with bullying revealed two distinct classes of bullying: physical and non-physical. Adolescents who experienced physical bullying were 3.05 times more likely to attempt suicide than those who were not bullied. Victims of (non-physical) cyber bullying were 2.94 times more likely to attempt suicide than were those who were not bullied. Conclusions Both physical and non-physical bullying were associated with suicide attempts, with similar effect sizes. Schools and mental health professionals should be more attentive than they currently are to non-physical bullying. PMID:26619356

  18. Organization of co-occurring Axis II features in borderline personality disorder.

    Science.gov (United States)

    Critchfield, Kenneth L; Clarkin, John F; Levy, Kenneth N; Kernberg, Otto F

    2008-06-01

    Considerable heterogeneity exists in the comorbid Axis II features that frequently accompany borderline personality disorder (BPD). These features have potential to be meaningfully organized, relate to specific BPD presentation, and have implications for treatment process and outcome. The present study explored patterns of Axis II comorbidity in order to identify subtypes of BPD. A well-defined sample of 90 patients diagnosed with BPD was recruited as part of an RCT study. Participants were administered the International Personality Disorder Examination (Loranger, 1999) to diagnose BPD and assess comorbid Axis II features. Other measures were also administered to assess aspects of current work and relationship functioning, symptomatology, and self-concept. Q-factoring was used to develop subtypes based on commonly occurring Axis II profiles, identifying three: Cluster A (elevated paranoid and schizotypal features), Cluster B (elevated narcissistic and histrionic features), and Cluster C (elevated avoidant and obsessive-compulsive features). An additional factor analysis revealed two dimensions underlying the comorbid features identifiable as: extraversion versus introversion and antagonism versus constraint. Validity of these two maps of comorbidity was explored in terms of the BPD criteria themselves, as well as on work and relationship functioning, identity diffusion, views of self and others, positive and negative affect, behavioural dyscontrol, and symptomatic distress. Clinically meaningful subtypes can be identified for BPD based on co-occurring Axis II features. Further research is needed to replicate and further establish base-rates of these subtypes as well as their differential implications for treatment.

  19. The Structure of Co-Occurring Bullying Experiences and Associations with Suicidal Behaviors in Korean Adolescents.

    Science.gov (United States)

    Roh, Beop-Rae; Yoon, Yoewon; Kwon, Ahye; Oh, Seunga; Lee, Soyoung Irene; Ha, Kyunghee; Shin, Yun Mi; Song, Jungeun; Park, Eun Jin; Yoo, Heejung; Hong, Hyun Ju

    2015-01-01

    This study had two main goals: to examine the structure of co-occurring peer bullying experiences among adolescents in South Korea from the perspective of victims and to determine the effects of bullying on suicidal behavior, including suicidal ideation and suicide attempts, among adolescents. This study used data gathered from 4,410 treatment-seeking adolescents at their initial visits to 31 local mental health centers in Gyeonggi Province, South Korea. The structure of peer bullying was examined using latent class analysis (LCA) to classify participants' relevant experiences. Then, a binomial logistic regression adjusted by propensity scores was conducted to identify relationships between experiences of being bullied and suicidal behaviors. The LCA of experiences with bullying revealed two distinct classes of bullying: physical and non-physical. Adolescents who experienced physical bullying were 3.05 times more likely to attempt suicide than those who were not bullied. Victims of (non-physical) cyber bullying were 2.94 times more likely to attempt suicide than were those who were not bullied. Both physical and non-physical bullying were associated with suicide attempts, with similar effect sizes. Schools and mental health professionals should be more attentive than they currently are to non-physical bullying.

  20. The Structure of Co-Occurring Bullying Experiences and Associations with Suicidal Behaviors in Korean Adolescents.

    Directory of Open Access Journals (Sweden)

    Beop-Rae Roh

    Full Text Available This study had two main goals: to examine the structure of co-occurring peer bullying experiences among adolescents in South Korea from the perspective of victims and to determine the effects of bullying on suicidal behavior, including suicidal ideation and suicide attempts, among adolescents.This study used data gathered from 4,410 treatment-seeking adolescents at their initial visits to 31 local mental health centers in Gyeonggi Province, South Korea. The structure of peer bullying was examined using latent class analysis (LCA to classify participants' relevant experiences. Then, a binomial logistic regression adjusted by propensity scores was conducted to identify relationships between experiences of being bullied and suicidal behaviors.The LCA of experiences with bullying revealed two distinct classes of bullying: physical and non-physical. Adolescents who experienced physical bullying were 3.05 times more likely to attempt suicide than those who were not bullied. Victims of (non-physical cyber bullying were 2.94 times more likely to attempt suicide than were those who were not bullied.Both physical and non-physical bullying were associated with suicide attempts, with similar effect sizes. Schools and mental health professionals should be more attentive than they currently are to non-physical bullying.

  1. Co-occurring woody species have diverse hydraulic strategies and mortality rates during an extreme drought.

    Science.gov (United States)

    Johnson, Daniel M; Domec, Jean-Christophe; Carter Berry, Z; Schwantes, Amanda M; McCulloh, Katherine A; Woodruff, David R; Wayne Polley, H; Wortemann, Remí; Swenson, Jennifer J; Scott Mackay, D; McDowell, Nate G; Jackson, Robert B

    2018-03-01

    From 2011 to 2013, Texas experienced its worst drought in recorded history. This event provided a unique natural experiment to assess species-specific responses to extreme drought and mortality of four co-occurring woody species: Quercus fusiformis, Diospyros texana, Prosopis glandulosa, and Juniperus ashei. We examined hypothesized mechanisms that could promote these species' diverse mortality patterns using postdrought measurements on surviving trees coupled to retrospective process modelling. The species exhibited a wide range of gas exchange responses, hydraulic strategies, and mortality rates. Multiple proposed indices of mortality mechanisms were inconsistent with the observed mortality patterns across species, including measures of the degree of iso/anisohydry, photosynthesis, carbohydrate depletion, and hydraulic safety margins. Large losses of spring and summer whole-tree conductance (driven by belowground losses of conductance) and shallower rooting depths were associated with species that exhibited greater mortality. Based on this retrospective analysis, we suggest that species more vulnerable to drought were more likely to have succumbed to hydraulic failure belowground. © 2018 John Wiley & Sons Ltd.

  2. Combined evoked potentials in co-occuring attention deficit hyperactivity disorder and epilepsy.

    Science.gov (United States)

    Major, Zoltán Zsigmond

    2011-07-30

    Evoked potentials, both stimulus related and event related, show disturbances in attention deficit-hyperactivity disorder and epilepsies, too. This study was designed to evaluate if these potentials are characteristically influenced by the presence of the two diseases, individually, and in the case of co-occurrence. Forty children were included, and four groups were formed, control group, ADHD group, epilepsy group and a group with the comorbidity of epilepsy and ADHD. Epilepsy patients were under proper antiepileptic treatment; ADHD patients were free of specific therapy. Brainstem auditory evoked potentials, visual evoked potentials and auditory P300 evaluation were performed. The latency of the P100 and N135 visual evoked potential components was significantly extended by the presence of epilepsy. If ADHD was concomitantly present, this effect was attenuated. Brainstem auditory evoked potential components were prolonged in the presence of the comorbidity, considering the waves elicited in the brainstem. P300 latencies were prolonged by the presence of co-occurring ADHD and epilepsy. Feedback parameters showed overall reduction of the tested cognitive performances in the ADHD group. Disturbances produced by the presence of ADHD-epilepsy comorbidity reveal hypothetically a linked physiopathological path for both diseases, and offers an approach with possible diagnostic importance, combined evoked potential recordings.

  3. Dealing with uncertainty in landscape genetic resistance models: a case of three co-occurring marsupials.

    Science.gov (United States)

    Dudaniec, Rachael Y; Worthington Wilmer, Jessica; Hanson, Jeffrey O; Warren, Matthew; Bell, Sarah; Rhodes, Jonathan R

    2016-01-01

    Landscape genetics lacks explicit methods for dealing with the uncertainty in landscape resistance estimation, which is particularly problematic when sample sizes of individuals are small. Unless uncertainty can be quantified, valuable but small data sets may be rendered unusable for conservation purposes. We offer a method to quantify uncertainty in landscape resistance estimates using multimodel inference as an improvement over single model-based inference. We illustrate the approach empirically using co-occurring, woodland-preferring Australian marsupials within a common study area: two arboreal gliders (Petaurus breviceps, and Petaurus norfolcensis) and one ground-dwelling antechinus (Antechinus flavipes). First, we use maximum-likelihood and a bootstrap procedure to identify the best-supported isolation-by-resistance model out of 56 models defined by linear and non-linear resistance functions. We then quantify uncertainty in resistance estimates by examining parameter selection probabilities from the bootstrapped data. The selection probabilities provide estimates of uncertainty in the parameters that drive the relationships between landscape features and resistance. We then validate our method for quantifying uncertainty using simulated genetic and landscape data showing that for most parameter combinations it provides sensible estimates of uncertainty. We conclude that small data sets can be informative in landscape genetic analyses provided uncertainty can be explicitly quantified. Being explicit about uncertainty in landscape genetic models will make results more interpretable and useful for conservation decision-making, where dealing with uncertainty is critical. © 2015 John Wiley & Sons Ltd.

  4. Natural Course of Co-Occurring PTSD and Alcohol Use Disorder Among Recent Combat Veterans.

    Science.gov (United States)

    Possemato, Kyle; Maisto, Stephen A; Wade, Michael; Barrie, Kimberly; Johnson, Emily M; Ouimette, Paige C

    2017-06-01

    Posttraumatic stress disorder (PTSD) and alcohol use disorder (AUD) commonly co-occur in veterans, yet little is known about the longitudinal course of PTSD and drinking in comorbid populations. This study assessed the natural course of daily alcohol consumption and weekly changes in PTSD symptoms in 112 recent combat veterans over the course of 11 months. Latent class growth mixture modeling was used to classify individuals into distinct classes with similar PTSD symptom and alcohol use growth trajectories. We then investigated theorized predictors of class membership including sociodemographics; pre-, peri-, and postdeployment factors; coping; symptom severity; and number of mental health/substance use appointments attended. Results revealed that most participants had severe and nonremitting PTSD. Trajectories for alcohol use included gradual and drastic declines, and chronic low-level drinking. The use of behavioral health services (odds ratio = 2.47) and fewer current stressors (odds ratio = 0.42) predicted AUD remission. Because little variation was observed in the PTSD course, our study did not observe coordinated fluctuations of PTSD symptoms and heavy drinking. Our findings suggest that treatment impacts the course of AUD and that recent combat veterans who do not seek PTSD treatment may have chronic and severe PTSD symptoms. Copyright © 2017 International Society for Traumatic Stress Studies.

  5. Klasifikasi Massa pada Citra Mammogram Berdasarkan Gray Level Cooccurence Matrix (GLCM

    Directory of Open Access Journals (Sweden)

    Refta Listia

    2014-01-01

    Breast cancer is the most common disease in women in many countries. Breast cancer can be performed using mammography. In this work, an approach is proposed to classify mammogram based on three classes such as normal, benign, and malignant. The proposed system consist of four major steps : preprocessing, segmentation, feature extraction and classification. In preprocessing grayscale, interpolation, amoeba mean filter and segmentation are applicated. Feature extraction using Gray level Cooccurence Matrix (GLCM and the features will be calculated in 4 angles (d=1 and d= 2,  GLCM 8 angles and GLCM 16 angles.  The 5 features are contrast, energy, entropy, correlation and homogeneity. The final step is classification using Backpropagation. Some of important parameters will be variated in this process such as learning rate and the number of node in  hidden layer. The research result suggest that extraction feature in 4 angles ( and d=1 is the best accuracy for classifying mammogram based on classes 81,1% and especially in accuracy is 100%.

  6. Differential Service Utilization Associated With Trauma-informed Integrated Treatment for Women With Co-occurring Disorders

    OpenAIRE

    Gilbert, Allison R.; Domino, Marisa E.; Morrissey, Joseph P.; Gaynes, Bradley N.

    2012-01-01

    Women with co-occurring mental health and substance use disorders and trauma histories vary greatly in symptom severity and use of support services. This study estimated differential effects of an integrated treatment intervention (IT) across sub-groups of women in this population on services utilization outcomes. Data from a national study were used to cluster participants by symptoms and service utilization, and then estimate the effect of IT versus usual care on 12-month service utilizatio...

  7. Psychological interventions for alcohol misuse among people with co-occurring depression or anxiety disorders: a systematic review.

    Science.gov (United States)

    Baker, Amanda L; Thornton, Louise K; Hiles, Sarah; Hides, Leanne; Lubman, Dan I

    2012-08-01

    Depression, anxiety and alcohol misuse frequently co-occur. While there is an extensive literature reporting on the efficacy of psychological treatments that target depression, anxiety or alcohol misuse separately, less research has examined treatments that address these disorders when they co-occur. We conducted a systematic review to determine whether psychological interventions that target alcohol misuse among people with co-occurring depressive or anxiety disorders are effective. We systematically searched the PubMed and PsychINFO databases from inception to March 2010. Individual searches in alcohol, depression and anxiety were conducted, and were limited to 'human' published 'randomized controlled trials' or 'sequential allocation' articles written in English. We identified randomized controlled trials that compared manual guided psychological interventions for alcohol misuse among individuals with depressive or anxiety disorders. Of 1540 articles identified, eight met inclusion criteria for the review. From each study, we recorded alcohol and mental health outcomes, and other relevant clinical factors including age, gender ratio, follow-up length and drop-out rates. Quality of studies was also assessed. Motivational interviewing and cognitive-behavioral interventions were associated with significant reductions in alcohol consumption and depressive and/or anxiety symptoms. Although brief interventions were associated with significant improvements in both mental health and alcohol use variables, longer interventions produced even better outcomes. There is accumulating evidence for the effectiveness of motivational interviewing and cognitive behavior therapy for people with co-occurring alcohol and depressive or anxiety disorders. Copyright © 2011 Elsevier B.V. All rights reserved.

  8. Demographics and co-occurring conditions in a clinic-based cohort with Down syndrome in the United Arab Emirates.

    Science.gov (United States)

    Corder, Jennifer Price; Al Ahbabi, Fatima Jaber Sehmi; Al Dhaheri, Hind Saif; Chedid, Fares

    2017-09-01

    The majority of studies describing demographics and co-occurring conditions in cohorts with Down syndrome come from regions outside of the Middle East, mainly from Europe and North America. This paper describes demographics and co-occurring conditions in a hospital-based cohort of individuals with Down syndrome living in the Middle Eastern country of the United Arab Emirates (UAE). The first dedicated Down syndrome clinic in the UAE was established in 2012 at Tawam Hospital in Al Ain. This paper describes a clinic-based cohort of 221 participants over 4 years from the Gulf Down Syndrome Registry, a new Down syndrome database and contact registry created at Tawam Hospital. Key demographic findings include mean maternal age of 37 years, among the highest described in the literature. Sixty-two percent of mothers are >35 years. Over 90% of mothers received post-natal diagnosis of Down syndrome. High sex ratio, parental consanguinity, and large family size also characterize the group. The spectrum of many co-occurring conditions mirrors that of previously described populations, with some notable differences. Cardiovascular malformations are well represented, however, atrioventricular canal is not the most common. Genitourinary conditions are common, as evidenced by 12% of males with hypospadias and 15% with undescended testes. Glucose-6-phosphate dehydrogenase deficiency, alpha thalassemia trait, hypovitaminosis D, and dental caries are common in our cohort. This study describes a large hospital-based group with Down syndrome presenting to a new dedicated Down syndrome clinic in the UAE, highlighting unique demographic and co-occurring conditions found in that population. © 2017 Wiley Periodicals, Inc.

  9. Clinical needs of in-treatment pregnant women with co-occurring disorders: implications for primary care.

    Science.gov (United States)

    Lee King, Patricia A; Duan, Lei; Amaro, Hortensia

    2015-01-01

    We investigated social vulnerability and behavioral health clinical profiles (symptom severity) of pregnant women with co-occurring disorders, defined as substance abuse, mental illness, and trauma at treatment entry compared to their nonpregnant counterparts and the role of interpersonal abuse in clinical presentation among pregnant women. Our objective was to provide primary health care providers with insight into the needs of pregnant patients with high behavioral health risks to serve them better during the critical window of opportunity for long-term impact. We conducted cross-sectional secondary analysis of baseline data from women enrolled in treatment programs in the Women, Co-occurring Disorders and Violence Study from nine sites across the United States. We used analysis of variance and Cochran-Mantel-Haenszel statistical analyses to compare means and frequencies of social vulnerability indicators and baseline Addiction Severity Index, Brief Symptom Inventory of mental health, and Posttraumatic Stress Diagnostic Scale scores between 152 pregnant and 2,577 nonpregnant women, and between pregnant women with and without current interpersonal abuse. Compared to nonpregnant women, pregnant women evidenced more social vulnerability but better behavioral health clinical profiles at treatment entry. Current interpersonal abuse was associated with increased mental health and trauma symptomatology but not with alcohol or drug abuse severity among pregnant women. The prenatal period is an important time for screening and intervention for factors such as social vulnerability and co-occurring disorders, known to affect pregnancy and infant outcomes; social and behavioral health services are particularly essential among pregnant women with co-occurring disorders.

  10. The Use of Exposure-Based Treatment Among Individuals With PTSD and Co-occurring Substance Use Disorders: Clinical Considerations

    OpenAIRE

    Killeen, Therese K.; Back, Sudie E.; Brady, Kathleen T.

    2011-01-01

    Integrative treatments for co-occurring posttraumatic stress (PTSD) and substance use disorders have been shown to be safe and effective. Improvement in PTSD symptoms can positively impact substance use outcomes. Interventions that include exposure-based techniques, which are considered the treatment of choice for PTSD, have not been well studied in substance abusing populations. Concurrent Treatment of PTSD and Substance Use Disorders with Prolonged Exposure (COPE) is a manualized psychother...

  11. Trauma, Delinquency, and Substance Use: Co-occurring Problems for Adolescent Girls in the Juvenile Justice System

    OpenAIRE

    Smith, Dana K.; Saldana, Lisa

    2013-01-01

    Girls in the juvenile justice system are known to have high rates of co-occurring childhood abuse, trauma, and substance abuse. Girls with this constellation of problems are at high risk for serious adverse outcomes, including problems with drug dependence and abuse. The relationship between childhood sexual abuse, childhood physical abuse, other types of childhood trauma, and rates of substance use during adolescence were examined for girls in the juvenile justice system. As expected, childh...

  12. A Comparison of Opioid and Nonopioid Substance Users in Residential Treatment for Co-Occurring Substance Use and Mental Disorders.

    Science.gov (United States)

    Bride, Brian E; Macmaster, Samuel A; Morse, Siobhan A; Watson, Cayce M; Choi, Sam; Seiters, John

    2016-01-01

    The past decade has seen a marked increase in the illicit use of opioids, as well as a doubling of the percentage of individuals seeking treatment for opioid use disorders. However, little is known about the differences between opioid users and nonopioid users in residential treatment. Further, no studies have been published that compare opioid users and nonopioid users in treatment for co-occurring substance use and mental disorders. To address this gap, this study examined differences between opioid and nonopioid substance users in residential treatment for co-occurring disorders. Data was drawn from 1,972 individuals treated between 2009 and 2011 at one of three private residential treatment centers that provide integrated treatment for co-occurring substance use and mental disorders. Data was collected at program intake, and 1- and 6-month postdischarge using the Addiction Severity Index and the University of Rhode Island Change Assessment. To examine within-group changes in substance use, addiction severity, and mental health across time, linear mixed-model analyses were conducted with facility, year, age, gender, and race included as covariates. The authors found more similarities than differences between the two groups on baseline characteristics, treatment motivation, length of stay, and outcomes on measures of substance use, addiction severity, and mental health. The results demonstrate that though opioid users entered treatment with higher levels of substance use-related impairment, they were just as successful in treatment outcomes as their non-opioid-using peers.

  13. Peer-led and professional-led group interventions for people with co-occurring disorders: a qualitative study.

    Science.gov (United States)

    Pallaveshi, Luljeta; Balachandra, Krishna; Subramanian, Priya; Rudnick, Abraham

    2014-05-01

    This pilot study evaluated the experience of people with co-occurring disorders (mental illness and addiction) in relation to peer-led and professional-led group interventions. The study used a qualitative (phenomenological) approach to evaluate the experience of a convenience sample of 6 individuals with co-occurring disorders who participated in up to 8 sessions each of both peer-led and professional-led group interventions (with a similar rate of attendance in both groups). The semi-structured interview data were coded and thematically analyzed. We found 5 themes within and across the 2 interventions. In both groups, participants experienced a positive environment and personal growth, and learned, albeit different things. They were more comfortable in the peer-led group and acquired more knowledge and skills in the professional-led group. Offering both peer-led and professional-led group interventions to people with co-occurring disorders may be better than offering either alone.

  14. Physical Comorbidities in Depression Co-Occurring with Anxiety: A Cross Sectional Study in the Czech Primary Care System

    Directory of Open Access Journals (Sweden)

    Petr Winkler

    2015-12-01

    Full Text Available Comorbidities associated with depression have been researched in a number of contexts. However, the epidemiological situation in clinical practice is understudied, especially in the post-Communist Central and Eastern Europe region. The aim of this study was to assess physical comorbidities in depression, and to identify whether there are increased odds of physical comorbidities associated with co-occurring depressive and anxiety disorders. Data on 4264 patients aged 18–98 were collected among medical doctors in the Czech Republic between 2010 and 2011. Descriptive statistics were calculated and multiple logistic regressions were performed to assess comorbidities among patients with depressive disorder. There were 51.29% of those who have a physical comorbidity, and 45.5% of those who have a comorbid anxiety disorders among patients treated with depression in Czech primary care. Results of logistic regressions show that odds of having pain, hypertension or diabetes mellitus are particularly elevated at those who have co-occurring depressive and anxiety disorder. Our findings demonstrate that comorbidities associated with depressive disorders are highly prevalent in primary health care practice, and that physical comorbidities are particularly frequent among those with co-occurring depressive and anxiety disorders.

  15. Co-occurring depression and alcohol-use disorders in South-East Asia: A narrative review.

    Science.gov (United States)

    Balhara, Yatan Pal Singh; Gupta, Prashant; Elwadhi, Deeksha

    2017-04-01

    Depression and alcohol-use disorders frequently co-occur and the presence of one augments the adverse consequences of the other. This article reviews and synthesizes the available literature on depression and alcohol-use disorders from the World Health Organization (WHO) South-East Asia Region, with respect to epidemiology, screening instruments, interventions and services, and policy. In common with other low- and middle-income settings, data from this region on co-occurring depression and alcohol-use disorders are scarce. The wide variations in language and cultural diversity within the countries of this region further make the identification and management of people with co-occurring depression and alcohol-use disorders a major challenge. A range of interventions for individuals with the two disorders have been studied. However, most of this work has been done in high-income countries, highlighting the need to explore the effectiveness and cost effectiveness of various pharmacological and non-pharmacological interventions in the WHO South-East Asia Region. Much of this region comprises low-resource settings, with a dearth of trained personnel and resources. Flexible transdiagnostic approaches, delivered by community health workers and integrated into primary health care may be a pragmatic approach. Such services should form part of strengthened national responses to alcohol-related public health problems across the region.

  16. The impact of fatherhood on treatment response for men with co-occurring alcohol dependence and intimate partner violence.

    Science.gov (United States)

    Smith Stover, Carla; McMahon, Thomas J; Easton, Caroline

    2011-01-01

    The role of fathers in the lives of children has gained increasing attention over the last several decades, however, studies that specifically examine the parenting role among men who are alcohol dependent and have co-occurring intimate partner violence (IPV) have been limited. This brief report is intended to highlight the need to develop and focus interventions for men with co-occurring substance abuse and IPV with an emphasis on their roles as fathers. Sixty-nine men who participated in a randomized comparison study of a coordinated substance abuse and domestic violence treatment program (SADV) and Twelve Step Facilitation (TSF) provided information about whether they were fathers. Analysis of covariance was used to assess the impact of fatherhood on the outcomes of intimate partner violence and alcohol use during the 12 weeks of treatment. There was a significant interaction between type of treatment (SADV vs. TSF) and fatherhood. SADV resulted in significantly less IPV and use of alcohol over the 12 weeks of treatment than TSF for men without children. There were no significant differences between SADV and TSF for men who were fathers. Results indicate a need to further explore the role of fatherhood for men with co-occurring substance abuse and IPV and development of specialized treatments that may improve treatment outcomes for fathers.

  17. Traits and Resource Use of Co-Occurring Introduced and Native Trees in a Tropical Novel Forest

    Directory of Open Access Journals (Sweden)

    Jéssica Fonseca da Silva

    2017-09-01

    Full Text Available Novel forests are naturally regenerating forests that have established on degraded lands and have a species composition strongly influenced by introduced species. We studied ecophysiological traits of an introduced species (Castilla elastica Sessé and several native species growing side by side in novel forests dominated by C. elastica in Puerto Rico. We hypothesized that C. elastica has higher photosynthetic capacity and makes more efficient use of resources than co-occurring native species. Using light response curves, we found that the photosynthetic capacity of C. elastica is similar to that of native species, and that different parameters of the curves reflected mostly sun light variation across the forest strata. However, photosynthetic nitrogen use-efficiency as well as leaf area/mass ratios were higher for C. elastica, and both the amount of C and N per unit area were lower, highlighting the different ecological strategies of the introduced and native plants. Presumably, those traits support C. elastica’s dominance over native plants in the study area. We provide empirical data on the ecophysiology of co-occurring plants in a novel forest, and show evidence that different resource-investment strategies co-occur in this type of ecosystem.

  18. High or low correlation between co-occuring gene clusters and 16S rRNA gene phylogeny.

    Science.gov (United States)

    Rudi, Knut; Sekelja, Monika

    2013-02-01

    Ribosomal RNA (rRNA) genes are universal for all living organisms. Yet, the correspondence between genome composition and rRNA phylogeny remains poorly known. The aim of this study was to use the information from genome sequence databases to address the correlation between rRNA gene phylogeny and total gene composition in bacteria. This was done by analysing 327 genomes with TIGRFAM functional gene annotations. Our approach consisted of two steps. First, we searched for discriminatory clusters of co-occurring genes. Using a multivariate statistical approach, we identified 11 such clusters which contain genes that were co-occurring only in a subset of genomes and contributed to explain the gene content differences between genome subsets. Second, we mapped the discovered clusters to 16S rRNA-based phylogeny and calculated the correlation between co-occuring genes and phylogeny. Six of the 11 clusters exhibited significant correlation with 16S rRNA gene phylogeny. The most distinct phylogenetic finding was a high correlation between iron-sulfur oxidoreductases in combination with carbon nitrogen ligases and Chlorobium. The other correlations identified covered relatively large phylogroups: Actinobacteria were positively associated with kinases, while Gammaproteobacteria were positively associated with methylases and acyltransferases. The suggested functional differences between higher phylogroups, however, need experimental verification. © 2012 Federation of European Microbiological Societies. Published by Blackwell Publishing Ltd. All rights reserved.

  19. Convergent validity of the ASAM criteria in co-occurring disorders.

    Science.gov (United States)

    Stallvik, Marianne; Nordahl, Hans M

    2014-01-01

    The complexity of substance use and psychiatric disorders demands thorough assessment of patients for integrated services. We tested the convergent validity of the software version of the American Society of Addiction Medicine (ASAM) second edition-revised criteria for patient placement by examining the software's ability to discriminate based on a variety of demographic and clinical factors. This prospective naturalistic multi-site study examined the software's assignment of patients to three types of treatment (addiction only services, dual diagnosis capable, and dual diagnosis enhanced) and whether these assignments indicated an ability to discriminate between patients with and without dual diagnosis based on clinical characteristics and severity. Ten addiction treatment clinics spanning three counties participated, and both patients and ASAM assessors were kept blind to the ASAM recommendation. Patients were assigned to their respective treatment options based on routine assessment by clinicians at intake, which they had in addition to the ASAM interview. Three months after treatment initiation a follow-up interview with ASAM was conducted. There were 261 patients in the study, 96 (36.7%) were assigned to addiction only services, 42 (16.1%) to dual diagnosis capable, and 123 (47.1%) to dual diagnosis enhanced. Patients assigned to the two dual diagnosis groups were significantly more likely to be younger and have fewer years of work than other patients. There were significant differences in history of inpatient and outpatient psychiatric treatment across groups. For example, a larger percentage of those in addiction only services had never been in inpatient treatment, while more of those in the two dual diagnosis groups had three or more inpatient stays. Despite similar alcohol and drug severity scores, patients recommended by the software for dual diagnosis enhanced programs showed a gradient of significantly higher psychiatric (p co-occurring program

  20. Range expansion potential of two co-occurring invasive vines to marginal habitats in Turkey

    Science.gov (United States)

    Farooq, Shahid; Tad, Sonnur; Onen, Huseyin; Gunal, Hikmet; Caldiran, Ugur; Ozaslan, Cumali

    2017-10-01

    Niche distribution models accurately predict the potential distribution range of invasive plants into new habitats based on their climatic requirements in the native regions. However, these models usually ignore the marginal habitats which can limit the distribution of exotic plants. We therefore tested the seedling survival, growth and nutrient acquisition capabilities of two co-occurring invasive vines [Persicaria perfoliata (L.) H. Gross and Sicyos angulatus L.] in three different manipulative greenhouse experiments to infer their range expansion potential to marginal habitats in Turkey. First experiment included five different moisture availability regimes (100, 75, 50, 25 and 12.5% available water), second experiment consisted of four different salinity levels (0, 3, 6 and 12 dSm-1 soil salinity) and third experiment had four different soil textures (clay-1, clay-2, sandy loam and silt-clay-loam). Seedling mortality was only observed under extreme moisture deficiency in both plant species, while most of the transplanted seedlings of both species did not survive under 6 and 12 dSm-1 salinity levels. Soil textures had no effect on seedling survival. POLPE better tolerated low moisture availability and high salinity compared to SIYAN. Biomass production in both plant species was linearly reduced with increasing salinity and moisture deficiency. SIYAN invested more resources towards shoot, accumulated higher K and P, whereas POLPE maintained higher root-to-shoot ratio under all experimental conditions. Both plant species employed different strategies to cope with adverse environmental conditions, but failed to persist under high soil salinity and moisture deficiency. Our study suggest that both plant species have limited potential of range expansion to marginal habitats and will be limited to moist and humid areas only. Therefore, further research activities should be concentrated in these regions to develop effective management strategies against both species.

  1. The visual rooting reflex in individuals with autism spectrum disorders and co-occurring intellectual disability.

    Science.gov (United States)

    de Bildt, Annelies; Mulder, Erik J; Van Lang, Natasja D J; de With, S A Jytte; Minderaa, Ruud B; Stahl, Sherin S; Anderson, George M

    2012-02-01

    The rooting reflex has long been studied by neurologists and developmentalists and is defined as an orientation toward tactile stimulation in the perioral region or visual stimulation near the face. Nearly, all previous reports of the visual rooting reflex (VRR) concern its presence in adults with neurological dysfunction. Previously, the VRR was reported to be present in a majority of individuals with autism and absent in control subjects. In the present larger study, we examined the presence of the VRR in 155 individuals with ASD and co-occurring Intellectual Disability (ASD + ID: autism, N = 60; Pervasive Developmental Disorder-Not Otherwise Specified (PDD_NOS), N = 95) and in a contrast group of 65 individuals with ID only. The VRR was present significantly more often in the ASD + ID (43.9%) group than in the ID-only group (24.6%; χ(1)(2)= 7.19; P = 0.007). Individuals with autism displayed a VRR more often (55.0%) than individuals with PDD-NOS (36.8%; χ(1)(2)= 4.92; P = 0.026) and individuals with ID only (24.6%; χ(1)(2)= 12.09; P = 0.001). A positive VRR was associated with lower IQ and adaptive functioning; in the ASD + ID group, ADI-R/ADOS domain scores were significantly higher in the VRR-positive subgroup. The results replicate and extend the finding of an increased occurrence of the VRR in autism. Although some association with IQ was observed, the VRR occurred substantially more often in the autism group compared with an intellectually disabled group, indicating some degree of specificity. Additional studies of infants and children with typical development, ASD and ID are needed to determine the utility of the VRR in ASD risk assessment and to elucidate possible specific behavioral associations. Copyright © 2011, International Society for Autism Research, Wiley-Liss, Inc.

  2. Brief screening for co-occurring disorders among women entering substance abuse treatment

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    Chernoff Miriam

    2006-09-01

    Full Text Available Abstract Background Despite the importance of identifying co-occurring psychiatric disorders in substance abuse treatment programs, there are few appropriate and validated instruments available to substance abuse treatment staff to conduct brief screen for these conditions. This paper describes the development, implementation and validation of a brief screening instrument for mental health diagnoses and trauma among a diverse sample of Black, Hispanic and White women in substance abuse treatment. With input from clinicians and consumers, we adapted longer existing validated instruments into a 14 question screen covering demographics, mental health symptoms and physical and sexual violence exposure. All women entering treatment (methadone, residential and out-patient at five treatment sites were screened at intake (N = 374. Results Eighty nine percent reported a history of interpersonal violence, and 70% reported a history of sexual assault. Eighty-eight percent reported mental health symptoms in the last 30 days. The screening questions administered to 88 female clients were validated against in-depth psychiatric diagnostic assessments by trained mental health clinicians. We estimated measures of predictive validity, including sensitivity, specificity and predictive values positive and negative. Screening items were examined multiple ways to assess utility. The screen is a useful and valid proxy for PTSD but not for other mental illness. Conclusion Substance abuse treatment programs should incorporate violence exposure questions into clinical use as a matter of policy. More work is needed to develop brief screening tools measures for front-line treatment staff to accurately assess other mental health needs of women entering substance abuse treatment

  3. Clinical characteristics of children with autism spectrum disorder and co-occurring epilepsy.

    Directory of Open Access Journals (Sweden)

    Emma W Viscidi

    Full Text Available To estimate the prevalence of epilepsy in children with Autism Spectrum Disorder (ASD and to determine the demographic and clinical characteristics of children with ASD and epilepsy in a large patient population.Cross-sectional study using four samples of children with ASD for a total of 5,815 participants with ASD. The prevalence of epilepsy was estimated from a population-based sample. Children with and without epilepsy were compared on demographic and clinical characteristics. Multivariate logistic regression was used to examine the association between demographic and clinical characteristics and epilepsy.The average prevalence of epilepsy in children with ASD 2-17 years was 12.5%; among children aged 13 years and older, 26% had epilepsy. Epilepsy was associated with older age, lower cognitive ability, poorer adaptive and language functioning, a history of developmental regression and more severe ASD symptoms. The association between epilepsy and the majority of these characteristics appears to be driven by the lower IQ of participants with epilepsy. In a multivariate regression model, only age and cognitive ability were independently associated with epilepsy. Children age 10 or older had 2.35 times the odds of being diagnosed with epilepsy (p<.001 and for a one standard deviation increase in IQ, the odds of having epilepsy decreased by 47% (p<.001.This is among the largest studies to date of patients with ASD and co-occurring epilepsy. Based on a representative sample of children with ASD, the average prevalence of epilepsy is approximately 12% and reaches 26% by adolescence. Independent associations were found between epilepsy and older age and lower cognitive ability. Other risk factors, such as poor language and developmental regression, are not associated with epilepsy after controlling for IQ. These findings can help guide prognosis and alert clinicians to patients with ASD who are at increased risk for epilepsy.

  4. Noise sensitivity: Symptoms, health status, illness behavior and co-occurring environmental sensitivities

    International Nuclear Information System (INIS)

    Baliatsas, Christos; Kamp, Irene van; Swart, Wim; Hooiveld, Mariëtte; Yzermans, Joris

    2016-01-01

    Epidemiological evidence on the symptomatic profile, health status and illness behavior of people with subjective sensitivity to noise is still scarce. Also, it is unknown to what extent noise sensitivity co-occurs with other environmental sensitivities such as multi-chemical sensitivity and sensitivity to electromagnetic fields (EMF). A cross-sectional study performed in the Netherlands, combining self-administered questionnaires and electronic medical records of non-specific symptoms (NSS) registered by general practitioners (GP) allowed us to explore this further. The study sample consisted of 5806 participants, drawn from 21 general practices. Among participants, 722 (12.5%) responded “absolutely agree” to the statement “I am sensitive to noise”, comprising the high noise-sensitive (HNS) group. Compared to the rest of the sample, people in the HNS group reported significantly higher scores on number and duration of self-reported NSS, increased psychological distress, decreased sleep quality and general health, more negative symptom perceptions and higher prevalence of healthcare contacts, GP-registered NSS and prescriptions for antidepressants and benzodiazepines. These results remained robust after adjustment for demographic, residential and lifestyle characteristics, objectively measured nocturnal noise exposure from road-traffic and GP-registered morbidity. Co-occurrence rates with other environmental sensitivities varied between 9% and 50%. Individuals with self-declared sensitivity to noise are characterized by high prevalence of multiple NSS, poorer health status and increased illness behavior independently of noise exposure levels. Findings support the notion that different types of environmental sensitivities partly overlap. - Highlights: • People with self-reported noise sensitivity experience multiple non-specific symptoms. • They also report comparatively poorer health and increased illness behavior. • Co-occurrence with other

  5. Evidence for the treatment of co-occurring stuttering and speech sound disorder: A clinical case series.

    Science.gov (United States)

    Unicomb, Rachael; Hewat, Sally; Spencer, Elizabeth; Harrison, Elisabeth

    2017-06-01

    There is a paucity of evidence to guide treatment for children with co-occurring stuttering and speech sound disorder. Some guidelines suggest treating the two disorders simultaneously using indirect treatment approaches; however, the research supporting these recommendations is over 20 years old. In this clinical case series, we investigate whether these co-occurring disorders could be treated concurrently using direct treatment approaches supported by up-to-date, high-level evidence, and whether this could be done in an efficacious, safe and efficient manner. Five pre-school-aged participants received individual concurrent, direct intervention for both stuttering and speech sound disorder. All participants used the Lidcombe Program, as manualised. Direct treatment for speech sound disorder was individualised based on analysis of each child's sound system. At 12 months post commencement of treatment, all except one participant had completed the Lidcombe Program, and were less than 1.0% syllables stuttered on samples gathered within and beyond the clinic. These four participants completed Stage 1 of the Lidcombe Program in between 14 and 22 clinic visits, consistent with current benchmark data for this programme. At the same assessment point, all five participants exhibited significant increases in percentage of consonants correct and were in alignment with age-expected estimates of this measure. Further, they were treated in an average number of clinic visits that compares favourably with other research on treatment for speech sound disorder. These preliminary results indicate that young children with co-occurring stuttering and speech sound disorder may be treated concurrently using direct treatment approaches. This method of service delivery may have implications for cost and time efficiency and may also address the crucial need for early intervention in both disorders. These positive findings highlight the need for further research in the area and contribute to

  6. Legacy Interventions With Patients with Co-Occurring Disorders: Legacy Definitions, Life Satisfaction, and Self-Efficacy.

    Science.gov (United States)

    Franklin, Felina C; Cheung, Monit

    2017-12-06

    Individuals with co-occurring disorders tend to avoid interaction with others. To instill hope, legacy intervention aims to highlight past experiences while managing life stressors for a positive outlook. Participants take part in legacy activities-crafting tangible projects and recording one's life events-in order to actualize a personal sense of legacy. This pre-posttest research tested whether legacy intervention in a partial hospital program (PHP) on reframing past experiences through creative activities could increase life satisfaction and self-efficacy among adults with co-occurring substance misuse and mental health symptoms. Eighty consented patients with co-occurring disorders were randomly assigned to two groups with 62 participants continuing: 37 in legacy intervention (LI) and 25 in partial hospital program only (PHP-only). LI participants were engaged in both PHP and legacy activities. Ten group sessions were held over the course of five weeks for cohorts of 10-15 adult patients in each intervention. Sense of legacy was measured to ensure that LI patients received the appropriate legacy dosage. With RANOVA analyses between and among three time points, life satisfaction was significantly higher in the LI group with group interaction effect over time. In terms of self-efficacy, both groups showed positive changes but no significant difference could be found between the two groups over time and the interaction (time X group) effect was not significant. The legacy definitions gathered from the LI group were consistent with existing literature and showed three additional themes: children's involvement, concreteness, and life continuation after death.

  7. The impact of addiction medications on treatment outcomes for persons with co-occurring PTSD and opioid use disorders.

    Science.gov (United States)

    Saunders, Elizabeth C; McGovern, Mark P; Lambert-Harris, Chantal; Meier, Andrea; McLeman, Bethany; Xie, Haiyi

    2015-12-01

    Previous research has been inconclusive about whether adding psychosocial treatment to medication assisted treatment (MAT) improves outcomes for patients with co-occurring psychiatric and opioid use disorders. This study evaluated the impact of MAT and psychosocial therapies on treatment outcomes for patients with co-occurring opioid use disorders and PTSD. Patients meeting criteria for PTSD and substance use disorders were randomly assigned to one of three treatment conditions: Standard Care (SC) alone, Integrated Cognitive Behavioral Therapy (ICBT) plus SC, or Individual Addiction Counseling (IAC) plus SC. Substance use and psychiatric symptoms were assessed at baseline and 6 months. Only patients with opioid use disorders were included in the present analyses (n = 126). Two-way ANOVAS and logistic regression analyses were used to examine associations between treatment conditions and MAT, for substance use and psychiatric outcomes. MAT patients receiving ICBT had significantly decreased odds of a positive urine drug screen, compared to non-MAT patients receiving SC alone (OR = .07, 95% CI = .01, .81, p = .03). For PTSD symptoms, a significant MAT by psychosocial treatment condition interaction demonstrated that MAT patients had comparable declines in PTSD symptoms regardless of psychosocial treatment type (F(2, 88) = 4.74, p = .011). Non-MAT patients in ICBT had significantly larger reductions in PTSD. For patients with co-occurring opioid use disorders and PTSD, MAT plus ICBT is associated with more significant improvement in substance use. For non-MAT patients, ICBT is most beneficial for PTSD symptoms. © American Academy of Addiction Psychiatry.

  8. Co-occurring psychiatric and drug use disorders among sexual minority men with lifetime alcohol use disorders.

    Science.gov (United States)

    Lee, Ji Hyun; Gamarel, Kristi E; Kahler, Christopher W; Marshall, Brandon D L; van den Berg, Jacob J; Bryant, Kendall; Zaller, Nickolas D; Operario, Don

    2015-06-01

    Emerging evidence indicates multiple health risks associated with harmful alcohol use among sexual minority men in the United States. In particular, sexual minority men with alcohol use disorders (AUD) might have greater co-occurring health problems compared with heterosexual men. We used nationally representative data to compare the prevalence of diagnostic co-occurring psychiatric disorders and drug use disorders (DUD) among sexual minority men with AUD compared with heterosexual males with a lifetime AUD diagnosis. We analyzed data from 6899 adult males with AUD participating in Wave 2 of the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC). Using weighted multivariable logistic regression models, we compared the odds of lifetime diagnosis of mood disorders, anxiety disorders, and drug use disorders in sexual minority and heterosexual adult males with AUD. Of participants included in this analysis, 176 (2.6%) self-identified as a sexual minority. In adjusted analyses, sexual minority men with AUD were more likely than heterosexual men with AUD to have any mood disorder (including major depressive episode), any anxiety disorder (including panic disorder without agoraphobia, specific phobia, posttraumatic stress disorder, and generalized anxiety disorder), and lifetime DUD. The elevated co-occurrence of psychiatric disorders and DUD among sexual minority men with AUD suggests that future research is warranted. A better understanding of the etiology of diagnostic co-occurring mental health and substance use disorders among sexual minority men is needed in order to develop effective integrated prevention and treatment programs. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  9. Naltrexone and Disulfiram Treatment Response in Veterans With Alcohol Dependence and Co-Occurring Problem-Gambling Features.

    Science.gov (United States)

    Grant, Jon E; Potenza, Marc N; Kraus, Shane W; Petrakis, Ismene L

    Disordered gambling behavior frequently co-occurs with alcohol dependence and other psychiatric conditions. Using data from a previously published trial, we conducted secondary analyses to examine the influence of problem-gambling features on treatment outcome for alcohol dependence or co-occurring psychopathology assessed via DSM-IV criteria. Two hundred fifty-four patients with alcohol dependence and co-occurring psychiatric disorders were treated for 12 weeks in an outpatient medication study conducted at 3 Veterans Administration outpatient clinics from October 1998 to March 2002. Randomization included assignment to 1 of 4 groups: (1) naltrexone alone, (2) placebo alone, (3) (open-label) disulfiram and (blinded) naltrexone, or (4) (open-label) disulfiram and (blinded) placebo. One hundred seventy-four participants were evaluated for the diagnostic inclusionary criteria for pathological gambling using the Massachusetts Gambling Screen. Primary outcome and secondary outcome measures assessed alcohol use and psychiatric domains. Forty-five of 174 participants (25.9%) exhibited problem-gambling features (acknowledged 1 or more inclusionary criteria for pathological gambling). A gambling-group-by-disulfiram interaction was observed for abstinence, with problem-gambling features not associated with beneficial response to disulfiram (z = 6.58, P = .01). Participants with problem-gambling features reported significantly less improvement over time in general psychiatric functioning (z = 2.62, P = .01), specifically within somatization (z = 3.77, P gambling features and poorer outcomes in alcohol and multiple nonsubstance psychiatric domains suggests the need for improved screening for gambling problems in dually diagnosed populations and for the development of empirically validated treatments for individuals with these disorders. © Copyright 2017 Physicians Postgraduate Press, Inc.

  10. The effects of co-occurring ADHD symptoms on electrophysiological correlates of cognitive control in young people with Tourette syndrome.

    Science.gov (United States)

    Shephard, Elizabeth; Jackson, Georgina M; Groom, Madeleine J

    2016-09-01

    Efficient cognitive control is implicated in tic control in young people with Tourette syndrome (TS). Attention-deficit/hyperactivity disorder (ADHD) frequently co-occurs with TS and is associated with impaired cognitive control. Young people with TS and ADHD (TS+ADHD) show poorer cognitive control performance than those with TS, but how co-occurring ADHD affects underlying neural activity is unknown. We investigated this issue by examining behavioural and event-related potential (ERP) correlates of cognitive control in young people with these conditions. Participants aged 9-17 with TS (n = 17), TS+ADHD (n = 17), ADHD (n = 11), and unaffected controls (n = 20) performed a visual Go/Nogo task during electroencephalography (EEG) recording. Behavioural performance measures (D-prime, RT, reaction time variability, post-error slowing) and ERP measures (N2, P3, error-related negativity (ERN), error positivity (Pe)) were analysed in a 2 (TS-yes, TS-no) × 2 (ADHD-yes, ADHD-no) factorial analysis to investigate the effects of TS, ADHD, and their interaction. The results of these analyses showed that ADHD was associated with poorer performance and reduced amplitude of all ERPs, reflecting widespread cognitive control impairments. Tourette syndrome was associated with slowed RTs, which might reflect a compensatory slowing of motor output to facilitate tic control. There was no interaction between the TS and ADHD factors for any behavioural or ERP measure, indicating the impairing effects of ADHD on behaviour and electrophysiological markers of cognitive control were present in TS+ADHD and that RT slowing associated with TS was unaffected by co-occurring ADHD symptoms. © 2015 The British Psychological Society.

  11. Seed trait-mediated selection by rodents affects mutualistic interactions and seedling recruitment of co-occurring tree species.

    Science.gov (United States)

    Zhang, Hongmao; Yan, Chuan; Chang, Gang; Zhang, Zhibin

    2016-02-01

    As mutualists, seed dispersers may significantly affect mutualistic interactions and seedling recruitment of sympatric plants that share similar seed dispersers, but studies are rare. Here, we compared seed dispersal fitness in two co-occurring plant species (Armeniaca sibirica and Amygdalus davidiana) that inhabit warm temperate deciduous forest in northern China. We tested the hypothesis that seed trait-mediated selection by rodents may influence mutualistic interactions with rodents and then seedling establishment of co-occurring plant species. A. davidiana seeds are larger and harder (thick endocarps) than A. sibirica seeds, but they have similar levels of nutrients (crude fat, crude protein), caloric value and tannin. More A. sibirica seedlings are found in the field. Semi-natural enclosure tests indicated that the two seed species were both harvested by the same six rodent species, but that A. sibirica had mutualistic interactions (scatter hoarding) with four rodent species (Apodemus peninsulae, A. agrarius, Sciurotamias davidianus, Tamias sibiricus), and A. davidiana with only one (S. davidianus). Tagged seed dispersal experiments in the field indicated that more A. sibirica seeds were scatter-hoarded by rodents, and more A. sibirica seeds survived to the next spring and became seedlings. A. sibirica seeds derive more benefit from seed dispersal by rodents than A. davidiana seeds, particularly in years with limited seed dispersers, which well explained the higher seedling recruitment of A. sibirica compared with that of A. davidiana under natural conditions. Our results suggest that seed dispersers may play a significant role in seedling recruitment and indirect competition between co-occurring plant species.

  12. The Impact of Addiction Medications on Treatment Outcomes for Persons With Co-Occurring PTSD and Opioid Use Disorders

    Science.gov (United States)

    Saunders, Elizabeth C.; McGovern, Mark P.; Lambert-Harris, Chantal; Meier, Andrea; McLeman, Bethany; Xie, Haiyi

    2016-01-01

    Background and Objectives Previous research has been inconclusive about whether adding psychosocial treatment to medication assisted treatment (MAT) improves outcomes for patients with co-occurring psychiatric and opioid use disorders. This study evaluated the impact of MAT and psychosocial therapies on treatment outcomes for patients with co-occurring opioid use disorders and PTSD. Methods Patients meeting criteria for PTSD and substance use disorders were randomly assigned to one of three treatment conditions: Standard Care (SC) alone, Integrated Cognitive Behavioral Therapy (ICBT) plus SC, or Individual Addiction Counseling (IAC) plus SC. Substance use and psychiatric symptoms were assessed at baseline and 6 months. Only patients with opioid use disorders were included in the present analyses (n = 126). Two-way ANOVAS and logistic regression analyses were used to examine associations between treatment conditions and MAT, for substance use and psychiatric outcomes. Results MAT patients receiving ICBT had significantly decreased odds of a positive urine drug screen, compared to non-MAT patients receiving SC alone (OR = .07, 95% CI = .01, .81, p = .03). For PTSD symptoms, a significant MAT by psychosocial treatment condition interaction demonstrated that MAT patients had comparable declines in PTSD symptoms regardless of psychosocial treatment type (F(2, 88) = 4.74, p = .011). Non-MAT patients in ICBT had significantly larger reductions in PTSD. Conclusions and Scientific Significance For patients with co-occurring opioid use disorders and PTSD, MAT plus ICBT is associated with more significant improvement in substance use. For non-MAT patients, ICBT is most beneficial for PTSD symptoms. PMID:26388539

  13. The Impact of Criminal Justice Involvement and Housing Outcomes Among Homeless Persons with Co-occurring Disorders.

    Science.gov (United States)

    Mitchell, Jessica N; Clark, Colleen; Guenther, Christina C

    2017-11-01

    The relationship between criminal justice involvement and housing among homeless persons with co-occurring disorders was examined. Program participants assisted in moving to stable housing were interviewed at baseline, six months, and discharge. Those who remained homeless at follow-up and discharge had significantly more time in jail in the past month than those who were housed. However, criminal justice involvement was not significantly related to housing status at the six month follow-up or discharge. Findings suggest that housing people with complex behavioral health issues reduces the likelihood of further criminal justice involvement.

  14. Organizational capacity to address co-occurring substance use and psychiatric disorders: assessing variation by level of care.

    Science.gov (United States)

    Lambert-Harris, Chantal; Saunders, Elizabeth C; McGovern, Mark P; Xie, Haiyi

    2013-01-01

    There is widespread recognition that services to persons with co-occurring substance use and psychiatric disorders should be accessible, yet most persons with these disorders do not receive care for both problems. Estimates of available services vary widely and have not examined potential variation by level of care. The present study samples 180 community addiction treatment programs and utilizes a standardized observational assessment of these programs using the dual diagnosis capability of addiction treatment (DDCAT) index. By level of care, the sample consisted of 53 outpatient programs, 50 intensive outpatient programs, and 77 residential programs. Overall, approximately 81.1% of programs across levels of care offered addiction-only services, 18.3% dual diagnosis capable services, and less than 1% dual diagnosis enhanced services. Relative to residential and intensive outpatient programs, outpatient programs were more likely to have greater dual diagnosis capability (dual diagnosis capable services). Outpatient programs scored significantly higher on the DDCAT dimensions associated with program policies and continuity of care. Specific DDCAT benchmark items revealing detailed differences were found in these dimensions and specific assessment and treatment practices. Access to physician-prescriber or to psychotropic medications did not differ by level of care. The findings suggest that across levels of care, addiction-treatment systems and programs must continue to improve capacity for patients with co-occurring disorders. The application of a standardized, objective, and observational instrument may be useful to guide and measure the effectiveness of these efforts.

  15. Carving out turf in a biodiversity hotspot: multiple, previously unrecognized shrew species co-occur on Java Island, Indonesia.

    Science.gov (United States)

    Esselstyn, Jacob A; Maharadatunkamsi; Achmadi, Anang S; Siler, Cameron D; Evans, Ben J

    2013-10-01

    In theory, competition among species in a shared habitat results in niche separation. In the case of small recondite mammals such as shrews, little is known about their autecologies, leaving open questions regarding the degree to which closely related species co-occur and how or whether ecological niches are partitioned. The extent to which species are able to coexist may depend on the degree to which they exploit different features of their habitat, which may in turn influence our ability to recognize them as species. We explored these issues in a biodiversity hotspot, by surveying shrew (genus Crocidura) diversity on the Indonesian island of Java. We sequenced portions of nine unlinked genes in 100-117 specimens of Javan shrews and incorporated homologous data from most known Crocidura species from other parts of island South-East Asia. Current taxonomy recognizes four Crocidura species on Java, including two endemics. However, our phylogenetic, population genetic and species delimitation analyses identify five species on the island, and all are endemic to Java. While the individual ranges of these species may not overlap in their entirety, we found up to four species living syntopically and all five species co-occurring on one mountain. Differences in species' body size, use of above ground-level habitats by one species and habitat partitioning along ecological gradients may have facilitated species diversification and coexistence. © 2013 John Wiley & Sons Ltd.

  16. Co-occurring motor, language and emotional-behavioral problems in children 3-6 years of age.

    Science.gov (United States)

    King-Dowling, Sara; Missiuna, Cheryl; Rodriguez, M Christine; Greenway, Matt; Cairney, John

    2015-02-01

    Developmental Coordination Disorder (DCD) has been shown to co-occur with behavioral and language problems in school-aged children, but little is known as to when these problems begin to emerge, or if they are inherent in children with DCD. The purpose of this study was to determine if deficits in language and emotional-behavioral problems are apparent in preschool-aged children with movement difficulties. Two hundred and fourteen children (mean age 4years 11months, SD 9.8months, 103 male) performed the Movement Assessment Battery for Children 2nd Edition (MABC-2). Children falling at or below the 16th percentile were classified as being at risk for movement difficulties (MD risk). Auditory comprehension and expressive communication were examined using the Preschool Language Scales 4th Edition (PLS-4). Parent-reported emotional and behavioral problems were assessed using the Child Behavior Checklist (CBCL). Preschool children with diminished motor coordination (n=37) were found to have lower language scores, higher externalizing behaviors in the form of increased aggression, as well as increased withdrawn and other behavior symptoms compared with their typically developing peers. Motor coordination, language and emotional-behavioral difficulties tend to co-occur in young children aged 3-6years. These results highlight the need for early intervention. Copyright © 2014 Elsevier B.V. All rights reserved.

  17. The impact of intolerance of emotional distress and uncertainty on veterans with co-occurring PTSD and substance use disorders.

    Science.gov (United States)

    Banducci, Anne N; Bujarski, Sarah J; Bonn-Miller, Marcel O; Patel, Amee; Connolly, Kevin M

    2016-06-01

    The risk of developing a substance use disorder (SUD) is significantly higher among veterans with posttraumatic stress disorder (PTSD). Veterans with this co-occurrence have poorer outcomes than singly diagnosed veterans, which may be related to two risk factors: intolerance uncertainty (IU) and low tolerance of emotional distress (TED). We hypothesized low TED and high IU would independently and interactively relate to heightened PTSD symptomatology and trauma-cue elicited SUD cravings. A sample of 70 veterans (M age=50; 95% men; 65% Black) with co-occurring PTSD-SUD was recruited. The Posttraumatic Stress Disorder Checklist (PCL), Craving Questionnaire, Distress Tolerance Scale, and Intolerance of Uncertainty Scale were administered. In general, low TED and high IU were significantly correlated with the PCL total and subscale scores. When examined within regression models, low TED was associated with elevated PCL scores and trauma-cue elicited SUD cravings; IU was not. However, there was a significant interaction between IU and TED; veterans with elevated IU and low TED had higher PCL Total, Hyperarousal, and Intrusions scores. This highlights the importance of assessing TED and IU among veterans with co-occurring PTSD-SUD, as these risk factors may not only be prognostic indicators of outcomes, but also treatment targets. Published by Elsevier Ltd.

  18. Prescription opioid abuse, chronic pain, and primary care: a Co-occurring Disorders Clinic in the chronic disease model.

    Science.gov (United States)

    Pade, Patricia A; Cardon, Karen E; Hoffman, Richard M; Geppert, Cynthia M A

    2012-12-01

    Abuse of opioids has become a public health crisis. The historic separation between the addiction and pain communities and a lack of training in medical education have made treatment difficult to provide, especially in primary care. The Co-occurring Disorders Clinic (COD) was established to treat patients with co-morbid chronic pain and addiction. This retrospective chart review reports results of a quality improvement project using buprenorphine/naloxone to treat co-occurring chronic non-cancer pain (CNCP) and opioid dependence in a primary care setting. Data were collected for 143 patients who were induced with buprenorphine/naloxone (BUP/NLX) between June 2009 and November 2011. Ninety-three patients (65%) continued to be maintained on the medication and seven completed treatment and were no longer taking any opioid (5%). Pain scores showed a modest, but statistically significant improvement on BUP/NLX, which was contrary to our expectations and may be an important factor in treatment retention for this challenging population. Published by Elsevier Inc.

  19. Neuropsychological deficits in BPD patients and the moderator effects of co-occurring mental disorders: A meta-analysis.

    Science.gov (United States)

    Unoka, Zsolt; J Richman, Mara

    2016-03-01

    Studies have shown that patients with borderline personality disorder (BPD) have co-occurring disorders; literature has also suggested that BPD patients have impairments in neuropsychological functioning, as seen in a previous meta-analysis (Ruocco, 2005). This meta-analysis showed that neuropsychological functioning are marked areas of concern in BPD; however, this meta-analytic research did not assess the effects of co-occurring disorders on neuropsychological functioning in BPD patients. The current meta-analysis takes this into consideration and a systematic review of cross-sectional studies comparing neuropsychological performance of individuals with BPD with age-matched healthy comparison subjects was carried out. Potential moderators (i.e., age, gender, education level, and co-morbid mental disorders) were analyzed. Significant deficits were observed in the decision making, memory, executive functioning, processing speed, verbal intelligence, and visuospatial abilities. BPD patients with more education and with parents of a higher educational level had better neuropsychological functioning. Globally, BPD samples with a higher percentage of co-morbid personality disorders, major depression, eating disorders, or any substance abuse disorders performed worse than patients with a less percentage; however, anxiety disorders and PTSD co-morbidity did not affect the cognitive performance of the BPD group. Differences are seen dependent on neuropsychological domain and specific co-morbidity. These findings highlight the clinical relevance of characterizing cognitive functioning in BPD and the importance of considering demographic and clinical moderators in future analyses. Copyright © 2015 Elsevier Ltd. All rights reserved.

  20. Disparities in use of mental health and substance abuse services by persons with co-occurring disorders.

    Science.gov (United States)

    Havassy, Barbara E; Alvidrez, Jennifer; Mericle, Amy A

    2009-02-01

    Individuals with co-occurring mental and substance use disorders require psychiatric and substance abuse treatments. A critical question is whether these individuals are treated for both disorders. This study prospectively examined 24-month service utilization patterns of 224 persons with co-occurring disorders who were recruited from crisis residential programs in the mental health treatment system (N=106) and from crisis residential detoxification programs in the substance abuse treatment system (N=118) in San Francisco. Utilization data were collected from the billing-information systems of both treatment systems. Demographic and clinical data were obtained in interviews with participants. Data were analyzed for group differences with chi square tests and logistic, linear, and zero-truncated negative binomial regression. After the analyses controlled for demographic and clinical factors, participants recruited from the substance abuse treatment system were less likely than those from the mental health treatment system to obtain any mental health services, mental health day treatment, transitional residential care, case management, and other outpatient services (probustness of these findings in other locales.

  1. Speech abilities in preschool children with speech sound disorder with and without co-occurring language impairment.

    Science.gov (United States)

    Macrae, Toby; Tyler, Ann A

    2014-10-01

    The authors compared preschool children with co-occurring speech sound disorder (SSD) and language impairment (LI) to children with SSD only in their numbers and types of speech sound errors. In this post hoc quasi-experimental study, independent samples t tests were used to compare the groups in the standard score from different tests of articulation/phonology, percent consonants correct, and the number of omission, substitution, distortion, typical, and atypical error patterns used in the production of different wordlists that had similar levels of phonetic and structural complexity. In comparison with children with SSD only, children with SSD and LI used similar numbers but different types of errors, including more omission patterns ( p < .001, d = 1.55) and fewer distortion patterns ( p = .022, d = 1.03). There were no significant differences in substitution, typical, and atypical error pattern use. Frequent omission error pattern use may reflect a more compromised linguistic system characterized by absent phonological representations for target sounds (see Shriberg et al., 2005). Research is required to examine the diagnostic potential of early frequent omission error pattern use in predicting later diagnoses of co-occurring SSD and LI and/or reading problems.

  2. Intensive weekend group treatment for panic disorder and its impact on co-occurring PTSD: A pilot study.

    Science.gov (United States)

    Teng, Ellen J; Barrera, Terri L; Hiatt, Emily L; Chaison, Angelic D; Dunn, Nancy Jo; Petersen, Nancy J; Stanley, Melinda A

    2015-06-01

    This pilot study examines the feasibility, acceptability, and potential effectiveness of delivering an intensive weekend group treatment for panic disorder (PD) to Veterans returning from deployments to Iraq and Afghanistan with co-occurring posttraumatic stress disorder (PTSD). The treatment program lasted 6h each day and was delivered by two experienced therapists. Patients received core components of panic treatment, including psychoeducation, cognitive restructuring, and interoceptive exposure. The interoceptive exposure exercises directly targeted anxiety sensitivity, a psychological construct also implicated in the maintenance of PTSD. Eighty-nine percent of patients who expressed interest in the treatment attended a baseline evaluation, and 63% of those who were study eligible initiated treatment. Treatment retention was high, with all 10 patients who initiated treatment completing the program. Veterans reported finding the treatment and delivery format highly acceptable and reported high levels of satisfaction. Panic symptoms improved significantly following the treatment and were maintained at a 7-month follow-up, with 71.4% of the sample reporting being panic free. Co-occurring PTSD symptoms also improved along with symptoms of anxiety and depression. Preliminary findings suggest that brief and intensive group treatments for PD/PTSD are a promising method of delivering cognitive behavioral therapy that may rapidly improve symptoms. This innovative treatment delivery format also may be a cost-effective way of increasing treatment engagement through increased access to quality care. Published by Elsevier Ltd.

  3. Investigating the Relationship between Self-Injurious Behavior, Social Deficits, and Cooccurring Behaviors in Children and Adolescents with Autism Spectrum Disorder

    Directory of Open Access Journals (Sweden)

    Paul Waters

    2012-01-01

    Full Text Available Research suggests that self-injurious behavior (SIB is related to social deficits and cooccurring problem behaviors in children and adolescents with autism spectrum disorder. A sample of 95 participants with ASD was assessed on presence and frequency of SIB (Behavior Problems Inventory, social deficits (the Matson Evaluation of Social Skills with Youngsters-II and cooccurring problem behaviors (ASD-Comorbidity-Child version. A model was created and tested to explain the relationship between these variables. Results showed that the model was acceptable in presenting the relationships between these variables. This information could be used to help predict which individuals are at risk of developing further cooccurring behavioral problems and determine risk markers for the development of social deficits.

  4. Co-Occurring Psychosocial Problems and HIV Risk Among Women Attending Drinking Venues in a South African Township: A Syndemic Approach

    Science.gov (United States)

    Pitpitan, Eileen V.; Kalichman, Seth C.; Eaton, Lisa A.; Cain, Demetria; Sikkema, Kathleen J.; Watt, Melissa H.; Skinner, Donald; Pieterse, Desiree

    2012-01-01

    Background In South Africa, women comprise the majority of HIV infections. Syndemics, or co-occurring epidemics and risk factors, have been applied to understanding HIV risk among marginalized groups. Purpose To apply the syndemic framework to examine psychosocial problems that co-occur among women attending drinking venues in South Africa, and to test how the co-occurrence of these problems may exacerbate risk for HIV infection. Method 560 women from a Cape Town township provided data on multiple psychosocial problems, including food insufficiency, depression, abuse experiences, problem drinking, and sexual behaviors. Results Bivariate associations among the syndemic factors showed a high degree of co-occurrence and regression analyses showed an additive effect of psychosocial problems on HIV risk behaviors. Conclusions These results demonstrate the utility of a syndemic framework to understand co-occurring psychosocial problems among women in South Africa. HIV prevention interventions should consider the compounding effects of psychosocial problems among women. PMID:23054944

  5. The bidirectional relationships between alcohol, cannabis, co-occurring alcohol and cannabis use disorders with major depressive disorder: results from a national sample.

    Science.gov (United States)

    Pacek, Lauren R; Martins, Silvia S; Crum, Rosa M

    2013-06-01

    Alcohol use disorders (AUD) and cannabis use disorders (CUD) are common in the United States (US), and are associated with major depressive disorder (MDD). Co-occurring alcohol and cannabis use/use disorders (AUD+CUD), though understudied, have been found to be associated with greater adverse outcomes than alcohol or cannabis use/use disorders alone. There is a paucity of research on the co-occurring relationships of the two disorders with depression. Data came from Waves 1 and 2 of the National Epidemiologic Survey of Alcohol and Related Conditions (NESARC), a population-based longitudinal survey of the adult non-institutionalized, civilian population in the US. Logistic regression analyses were used to assess the associations between: 1) baseline AUD, CUD, and co-occurring AUD+CUD with incident MDD at follow-up and 2) baseline MDD with incident AUD, CUD, and co-occurring AUD+CUD at follow-up, adjusted for potential confounding variables. For Aim 1, most of the AUD and CUD were positively associated with MDD. The strongest associations with incident MDD were observed for cannabis dependence (OR=6.61, CI=1.67-26.21) and co-occurring alcohol and cannabis dependence (OR=2.34, CI=1.23-4.48). For Aim 2, baseline MDD was significantly associated with comparatively fewer cases of incident AUD and CUD but the strongest association was observed for new onset co-occurring alcohol and cannabis dependence (OR=4.51, CI=1.31-15.60). The present study is limited by the potential for social desirability and recall biases. Positive associations between AUD, CUD and MDD were observed bidirectionally. Findings have implications for preventive and treatment programs and initiatives. Copyright © 2012 Elsevier B.V. All rights reserved.

  6. Identification of networks of co-occurring, tumor-related DNA copy number changes using a genome-wide scoring approach.

    Directory of Open Access Journals (Sweden)

    Christiaan Klijn

    2010-01-01

    Full Text Available Tumorigenesis is a multi-step process in which normal cells transform into malignant tumors following the accumulation of genetic mutations that enable them to evade the growth control checkpoints that would normally suppress their growth or result in apoptosis. It is therefore important to identify those combinations of mutations that collaborate in cancer development and progression. DNA copy number alterations (CNAs are one of the ways in which cancer genes are deregulated in tumor cells. We hypothesized that synergistic interactions between cancer genes might be identified by looking for regions of co-occurring gain and/or loss. To this end we developed a scoring framework to separate truly co-occurring aberrations from passenger mutations and dominant single signals present in the data. The resulting regions of high co-occurrence can be investigated for between-region functional interactions. Analysis of high-resolution DNA copy number data from a panel of 95 hematological tumor cell lines correctly identified co-occurring recombinations at the T-cell receptor and immunoglobulin loci in T- and B-cell malignancies, respectively, showing that we can recover truly co-occurring genomic alterations. In addition, our analysis revealed networks of co-occurring genomic losses and gains that are enriched for cancer genes. These networks are also highly enriched for functional relationships between genes. We further examine sub-networks of these networks, core networks, which contain many known cancer genes. The core network for co-occurring DNA losses we find seems to be independent of the canonical cancer genes within the network. Our findings suggest that large-scale, low-intensity copy number alterations may be an important feature of cancer development or maintenance by affecting gene dosage of a large interconnected network of functionally related genes.

  7. Impairments of spontaneous and deliberative mentalizing co-occur, yet dissociate, in schizophrenia.

    Science.gov (United States)

    Langdon, Robyn; Flynn, Michaela; Connaughton, Emily; Brüne, Martin

    2017-11-01

    goal-driven behaviours. These impairments were even more pronounced when participants were instructed to think of the stimuli as people, suggesting that perceiving others in social roles does not prompt people with schizophrenia to anthropomorphize about others as agents motivated by their own inner worlds. Impairments of spontaneous mentalizing were found to co-occur independently with explicit mentalizing deficits in schizophrenia, consistent with the claim that humans can access two distinct systems for understanding others' minds. Findings suggest that interventions to improve conscious deliberative mentalizing in schizophrenia may not be enough; we also need to target implicit mentalizing processes. Limitations The patient sample was chronic and only mildly symptomatic. As such, findings cannot be generalized to other stages and phases of the illness. All patients were also medicated, allowing for the possibility that automatic responses to socially salient stimuli may have been pharmacologically attenuated. Future research may examine whether unmedicated young people at ultra-high risk of psychosis show a similar profile of mentalizing impairment. Future work may also examine whether impairments of deliberative and spontaneous mentalizing associate differentially with social functioning and different cognitive domains in schizophrenia. © 2017 The British Psychological Society.

  8. Soil fertility and disturbance interact to drive contrasting responses of co-occurring native and nonnative species.

    Science.gov (United States)

    Peltzer, Duane A; Kurokawa, Hiroko; Wardle, David A

    2016-02-01

    Some plant functional groups such as nonnative invasive and nitrogen (N)-fixing plants are widely thought to have consistent, coordinated differences in their functional traits relative to other groups such as native and non -N-fixing plants. Recent evidence suggests that these trait differences between groups can be context dependent, varying with environmental factors such as resource availability and disturbance. However, many previous comparisons among plant groups differing in invasion status have not standardized growth form between groups or have compared species that do not co-occur, which could result in invasion status per se being confounded with other factors. We determined growth and leaf functional trait responses of 20 co-occurring woody species, that is, five species within each of four functional groups (native N-fixers, native non -N-fixers, nonnative [invasive] N-fixers and nonnative [invasive] non-N-fixers), to factorial combinations of soil fertility and defoliation treatments in a mesocosm experiment to test each of two hypotheses. First, we hypothesized that nonnative invasive and N-fixing species will have functional traits associated with rapid resource acquisition whereas natives and non -N-fixing species will have traits linked to resource conservation. Second, we hypothesized that plant growth and leaf traits of nonnative and N-fixing species will be more strongly influenced by environmental factors (i.e., soil fertility and disturbance) than will natives and non-N-fixers. Plant growth, foliar nutrients, and leaf structural traits varied among plant functional groups in a manner consistent with our first hypothesis. Support for our second hypothesis was mixed; origin (native vs. nonnative) and soil fertility rarely interacted to determine plant growth or variation in leaf traits whereas interactions involving N-fixing ability and soil fertility were common. Further, there were no consistent interactive effects between plant groupings and

  9. Association Between Quality Measures and Mortality in Individuals With Co-Occurring Mental Health and Substance Use Disorders.

    Science.gov (United States)

    Watkins, Katherine E; Paddock, Susan M; Hudson, Teresa J; Ounpraseuth, Songthip; Schrader, Amy M; Hepner, Kimberly A; Sullivan, Greer

    2016-10-01

    Individuals with co-occurring mental and substance use disorders have increased rates of mortality relative to the general population. The relationship between measures of treatment quality and mortality for these individuals is unknown. To examine the association between 5 quality measures and 12- and 24-month mortality. Retrospective cohort study of patients with co-occurring mental illness (schizophrenia, bipolar disorder, post-traumatic stress disorder and major depression) and substance use disorders who received care for these disorders paid for by the Veterans Administration between October 2006 and September 2007. Logistic regression models were used to examine the association between 12 and 24-month mortality and 5 patient-level quality measures, while risk-adjusting for patient characteristics. Quality measures included receipt of psychosocial treatment, receipt of psychotherapy, treatment initiation and engagement, and a measure of continuity of care. We also examined the relationship between number of diagnosis-related outpatient visits and mortality, and conducted sensitivity analyses to examine the robustness of our findings to an unobserved confounder. Mortality 12 and 24 months after the end of the observation period. All measures except for treatment engagement at 24 months were significantly associated with lower mortality at both 12 and 24 months. At 12 months, receiving any psychosocial treatment was associated with a 21% decrease in mortality; psychotherapy, a 22% decrease; treatment initiation, a 15% decrease, treatment engagement, a 31% decrease; and quarterly, diagnosis-related visits a 28% decrease. Increasing numbers of visits were associated with decreasing mortality. Sensitivity analyses indicated that the difference in the prevalence of an unobserved confounder would have to be unrealistically large given the observed data, or there would need to be a large effect of an unobserved confounder, to render these findings non

  10. Role of two co-occurring Mediterranean sea urchins in the formation of barren from Cystoseira canopy

    Science.gov (United States)

    Agnetta, D.; Badalamenti, F.; Ceccherelli, G.; Di Trapani, F.; Bonaviri, C.; Gianguzza, P.

    2015-01-01

    In the Mediterranean Sea the co-occurring sea urchins Paracentrotus lividus and Arbacia lixula are usually considered to share the same ecological role in the formation of barren from Cystoseira canopy. However, their foraging ability may vary due to feeding behavior and species-specific morphological traits. The relative effects of P. lividus and A. lixula on Cystoseira canopy was tested experimentally both in the laboratory, at a density of about 20 ind./m2, and in the field by gut content analysis. Field and laboratory results show that A. lixula is unable to affect Cystoseira spp. Furthermore, these results confirmed the great ability of P. lividus to consume Cystoseira canopy, thus supporting the evidence of the major role of this species in the creation of a barren state.

  11. Latent class profile of psychiatric symptoms and treatment utilization in a sample of patients with co-occurring disorders.

    Science.gov (United States)

    Villalobos-Gallegos, Luis; Marín-Navarrete, Rodrigo; Roncero, Calos; González-Cantú, Hugo

    2017-01-01

    To identify symptom-based subgroups within a sample of patients with co-occurring disorders (CODs) and to analyze intersubgroup differences in mental health services utilization. Two hundred and fifteen patients with COD from an addiction clinic completed the Symptom Checklist 90-Revised. Subgroups were determined using latent class profile analysis. Services utilization data were collected from electronic records during a 3-year span. The five-class model obtained the best fit (Bayesian information criteria [BIC] = 3,546.95; adjusted BIC = 3,363.14; bootstrapped likelihood ratio test p < 0.0001). Differences between classes were quantitative, and groups were labeled according to severity: mild (26%), mild-moderate (28.8%), moderate (18.6%), moderate-severe (17.2%), and severe (9.3%). A significant time by class interaction was obtained (chi-square [χ2[15

  12. Changes in hippocampal volume and neuron number co-occur with memory decline in old homing pigeons (Columba livia).

    Science.gov (United States)

    Coppola, Vincent J; Kanyok, Nate; Schreiber, Austin J; Flaim, Mary E; Bingman, Verner P

    2016-05-01

    The mammalian hippocampus is particularly susceptible to age-related structural changes, which have been used to explain, in part, age-related memory decline. These changes are generally characterized by atrophy (e.g., a decrease in volume and number of synaptic contacts). Recent studies have reported age-related spatial memory deficits in older pigeons similar to those seen in older mammals. However, to date, little is known about any co-occurring changes in the aging avian hippocampal formation (HF). In the current study, it was found that the HF of older pigeons was actually larger and contained more neurons than the HF of younger pigeons, a finding that suggests that the pattern of structural changes during aging in the avian HF is different from that seen in the mammalian hippocampus. A working hypothesis for relating the observed structural changes with spatial-cognitive decline is offered. Copyright © 2016 Elsevier Inc. All rights reserved.

  13. Latent class profile of psychiatric symptoms and treatment utilization in a sample of patients with co-occurring disorders

    Directory of Open Access Journals (Sweden)

    Luis Villalobos-Gallegos

    Full Text Available Objective: To identify symptom-based subgroups within a sample of patients with co-occurring disorders (CODs and to analyze intersubgroup differences in mental health services utilization. Methods: Two hundred and fifteen patients with COD from an addiction clinic completed the Symptom Checklist 90-Revised. Subgroups were determined using latent class profile analysis. Services utilization data were collected from electronic records during a 3-year span. Results: The five-class model obtained the best fit (Bayesian information criteria [BIC] = 3,546.95; adjusted BIC = 3,363.14; bootstrapped likelihood ratio test p < 0.0001. Differences between classes were quantitative, and groups were labeled according to severity: mild (26%, mild-moderate (28.8%, moderate (18.6%, moderate-severe (17.2%, and severe (9.3%. A significant time by class interaction was obtained (chi-square [χ2[15

  14. A critical black feminist ethnography of treatment for women with co-occurring disorders in the psychiatric hospital.

    Science.gov (United States)

    Creswell, Laryssa M

    2014-04-01

    The purpose of this study was to explore the perspectives of women diagnosed with co-occurring disorders on the treatments provided by a state psychiatric hospital so that appropriate recommendations for changes in treatment may be made. Critical ethnography was used and the data was viewed through the lens of intersectionality from the black feminist perspective. Seven women hospitalized in one psychiatric hospital in the Mid-Atlantic region participated in the study. Data was collected via semistructured interviews, Consumer Perceptions of Care survey, researcher's observations, and archival data. Three major findings emerged: (1) Dialectical Behavioral Therapy (DBT) was identified as a beneficial treatment, (2) a lack of trust in the system and people in the system, and (3) housing or homelessness was perceived as a barrier. Based on the results of this study, it is recommended clinicians, administrators, and policy makers listen closely to individuals receiving treatment to make decisions regarding treatment accordingly.

  15. Pre- and perinatal complications in relation to Tourette syndrome and co-occurring obsessive-compulsive disorder and attention-deficit/hyperactivity disorder

    NARCIS (Netherlands)

    Abdulkadir, Mohamed; Tischfield, Jay A.; King, Robert A.; Fernandez, Thomas V.; Brown, Lawrence W.; Cheon, Keun-Ah; Coffey, Barbara J.; de Bruijn, Sebastian F. T. M.; Elzerman, Lonneke; Garcia-Delgar, Blanca; Gilbert, Donald L.; Grice, Dorothy E.; Hagstrom, Julie; Hedderly, Tammy; Heyman, Isobel; Hong, Hyun Ju; Huyser, Chaim; Ibanez-Gomez, Laura; Kim, Young Key; Kim, Young-Shin; Koh, Yun-Joo; Kook, Sodahm; Kuperman, Samuel; Lamerz, Andreas; Leventhal, Bennett; Ludolph, Andrea G.; Madruga-Garrido, Marcos; Maras, Athanasios; Messchendorp, Marieke D.; Mir, Pablo; Morer, Astrid; Munchau, Alexander; Murphy, Tara L.; Openneer, Thaira J. C.; Plessen, Kerstin J.; Rath, Judith J. G.; Roessner, Veit; Frundt, Odette; Shin, Eun-Young; Sival, Deborah A.; Song, Dong-Ho; Song, Jungeun; Stolte, Anne-Marie; Tubing, Jennifer; van den Ban, Els; Visscher, Frank; Wanderer, Sina; Woods, Martin; Zinner, Samuel H.; State, Matthew W.; Heiman, Gary A.; Hoekstra, Pieter J.; Dietrich, Andrea

    2016-01-01

    Pre- and perinatal complications have been implicated in the onset and clinical expression of Tourette syndrome albeit with considerable inconsistencies across studies. Also, little is known about their role in co-occurring obsessive-compulsive disorder (OCD) and attention-deficit/hyperactivity

  16. Feasibility of teaching motivational interviewing to parents of young adults with recent-onset schizophrenia and co-occurring cannabis use

    NARCIS (Netherlands)

    Smeerdijk, Maarten; Keet, René; de Haan, Lieuwe; Barrowclough, Christine; Linszen, Don; Schippers, Gerard

    2014-01-01

    This study examined the feasibility of providing motivational interviewing (MI) training to parents of young adults with recent-onset schizophrenia and co-occurring cannabis use. The training was offered in a mental health care setting as part of a family motivational intervention (FMI).

  17. Predictors of Depressive Symptomatology in Family Caregivers of Women with Substance Use Disorders or Co-Occurring Substance Use and Mental Disorders

    Science.gov (United States)

    Biegel, David E.; Katz-Saltzman, Shiri; Meeks, David; Brown, Suzanne; Tracy, Elizabeth M.

    2010-01-01

    This study utilized a stress-process model to examine the impact of having a female family member with substance use or co-occurring substance use and mental disorders on family caregivers' depressive symptomatology. Participants were 82 women receiving substance abuse treatment and the family member providing the most social support for each…

  18. The Impact of Caregiver-Care Recipient Relationship Quality on Family Caregivers of Women with Substance-Use Disorders or Co-Occurring Substance and Mental Disorders

    Science.gov (United States)

    Katz-Saltzman, Shiri; Biegel, David E.; Townsend, Aloen

    2008-01-01

    This cross-sectional study utilized a stress-process model to examine the impact of caregivers' (N = 82) perceptions of their relationship quality with a female family member (i.e., care-recipient) with substance-use or co-occurring substance and mental disorders on caregivers' perceived burden. Regression findings indicate that relationship…

  19. The Adolescent Community Reinforcement Approach (A-CRA) as a model paradigm for the management of adolescents with substance use disorders and co-occurring psychiatric disorders.

    Science.gov (United States)

    Godley, Susan H; Smith, Jane Ellen; Passetti, Lora L; Subramaniam, Geetha

    2014-01-01

    Integrated treatment for youth with substance use disorders (SUDs) and co-occurring psychiatric disorders is recommended; however, there are few studies that have evaluated integrated treatment approaches. This paper includes a brief review of cognitive-behavioral and family therapies, since they have been demonstrated to be effective treatments for the disorders that commonly co-occur with substance use. It also describes how an integrated treatment paradigm has been implemented using one Empirically Supported Treatment, the Adolescent Community Reinforcement Approach (A-CRA). There is existing research that supports the use of several A-CRA procedures to treat substance use and commonly co-occurring psychiatric disorders. In the absence of further research, it is reasonable in the interim to train clinicians in treatments that incorporate components that have been found to be effective for both substance use and commonly co-occurring psychiatric disorders. These treatments can then be adapted as needed based on an individual youth's set of problems. Further research is needed to test treatments for various combinations of SUDs and psychiatric disorders (i.e., depression, trauma-related problems, conduct disorder/behavior problems, and attention-deficit/hyperactivity disorder [ADHD]).

  20. Co-Occurring Serious Mental Illness and Substance Use Disorders within a Countywide System: Who Interfaces with the Jail and Who Does Not?

    Science.gov (United States)

    Kubiak, Sheryl Pimlott; Essenmacher, Lynnette; Hanna, Julie; Zeoli, April

    2011-01-01

    The presence of a co-occurring substance use disorder increases the risk of incarceration for those with a serious mental illness. To examine the interface between jail and mental health systems, a sample of 1,440 individuals diagnosed with both disorders was followed for 48 months using administrative data. The majority (63%) experienced…

  1. Multidisciplinary Treatment for Adults with Autism Spectrum Disorder and Co-Occurring Mental Health Disorders: Adapting Clinical Research Tools to Everyday Clinical Practice

    Science.gov (United States)

    Battaglia, Maurizio; Detrick, Susan; Fernandez, Anna

    2016-01-01

    In California, individuals with autism and co-occurring mental disorders, and their families, face two serious barriers when attempting to access the mental health services they need. The first is that the State Mental Health Specialty Service guidelines specifically exclude autism as a qualifying primary diagnosis for eligibility for mental…

  2. Military Sexual Trauma and Co-occurring Posttraumatic Stress Disorder, Depressive Disorders, and Substance Use Disorders among Returning Afghanistan and Iraq Veterans.

    Science.gov (United States)

    Gilmore, Amanda K; Brignone, Emily; Painter, Janelle M; Lehavot, Keren; Fargo, Jamison; Suo, Ying; Simpson, Tracy; Carter, Marjorie E; Blais, Rebecca K; Gundlapalli, Adi V

    2016-01-01

    Posttraumatic stress disorder (PTSD), depressive disorders (DD), and substance use disorders (SUD) are prevalent among veterans. A positive military sexual trauma (MST) screen is associated with higher likelihood of each of these disorders. The current study examined the associations between MST, gender, and co-occurring PTSD, DD, and SUD among veterans receiving services at the Department of Veterans Affairs to inform assessment and treatment. We were specifically interested in the interactions between MST and gender on co-occurring disorders. The sample included 494,822 Department of Veterans Affairs service-seeking veterans (12.5% women) deployed to Iraq and Afghanistan who recently separated from the military and were screened for MST between 2004 and 2013. Veterans with positive MST screens had higher odds than those with negative screens of individual and co-occurring PTSD, DD, and SUD. The association between positive MST screens and diagnostic outcomes, including PTSD, was stronger for women than for men, and the association between positive MST screens and some diagnostic outcomes, including DD, was stronger for men than for women. These results highlight the importance of assessing for and recognizing the potential MST and gender interactions in the clinical context among veterans with co-occurring PTSD, DD, and/or SUD. Copyright © 2016 Jacobs Institute of Women's Health. Published by Elsevier Inc. All rights reserved.

  3. Racial/Ethnic Differences in Social Vulnerability among Women with Co-Occurring Mental Health and Substance Abuse Disorders: Implications for Treatment Services

    Science.gov (United States)

    Amaro, Hortensia; Larson, Mary Jo; Gampel, Joanne; Richardson, Erin; Savage, Andrea; Wagler, Debra

    2005-01-01

    Little attention has been given to racial/ethnic differences in studies of co-occurring disorders among women. In this article, we present findings from analyses conducted on the influence of racial/ethnic differences on the demographic and clinical profiles of 2,534 women in the Substance Abuse and Mental Health Services Administration-sponsored…

  4. Developing Consumer/Survivor/Recovering Voice and Its Impact on Services and Research: Our Experience with the SAMHSA Women, Co-Occurring Disorders and Violence Study

    Science.gov (United States)

    Mockus, Susan; Mars, Laura Cinq; Ovard, Dorothy Guazzo; Mazelis, Ruta; Bjelajac, Paula; Grady, Janice; LaClair, Christine; Livingston, Cardenia; Slavin, Sharon; Williams, Susan; McKinney, Jacki

    2005-01-01

    Integrating consumer/survivor/recovering (C/S/R) women in the Substance Abuse and Mental Health Services Administration's Women, Co-Occurring Disorders and Violence Study involved both struggles and growth. The C/S/R women and all of our professional allies, both individually and collectively, greatly enhanced the study by overcoming what earlier…

  5. Promoting Resiliency in Children of Mothers with Co-Occurring Disorders and Histories of Trauma: Impact of a Skills-Based Intervention Program on Child Outcomes

    Science.gov (United States)

    Noether, Chanson D.; Brown, Vivian; Finkelstein, Norma; Russell, Lisa A.; VanDeMark, Nancy R.; Morris, Laura S.; Graeber, Carla

    2007-01-01

    Using a quasi-experimental design, this study examined the effectiveness of a standardized intervention model designed to build resiliency in children of women with co-occurring mental health and substance use disorders and histories of interpersonal abuse. The children and mothers who participated in this study were a subset of the sample used…

  6. Service Based Internship Training to Prepare Workers to Support the Recovery of People with Co-Occurring Substance Abuse and Mental Health Disorders

    Science.gov (United States)

    Crowe, Trevor P.; Kelly, Peter; Pepper, James; McLennan, Ross; Deane, Frank P.; Buckingham, Mark

    2013-01-01

    A repeated measures design was used to evaluate a 12 month on-site counsellor internship programme aimed at training staff to support the recovery needs of people with co-occurring substance use and mental health disorders. Fifty-four interns completed measures of recovery knowledge, attitudes, confidence/competence, as well as identifying…

  7. Effectiveness of an Integrated, Trauma-Informed Approach to Treating Women with Co-Occurring Disorders and Histories of Trauma: The Los Angeles Site Experience

    Science.gov (United States)

    Gatz, Margaret; Brown, Vivian; Hennigan, Karen; Rechberger, Elke; O'Keefe, Maura; Rose, Tara; Bjelajac, Paula

    2007-01-01

    Effectiveness of an integrated trauma-informed approach to treating women with co-occurring disorders and histories of trauma was evaluated. Baseline and 12-month assessments were completed by 136 intervention- and 177 comparison-group women. The intervention group received Seeking Safety, a trauma-specific group treatment focusing on safety and…

  8. A Clinician's Guide to Co-Occurring ADHD among Adolescent Substance Users: Comorbidity, Neurodevelopmental Risk, and Evidence-Based Treatment Options

    Science.gov (United States)

    Hogue, Aaron; Evans, Steven W.; Levin, Frances R.

    2017-01-01

    This article introduces neurodevelopmental and clinical considerations for treating adolescents with co-occurring attention deficit hyperactivity disorder (ADHD) and adolescent substance use (ASU) in outpatient settings. We first describe neurobiological impairments common to ADHD and ASU, including comorbidity with conduct disorder, that evoke a…

  9. Role of Comorbid Depression and Co-Occurring Depressive Symptoms in Outcomes for Anxiety-Disordered Youth Treated with Cognitive-Behavioral Therapy

    Science.gov (United States)

    O'Neil, Kelly A.; Kendall, Philip C.

    2012-01-01

    This study examined the role of comorbid depressive disorders (major depressive disorder or dysthymic disorder) and co-occurring depressive symptoms in treatment outcome and maintenance for youth (N = 72, aged 7-14) treated with cognitive-behavioral therapy for a principal anxiety disorder (generalized anxiety disorder, separation anxiety…

  10. Structure revision of aspergicin by the crystal structure of aspergicine, a co-occurring isomer produced by co-culture of two mangrove epiphytic fungi.

    Science.gov (United States)

    Zhu, Feng; Li, Jie-Sen; Xie, Wu-Cheng; Shi, Jun-Jun; Xu, Feng; Song, Zhao-Feng; Liu, Yi-Lu

    2017-10-01

    The structure of aspergicin (1), an antibacterial alkaloid produced by co-culture of two marine-derived mangrove epiphytic fungi, were revised by the co-occurring isomer named as aspergicine (2), whose structure was determined on the basis of spectroscopic analysis and X-ray crystallography.

  11. Comparison of Perinatal Risk Factors Associated with Autism Spectrum Disorder (ASD), Intellectual Disability (ID), and Co-Occurring ASD and ID

    Science.gov (United States)

    Schieve, Laura A.; Clayton, Heather B.; Durkin, Maureen S.; Wingate, Martha S.; Drews-Botsch, Carolyn

    2015-01-01

    While studies report associations between perinatal outcomes and both autism spectrum disorder (ASD) and intellectual disability (ID), there has been little study of ASD with versus without co-occurring ID. We compared perinatal risk factors among 7547 children in the 2006-2010 Autism and Developmental Disability Monitoring Network classified as…

  12. Coping styles in substance use disorder (SUD) patients with and without co-occurring attention deficit/hyperactivity disorder (ADHD) or autism spectrum disorder (ASD)

    NARCIS (Netherlands)

    Kronenberg, Linda M.; Goossens, Peter J. J.; van Busschbach, Jooske; van Achterberg, Theo; van den Brink, Wim

    2015-01-01

    Background: Patients with a substance use disorder (SUD) and co-occurring attention deficit hyperactivity disorder (ADHD) or autism spectrum disorder (ASD) often start using substances in an attempt to cope with the stress related to their ADHD or ASD. To improve treatment for these patient groups,

  13. Keeping the Music Alive: Using the "Grief and Hope Box" with Adult Offenders with Co-Occurring Mental Health and Substance Use Issues

    Science.gov (United States)

    Gee, Robert; Springer, Paul; Bitar, George; Drew, Faith; Graff, Chad

    2005-01-01

    Individuals with co-occurring mental health and substance use disorder (COD) present unique challenges for counselors. When individuals are incarcerated, they suffer unique forms of losses, including the loss and grief of their family members. In addition, they often struggle with stigma and cultural stereotypes that are oppressive and…

  14. Coping styles in substance use disorder (SUD) patients with and without co-occurring attention deficit/hyperactivity disorder (ADHD) or autism spectrum disorder (ASD)

    NARCIS (Netherlands)

    Kronenberg, Linda M.; Goossens, Peter J. J.; van Busschbach, Jooske; van Achterberg, Theo; van den Brink, Wim

    2015-01-01

    Patients with a substance use disorder (SUD) and co-occurring attention deficit hyperactivity disorder (ADHD) or autism spectrum disorder (ASD) often start using substances in an attempt to cope with the stress related to their ADHD or ASD. To improve treatment for these patient groups, it is

  15. Coping styles in substance use disorder (SUD) patients with and without co-occurring attention deficit/hyperactivity disorder (ADHD) or autism spectrum disorder (ASD)

    NARCIS (Netherlands)

    Kronenberg, L.M.; Goossens, P.J.J.; Busschbach, J. van; Achterberg, T. van; Brink, W. van den

    2015-01-01

    BACKGROUND: Patients with a substance use disorder (SUD) and co-occurring attention deficit hyperactivity disorder (ADHD) or autism spectrum disorder (ASD) often start using substances in an attempt to cope with the stress related to their ADHD or ASD. To improve treatment for these patient groups,

  16. d13C vs d15N of co-occurring molluscs within a community dominated by Crassostrea gigas and Crepidula fornicata (Oosterschelde, The Netherlands)

    NARCIS (Netherlands)

    Riera, P.; Stal, L.J.; Nieuwenhuize, J.

    2002-01-01

    The aim of this study was to investigate, by use of d13C and d15N, the diet of co-occurring intertidal molluscs species within a community dominated by the oyster Crassostrea gigas and its epibiont, the common Atlantic slipper limpet Crepidula fornicata. The results showed that the d13C versus d15N

  17. Pre- and perinatal complications in relation to Tourette syndrome and co-occurring obsessive-compulsive disorder and attention-deficit/hyperactivity disorder

    NARCIS (Netherlands)

    Abdulkadir, M. (Mohamed); J.A. Tischfield (Jay); King, R.A. (Robert A.); T.V. Fernandez (Thomas); Brown, L.W. (Lawrence W.); Cheon, K.-A. (Keun-Ah); Coffey, B.J. (Barbara J.); S.F. de Bruijn (S.); Elzerman, L. (Lonneke); Garcia-Delgar, B. (Blanca); D.L. Gilbert (D.); S.F.J. Le Grice; Hagstrøm, J. (Julie); T. Hedderly (Tammy); Heyman, I. (Isobel); Hong, H.J. (Hyun Ju); J. Huyser (Jochanan); Ibanez-Gomez, L. (Laura); Kim, Y.K. (Young Key); Kim, Y.-S. (Young-Shin); Koh, Y.-J. (Yun-Joo); Kook, S. (Sodahm); Kuperman, S. (Samuel); Lamerz, A. (Andreas); Leventhal, B. (Bennett); Ludolph, A.G. (Andrea G.); Madruga-Garrido, M. (Marcos); A. Maras (Athanasios); Messchendorp, M.D. (Marieke D.); Mir, P. (Pablo); Morer, A. (Astrid); A. Münchau (Alexander); Murphy, T.L. (Tara L.); Openneer, T.J.C. (Thaïra J.C.); Plessen, K.J. (Kerstin J.); S. Rath (Santosh); V. Rœssner (Veit); Fründt, O. (Odette); Shin, E.-Y. (Eun-Young); D.A. Sival (Deborah); Song, D.-H. (Dong-Ho); Song, J. (Jungeun); Stolte, A.-M. (Anne-Marie); Tübing, J. (Jennifer); van den Ban, E. (Els); F. Visscher (Frank); Wanderer, S. (Sina); Woods, M. (Martin); Zinner, S.H. (Samuel H.); M.W. State (Matthew); M.L. Heiman (Mark); P.J. Hoekstra (Pieter); A. Dietrich (Andrea)

    2016-01-01

    textabstractPre- and perinatal complications have been implicated in the onset and clinical expression of Tourette syndrome albeit with considerable inconsistencies across studies. Also, little is known about their role in co-occurring obsessive-compulsive disorder (OCD) and

  18. Contrasting secondary growth and water use efficiency patterns in native and exotic trees co-occurring in inner Spain riparian forests

    NARCIS (Netherlands)

    González Muñoz, N.; Linares, J.C.; Castro-Diez, P.; Sass-Klaassen, U.G.W.

    2015-01-01

    Aim of study: The invasive trees Ailanthus altissima and Robinia pseudoacacia are widely spreading in inner Spain riparian forests, where they co-occur with the natives Fraxinus angustifolia and Ulmus minor. In a climate change context, we aimed to identify some of the species traits that are

  19. Interactive effects of water table and precipitation on net CO2 assimilation of three co-occurring Sphagnum mosses differing in distribution above the water table

    NARCIS (Netherlands)

    Robroek, B.J.M.; Schouten, M.G.C.; Limpens, J.; Berendse, F.; Poorter, H.

    2009-01-01

    Sphagnum cuspidatum, S. magellanicum and S. rubellum are three co-occurring peat mosses, which naturally have a different distribution along the microtopographical gradient of the surface of peatlands. We set out an experiment to assess the interactive effects of water table (low: -10 cm and high:

  20. The influence of family and social problems on treatment outcomes of persons with co-occurring substance use disorders and PTSD

    Science.gov (United States)

    Saunders, Elizabeth C.; McLeman, Bethany M.; McGovern, Mark P.; Xie, Haiyi; Lambert-Harris, Chantal; Meier, Andrea

    2016-01-01

    Objective Family and social problems may contribute to negative recovery outcomes in patients with co-occurring substance use and psychiatric disorders, yet few studies have empirically examined this relationship. This study investigates the impact of family and social problems on treatment outcomes among patients with co-occurring substance use and posttraumatic stress disorder (PTSD). Method A secondary analysis was conducted using data collected from a randomized controlled trial of an integrated therapy for patients with co-occurring substance use and PTSD. Substance use, psychiatric symptoms, and social problems were assessed. Longitudinal outcomes were analyzed using generalized estimating equations (GEE) and multiple linear regression. Results At baseline, increased family and social problems were associated with more severe substance use and psychiatric symptoms. Over time, all participants had comparable decreases in substance use and psychiatric problem severity. However, changes in family and social problem severity were predictive of PTSD symptom severity, alcohol use, and psychiatric severity at follow-up. Conclusions For patients with co-occurring substance use and PTSD, family and social problem severity is associated with substance use and psychiatric problem severity at baseline and over time. Targeted treatment for social and family problems may be optimal. PMID:27182200

  1. A Retrospective Population-Based Data Analyses of Inpatient Care Use and Medical Expenditure in People with Intellectual Disability Co-Occurring Schizophrenia

    Science.gov (United States)

    Lai, Chia-Im; Hung, Wen-Jiu; Lin, Lan-Ping; Chien, Wu-Chien; Lin, Jin-Ding

    2011-01-01

    The paper aims to analyze the hospital inpatient care use and medical fee of people with ID co-occurring with schizophrenia in Taiwan. A nationwide data were collected concerning hospital admission and medical expenditure of people with ID (n = 2565) among national health insurance beneficiaries in Taiwan. Multiple regression analyses were…

  2. Bud-bank and tiller dynamics of co-occurring C3 caespitose grasses in mixed-grass prairie.

    Science.gov (United States)

    Ott, Jacqueline P; Hartnett, David C

    2015-09-01

    Tiller recruitment from the belowground bud bank of caespitose grasses influences their ability to monopolize local resources and, hence, their genet fitness. Differences in bud production and outgrowth among tiller types within a genet and among species may explain co-occurrence of caespitose grasses. This study aimed to characterize genet bud-bank and tiller production and dynamics in two co-occurring species and compare their vegetative reproductive strategies. Bud-bank and tiller dynamics of Hesperostipa comata and Nassella viridula, dominant C3 caespitose grasses in the northern mixed-grass prairie of North America, were assessed throughout an annual cycle. The two species showed similar strategies, maintaining polycyclic tillers and thus creating mixed-age genet bud banks comprising multiple bud cohorts produced in different years. Vegetative tillers produced the majority of buds, whereas flowering tillers contributed little to the bud bank. Buds lived for at least 2 yr and were maintained in multiple developmental stages throughout the year. Because bud longevity rarely exceeded tiller longevity, tiller longevity drove turnover within the bud bank. Tiller population dynamics, more than bud production per tiller, determined the differential contribution of tiller types to the bud bank. Nassella viridula had higher bud production per tiller, a consistent annual tiller recruitment density, and greater longevity of buds on senesced and flowering tillers than H. comata. Co-occurring C3 caespitose grasses had similar bud-bank and tiller dynamics contributing to genet persistence but differed in bud characteristics that could affect genet longevity and species coexistence. © 2015 Botanical Society of America.

  3. Mindfulness-based stress reduction for older adults with worry symptoms and co-occurring cognitive dysfunction.

    Science.gov (United States)

    Lenze, Eric J; Hickman, Steven; Hershey, Tamara; Wendleton, Leah; Ly, Khanh; Dixon, David; Doré, Peter; Wetherell, Julie Loebach

    2014-10-01

    Mindfulness-based stress reduction (MBSR) has the potential to reduce worry and improve cognitive functioning. In this treatment development project, we examined MBSR in older adults with worry symptoms and co-occurring cognitive dysfunction. We examined (i) acceptability of MBSR, (ii) whether MBSR needs to be lengthened providing more repetition, (iii) MBSR's benefits for worry reduction and cognitive improvements, and (iv) continued use of MBSR techniques during follow-up. Two sites (St. Louis and San Diego) enrolled individuals aged 65 years or older with significant anxiety-related distress plus subjective cognitive dysfunction, into traditional 8-session MBSR groups and 12-session groups that had the same content but more repetition of topics and techniques. We examined measures of mindfulness, worry, and a neuropsychological battery focused on memory and executive function before and after the MBSR program, and we followed up participants for 6 months after the completion of MBSR regarding their continued use of its techniques. Participants (N = 34) showed improvements in worry severity, increases in mindfulness, and improvements in memory as measured by paragraph learning and recall after a delay, all with a large effect size. Most participants continued to use MBSR techniques for 6 months post-instruction and found them helpful in stressful situations. There was no evidence that the extended 12-week MBSR produced superior cognitive or clinical outcomes, greater satisfaction, or greater continuation of MBSR techniques than 8-week MBSR. These preliminary findings are promising for the further testing and use of MBSR in older adults suffering from clinical worry symptoms and co-occurring cognitive dysfunction. These are common problems in a broad range of older adults, many of whom have anxiety and mood disorders; therefore, stress reduction intervention for them may have great public health value. Copyright © 2014 John Wiley & Sons, Ltd.

  4. Co-occurring substance-related and behavioral addiction problems: A person-centered, lay epidemiology approach.

    Science.gov (United States)

    Konkolÿ Thege, Barna; Hodgins, David C; Wild, T Cameron

    2016-12-01

    Background and aims The aims of this study were (a) to describe the prevalence of single versus multiple addiction problems in a large representative sample and (b) to identify distinct subgroups of people experiencing substance-related and behavioral addiction problems. Methods A random sample of 6,000 respondents from Alberta, Canada, completed survey items assessing self-attributed problems experienced in the past year with four substances (alcohol, tobacco, marijuana, and cocaine) and six behaviors (gambling, eating, shopping, sex, video gaming, and work). Hierarchical cluster analyses were used to classify patterns of co-occurring addiction problems on an analytic subsample of 2,728 respondents (1,696 women and 1032 men; M age  = 45.1 years, SD age  = 13.5 years) who reported problems with one or more of the addictive behaviors in the previous year. Results In the total sample, 49.2% of the respondents reported zero, 29.8% reported one, 13.1% reported two, and 7.9% reported three or more addiction problems in the previous year. Cluster-analytic results suggested a 7-group solution. Members of most clusters were characterized by multiple addiction problems; the average number of past year addictive behaviors in cluster members ranged between 1 (Cluster II: excessive eating only) and 2.5 (Cluster VII: excessive video game playing with the frequent co-occurrence of smoking, excessive eating and work). Discussion and conclusions Our findings replicate previous results indicating that about half of the adult population struggles with at least one excessive behavior in a given year; however, our analyses revealed a higher number of co-occurring addiction clusters than typically found in previous studies.

  5. Pre- and perinatal complications in relation to Tourette syndrome and co-occurring obsessive-compulsive disorder and attention-deficit/hyperactivity disorder.

    Science.gov (United States)

    Abdulkadir, Mohamed; Tischfield, Jay A; King, Robert A; Fernandez, Thomas V; Brown, Lawrence W; Cheon, Keun-Ah; Coffey, Barbara J; de Bruijn, Sebastian F T M; Elzerman, Lonneke; Garcia-Delgar, Blanca; Gilbert, Donald L; Grice, Dorothy E; Hagstrøm, Julie; Hedderly, Tammy; Heyman, Isobel; Hong, Hyun Ju; Huyser, Chaim; Ibanez-Gomez, Laura; Kim, Young Key; Kim, Young-Shin; Koh, Yun-Joo; Kook, Sodahm; Kuperman, Samuel; Lamerz, Andreas; Leventhal, Bennett; Ludolph, Andrea G; Madruga-Garrido, Marcos; Maras, Athanasios; Messchendorp, Marieke D; Mir, Pablo; Morer, Astrid; Münchau, Alexander; Murphy, Tara L; Openneer, Thaïra J C; Plessen, Kerstin J; Rath, Judith J G; Roessner, Veit; Fründt, Odette; Shin, Eun-Young; Sival, Deborah A; Song, Dong-Ho; Song, Jungeun; Stolte, Anne-Marie; Tübing, Jennifer; van den Ban, Els; Visscher, Frank; Wanderer, Sina; Woods, Martin; Zinner, Samuel H; State, Matthew W; Heiman, Gary A; Hoekstra, Pieter J; Dietrich, Andrea

    2016-11-01

    Pre- and perinatal complications have been implicated in the onset and clinical expression of Tourette syndrome albeit with considerable inconsistencies across studies. Also, little is known about their role in co-occurring obsessive-compulsive disorder (OCD) and attention-deficit/hyperactivity disorder (ADHD) in individuals with a tic disorder. Therefore, we aimed to investigate the role of pre- and perinatal complications in relation to the presence and symptom severity of chronic tic disorder and co-occurring OCD and ADHD using data of 1113 participants from the Tourette International Collaborative Genetics study. This study included 586 participants with a chronic tic disorder and 527 unaffected family controls. We controlled for age and sex differences by creating propensity score matched subsamples for both case-control and within-case analyses. We found that premature birth (OR = 1.72) and morning sickness requiring medical attention (OR = 2.57) were associated with the presence of a chronic tic disorder. Also, the total number of pre- and perinatal complications was higher in those with a tic disorder (OR = 1.07). Furthermore, neonatal complications were related to the presence (OR = 1.46) and severity (b = 2.27) of co-occurring OCD and also to ADHD severity (b = 1.09). Delivery complications were only related to co-occurring OCD (OR = 1.49). We conclude that early exposure to adverse situations during pregnancy is related to the presence of chronic tic disorders. Exposure at a later stage, at birth or during the first weeks of life, appears to be associated with co-occurring OCD and ADHD. Copyright © 2016 Elsevier Ltd. All rights reserved.

  6. American counselors' acceptance of non-abstinence outcome goals for clients diagnosed with co-occurring substance use and other psychiatric disorders.

    Science.gov (United States)

    Davis, Alan K; Rosenberg, Harold; Rosansky, Joseph A

    2017-11-01

    Previous research has examined clinicians' acceptance of non-abstinence for clients who have a substance use disorder (SUD), but many SUD clients also present with a psychiatric disorder. To evaluate the acceptability of non-abstinence as a final outcome goal for clients with co-occurring diagnoses, we recruited a nationwide sample of 751 American substance abuse counselors to complete a web-based questionnaire. Respondents rated the acceptability of limited/moderate consumption by clients diagnosed with each of 18 co-occurring disorders: three psychiatric disorders (Major Depressive Disorder, Post-Traumatic Stress Disorder, Social Phobia) x three substances (alcohol, cannabis, opioids) x two levels of severity (DSM-5 Moderate SUD, DSM-5 Severe SUD). On average, non-abstinence was rated as unacceptable for clients with any of the 18 diagnostic pairs, although one-fourth to almost one-third rated limited/moderate use of cannabis somewhat or completely acceptable for clients diagnosed with a Moderate Cannabis Use Disorder when paired with any of the three psychiatric disorders. Furthermore, small proportions of respondents (13% to 20%) rated non-abstinence at least somewhat acceptable even when clients were diagnosed with a Severe SUD for any of the three substances and any co-occurring psychiatric disorder. Based on our findings, clients with co-occurring disorders who want to moderate their substance use will typically find their counselor does not accept that outcome goal. Because supporting non-abstinence respects client autonomy, could attract and retain clients in counseling, and is consistent with a recovery-oriented treatment model, we encourage continuing education about the benefits of non-abstinence as a treatment goal for clients with co-occurring disorders. Copyright © 2017 Elsevier Inc. All rights reserved.

  7. Pre- and perinatal complications in relation to Tourette syndrome and co-occurring obsessive-compulsive disorder and attention-deficit/hyperactivity disorder

    Science.gov (United States)

    Abdulkadir, Mohamed; Tischfield, Jay A.; King, Robert A.; Fernandez, Thomas V.; Brown, Lawrence W.; Cheon, Keun-Ah; Coffey, Barbara J.; de Bruijn, Sebastian F. T. M.; Elzerman, Lonneke; Garcia-Delgar, Blanca; Gilbert, Donald L.; Grice, Dorothy E.; Hagstrøm, Julie; Hedderly, Tammy; Heyman, Isobel; Hong, Hyun Ju; Huyser, Chaim; Ibanez-Gomez, Laura; Kim, Young Key; Kim, Young-Shin; Koh, Yun-Joo; Kook, Sodahm; Kuperman, Samuel; Lamerz, Andreas; Leventhal, Bennett; Ludolph, Andrea G.; Madruga-Garrido, Marcos; Maras, Athanasios; Messchendorp, Marieke D.; Mir, Pablo; Morer, Astrid; Münchau, Alexander; Murphy, Tara L.; Openneer, Thaïra J. C.; Plessen, Kerstin J.; Rath, Judith J. G.; Roessner, Veit; Fründt, Odette; Shin, Eun-Young; Sival, Deborah A.; Song, Dong-Ho; Song, Jungeun; Stolte, Anne-Marie; Tübing, Jennifer; van den Ban, Els; Visscher, Frank; Wanderer, Sina; Woods, Martin; Zinner, Samuel H.; State, Matthew W.; Heiman, Gary A.; Hoekstra, Pieter J.; Dietrich, Andrea

    2016-01-01

    Pre- and perinatal complications have been implicated in the onset and clinical expression of Tourette syndrome albeit with considerable inconsistencies across studies. Also, little is known about their role in co-occurring obsessive-compulsive disorder (OCD) and attention–deficit/hyperactivity disorder (ADHD) in individuals with a tic disorder. Therefore, we aimed to investigate the role of pre- and perinatal complications in relation to the presence and symptom severity of chronic tic disorder and co-occurring OCD and ADHD using data of 1,113 participants from the Tourette International Collaborative Genetics study. This study included 586 participants with a chronic tic disorder and 527 unaffected family controls. We controlled for age and sex differences by creating propensity score matched subsamples for both case-control and within-case analyses. We found that premature birth (OR=1.72) and morning sickness requiring medical attention (OR=2.57) were associated with the presence of a chronic tic disorder. Also, the total number of pre- and perinatal complications was higher in those with a tic disorder (OR=1.07). Furthermore, neonatal complications were related to the presence (OR=1.46) and severity (b=2.27) of co-occurring OCD and also to ADHD severity (b=1.09). Delivery complications were only related to co-occurring OCD (OR=1.49). We conclude that early exposure to adverse situations during pregnancy is related to the presence of chronic tic disorders. Exposure at a later stage, at birth or during the first weeks of life, appears to be associated with co-occurring OCD and ADHD. PMID:27494079

  8. 214 D. P. Verna, B. Kumar and H C Verma and by

    Indian Academy of Sciences (India)

    To minimise the truncation error, special care was taken while programming and the terms of too different magnitudes, were not added directly. 4. Results and discussion. The results for different c/a are listed in table 1 together with the available calculation of de Wette (1961) using Fourier transforms. The good agreement ...

  9. Book Review ~ Action learning: Images and pathways. Author: Robert L. Dilworth and Verna J. Willis

    Directory of Open Access Journals (Sweden)

    Reviewed by Patrick J. Fahy

    2003-10-01

    Full Text Available Action learning, as defined in this book, is “a process of reflecting on one’s work and beliefs in the supportive/ confrontational environment of one’s peers for the purpose of gaining new insights and resolving real business and community problems in real time” (p. 11. The claims made for action learning are impressive. Action learning: * Allows participants (who work in groups called sets to answer the question, “What is an honest man, and what do I need to do to become one?” (p. viii. * Is more than learning by doing, action learning “has the potential for putting control of lifelong learning directly in the hands of learners, in ways that alter their perceptions, amplify self-efficacy, and re-connect these individuals to spontaneous curiosity and confidence in the exercise of their own good judgment” (p. xi. * Is a “sleeping giant in the catalogue of individual and organizational change strategies” (p. xi. * Is believed to address the five most important needs facing organizations today: 1 problem-solving; 2 organizational learning; 3 leadership development; 4 professional growth; and 5 career development (p. xiii.

  10. Comparison of associated features and drug treatment between co-occurring unipolar and bipolar disorders in depressed eating disorder patients.

    Science.gov (United States)

    Tseng, Mei-Chih Meg; Chang, Chin-Hao; Liao, Shih-Cheng; Chen, Hsi-Chung

    2017-02-27

    To examine the differences of associated characteristics and prescription drug use between co-occurring unipolar and bipolar disorders in patients with eating disorders (EDs). Patients with EDs and major depressive episode (MDE) were recruited from psychiatric outpatient clinics. They were interviewed and completed self-administered measures assessing eating and general psychopathology. The prescribed drugs at the index outpatient visit were recorded. Clinical characteristics and prescription drugs of groups with major depressive disorder (ED-MDD), MDE with lifetime mania (ED-BP I), and MDE with lifetime hypomania (ED-BP II) were compared. Continuous variables between groups were compared using generalized linear regression with adjustments of age, gender, and ED subtype for pair-wise comparisons. Multivariate logistic regression with adjustments of age, gender, and ED subtype was employed to estimate adjusted odds ratios with 95% confidence intervals between groups. Two hundred and twenty-seven patients with EDs had a current MDE. Among them, 17.2% and 24.2% experienced associated manic and hypomanic episodes, respectively. Bipolar I and II patients displayed significantly poorer weight regulation, more severe impulsivity and emotional lability, and higher rates of co-occurring alcohol use disorders than ED-MDD patients. ED-BP I patients were found to have the lowest IQ, poorest working memory, and the most severe depression, suicidality and functional impairment among all patients. Patients with ED-BP II shared affect and behavioral dysregulations with ED-BP I, but had less severe degrees of cognitive and functional impairments than ED-BP I. Patients with ED-BP I were significantly less likely than those in the ED-MDD and ED-BP II groups to be on antidepressant monotherapy, but a great rate (27%) of ED-BP I individuals taking antidepressant monotherapy had potential risk of mood switch during the course of treatment. Our study identified discriminative features

  11. When acute-stage psychosis and substance use co-occur: differentiating substance-induced and primary psychotic disorders.

    Science.gov (United States)

    Caton, C L; Samet, S; Hasin, D S

    2000-09-01

    Substances such as alcohol, cocaine, amphetamine, and cannabis can produce psychotic reactions in individuals who are otherwise free of serious mental illness. However, persons with primary psychotic disorders, such as schizophrenia and bipolar disorder, who use these substances often present for treatment with signs and symptoms similar to those whose psychosis resulted from the use of drugs alone. While it is often difficult to distinguish substance-induced from primary psychoses, especially early in the course of treatment, this differential diagnosis has important implications for treatment planning. To help clinicians distinguish these two types of presentations, the authors first review the types of psychotic symptoms that can co-occur with substance use. They discuss the prevalence and patterns of substance use that have been found in patients with schizophrenia and other primary psychotic disorders and review the negative outcomes associated with substance use in this population. The prevalence of and types of symptoms and problems associated with psychotic symptoms that occur as a result of substance use alone are also reviewed. The authors describe assessment procedures for differentiating substance-induced and primary psychotic disorders. They stress the importance of accurately establishing the temporal relationship between the substance use and the onset and continuation of psychotic symptoms in making a differential diagnosis, as well as the importance of being familiar with the types of psychological symptoms that can occur with specific substances. The authors review the utility and limitations of a number of diagnostic instruments for assessing patients with co-occurring psychosis and substance use problems, including The Addiction Severity Index, The Michigan Alcohol Screening Test, and diagnostic interviews such as the Schedule for Affective Disorders and Schizophrenia and the Structured Clinical Interview for DSM. They then discuss the

  12. Associations between Prenatal and Early Childhood Fish and Processed Food Intake, Conduct Problems, and Co-Occurring Difficulties.

    Science.gov (United States)

    Mesirow, Maurissa Sc; Cecil, Charlotte; Maughan, Barbara; Barker, Edward D

    2017-07-01

    Little is known about early life diet as a risk factor for early-onset persistent conduct problems (EOP CP). To investigate this, we used data from the Avon Longitudinal Study of Parents and Children, a UK-based prospective epidemiological birth cohort. 5727 mother-child pairs (49.9 % boys) monitored since pregnancy (delivery date between 1 April, 1991 and 31 December, 1992) reported intake of fish and processed foods at 32 weeks gestation and, for the child, at 3 years; EOP (n = 666) and Low conduct problem (Low CP, n = 5061) trajectories were measured from 4 to 13 years; hyperactivity and emotional difficulties were assessed in childhood (4-10 years) and early adolescence (12-13 years), in addition to potential confounding factors (family adversity, birth complications, income). Compared to Low CP, mothers of EOP children consumed less fish (p processed food (p processed food at 3 years (p processed food (vs. less than one serving/day, p processed food, and low in fish, associate with an EOP CP trajectory and co-occurring difficulties in early adolescence. As small effect size differences were found, further studies are needed to investigate the long-term impact of early unhealthy diet.

  13. Co-occurring medical, psychiatric, and alcohol-related disorders among veterans returning from Iraq and Afghanistan.

    Science.gov (United States)

    Stecker, Tracy; Fortney, John; Owen, Richard; McGovern, Mark P; Williams, Silas

    2010-01-01

    Soldiers often return from war with a variety of combat-related mental health conditions, including posttraumatic stress disorder, depression, and substance-use disorders. The authors investigated common co-occurring medical and psychiatric conditions and patterns of conditions among returning Iraq/Afghanistan veterans using the Veterans Administration (VA) healthcare systems. Common clusters of ICD-9 diagnostic-related conditions among returning soldiers (N=293,861) were extracted from the VA data center. Diagnoses involving pain are extremely common among returning veterans seeking health care at the VA. In addition to pain-related conditions, psychiatric disorders rank second most prevalent. Psychiatric disorders, and in particular the multimorbid triad of pain, posttraumatic stress disorder, and depression frequently overlap. As more veterans return from war, there will be greater need for effective services. Given the findings of high rates of comorbidity and multimorbidity, VA services should be reorganized so as to co-locate psychiatric staff in pain centers, simultaneously targeting pain and psychiatric disorders.

  14. Motivation for Treatment and Motivation for Change in Substance-Dependent Patients with Co-Occurring Psychiatric Disorders.

    Science.gov (United States)

    de Weert-van Oene, Gerdien H; Gongora, Vanesa; von Sternberg, Kirk; de Jong, Cor A J

    2015-01-01

    The aims of this study were to examine the relationship between motivation for treatment and for change, and to explore their role in the prediction of treatment completion. The sample was composed of 560 predominantly polydrug-using inpatients with co-occurring psychiatric disorders. Motivation for treatment was assessed with the Motivation for Treatment Scales, and motivation for change was measured with the Readiness to Change Questionnaire. Patients indicated strong motivation to change illegal drug and alcohol use. In initial factor analysis, motivation for treatment and for change did not load on the same factors, confirming that these are distinct domains. Four categories were discerned with respect to readiness for treatment and for change, with low agreement between the two. In performing survival analysis, we found that being in readiness category 4 (RT↑RC↑) was associated with a greater chance of remaining in treatment for a period of 105 days without premature attrition (Log Rank chi-sq=5.000; p=0.02). To a limited extent, intake measures of motivation can be used to predict attrition from treatment. Clinicians can use motivation assessment both for clinical purposes and in the prediction of those who need extra monitoring due to increased risk of premature attrition.

  15. Hydrogeochemistry of co-occurring geogenic arsenic, fluoride and iodine in groundwater at Datong Basin, northern China.

    Science.gov (United States)

    Pi, Kunfu; Wang, Yanxin; Xie, Xianjun; Su, Chunli; Ma, Teng; Li, Junxia; Liu, Yaqing

    2015-12-30

    Abnormal levels of co-occurring arsenic (As), fluorine (F) and iodine (I) in groundwater at Datong Basin, northern China are geochemically unique. Hydrochemical, (18)O and (2)H characteristics of groundwater were analyzed to elucidate their mobilization processes. Aqueous As, F and I ranged from 5.6 to 2680 μg/L, 0.40 to 3.32 mg/L and 10.1 to 186 μg/L, respectively. High As, F and I groundwater was characterized by moderately alkaline, high HCO3(-), Fe(II), HS(-) and DOC concentrations with H3AsO3, F(-) and I(-) as the dominant species. The plots of δ(18)O values and Cl/Br ratios versus Cl(-) concentration demonstrate build-up of more oxidizing conditions and precipitation of carbonate minerals induced by vertical recharge and intensive evaporation facilitate As retention to Fe (hydr) oxides, but enhance F and I mobilization from host minerals. Under reducing conditions, As and I can be simultaneously released via reductive dissolution of Fe (hydr) oxides and reduction of As(V) and I(V) while F migration may be retarded due to effects of dissolution-precipitation equilibria between carbonate minerals and fluorite. With the prevalence of sulfate-reducing condition and lowering of HCO3(-) concentration, As and I may be sequestered by Fe(II) sulfides and F is retained to fluorite and on clay mineral surfaces. Copyright © 2015 Elsevier B.V. All rights reserved.

  16. Critical exploration of co-occurring Attention-Deficit/Hyperactivity Disorder, mood disorder and Substance Use Disorder.

    Science.gov (United States)

    Regnart, Judith; Truter, Ilse; Meyer, Anneke

    2017-06-01

    Co-occurring disorders (CODs) describe a Substance Use Disorder (SUD) accompanied by a comorbid psychiatric disorder. Attention-Deficit/Hyperactivity Disorder (ADHD) and mood disorders are common CODs with high prevalence rates in SUD populations. It is proposed that literature on a tri-condition presentation of ADHD, mood disorder and SUD is limited. Areas covered: A literature search was conducted using a keyword search on EBSCOhost. Initially 2 799 records were identified, however, only two articles included all three conditions occurring concurrently in individuals. CODs constitute a major concern due to their overarching burden on society as a whole. Diagnosis and treatment of such patients is challenging. There is evidence that dysfunction of dopamine in the brain reward circuitry impacts the development or symptomology of all three disorders. Disparity exists regarding whether ADHD or mood disorders are greater modifiers for increased SUD severity. However, it has been reported that poor functional capacity may have a greater influence than comorbidities on SUD development. Expert commentary: Challenges exist which confound the clear distinction of CODs, however, with greater emergence of adult ADHD its screening in SUD populations should become standard practice to establish data on multi-condition presentations with the ultimate goal of improving clinical outcomes.

  17. Differences in trauma history and psychopathology between PTSD patients with and without co-occurring dissociative disorders

    Science.gov (United States)

    Wabnitz, Pascal; Gast, Ursula; Catani, Claudia

    2013-01-01

    Background The interplay between different types of potentially traumatizing events, posttraumatic symptoms, and the pathogenesis of PTSD or major dissociative disorders (DD) has been extensively studied during the last decade. However, the phenomenology and nosological classification of posttraumatic disorders is currently under debate. The current study was conducted to investigate differences between PTSD patients with and without co-occurring major DD with regard to general psychopathology, trauma history, and trauma-specific symptoms. Methods Twenty-four inpatients were administered the Clinician-Administered PTSD Scale for DSM-IV (CAPS) and the Mini-Structured Clinical Interview for DSM-IV Dissociative Disorders (MINI-SKID-D) to assess DD and PTSD. Additionally, participants completed questionnaires to assess general psychopathology and health status. Results Symptom profiles and axis I comorbidity were similar in all patients. Traumatic experiences did not differ between the two groups, with both reporting high levels of childhood trauma. Only trauma-specific avoidance behavior and dissociative symptoms differed between groups. Conclusion Results support the view that PTSD and DD are affiliated disorders that could be classified within the same diagnostic category. Our results accord with a typological model of dissociation in which profound forms of dissociation are specific to DD and are accompanied with higher levels of trauma-specific avoidance in DD patients. PMID:24298325

  18. Effects of Drought on Xylem Anatomy and Water-Use Efficiency of Two Co-Occurring Pine Species

    Directory of Open Access Journals (Sweden)

    Dario Martin-Benito

    2017-09-01

    Full Text Available Exploring how drought influences growth, performance, and survival in different species is crucial to understanding the impacts of climate change on forest ecosystems. Here, we investigate the responses of two co-occurring pines (Pinus nigra and Pinus sylvestris to interannual drought in east-central Spain by dendrochronological and wood anatomical features integrated with isotopic ratios of carbon (δ13C and oxygen (δ18O in tree rings. Our results showed that drought induces both species to allocate less carbon to build tracheid cell-walls but increases tracheid lumen diameters, particularly in the transition wood between early and latewood, potentially maximizing hydraulic conductivity but reducing resistance to embolism at a critical phase during the growing season. The thicker cell-wall-to-lumen ratio in P. nigra could imply that its xylem may be more resistant to bending stress and drought-induced cavitation than P. sylvestris. In contrast, the higher intrinsic water-use efficiency (iWUE in P. sylvestris suggests that it relies more on a water-saving strategy. Our results suggest that narrower cell-walls and reduced growth under drought are not necessarily linked to increased iWUE. At our site P. nigra showed a higher growth plasticity, grew faster and was more competitive than P. sylvestris. In the long term, these sustained differences in iWUE and anatomical characters could affect forest species performance and composition, particularly under increased drought stress.

  19. Risky driving and sexual behaviors as developmental outcomes of co-occurring substance use and antisocial behavior.

    Science.gov (United States)

    Luk, Jeremy W; Worley, Matthew J; Winiger, Evan; Trim, Ryan S; Hopfer, Christian J; Hewitt, John K; Brown, Sandra A; Wall, Tamara L

    2016-12-01

    To examine the associations between substance use and antisocial behavior trajectories and seven risky behaviors over time. Data were collected from a high-risk sample of adolescents followed into young adulthood. Five trajectory classes, identified based on dual development of substance use and antisocial behavior symptoms, were used to predict three risky driving and four risky sexual behaviors. In this high-risk sample (n=530), participants reported notably high overall rates of reckless driving (55.5%) and unprotected sex under the influence (44.8%) in the past year. Risky behaviors that are typically of low base rates in population-based studies were also elevated, with 8.8% reporting past-year driving under the influence (DUI) charge, 17.6% reporting lifetime sexually transmitted infection (STI), and 10.4% reporting lifetime injection drug use. The Dual Chronic class had the highest levels of all seven risky behaviors, and were 3-4 times more likely to report risky driving, lifetime STI, and injection drug use than the Relatively Resolved class. Rates of past-year reckless driving and DUI were elevated among classes with persistent antisocial behavior, whereas rates of DUI, DUI charge, and unprotected sex under the influence were elevated among classes with persistent substance use. Young adults with persistent co-occurring substance use and antisocial behavior engage in multiple very costly risky behaviors. Differential associations between risky behaviors and trajectory classes highlight the need for targeted interventions. Published by Elsevier Ireland Ltd.

  20. Homelessness predicts attrition but not alcohol abstinence in outpatients experiencing co-occurring alcohol dependence and serious mental illness.

    Science.gov (United States)

    Leickly, Emily; Skalisky, Jordan; Oluwoye, Oladunni; McPherson, Sterling M; Srebnik, Debra; Roll, John M; Ries, Richard K; McDonell, Michael G

    2017-11-21

    Adults experiencing homelessness and serious mental illnesses (SMI) are at an increased risk of poor mental health and treatment outcomes compared with stably housed adults with SMI. The additional issue of alcohol misuse further complicates the difficulties of those living with homelessness and SMI. In this secondary data analysis, the authors investigated the impact of homelessness on attrition and alcohol use in a contingency management (CM) intervention that rewarded alcohol abstinence in outpatients with SMI. The associations between housing status and attrition and alcohol abstinence during treatment, as assessed by ethyl glucuronide (EtG) urine tests, were evaluated in 79 adults diagnosed with alcohol dependence and SMI. Thirty-nine percent (n = 31) of participants reported being homeless at baseline. Individuals who were homeless were more likely to drop out of CM (n = 10, 62.5%) than those who were housed (n = 4, 16.7%), χ 2 (1) = 8.86, P < .05. Homelessness was not associated with attrition in the noncontingent control group. Accounting for treatment group and prerandomization EtG levels, neither the effect of housing status nor the interaction of housing status and group were associated with EtG-assessed alcohol abstinence during treatment. Individuals experiencing homelessness and co-occurring alcohol dependence and SMI receiving CM had higher rates of attrition, relative to those who were housed. Homelessness was not associated with differences in biologically assessed alcohol abstinence.

  1. Leadership and Licensure for Drug Treatment and the Implementation of Co-Occurring Disorder Treatment in Community Mental Health Centers.

    Science.gov (United States)

    Guerrero, Erick G; Padwa, Howard; Lengnick-Hall, Rebecca; Kong, Yinfei; Perrigo, Judith L

    2015-07-01

    Using a random sample of 48 outpatient mental health programs in low-income and racial and ethnic minority communities, this study examined directorial leadership, drug treatment licensure, and implementation of evidence-based protocols and practices to address co-occurring mental health and substance abuse disorders (COD). Understanding of findings was enhanced with focus groups at six clinics. Most programs (81 %) offered COD treatment. Directorial leadership was positively associated with COD treatment (β = 0.253, p = 0.047, 95 % CI 0.003, 0.502) and COD supervision and training (β = 0.358, p = 0.002, 95 % CI 0.142, 0.575). Licensure was negatively associated with COD treatment (β = -0.235, p = 0.041, 95 % CI -0.460, -0.010) and COD supervision and training (β = -0.195, p = 0.049, 95 % CI -0.389, -0.001). Although lack of financial integration may limit the effect of licensing on COD treatment implementation, the response of leaders to regulation, funding, and human resources issues may encourage COD treatment practices. Implications for leadership interventions and policy are discussed in the context of health care reform.

  2. Latent Impulsivity Subtypes in Substance Use Disorders and Interactions with Internalizing and Externalizing Co-Occurring Disorders

    Directory of Open Access Journals (Sweden)

    Rodrigo Marín-Navarrete

    2018-02-01

    Full Text Available This study explored the clinical importance of latent impulsivity subtypes within a sample of individuals with substance use disorders (SUDs and high rates of co-occurring disorders (CODs receiving residential treatment, aiming to assess the heterogeneity of the associations between SUDs and CODs across such impulsivity subtypes. The abbreviated Barratt impulsiveness scale was used to assess motor and cognitive (attentional and nonplanning impulsivity, a structured interview for diagnosis of SUD and CODs, and other clinimetric measures for severity of substance use. Latent class analysis was conducted to extract subgroups of impulsivity subtypes and Poisson regression to analyze effects of interactions of classes by CODs on severity of substance use. 568 participants were evaluated. Results featured a four-class model as the best-fitted solution: overall high impulsivity (OHI; overall low impulsivity; high cognitive-low motor impulsivity; and moderate cognitive-low motor impulsivity (MC-LMI. OHI and MC-LMI concentrated on most of the individuals with CODs, and individuals within OHI and MC-LMI showed more severity of substance use. The expression of this severity relative to the impulsivity subtypes was modified by their interaction with internalizing and externalizing CODs in very heterogeneous ways. Our findings suggest that knowing either the presence of trait-based subtypes or CODs in individuals with SUDs is not enough to characterize clinical outcomes, and that the analysis of interactions between psychiatric categories and behavioral traits is necessary to better understand the expressions of psychiatric disorders.

  3. Latent Impulsivity Subtypes in Substance Use Disorders and Interactions with Internalizing and Externalizing Co-Occurring Disorders.

    Science.gov (United States)

    Marín-Navarrete, Rodrigo; Toledo-Fernández, Aldebarán; Villalobos-Gallegos, Luis; Roncero, Carlos; Szerman, Nestor; Medina-Mora, María Elena

    2018-01-01

    This study explored the clinical importance of latent impulsivity subtypes within a sample of individuals with substance use disorders (SUDs) and high rates of co-occurring disorders (CODs) receiving residential treatment, aiming to assess the heterogeneity of the associations between SUDs and CODs across such impulsivity subtypes. The abbreviated Barratt impulsiveness scale was used to assess motor and cognitive (attentional and nonplanning) impulsivity, a structured interview for diagnosis of SUD and CODs, and other clinimetric measures for severity of substance use. Latent class analysis was conducted to extract subgroups of impulsivity subtypes and Poisson regression to analyze effects of interactions of classes by CODs on severity of substance use. 568 participants were evaluated. Results featured a four-class model as the best-fitted solution: overall high impulsivity (OHI); overall low impulsivity; high cognitive-low motor impulsivity; and moderate cognitive-low motor impulsivity (MC-LMI). OHI and MC-LMI concentrated on most of the individuals with CODs, and individuals within OHI and MC-LMI showed more severity of substance use. The expression of this severity relative to the impulsivity subtypes was modified by their interaction with internalizing and externalizing CODs in very heterogeneous ways. Our findings suggest that knowing either the presence of trait-based subtypes or CODs in individuals with SUDs is not enough to characterize clinical outcomes, and that the analysis of interactions between psychiatric categories and behavioral traits is necessary to better understand the expressions of psychiatric disorders.

  4. Initial Findings From Project Recover: Overcoming Co-Occurring Eating Disorders and Posttraumatic Stress Disorder Through Integrated Treatment.

    Science.gov (United States)

    Trottier, Kathryn; Monson, Candice M; Wonderlich, Stephen A; Olmsted, Marion P

    2017-04-01

    This pilot study is the initial investigation of an integrated cognitive behavioral therapy (CBT) for co-occurring eating disorders (ED) and posttraumatic stress disorder (PTSD). Following a course of intensive hospital-based ED treatment focused on ED behavioral symptom interruption, 10 individuals with ED-PTSD received 16 sessions of CBT that focused on maintaining improvements in ED symptoms outside of the hospital environment and integrated cognitive processing therapy for PTSD. We hypothesized that the treatment would be associated with significant improvements in PTSD symptoms, depression, and anxiety, as well as sustained improvements in ED symptomatology. There were statistically significant improvements in clinician-rated PTSD symptoms (gav = 4.58), depression (gav = 1.37), and anxiety (gav = 1.00). As expected, there was no statistically significant change in ED cognitions (gav = .28). Reliable change analyses revealed that only 1 participant experienced deterioration in ED cognitions over the course of the integrated treatment. Of the 9 participants who were remitted from behavioral ED symptoms at the end of intensive treatment/beginning of the integrated treatment, 8 remained behaviorally remitted at poststudy treatment, which is encouraging given the high rate of rapid relapse following intensive ED treatment. Findings from this study provide preliminary support for the efficacy of an integrated CBT for ED-PTSD. Copyright © 2017 International Society for Traumatic Stress Studies.

  5. Effects of Co-occurring marijuana use and anxiety on brain structure and functioning: A systematic review of adolescent studies.

    Science.gov (United States)

    Cancilliere, Mary Kathryn; Yusufov, Miryam; Weyandt, Lisa

    2018-03-28

    The prevalence of marijuana use among adolescents with anxiety disorders in the USA is markedly high and well documented; however, the literature on this co-occurrence's effect on adolescent brain development and functioning is limited. This systematic review searched six databases to 1) explore the literature concerning marijuana use among adolescents with anxiety and 2) examine the effects of marijuana on brain structure and functioning. Overall, 27 studies from six countries were included in this review. Out of these studies, several disparate designs were utilized. The majority of studies revealed an association between marijuana use and anxiety, but the strength of the association and the variability among the studies' designs limited the comparison and warrants additional investigation. Only five studies met criteria that used brain-imaging techniques, and findings were non-conclusive. Future evaluations should further investigate the effects of co-occurring marijuana use and anxiety disorders on brain structure and functioning among adolescents. Copyright © 2018 The Foundation for Professionals in Services for Adolescents. Published by Elsevier Ltd. All rights reserved.

  6. Differences in trauma history and psychopathology between PTSD patients with and without co-occurring dissociative disorders

    Directory of Open Access Journals (Sweden)

    Pascal Wabnitz

    2013-11-01

    Full Text Available Background: The interplay between different types of potentially traumatizing events, posttraumatic symptoms, and the pathogenesis of PTSD or major dissociative disorders (DD has been extensively studied during the last decade. However, the phenomenology and nosological classification of posttraumatic disorders is currently under debate. The current study was conducted to investigate differences between PTSD patients with and without co-occurring major DD with regard to general psychopathology, trauma history, and trauma-specific symptoms. Methods: Twenty-four inpatients were administered the Clinician-Administered PTSD Scale for DSM-IV (CAPS and the Mini-Structured Clinical Interview for DSM-IV Dissociative Disorders (MINI-SKID-D to assess DD and PTSD. Additionally, participants completed questionnaires to assess general psychopathology and health status. Results: Symptom profiles and axis I comorbidity were similar in all patients. Traumatic experiences did not differ between the two groups, with both reporting high levels of childhood trauma. Only trauma-specific avoidance behavior and dissociative symptoms differed between groups. Conclusion: Results support the view that PTSD and DD are affiliated disorders that could be classified within the same diagnostic category. Our results accord with a typological model of dissociation in which profound forms of dissociation are specific to DD and are accompanied with higher levels of trauma-specific avoidance in DD patients.

  7. Microbiomes of Muricea californica and M. fruticosa: Comparative Analyses of Two Co-occurring Eastern Pacific Octocorals.

    Science.gov (United States)

    Holm, Johanna B; Heidelberg, Karla B

    2016-01-01

    Octocorals are sources of novel but understudied microbial diversity. Conversely, scleractinian or reef-building coral microbiomes have been heavily examined in light of the threats of climate change. Muricea californica and Muricea fruticosa are two co-occurring species of gorgonian octocoral abundantly found in the kelp forests of southern California, and thus provide an excellent basis to determine if octocoral microbiomes are host specific. Using Illumina MiSeq amplicon sequencing and replicate samples, we evaluated the microbiomes collected from multiple colonies of both species of Muricea to measure both inter- and intra-colony microbiome variabilities. In addition, microbiomes from overlying sea water and nearby zoanthids (another benthic invertebrate) were also included in the analysis to evaluate whether bacterial taxa specifically associate with octocorals. This is also the first report of microbiomes from these species of Muricea. We show that microbiomes isolated from each sample type are distinct, and specifically, that octocoral species type had the greatest effect on predicting the composition of the Muricea microbiome. Bacterial taxa contributing to compositional differences include distinct strains of Mycoplasma associated with either M. californica or M. fruticosa, an abundance of Spirochaetes observed on M. californica, and a greater diversity of γ-Proteobacteria associated with M. fruticosa. Many of the bacterial taxa contributing to these differences are known for their presence in photosymbiont-containing invertebrate microbiomes.

  8. Trophic interaction between topmouth gudgeon (Pseudorasbora parva and the co-occurring species during summer in the Dniprodzerzhynsk reservoir

    Directory of Open Access Journals (Sweden)

    Didenko A.V.

    2015-01-01

    Full Text Available Topmouth gudgeon, Pseudorasbora parva is the most common invasive fish in Europe, which can compete with the juveniles of valuable commercial fishes. The goal of this work is to study the diet of topmouth gudgeon and trophic relationships with some native fishes inhabiting the littoral zone of the Dniprodzerzhynsk reservoir. The obtained relatively low values of diet overlaps between topmouth gudgeon and other co-occurring cyprinids such as juvenile roach, Rutilus rutilus; silver bream, Blicca bjoerkna; rudd, Scardinius erythrophthalmus; Prussian carp, Carassius gibelio and bleak, Abramis brama, indicate that it is not a serious food competitor for them, especially commercially valuable ones. On the contrary, high diet overlaps were observed among some native cyprinids such as juvenile roach, silver bream, rudd, and bleak. The major prey items of topmouth gudgeon were Chydorus sphaericus and chironomids, whereas other cyprinids selected Bosmina spp. This peculiarity may be due to different vertical distributions of these fish in the littoral zone of the reservoir, where topmouth gudgeon inhabit near-bottom water layers, where they preyed on near-bottom and benthic zooplankters and chironomids, while juvenile roach, silver bream, rudd, and juvenile and adult bleak live in higher water layers, where they preyed on pelagic zooplankton.

  9. Coordination between water transport capacity, biomass growth, metabolic scaling and species stature in co-occurring shrub and tree species.

    Science.gov (United States)

    Smith, Duncan D; Sperry, John S

    2014-12-01

    The significance of xylem function and metabolic scaling theory begins from the idea that water transport is strongly coupled to growth rate. At the same time, coordination of water transport and growth seemingly should differ between plant functional types. We evaluated the relationships between water transport, growth and species stature in six species of co-occurring trees and shrubs. Within species, a strong proportionality between plant hydraulic conductance (K), sap flow (Q) and shoot biomass growth (G) was generally supported. Across species, however, trees grew more for a given K or Q than shrubs, indicating greater growth-based water-use efficiency (WUE) in trees. Trees also showed slower decline in relative growth rate (RGR) than shrubs, equivalent to a steeper G by mass (M) scaling exponent in trees (0.77-0.98). The K and Q by M scaling exponents were common across all species (0.80, 0.82), suggesting that the steeper G scaling in trees reflects a size-dependent increase in their growth-based WUE. The common K and Q by M exponents were statistically consistent with the 0.75 of ideal scaling theory. A model based upon xylem anatomy and branching architecture consistently predicted the observed K by M scaling exponents but only when deviations from ideal symmetric branching were incorporated. © 2014 John Wiley & Sons Ltd.

  10. Pollination Biology of Potentilla recta (Sulfur Cinquefoil and Its Cooccurring Native Congener Potentilla gracilis in Northeastern Oregon

    Directory of Open Access Journals (Sweden)

    James McIver

    2012-01-01

    Full Text Available Pollination biology of the invasive plant sulfur cinquefoil (Potentilla recta L. and it's native cooccurring congener slender cinquefoil (P. gracilis Dougl. ex. Hook. was studied from 2002–2004, at four sites in northeastern Oregon, USA The native cinquefoil flowered first for five weeks, followed by the invasive for five weeks, with two weeks overlap in mid-June. Invasive flowers attracted 74 species and 543 individuals; the native attracted 93 species and 619 individuals. The most important pollinators for the invasive, in order of importance, were: Apis mellifera, Ceratina nanula, Halictus tripartitus, Lasioglossum sisymbrii, and Bombus rufocinctus; for the native: C. nanula, Trichodes ornatus, H. ligatus, L. sisymbrii, and L. olympiae. The invasive produced higher numbers of seeds per plant, having greater mass per unit vegetation. Mean seed size was lower for the invasive when pollinators were allowed access to flowers, but seed size increased linearly with more complete exclusion of pollinators; the native showed no such response to pollinator exclusion. Compared to the native, nearly twice as many seeds germinated for sulfur cinquefoil (35.0% versus 19.5%, with seeds germinating over a longer period of time. Results are discussed as they relate to the invasiveness of sulfur cinquefoil relative to the native.

  11. A comparative network analysis of eating disorder psychopathology and co-occurring depression and anxiety symptoms before and after treatment.

    Science.gov (United States)

    Smith, Kathryn E; Mason, Tyler B; Crosby, Ross D; Cao, Li; Leonard, Rachel C; Wetterneck, Chad T; Smith, Brad E R; Farrell, Nicholas R; Riemann, Bradley C; Wonderlich, Stephen A; Moessner, Markus

    2018-04-15

    Network analysis is an emerging approach in the study of psychopathology, yet few applications have been seen in eating disorders (EDs). Furthermore, little research exists regarding changes in network strength after interventions. Therefore the present study examined the network structures of ED and co-occurring depression and anxiety symptoms before and after treatment for EDs. Participants from residential or partial hospital ED treatment programs (N = 446) completed assessments upon admission and discharge. Networks were estimated using regularized Graphical Gaussian Models using 38 items from the Eating Disorders Examination-Questionnaire, Quick Inventory of Depressive Symptomatology, and State-Trait Anxiety Inventory. ED symptoms with high centrality indices included a desire to lose weight, guilt about eating, shape overvaluation, and wanting an empty stomach, while restlessness, self-esteem, lack of energy, and feeling overwhelmed bridged ED to depression and anxiety symptoms. Comparisons between admission and discharge networks indicated the global network strength did not change significantly, though symptom severity decreased. Participants with denser networks at admission evidenced less change in ED symptomatology during treatment. Findings suggest that symptoms related to shape and weight concerns and guilt are central ED symptoms, while physical symptoms, self-esteem, and feeling overwhelmed are links that may underlie comorbidities in EDs. Results provided some support for the validity of network approaches, in that admission networks conveyed prognostic information. However, the lack of correspondence between symptom reduction and change in network strength indicates that future research is needed to examine network dynamics in the context of intervention and relapse prevention.

  12. Multimodal examination of emotion regulation difficulties as a function of co-occurring avoidant personality disorder among women with borderline personality disorder.

    Science.gov (United States)

    Gratz, Kim L; Tull, Matthew T; Matusiewicz, Alexis M; Breetz, Alisa A; Lejuez, C W

    2013-10-01

    Despite a robust association between borderline personality disorder (BPD) and emotion dysregulation, evidence of within-BPD group differences in emotion regulation (ER) difficulties highlights the need to examine factors that increase the risk for ER difficulties within BPD. One factor that warrants consideration is co-occurring avoidant personality disorder (AVPD), the presence of which is associated with worse outcomes in and outside of BPD and theorized to interfere with adaptive ER. Thus, this study examined if co-occurring AVPD among women with BPD is associated with heightened ER difficulties (assessed across self-report, behavioral, and physiological domains). Participants included 39 women with BPD (13 with co-occurring AVPD) and 18 women without BPD. Although results revealed no significant differences in overall self-reported ER difficulties (or the specific dimensions involving emotional clarity and the control of behaviors when distressed) between BPD participants with and without AVPD (with both groups reporting greater ER difficulties than non-BPD participants), other ER difficulties were found to be heightened among BPD participants with AVPD. Specifically, BPD participants with (vs. without) AVPD reported greater difficulties accessing effective ER strategies, evidenced less willingness to experience distress on a laboratory stressor, and exhibited a greater decrease in high frequency heart rate variability in response to this stressor (indicative of poor ER capacity). Findings add to the literature on ER difficulties in BPD, suggesting that co-occurring AVPD within BPD may be associated with a lower capacity for regulating distress and greater difficulties accessing effective ER strategies, potentially leading to greater efforts to avoid emotional distress. PsycINFO Database Record (c) 2013 APA, all rights reserved.

  13. Characterizing the intersection of Co-occurring risk factors for illicit drug abuse and dependence in a U.S. nationally representative sample.

    Science.gov (United States)

    Kurti, Allison N; Keith, Diana R; Noble, Alyssa; Priest, Jeff S; Sprague, Brian; Higgins, Stephen T

    2016-11-01

    Few studies have attempted to characterize how co-occurring risk factors for substance use disorders intersect. A recent study examined this question regarding cigarette smoking and demonstrated that co-occurring risk factors generally act independently. The present study examines whether that same pattern of independent intersection of risk factors extends to illicit drug abuse/dependence using a U.S. nationally representative sample (National Survey on Drug Use and Health, 2011-2013). Logistic regression and classification and regression tree (CART) modeling were used to examine risk of past-year drug abuse/dependence associated with a well-established set of risk factors for substance use (age, gender, race/ethnicity, education, poverty, smoking status, alcohol abuse/dependence, mental illness). Each of these risk factors was associated with significant increases in the odds of drug abuse/dependence in univariate logistic regressions. Each remained significant in a multivariate model examining all eight risk factors simultaneously. CART modeling of these 8 risk factors identified subpopulation risk profiles wherein drug abuse/dependence prevalence varied from 80% corresponding to differing combinations of risk factors present. Alcohol abuse/dependence and cigarette smoking had the strongest associations with drug abuse/dependence risk. These results demonstrate that co-occurring risk factors for illicit drug/abuse dependence generally intersect in the same independent manner as risk factors for cigarette smoking, underscoring further fundamental commonalities across these different types of substance use disorders. These results also underscore the fundamental importance of differences in the presence of co-occurring risk factors when considering the often strikingly different prevalence rates of illicit drug abuse/dependence in U.S. population subgroups. Copyright © 2016 Elsevier Inc. All rights reserved.

  14. Co-occurring substance use and mental disorders in the criminal justice system: a new frontier of clinical practice and research.

    Science.gov (United States)

    Peters, Roger H; Wexler, Harry K; Lurigio, Arthur J

    2015-03-01

    This editorial introduces this special section of the Psychiatric Rehabilitation Journal, which focuses on justice-involved persons with co-occurring mental and substance use disorders (CODs). It contains seven original articles examining CODs among justice-involved populations that vary by gender, age, setting (e.g., community/ court, jail, prison), environment (urban, rural), geographic region, and nationality. (PsycINFO Database Record (c) 2015 APA, all rights reserved).

  15. Disorder-specific characteristics of borderline personality disorder with co-occurring depression and its comparison with major depression: An fMRI study with emotional interference task

    Directory of Open Access Journals (Sweden)

    Natalia Chechko

    2016-01-01

    Thus, our data indicate dysfunctionality in the neural circuitry responsible for emotional conflict control in both disorders. The enhanced visual cortex activation in BPD + MDD suggests the visual system's hyperresponsiveness to faces at an early perceptual level. Not being associated with co-occurring depression, this effect in BPD + MDD appears to represent specific personality traits such as disturbed reactivity toward emotionally expressive facial stimuli.

  16. Jail-to-community treatment continuum for adults with co-occurring substance use and mental disorders: study protocol for a pilot randomized controlled trial

    OpenAIRE

    Van Dorn, Richard A.; Desmarais, Sarah L.; Rade, Candalyn B.; Burris, Elizabeth N.; Cuddeback, Gary S.; Johnson, Kiersten L.; Tueller, Stephen J.; Comfort, Megan L.; Mueser, Kim T.

    2017-01-01

    Background Adults with co-occurring mental and substance use disorders (CODs) are overrepresented in jails. In-custody barriers to treatment, including a lack of evidence-based treatment options and the often short periods of incarceration, and limited communication between jails and community-based treatment agencies that can hinder immediate enrollment into community care once released have contributed to a cycle of limited treatment engagement, unaddressed criminogenic risks, and (re)arres...

  17. A treatment development study of a cognitive and mindfulness-based therapy for adolescents with co-occurring post-traumatic stress and substance use disorder.

    Science.gov (United States)

    Fortuna, Lisa R; Porche, Michelle V; Padilla, Auralyd

    2018-03-01

    Substance use is common among adolescents with post-traumatic stress disorder (PTSD). We aimed to develop and study an integrated treatment for adolescents with co-occurring disorders. This is a therapy development and open pilot trial study of a manualized therapy for adolescents with post-traumatic stress, depression, and substance use that uses a combination of cognitive therapy (CT) and mindfulness. Descriptive statistics and paired sample t-tests were calculated to assess for changes in PTSD symptoms, depression, and substance use frequency from baseline to end of treatment using standardized measures and validated by urine drug screens. We also examined for safety, predictors of clinical outcomes, and treatment retention. Thirty-seven adolescents participated in the study; 62% were study completers as defined by retention for at least 6 weeks of treatment. There were significant improvements in PTSD and depression symptoms from baseline to end of treatment, reflecting medium effect sizes, and which was associated with changes in trauma-associated cognitions. There was a reduction in cannabis use, which was the most commonly used substance. Preliminary results suggest feasibility, safety, and potential clinical effectiveness of an integrated therapy for adolescents with PTSD, depression, and substance use. Retention was comparable to other therapy clinical trial studies of adolescents despite the high risk for poor treatment retention and poor clinical outcomes among adolescents with PTSD and co-occurring disorders. We discuss the rationale for continued research of this mindfulness-based CT for adolescents with co-occurring disorders. Adolescents with co-occurring PTSD and substance use achieved meaningful improvement in PTSD and depression symptom severity after receiving a CT and mindfulness dual diagnosis approach. An integrated manualized therapy for dual diagnosis shows promise for reducing cannabis use in adolescents with PTSD. Changes in trauma

  18. Changes in Functional State of Cardiovascular and Respiratory System when Using Lazer Therapy in Complex Treatment of Patients with Arterial Hypertension along with a Co-Occurring COPD

    OpenAIRE

    Matsehora, N. A.

    2014-01-01

    65 patients with arterial hypertension (AH) along with a co-occurring chronic obstructive pulmonary disease (COPD) were examined. They were divided into two treatment groups: the first group received only drug therapy (DT) that included verapamil and sydnofarm (DT-1), the second group received additional laser therapy (DT - 2). Arterial hypertension in patients with COPD was characterized by increased hypertension load mainly at night with exaggerated type and inadequate nocturnal BP decrease...

  19. Outcomes of an integrated cognitive behaviour therapy (CBT) treatment program for co-occurring depression and substance misuse in young people.

    Science.gov (United States)

    Hides, Leanne; Carroll, Steve; Catania, Lisa; Cotton, Sue M; Baker, Amanda; Scaffidi, Antonietta; Lubman, Dan I

    2010-02-01

    There are high rates of co-occurring depression among young people with substance use disorders. While there is preliminary evidence for the effectiveness of integrated cognitive behaviour therapy (CBT) in combination with antidepressants among alcohol and substance dependent adolescents and adults with co-existing depression, no studies have examined the effectiveness of integrated CBT interventions in the absence of pharmacotherapy. The aim of the current study was to determine the outcomes of an integrated CBT intervention for co-occurring depression and substance misuse in young people presenting to a mental health setting. Sixty young people (aged 15 to 25), with a DSM-IV diagnosis of Major Depressive Disorder and concurrent substance misuse (at least weekly use in the past month) or disorder were recruited from a public youth mental health service in Melbourne, Australia. Participants received 10 sessions of individual integrated CBT treatment delivered with case management over a 20-week period. The intervention was associated with significant improvements in depression, anxiety, substance use, coping skills, depressive and substance use cognitions and functioning at mid- (10 weeks) and post- (20 weeks) treatment. These changes were maintained at 6 months follow-up (44 weeks). These results provide preliminary evidence for the effectiveness of the integrated CBT intervention in young people with co-occurring depression and substance misuse. Further studies using randomised controlled designs are required to determine its efficacy. 2009 Elsevier B.V. All rights reserved.

  20. Mindfulness-Oriented Recovery Enhancement versus CBT for co-occurring substance dependence, traumatic stress, and psychiatric disorders: Proximal outcomes from a pragmatic randomized trial.

    Science.gov (United States)

    Garland, Eric L; Roberts-Lewis, Amelia; Tronnier, Christine D; Graves, Rebecca; Kelley, Karen

    2016-02-01

    In many clinical settings, there is a high comorbidity between substance use disorders, psychiatric disorders, and traumatic stress. Novel therapies are needed to address these co-occurring issues efficiently. The aim of the present study was to conduct a pragmatic randomized controlled trial comparing Mindfulness-Oriented Recovery Enhancement (MORE) to group Cognitive-Behavioral Therapy (CBT) and treatment-as-usual (TAU) for previously homeless men residing in a therapeutic community. Men with co-occurring substance use and psychiatric disorders, as well as extensive trauma histories, were randomly assigned to 10 weeks of group treatment with MORE (n = 64), CBT (n = 64), or TAU (n = 52). Study findings indicated that from pre-to post-treatment MORE was associated with modest yet significantly greater improvements in substance craving, post-traumatic stress, and negative affect than CBT, and greater improvements in post-traumatic stress and positive affect than TAU. A significant indirect effect of MORE on decreasing craving and post-traumatic stress by increasing dispositional mindfulness was observed, suggesting that MORE may target these issues via enhancing mindful awareness in everyday life. This pragmatic trial represents the first head-to-head comparison of MORE against an empirically-supported treatment for co-occurring disorders. Results suggest that MORE, as an integrative therapy designed to bolster self-regulatory capacity, may hold promise as a treatment for intersecting clinical conditions. Copyright © 2015 Elsevier Ltd. All rights reserved.

  1. Prevalence of cerebral palsy, co-occurring autism spectrum disorders, and motor functioning - Autism and Developmental Disabilities Monitoring Network, USA, 2008.

    Science.gov (United States)

    Christensen, Deborah; Van Naarden Braun, Kim; Doernberg, Nancy S; Maenner, Matthew J; Arneson, Carrie L; Durkin, Maureen S; Benedict, Ruth E; Kirby, Russell S; Wingate, Martha S; Fitzgerald, Robert; Yeargin-Allsopp, Marshalyn

    2014-01-01

    The aim of this study was to report the prevalence and characteristics of children with cerebral palsy (CP). Children with CP (n=451) were ascertained by the Autism and Developmental Disabilities Monitoring (ADDM) Network, a population-based, record-review surveillance system monitoring CP in four areas of the USA. Prevalence was calculated as the number of children with CP among all 8-year-old children residing in these areas in 2008. Motor function was categorized by Gross Motor Function Classification System level and walking ability. Co-occurring autism spectrum disorders (ASD) and epilepsy were ascertained using ADDM Network surveillance methodology. The period prevalence of CP for 2008 was 3.1 per 1000 8-year-old children (95% confidence interval 2.8-3.4). Approximately 58% of children walked independently. Co-occurring ASD frequency was 6.9% and was higher (18.4%) among children with non-spastic CP, particularly hypotonic CP. Co-occurring epilepsy frequency was 41% overall, did not differ by ASD status or CP subtype, and was highest (67%) among children with limited or no walking ability. The prevalence of CP in childhood from US surveillance data has remained relatively constant, in the range of 3.1 to 3.6 per 1000, since 1996. The higher frequency of ASD in non-spastic than in spastic subtypes of CP calls for closer examination. © 2013 Mac Keith Press.

  2. Does Anxiety Modify the Risk for, or Severity of, Conduct Problems Among Children With Co-Occurring ADHD: Categorical and Dimensional and Analyses.

    Science.gov (United States)

    Danforth, Jeffrey S; Doerfler, Leonard A; Connor, Daniel F

    2017-08-01

    The goal was to examine whether anxiety modifies the risk for, or severity of, conduct problems in children with ADHD. Assessment included both categorical and dimensional measures of ADHD, anxiety, and conduct problems. Analyses compared conduct problems between children with ADHD features alone versus children with co-occurring ADHD and anxiety features. When assessed by dimensional rating scales, results showed that compared with children with ADHD alone, those children with ADHD co-occurring with anxiety are at risk for more intense conduct problems. When assessment included a Diagnostic and Statistical Manual of Mental Disorders (4th ed.; DSM-IV) diagnosis via the Schedule for Affective Disorders and Schizophrenia for School Age Children-Epidemiologic Version (K-SADS), results showed that compared with children with ADHD alone, those children with ADHD co-occurring with anxiety neither had more intense conduct problems nor were they more likely to be diagnosed with oppositional defiant disorder or conduct disorder. Different methodological measures of ADHD, anxiety, and conduct problem features influenced the outcome of the analyses.

  3. Linking trait differences to community dynamics: evidence from Eupatorium adenophorum and co-occurring native species during a three-year succession.

    Directory of Open Access Journals (Sweden)

    Xianming Gao

    Full Text Available Trait differences between invasive and native species are believed to be closely related to whether the former are successful. However, few studies have measured trait differences between invasive and native species directly under field conditions or during long term experiments. We examined the phenological pattern, plant height and biomass accumulation and allocation of Crofton weed (Eupatorium adenophorum Spreng. and co-occurring native species in a community during a three-year succession. The phenological pattern of Crofton weed differed from that of co-occurring native species. Crofton weed had longer vegetative stage (when resources were more available, a higher biomass accumulation and a higher above/below-ground ratio compared to native species. Crofton weed was shorter than grasses and two forbs (Artemisia tangutica and Cynoglossum amabile during its first year of growth, but was significantly taller than all other species during subsequent years. The dominance (calculated as the importance value of Crofton weed was the highest among all other species and continually increased over time while the dominance of co-occurring native species decreased. This study provides direct field evidence that trait differences are important to plant invasion.

  4. Cardiac vagal control and theoretical models of co-occurring depression and anxiety: A cross-sectional psychophysiological study of community elderly

    Directory of Open Access Journals (Sweden)

    Chen Hsi-Chung

    2012-07-01

    Full Text Available Abstract Background In order to elucidate the complex relationship between co-occurring depression and anxiety with cardiac autonomic function in the elderly, this study examined the correlation between cardiac vagal control (CVC and pre-defined, theoretical factors from the Hospital Anxiety and Depression Scale (HADS. Methods Three hundred fifty-four randomly selected Chinese male subjects aged ≥65 years and living in the community were enrolled. CVC was measured using a frequency-domain index of heart rate variability. Results Confirmatory factor analysis showed that the flat tripartite model of HADS provided a modest advantage in model fit when compared with other theoretical factor solutions. In the flat tripartite model, there was a significant negative association between anhedonic depression and CVC. In contrast, autonomic anxiety showed a significant positive correlation with CVC. In the hierarchical tripartite model, negative affectivity was not directly associated with CVC; instead, it had positive and negative indirect effects on CVC via autonomic anxiety and anhedonic depression, respectively. As scores for negative affectivity increased, these specific indirect effects diminished. Conclusions Among competing models of co-occurring depression and anxiety, constructs from tripartite models demonstrate fair conformity with the data but unique and distinct correlations with CVC. Negative affectivity may determine the relationship of anhedonic depression and autonomic anxiety with CVC. Separating affective symptoms under the constructs of the tripartite models helps disentangle complex associations between co-occurring depression and anxiety with CVC.

  5. Prevalence and pattern of co-occurring musculoskeletal pain and its association with back-related disability among people with persistent low back pain: protocol for a systematic review and meta-analysis

    OpenAIRE

    Overaas, Cecilie K.; Johansson, Melker S.; de Campos, Tarcisio F.; Ferreira, Manuela L.; Natvig, Bard; Mork, Paul J.; Hartvigsen, Jan

    2017-01-01

    Background Individuals with persistent low back pain commonly have a broad range of other health concerns including co-occurring musculoskeletal pain, which significantly affect their quality of life, symptom severity, and treatment outcomes. The purpose of this review is to get a better understanding of prevalence and patterns of co-occurring musculoskeletal pain complaints in those with persistent low back pain and its potential association with age, sex, and back-related...

  6. Hydrogeochemistry of co-occurring geogenic arsenic, fluoride and iodine in groundwater at Datong Basin, northern China

    Energy Technology Data Exchange (ETDEWEB)

    Pi, Kunfu; Wang, Yanxin, E-mail: yx.wang@cug.edu.cn; Xie, Xianjun, E-mail: xjxie@cug.edu.cn; Su, Chunli; Ma, Teng; Li, Junxia; Liu, Yaqing

    2015-12-30

    Highlights: • Co-mobilization of As, F and I was identified at Datong Basin. • Both As and I are released via reductive dissolution of Fe minerals. • Some amounts of As and I may be sequestered by FeS precipitates. • Intensive evaporation promotes retention of As but mobilization of F and I. - Abstract: Abnormal levels of co-occurring arsenic (As), fluorine (F) and iodine (I) in groundwater at Datong Basin, northern China are geochemically unique. Hydrochemical, {sup 18}O and {sup 2}H characteristics of groundwater were analyzed to elucidate their mobilization processes. Aqueous As, F and I ranged from 5.6 to 2680 μg/L, 0.40 to 3.32 mg/L and 10.1 to 186 μg/L, respectively. High As, F and I groundwater was characterized by moderately alkaline, high HCO{sub 3}{sup −}, Fe(II), HS{sup −} and DOC concentrations with H{sub 3}AsO{sub 3}, F{sup −} and I{sup −} as the dominant species. The plots of δ{sup 18}O values and Cl/Br ratios versus Cl{sup −} concentration demonstrate build-up of more oxidizing conditions and precipitation of carbonate minerals induced by vertical recharge and intensive evaporation facilitate As retention to Fe (hydr) oxides, but enhance F and I mobilization from host minerals. Under reducing conditions, As and I can be simultaneously released via reductive dissolution of Fe (hydr) oxides and reduction of As(V) and I(V) while F migration may be retarded due to effects of dissolution-precipitation equilibria between carbonate minerals and fluorite. With the prevalence of sulfate-reducing condition and lowering of HCO{sub 3}{sup −} concentration, As and I may be sequestered by Fe(II) sulfides and F is retained to fluorite and on clay mineral surfaces.

  7. Disciplinary responses to misconduct among female prison inmates with mental illness, substance use disorders, and co-occurring disorders.

    Science.gov (United States)

    Houser, Kimberly; Belenko, Steven

    2015-03-01

    Most female inmates have mental health, substance use, or co-occurring disorders (CODs), which can create greater difficulty adjusting to incarceration and higher rates of prison misconduct. The response of prison officials to institutional misbehaviors has important implications for female inmates' experiences while incarcerated, their likelihood of parole, and the clinical course of their condition. This article examined whether disciplinary actions are more severe for women with CODs. Data were provided by the Pennsylvania Department of Corrections for all female state prison inmates incarcerated between January 1, 2007, and July 30, 2009 (N = 2,279). The final sample of 211 women included those who had committed a minor misconduct during their incarceration. Disorder categories were created based on intake assessments, and multivariate models were estimated to determine the effect of disorder category on whether the prison imposed a severe or minor disciplinary response to the misconduct. The odds of receiving severe disciplinary responses to minor misconduct was significantly greater for women with CODs than those with the singular disorders of mental illness or substance abuse disorders, or those with no disorders. Findings suggest correctional institutions are responding in a punitive manner to the symptomatic manifestations of CODs in female inmates. These findings suggest the importance of screening instruments in correctional settings that assess for the presence of dual disorders. In addition, correctional administrators must implement training protocols for correctional officers and staff on the complexity of CODs and the ability to identify behavioral and emotional symptoms associated with this vulnerable subset of the offender population. (PsycINFO Database Record (c) 2015 APA, all rights reserved).

  8. Individual, social, and behavioral factors associated with co-occurring conduct problems and callous-unemotional traits.

    Science.gov (United States)

    Fanti, Kostas A

    2013-07-01

    Conduct problems (CP) and callous-unemotional (CU) traits can have a long-lasting negative impact into adulthood. Importantly, among youth with CP, those high on CU traits engage in a more severe, aggressive, and persistent pattern of antisocial behavior. The current study investigates the co-occurrence between CP and CU traits among a large sample of Greek-Cypriot adolescents (N = 1,674; 50.1 % girls). Five distinct groups were identified with Latent Profile Analysis: low risk (48.7 %), average risk (33.8 %), co-occurring high CP-high CU (5.4 %), high CP-low CU (5.2 %), and low CP-high CU (6.9 %). Although more boys were identified in the higher risk groups, boys and girls within each group were not differentiated on levels of CP or CU traits during early adolescence. Youth in the identified groups were compared on early (Mean age = 12.12) and middle (Mean age = 14.02) adolescence individual and contextual factors. Youth with high CP-high CU were at higher risk for behavioral (bullying and substance use), individual (inattention, impulsivity, narcissism), and contextual (low family-support) problems compared to youth in the high CP-low CU and low CP-high CU groups, providing evidence that the combination of CP and CU traits might constitute a pathological group. These findings demonstrate the usefulness of sub-typing CP based on CU traits for the forthcoming fifth edition of the Diagnostic and Statistical Manual. Additional novel findings suggested that adolescents scoring high on CP, irrespective of CU, were not differentiated on hyperactivity, victimization, and anxiety/depression, and adolescents scoring high on CU traits, with or without CP, reported similar low levels of self-esteem and peer and family social-support.

  9. Co-occurring Substance Abuse and Mental Health Problems among Homeless Persons: Suggestions for Research and Practice.

    Science.gov (United States)

    Polcin, Douglas L

    Communities throughout the U.S. are struggling to find solutions for serious and persistent homelessness. Alcohol and drug problems can be causes and consequences of homelessness, as well as co-occurring problems that complicate efforts to succeed in finding stable housing. Two prominent service models exist, one known as "Housing First" takes a harm reduction approach and the other known as the "linear" model typically supports a goal of abstinence from alcohol and drugs. Despite their popularity, the research supporting these models suffers from methodological problems and inconsistent findings. One purpose of this paper is to describe systematic reviews of the homelessness services literature, which illustrate weaknesses in research designs and inconsistent conclusions about the effectiveness of current models. Problems among some of the seminal studies on homelessness include poorly defined inclusion and exclusion criteria, inadequate measures of alcohol and drug use, unspecified or poorly implemented comparison conditions, and lack of procedures documenting adherence to service models. Several recent papers have suggested broader based approaches for homeless services that integrate alternatives and respond better to consumer needs. Practical considerations for implementing a broader system of services are described and peer managed recovery homes are presented as examples of services that address some of the gaps in current approaches. Three issues are identified that need more attention from researchers: 1) improving upon the methodological limitations in current studies, 2) assessing the impact of broader based, integrated services on outcome, and 3) assessing approaches to the service needs of homeless persons involved in the criminal justice system.

  10. Use of a Smartphone Recovery Tool for Latinos with Co-Occurring Alcohol and Other Drug Disorders and Mental Disorders.

    Science.gov (United States)

    Muroff, Jordana; Robinson, Winslow; Chassler, Deborah; López, Luz M; Gaitan, Erika; Lundgren, Lena; Guauque, Claudia; Dargon-Hart, Susan; Stewart, Emily; Dejesus, Diliana; Johnson, Kimberly; Pe-Romashko, Klaren; Gustafson, David H

    2017-01-01

    Addressing alcohol and other drug disorders and other mental disorders among adult Hispanics/Latinos is of critical concern, as they are one of the fastest-growing ethnic groups with a disproportionate rate of disease, mental disorders, and poverty. Although improvement in outcomes is associated with sustained participation in ongoing treatment for co-occurring alcohol and other drug disorders/mental disorders, continuing care is rare for these chronic conditions, especially for Latinos with more limited access to culturally and linguistically competent services. The evidence-based smartphone recovery application Addiction-Comprehensive Health Enhancement Support System (A-CHESS) was translated and adapted for Spanish-speaking Latinos with alcohol and other drug disorders/mental disorders, thus developing CASA-CHESS to address a high level of need for services, high rates of relapse, and lack of existing culturally competent services for Latinos. Of the 79 Latino clients who completed residential treatment and received a smartphone equipped with CASA-CHESS, 26.6% discontinued using CASA-CHESS and 73.4% remained active for four or more months. CASA-CHESS usage was sustained over the four months across all three tenets of self-determination theory (competence, relatedness, and autonomy), with the most commonly utilized services being relevant to relatedness (e.g., messaging, discussion boards). CASA-CHESS clients demonstrated a similar pattern of usage to A-CHESS clients. Findings illustrate that Spanish-speaking Latinos with alcohol and other drug disorders/mental disorders will use a smartphone application to assist with their recovery, continuing their access to resources, case management, and quality information after leaving residential treatment. Consistent with previous findings, our results also emphasize the importance of social support during the four months post-discharge. Such evidence-based, theory-driven digital interventions may extend access to

  11. A Post-Hurricane Katrina Examination of Substance Abuse Treatment Discharges With Co-Occurring Psychiatric and Substance Use Disorders.

    Science.gov (United States)

    Shuler, Monique; Suzuki, Sumihiro; Podesta, Arwen; Qualls-Hampton, Raquel; Wallington, Sherrie Flynt

    2017-01-01

    There is increasing literature supporting the adverse effects of disasters on substance use and psychiatric disorders. The co-occurrence of psychiatric disorders with substance use intensifies the challenge of treatment delivery. Thus the aim of this study was to examine the prevalence of substance use, treatment characteristics, and demographics of discharges from substance abuse treatment in New Orleans, post-Hurricane Katrina. Trends associated with discharges that have a co-occurring psychiatric and substance use disorder (COD) were also assessed. The secondary aim of this study was to examine the association of successful substance abuse treatment completion among those with a COD post-Hurricane Katrina. Substance abuse treatment discharge data (N = 16,507) from New Orleans, Louisiana, for years 2006 through 2011 were obtained from the Treatment Episode Data Set-Discharge. Multiple logistic regression analysis was employed to examine the association of discharges with a COD and completion of substance abuse treatment. Demographic, psychiatric, and treatment characteristics of discharges in 2006 were compared to characteristics in 2011. Trends of characteristics were also assessed through the study period. Roughly a third (35.2%) of all discharges in New Orleans from 2006 to 2011 had a COD. After controlling for race, employment, treatment service setting at discharge, primary substance problem, and the discharge's principal source of referral, discharges with a COD were 29% less likely to complete treatment as compared to those with no COD (AOR = 0.71, 95% CI [0.56, 0.90], p = .004). Treatment completion among discharges with a COD has significantly declined from 36.8% in 2006 to 18.7% in 2011 (p disorder. Unmet treatment needs may also increase odds of criminalization and homelessness.

  12. Wood properties and trunk allometry of co-occurring rainforest canopy trees in a cyclone-prone environment.

    Science.gov (United States)

    Read, Jennifer; Evans, Robert; Sanson, Gordon D; Kerr, Stuart; Jaffré, Tanguy

    2011-11-01

    New Caledonia commonly experiences cyclones, so trees there are expected to have enhanced wood traits and trunk allometry that confer resistance to wind damage. We ask whether there is evidence of a trade-off between these traits and growth rate among species. Wood traits, including density, microfibril angle (MFA), and modulus of elasticity (MOE), ratio of tree height to stem diameter, and growth rate were investigated in mature trees of 15 co-occurring canopy species in a New Caledonian rainforest. In contrast to some studies, wood density did not correlate negatively with growth increment. Among angiosperms, wood density and MOE correlated positively with diameter-adjusted tree height, and MOE correlated positively with stem-diameter growth increment. Tall slender trees achieved high stiffness with high efficiency with respect to wood density, in part by low MFA, and with a higher diameter growth increment but a lower buckling safety factor. However, some tree species of a similar niche differed in whole-tree resistance to wind damage and achieved wood stiffness in different ways. There was no evidence of a growth-safety trade-off in these trees. In forests that regularly experience cyclones, there may be stronger selection for high wood density and/or stiffness in fast-growing trees of the upper canopy, with the potential growth trade-off amortized by access to the upper canopy and by other plant traits. Furthermore, decreasing wood density does not necessarily decrease resistance to wind damage, resistance being influenced by other characteristics including cell-level traits (e.g., MFA) and whole-plant architecture.

  13. Primary care patients reporting concerns about their gambling frequently have other co-occurring lifestyle and mental health issues

    Directory of Open Access Journals (Sweden)

    Shepherd Robin

    2006-04-01

    Full Text Available Abstract Background Problem gambling often goes undetected by family physicians but may be associated with stress-related medical problems as well as mental disorders and substance abuse. Family physicians are often first in line to identify these problems and to provide a proper referral. The aim of this study was to compare a group of primary care patients who identified concerns with their gambling behavior with the total population of screened patients in relation to co-morbidity of other lifestyle risk factors or mental health issues. Methods This is a cross sectional study comparing patients identified as worrying about their gambling behavior with the total screened patient population for co morbidity. The setting was 51 urban and rural New Zealand practices. Participants were consecutive adult patients per practice (N = 2,536 who completed a brief multi-item tool screening primary care patients for lifestyle risk factors and mental health problems (smoking, alcohol and drug misuse, problem gambling, depression, anxiety, abuse, anger. Data analysis used descriptive statistics and non-parametric binomial tests with adjusting for clustering by practitioner using STATA survey analysis. Results Approximately 3/100 (3% answered yes to the gambling question. Those worried about gambling more likely to be male OR 1.85 (95% CI 1.1 to 3.1. Increasing age reduced likelihood of gambling concerns – logistic regression for complex survey data OR = 0.99 (CI 95% 0.97 to 0.99 p = 0.04 for each year older. Patients concerned about gambling were significantly more likely (all p Conclusion Our questionnaire identifies patients who express a need for help with gambling and other lifestyle and mental health issues. Screening for gambling in primary care has the potential to identify individuals with multiple co-occurring disorders.

  14. Functional traits enhance invasiveness of bamboos over co-occurring tree saplings in the semideciduous Atlantic Forest

    Science.gov (United States)

    Montti, Lía; Villagra, Mariana; Campanello, Paula I.; Gatti, M. Genoveva; Goldstein, Guillermo

    2014-01-01

    Many woody bamboo species are forest understory plants that become invasive after disturbance. They can grow rapidly forming a dense, nearly monospecific understory that inhibits tree regeneration. The principal aim of this study was to understand what functional traits of bamboos allow them to outcompete tree seedlings and saplings and become successful species in the semideciduous Atlantic Forests of northeastern Argentina. We studied leaf and whole-plant functional traits of two bamboo species of the genus Chusquea and five co-occurring saplings of common tree species growing under similar solar radiation and soil nutrient availabilities. Nutrient addition had no effect on bamboo or tree sapling survival and growth after two years. Tree species with high-light requirements had higher growth rates and developed relatively thin leaves with high photosynthetic capacity per unit leaf area and short leaf life-span when growing in gaps, but had lower survival rates in the understory. The opposite pattern was observed in shade-tolerant species that were able to survive in the understory but had lower photosynthetic capacity and growth than light-requiring species in gaps. Bamboos exhibited a high plasticity in functional traits and leaf characteristics that enabled them to grow rapidly in gaps (e.g., higher photosynthetic capacity per unit dry mass and clonal reproduction in gaps than in the understory) but at the same time to tolerate closed-canopy conditions (they had thinner leaves and a relatively longer leaf life-span in the understory compared to gaps). Photosynthetic capacity per unit dry mass was higher in bamboos than in trees. Bamboo plasticity in key functional traits, such as clonal reproduction at the plant level and leaves with a relatively low C cost and high photosynthesis rates, allows them to colonize disturbed forests with consequences at the community and ecosystem levels. Increasing disturbance in some forests worldwide will likely enhance bamboo

  15. Co-occurring substance abuse and mental health problems among homeless persons: Suggestions for research and practice

    Science.gov (United States)

    Polcin, Douglas L.

    2016-01-01

    Abstract Communities throughout the U.S. are struggling to find solutions for serious and persistent homelessness. Alcohol and drug problems can be causes and consequences of homelessness, as well as co-occurring problems that complicate efforts to succeed in finding stable housing. Two prominent service models exist, one known as “Housing First” takes a harm reduction approach and the other known as the “linear” model typically supports a goal of abstinence from alcohol and drugs. Despite their popularity, the research supporting these models suffers from methodological problems and inconsistent findings. One purpose of this paper is to describe systematic reviews of the homelessness services literature, which illustrate weaknesses in research designs and inconsistent conclusions about the effectiveness of current models. Problems among some of the seminal studies on homelessness include poorly defined inclusion and exclusion criteria, inadequate measures of alcohol and drug use, unspecified or poorly implemented comparison conditions, and lack of procedures documenting adherence to service models. Several recent papers have suggested broader based approaches for homeless services that integrate alternatives and respond better to consumer needs. Practical considerations for implementing a broader system of services are described and peer-managed recovery homes are presented as examples of services that address some of the gaps in current approaches. Three issues are identified that need more attention from researchers: (1) improving upon the methodological limitations in current studies, (2) assessing the impact of broader based, integrated services on outcome, and (3) assessing approaches to the service needs of homeless persons involved in the criminal justice system. PMID:27092027

  16. Non-targeted Colonization by the Endomycorrhizal Fungus, Serendipita vermifera, in Three Weeds Typically Co-occurring with Switchgrass

    Directory of Open Access Journals (Sweden)

    Prasun Ray

    2018-01-01

    Full Text Available Serendipita vermifera (=Sebacina vermifera; isolate MAFF305830 is a mycorrhizal fungus originally isolated from the roots of an Australian orchid that we have previously shown to be beneficial in enhancing biomass yield and drought tolerance in switchgrass, an important bioenergy crop for cellulosic ethanol production in the United States. However, almost nothing is known about how this root-associated fungus proliferates and grows through the soil matrix. Such information is critical to evaluate the possibility of non-target effects, such as unintended spread to weedy plants growing near a colonized switchgrass plant in a field environment. A microcosm experiment was conducted to study movement of vegetative mycelia of S. vermifera between intentionally inoculated switchgrass (Panicum virgatum L. and nearby weeds. We constructed size-exclusion microcosms to test three different common weeds, large crabgrass (Digitaria sanguinalis L., Texas panicum (Panicum texanum L., and Broadleaf signalgrass (Brachiaria platyphylla L., all species that typically co-occur in Southern Oklahoma and potentially compete with switchgrass. We report that such colonization of non-target plants by S. vermifera can indeed occur, seemingly via co-mingled root systems. As a consequence of colonization, significant enhancement of growth was noted in signalgrass, while a mild increase (albeit not significant was evident in crabgrass. Migration of the fungus seems unlikely in root-free bulk soil, as we failed to see transmission when the roots were kept separate. This research is the first documentation of non-targeted colonization of this unique root symbiotic fungus and highlights the need for such assessments prior to deployment of biological organisms in the field.

  17. Contrasting physiological responses of two co-occurring eucalypts to seasonal drought at restored bauxite mine sites.

    Science.gov (United States)

    Szota, Christopher; Farrell, Claire; Koch, John M; Lambers, Hans; Veneklaas, Erik J

    2011-10-01

    This study describes the physiological response of two co-occurring tree species (Eucalyptus marginata and Corymbia calophylla) to seasonal drought at low- and high-quality restored bauxite mine sites in south-western Australia. Seasonal changes in photosynthesis (A), stomatal conductance (g(s)), leaf water potential (ψ), leaf osmotic potential (ψ), leaf relative water content (RWC) and pressure-volume analysis were captured over an 18-month field study to (i) determine the nature and severity of physiological stress in relation to site quality and (ii) identify any physiological differences between the two species. Root system restriction at the low-quality site reduced maximum rates of gas exchange (g(s) and A) and increased water stress (midday ψ and daily RWC) in both species during drought. Both species showed high stomatal sensitivity during drought; however, E. marginata demonstrated a higher dehydration tolerance where ψ and RWC fell to -3.2 MPa and 73% compared with -2.4 MPa and 80% for C. calophylla. Corymbia calophylla showed lower g(s) and higher ψ and RWC during drought, indicating higher drought tolerance. Pressure-volume curves showed that cell-wall elasticity of E. marginata leaves increased in response to drought, while C. calophylla leaves showed lower osmotic potential at zero turgor in summer than in winter, indicating osmotic adjustment. Both species are clearly able to tolerate seasonal drought at hostile sites; however, by C. calophylla closing stomata earlier in the drought cycle, maintaining a higher water status during drought and having the additional mechanism of osmotic adjustment, it may have a greater capacity to survive extended periods of drought.

  18. Thermotolerance and Photosystem II Behaviour in Co-occuring Temperate Tree Species Exposed to Short-term Extreme Heat Waves

    Science.gov (United States)

    Guha, A.; Warren, J.; Cummings, C.; Han, J.

    2017-12-01

    Thermal stress can induce irreversible photodamage with longer consequences for plant metabolism. We focused on photosystem II (PSII) behaviour to understand how this complex responds in different co-occuring temperate trees exposed to short-term extreme heat waves. The study was designed for understanding complex heat tolerance mechanisms in trees. During manipulative heat-wave experiments, we monitored instantaneous PSII performance and tracked both transient and chronic PSII damages using chlorophyll a fluorescence characteristics. Fluorescence signals were used to simulate PSII bioenergetic processes. The light (Fv'/Fm') and dark-adapted (Fv/Fm) fluorescence traits including fast induction kinetics (OJIP), electron transport rate, PSII operating efficiency and quenching capacities were significantly affected by the heat treatments. Loss in PSII efficiency was more apparent in species like black cottonwood, yellow poplar, walnuts and conifers, whereas oaks maintained relatively better PSII functions. The post-heat recovery of Fv/Fm varied across the studied species showing differential carry over effects. PSII down-regulation was one of dominant factors for the loss in operational photosynthesis during extreme heat wave events. Both light and dark-adapted fluorescence characteristics showed loss in photo-regulatory functions and photodamage. Some resilient species showed rapid recovery from transient PSII damage, whereas fingerprints of chronic PSII damage were observed in susceptibles. Thresholds for Fv/Fm and non-photochemical quenching were identified for the studied species. PSII malfunctioning was largely associated with the observed photosynthetic down-regulation during heat wave treatments, however, its physiological recovery should be a key factor to determine species resilience to short-term extreme heat wave events.

  19. Non-targeted Colonization by the Endomycorrhizal Fungus, Serendipita vermifera, in Three Weeds Typically Co-occurring with Switchgrass

    Science.gov (United States)

    Ray, Prasun; Guo, Yingqing; Kolape, Jaydeep; Craven, Kelly D.

    2018-01-01

    Serendipita vermifera (=Sebacina vermifera; isolate MAFF305830) is a mycorrhizal fungus originally isolated from the roots of an Australian orchid that we have previously shown to be beneficial in enhancing biomass yield and drought tolerance in switchgrass, an important bioenergy crop for cellulosic ethanol production in the United States. However, almost nothing is known about how this root-associated fungus proliferates and grows through the soil matrix. Such information is critical to evaluate the possibility of non-target effects, such as unintended spread to weedy plants growing near a colonized switchgrass plant in a field environment. A microcosm experiment was conducted to study movement of vegetative mycelia of S. vermifera between intentionally inoculated switchgrass (Panicum virgatum L.) and nearby weeds. We constructed size-exclusion microcosms to test three different common weeds, large crabgrass (Digitaria sanguinalis L.), Texas panicum (Panicum texanum L.), and Broadleaf signalgrass (Brachiaria platyphylla L.), all species that typically co-occur in Southern Oklahoma and potentially compete with switchgrass. We report that such colonization of non-target plants by S. vermifera can indeed occur, seemingly via co-mingled root systems. As a consequence of colonization, significant enhancement of growth was noted in signalgrass, while a mild increase (albeit not significant) was evident in crabgrass. Migration of the fungus seems unlikely in root-free bulk soil, as we failed to see transmission when the roots were kept separate. This research is the first documentation of non-targeted colonization of this unique root symbiotic fungus and highlights the need for such assessments prior to deployment of biological organisms in the field. PMID:29375607

  20. Psychopathology and friendship in children and adolescents: disentangling the role of co-occurring symptom domains with serial mediation models.

    Science.gov (United States)

    Manfro, Arthur Gus; Pan, Pedro M; Gadelha, Ary; Fleck, Marcelo; do Rosário, Maria C; Cogo-Moreira, Hugo; Affonseca-Bressan, Rodrigo; Mari, Jair; Miguel, Euripedes C; Rohde, Luis A; Salum, Giovanni A

    2017-11-01

    The consolidation of social friendship groups is a vital part of human development. The objective of this study is to understand the direct and indirect influences of three major symptomatic domains-emotional, hyperkinetic, and conduct-on friendship. Specifically, we aim to study if the associations of one domain with friendship may be mediated by co-occurring symptoms from another domain. A total of 2512 subjects aged 6-14 years participated in this study. Friendship was evaluated by the Development and Well-Being Assessment's friendship section. We evaluated two main constructs as outcomes: (1) social isolation and (2) friendship latent construct. Emotional, hyperkinetic, and conduct symptomatic domains were evaluated with the Strengths and Difficulties Questionnaire (SDQ). All SDQ domains were positively associated with social isolation and negatively associated with friendship latent construct in univariate analysis. However, serial mediation models showed that the association between conduct domains with social isolation was mediated by emotion and hyperkinetic domains. Moreover, the associations between emotional and hyperkinetic domains with friendship latent construct in non-isolated children were mediated by the conduct domain. Emotion and hyperkinetic domains were directly and indirectly associated with social isolation, whereas conduct was directly and indirectly associated with overall friendship in non-isolated children. Results suggest that interventions aimed to improve social life in childhood and adolescence may have stronger effects if directed towards the treatment of emotion and hyperkinetic symptoms in socially isolated children and directed towards the treatment of conduct symptoms in children with fragile social connections.

  1. Independent Versus Co-occurring Substance Use in Relation to Gambling Outcomes in Older Adolescents and Young Adults.

    Science.gov (United States)

    Cronce, Jessica M; Bittinger, Joyce N; Di Lodovico, Cory M; Liu, Junny

    2017-05-01

    Gambling is prevalent among college students and can be associated with significant negative consequences. Students who report gambling also tend to report use of alcohol and cannabis, but little research has explored the associated risks of using these substances in relation to gambling episodes. This study explored associations between the independent and co-occurring use of alcohol and cannabis before/during gambling episodes and gambling outcomes. Students (n = 1,834) completed an online survey that included measures of gambling frequency, amount lost, negative gambling consequences, gambling problem severity, and substance use. As hypothesized, individuals who reported using either alcohol or cannabis alone or both substances before/while gambling endorsed greater gambling quantity, frequency, negative consequences, and problem severity than individuals who used alcohol and cannabis in general but denied use of either substance before/while gambling. Use of both substances compared to use of alcohol alone was associated with greater gambling quantity, frequency, and negative consequences, although these groups did not differ on gambling problem severity. Cannabis use alone was no different on any outcome than use of both substances, and alcohol use alone was no different than cannabis use alone on any outcome. Use of cannabis alone before/while gambling may confer the same level of risk for negative gambling outcomes as use of both cannabis and alcohol. Prevention efforts may, therefore, benefit from targeting cannabis use in relation to gambling. Additional investigation is needed in light of recent and upcoming state legislation on the legalization of cannabis. Copyright © 2016 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

  2. Six-month outcomes of co-occurring delirium, depression, and dementia in long-term care.

    Science.gov (United States)

    McCusker, Jane; Cole, Martin G; Voyer, Philippe; Monette, Johanne; Champoux, Nathalie; Ciampi, Antonio; Vu, Minh; Belzile, Eric

    2014-12-01

    To describe the 6-month outcomes of co-occurring delirium (full syndrome and subsyndromal symptoms), depression, and dementia in a long-term care (LTC) population. Observational, prospective cohort study with 6-month follow-up conducted from 2005 to 2009. Seven LTC facilities in the province of Quebec, Canada. Newly admitted and long-term residents recruited consecutively from lists of residents aged 65 and older admitted for LTC, with stratification into groups with and without severe cognitive impairment. The study sample comprised 274 residents with complete data at baseline on delirium, dementia, and depression. Outcomes were 6-month mortality, functional decline (10-point decline from baseline on 100-point Barthel scale), and cognitive decline (3-point decline on 30-point Mini-Mental State Examination). Predictors included delirium (full syndrome or subsyndromal symptoms, using the Confusion Assessment Method), depression (Cornell Scale for Depression in Dementia), and dementia (chart diagnosis). The baseline prevalences of delirium, subsyndromal symptoms of delirium (SSD), depression, and dementia were 11%, 44%, 19%, and 66%, respectively. By 6 months, 10% of 274 had died, 19% of 233 had experienced functional decline, and 17% of 246 had experienced cognitive decline. An analysis using multivariable generalized linear models found the following significant interaction effects (P delirium and depression for functional decline, and between SSD and dementia for cognitive decline. Co-occurrence of delirium, SSD, depression, and dementia in LTC residents appears to affect some 6-month outcomes. Because of limited statistical power, it was not possible to draw conclusions about the effects of the co-occurrence of some syndromes on poorer outcomes. © 2014, Copyright the Authors Journal compilation © 2014, The American Geriatrics Society.

  3. Embryogenesis of Gentiana straminea and assessment of genetic ...

    African Journals Online (AJOL)

    Tibet Plateau. To speed up the production of this species, an in vitro protocol for efficient plant regeneration was developed from its leaf explants. Auxins and cytokinin alone or in combination were examined for their effects on callus induction and ...

  4. Screening for co-occurring conditions in adults with autism spectrum disorder using the strengths and difficulties questionnaire: A pilot study.

    Science.gov (United States)

    Findon, James; Cadman, Tim; Stewart, Catherine S; Woodhouse, Emma; Eklund, Hanna; Hayward, Hannah; De Le Harpe Golden, Daniel; Chaplin, Eddie; Glaser, Karen; Simonoff, Emily; Murphy, Declan; Bolton, Patrick F; McEwen, Fiona S

    2016-12-01

    Adolescents and adults with autism spectrum disorder (ASD) are at elevated risk of co-occurring mental health problems. These are often undiagnosed, can cause significant impairment, and place a very high burden on family and carers. Detecting co-occurring disorders is extremely important. However, there is no validated screening tool for this purpose. The aim of this pilot study is to test the utility of the strengths and difficulties questionnaire (SDQ) to screen for co-occurring emotional disorders and hyperactivity in adolescents and adults with ASD. The SDQ was completed by 126 parents and 98 individuals with ASD (in 79 cases both parent and self-report were available from the same families). Inter-rater reliability, test-retest stability, internal consistency, and construct validity were examined. SDQ subscales were also compared to clinically utilized measures of emotional disorders and hyperactivity to establish the ability to predict risk of disorder. Inter-rater reliability (r = 0.42), test-retest stability (r = 0.64), internal consistency (α = 0.52-0.81) and construct validity (r = 0.42-0.57) for the SDQ subscales were comparable to general population samples. Parent- and self-report SDQ subscales were significantly associated with measures of anxiety, depression and hyperactivity (62-74% correctly classified). Parent-report performed significantly better than self-report; adults with ASD under-reported difficulties. The SDQ shows promise as a simple and efficient way to screen for emotional disorders and hyperactivity in adolescents and adults with ASD that could help reduce the impact of these disorders on individuals and their families. However, further more systematic attempts at validation are warranted. Autism Res 2016, 9: 1353-1363. © 2016 International Society for Autism Research, Wiley Periodicals, Inc. © 2016 The Authors Autism Research published by Wiley Periodicals, Inc. on behalf of International Society for Autism

  5. Risk of venous thromboembolism after total hip and knee replacement in older adults with comorbidity and co-occurring comorbidities in the Nationwide Inpatient Sample (2003-2006

    Directory of Open Access Journals (Sweden)

    Katz Jeffrey N

    2010-09-01

    Full Text Available Abstract Background Venous thromboembolism is a common, fatal, and costly injury which complicates major surgery in older adults. The American College of Chest Physicians recommends high potency prophylaxis regimens for individuals undergoing total hip or knee replacement (THR or TKR, but surgeons are reluctant to prescribe them due to fear of excess bleeding. Identifying a high risk cohort such as older adults with comorbidities and co-occurring comorbidities who might benefit most from high potency prophylaxis would improve how we currently perform preoperative assessment. Methods Using the Nationwide Inpatient Sample, we identified older adults who underwent THR or TKR in the U.S. between 2003 and 2006. Our outcome was VTE, including any pulmonary embolus or deep venous thrombosis. We performed multivariate logistic regression analyses to assess the effects of comorbidities on VTE occurrence. Comorbidities under consideration included coronary artery disease, congestive heart failure (CHF, chronic obstructive pulmonary disease (COPD, diabetes, and cerebrovascular disease. We also examined the impact of co-occurring comorbidities on VTE rates. Results CHF increased odds of VTE in both the THR cohort (OR = 3.08 95% CI 2.05-4.65 and TKR cohort (OR = 2.47 95% CI 1.95-3.14. COPD led to a 50% increase in odds in the TKR cohort (OR = 1.49 95% CI 1.31-1.70. The data did not support synergistic effect of co-occurring comorbidities with respect to VTE occurrence. Conclusions Older adults with CHF undergoing THR or TKR and with COPD undergoing TKR are at increased risk of VTE. If confirmed in other datasets, these older adults may benefit from higher potency prophylaxis.

  6. Co-occurring symptoms of attention deficit hyperactivity disorder (ADHD) in a population-based sample of adolescents screened for depression.

    Science.gov (United States)

    Lundervold, Astri J; Hinshaw, Stephen P; Sørensen, Lin; Posserud, Maj-Britt

    2016-02-25

    Depression is common in adolescents, with a gender bias towards girls. Symptoms associated with attention deficit hyperactivity disorder (ADHD) tend to co-occur in depressed adolescents. This may be related to common features between the two symptom domains, but co-occurring ADHD symptoms may also inflate the severity of depression. The present study investigates the frequency and influence of ADHD symptoms co-occurring with depression in a gender balanced population-based sample of Norwegian adolescents. A sample of 9614 adolescents (16-19 years) completed a questionnaire including the short version of the Mood and Feelings Questionnaire (sMFQ) and the Adult ADHD Self-Report Scale (ASRS), with items reflecting symptoms associated with depression and ADHD, respectively. The sMFQ sum score was used as a proxy for severity of depression, and adolescents with a score equal to or above the 90th percentile were defined as depressed. A high response on any of the ASRS items was used to define the presence of an ADHD symptom, and the number of high scores was used to indicate severity. ADHD symptoms were frequently reported by the adolescents, with a higher frequency in girls than in boys. The gender differences were, however, minor when the analysis was restricted to the adolescents defined as depressed. Each severe symptom reported on the ASRS contributed significantly to increase the sum score on the sMFQ, and more than 20 % of the adolescents defined as depressed reported six or more symptoms within the ASRS inattention subscale. The results emphasize the importance of screening for symptoms associated with ADHD when assessing adolescents presenting symptoms indicating depression. Although girls reported higher frequency of symptoms within both domains, the gender bias was dependent on the overall symptom severity. Awareness of co-occurrence of symptoms and gender biases are of importance for both clinical work and future research on mental health and service use in

  7. Co-Occurring Disorders

    Science.gov (United States)

    ... In Patient Care Understanding Clinical Trials Electroconvulsive Therapy (ECT) Psychiatric Advance Directives: Taking Charge of Your Care ... Monthly Gift Legacy Gift Clifford Beers Society In Memory In ... the billions of dollars annually for health care, related injuries and loss of life, property destruction, loss of productivity and ...

  8. Field clearance of an intertidal bivalve bed: relative significance of the co-occurring blue mussel Mytilus edulis and Pacific oyster Crassostrea gigas

    DEFF Research Database (Denmark)

    Vismann, Bent; Holm, Mark Wejlemann; Davids, Jens

    2016-01-01

    At an approximately 12 000 m2 sheltered intertidal bivalve bed in the western part of the Limfjord, Denmark, the Pacific oyster Crassostrea gigas co-occurs with the blue mussel Mytilus edulis. The relative significance of the impact of the 2 species on phytoplankton density during a tidal cycle...... was estimated by combining field measurements of clearance rates and modelling of the bivalve bed (topography, biomass distribution, temporal and spatial water coverage and depth). The average density of C. gigas and M. edulis was 35 ± 36 and 1001 ± 685 ind. m−2, respectively. The water volume cleared during...

  9. Plant Survival and Mortality during Drought Can be Mediated by Co-occurring Species' Physiological and Morphological Traits: Results from a Model

    Science.gov (United States)

    Tai, X.; Mackay, D. S.

    2015-12-01

    Interactions among co-occurring species are mediated by plant physiology, morphology and environment. Without proper mechanisms to account for these factors, it remains difficult to predict plant mortality/survival under changing climate. A plant ecophysiological model, TREES, was extended to incorporate co-occurring species' belowground interaction for water. We used it to examine the interaction between two commonly co-occurring species during drought experiment, pine (Pinus edulis) and juniper (Juniperus monosperma), with contrasting physiological traits (vulnerability to cavitation and leaf water potential regulation). TREES was parameterized and validated using field-measured plant physiological traits. The root architecture (depth, profile, and root area to leaf area ratio) of juniper was adjusted to see how root morphology could affect the survival/mortality of its neighboring pine under both ambient and drought conditions. Drought suppressed plant water and carbon uptake, as well increased the average percentage loss of conductivity (PLC). Pine had 59% reduction in water uptake, 48% reduction in carbon uptake, and 38% increase in PLC, while juniper had 56% reduction in water uptake, 50% reduction in carbon and 29% increase in PLC, suggesting different vulnerability to drought as mediated by plant physiological traits. Variations in juniper root architecture further mediated drought stress on pine, from negative to positive. Different juniper root architecture caused variations in response of pine over drought (water uptake reduction ranged 0% ~63%, carbon uptake reduction ranged 0% ~ 70%, and PLC increase ranged 2% ~ 91%). Deeper or more uniformly distributed roots of juniper could effectively mitigate stress experienced by pine. In addition, the total water and carbon uptake tended to increase as the ratio of root area to leaf area increased while PLC showed non-monotonic response, suggesting the potential trade-off between maximizing resource uptake and

  10. Co-occurring aggression and suicide attempt among veterans entering residential treatment for PTSD: The role of PTSD symptom clusters and alcohol misuse.

    Science.gov (United States)

    Watkins, Laura E; Sippel, Lauren M; Pietrzak, Robert H; Hoff, Rani; Harpaz-Rotem, Ilan

    2017-04-01

    Aggression and suicidality are two serious public health concerns among U.S. veterans that can co-occur and share many overlapping risk factors. The current study aims to elucidate the contribution of posttraumatic stress disorder (PTSD) symptom clusters defined by a five-factor model and alcohol misuse in predicting aggression and suicide attempts among veterans entering residential treatment for PTSD. Participants were 2570 U.S. veterans across 35 Veterans Health Administration sites. Multinomial logistic regression models were used to identify correlates of aggression only (n = 1471; 57.2%), suicide attempts only (n = 41; 1.6%), co-occurring aggression and suicide attempts (n = 202; 7.9%), and neither behavior (n = 856; 33.3%) over the past four months. When compared to veterans endorsing neither behavior, greater PTSD re-experiencing symptoms were related to suicide attempts (odds ratio [OR] = 1.58, 95% confidence interval [CI] = 1.09-2.30), aggression (OR = 1.13, 95% CI = 1.02-1.26), and co-occurring aggression and suicide (OR = 1.38, 95% CI = 1.13-1.68), and higher PTSD dysphoric arousal symptoms and alcohol misuse symptoms were related to aggression (OR = 1.54, 95% CI = 1.38-1.71; OR = 1.30, 95% CI = 1.18-1.44, respectively) and co-occurring aggression and suicide (OR = 1.66, 95% CI = 1.35-2.04; OR = 1.50, 95% CI = 1.28-1.75, respectively). Our findings suggest that assessment of PTSD symptom clusters and alcohol misuse can potentially help to identify veterans who endorse suicide attempts, aggression, or both concurrently. These results have important implications for risk assessment and treatment planning with U.S. veterans seeking care for PTSD. Published by Elsevier Ltd.

  11. Evolution and clinical impact of co-occurring genetic alterations in advanced-stage EGFR-mutant lung cancers. | Office of Cancer Genomics

    Science.gov (United States)

    A widespread approach to modern cancer therapy is to identify a single oncogenic driver gene and target its mutant-protein product (for example, EGFR-inhibitor treatment in EGFR-mutant lung cancers). However, genetically driven resistance to targeted therapy limits patient survival. Through genomic analysis of 1,122 EGFR-mutant lung cancer cell-free DNA samples and whole-exome analysis of seven longitudinally collected tumor samples from a patient with EGFR-mutant lung cancer, we identified critical co-occurring oncogenic events present in most advanced-stage EGFR-mutant lung cancers.

  12. Racial/ethnic disparities in service utilization for individuals with co-occurring mental health and substance use disorders in the general population: results from the national epidemiologic survey on alcohol and related conditions.

    Science.gov (United States)

    Hatzenbuehler, Mark L; Keyes, Katherine M; Narrow, William E; Grant, Bridget F; Hasin, Deborah S

    2008-07-01

    This study sought to determine whether black/white disparities in service utilization for mental health and substance use disorders persist or are diminished among individuals with psychiatric comorbidity in the general population. The 2001-2002 National Epidemiologic Survey on Alcohol and Related Conditions was used to identify individuals with lifetime co-occurring substance use disorders and mood/anxiety disorders (N = 4250; whites, N = 3597; blacks, N = 653). Lifetime service utilization for problems with mood, anxiety, alcohol, and drugs was assessed. Compared to whites, blacks with co-occurring mood or anxiety and substance use disorders were significantly less likely to receive services for mood or anxiety disorders, equally likely to receive services for alcohol use disorders, and more likely to receive some types of services for drug use disorders. Regardless of race/ethnicity, individuals with these co-occurring disorders were almost twice as likely to use services for mood/anxiety disorders than for substance use disorders. Despite the fact that comorbidity generally increases the likelihood of service use, black/white disparities in service utilization among an all-comorbid sample were found, although these disparities differed by type of disorder. Further research is warranted to understand the factors underlying these differences. Prevention and intervention strategies are needed to address the specific mental health needs of blacks with co-occurring disorders, as well as the overall lack of service use for substance use disorders among individuals with co-occurring psychiatric conditions.

  13. Diazepam Potentiates the Antidiabetic, Antistress and Anxiolytic Activities of Metformin in Type-2 Diabetes Mellitus with Cooccurring Stress in Experimental Animals

    Science.gov (United States)

    2014-01-01

    Psychological stress is considered as one of the limiting factors in the management of type-2 diabetes mellitus (T2DM). Therefore, the basic objective of the present study was to evaluate the antidiabetic effect of metformin, diazepam, and their combination in cooccurring T2DM and stress condition (DMS). T2DM was induced in the male rats by administering streptozotocin (45 mg/kg, i.p.) and nicotinamide (110 mg/kg, i.p.) with time lag of 15 min. Rats were subjected to two sessions of cold restraint stress paradigm for one hour on the sixth and seventh day after streptozotocin injection. Administration of metformin (25 mg/kg, p.o.) and diazepam (1 mg/kg, p.o.) in combination from the seventh to thirteenth day after streptozotocin injection showed better improvement in glucose tolerance and insulin sensitivity compared to monotherapy of either drug. In addition, the combination significantly attenuated DMS-induced hyperglycemia, hypertriglyceridaemia, hypercorticosteronemia, anxiety-like behavior, and insulin resistance through modulating insulin signaling pathway in the liver compared to monotherapy. Further, improvement of mitochondrial function, integrity, and oxidative stress in hippocampus, hypothalamus, prefrontal cortex, striatum, amygdala, and nucleus accumbens was observed with the combination. Therefore, metformin in combination with diazepam may be a better therapeutic option in the management of T2DM with cooccurring stress condition. PMID:24995322

  14. Prevalence of Nonmedical Use of Prescription Opioids and Association With Co-occurring Substance Use Disorders Among Adolescents in Substance Use Treatment.

    Science.gov (United States)

    Al-Tayyib, Alia; Riggs, Paula; Mikulich-Gilbertson, Susan; Hopfer, Christian

    2018-02-01

    We sought to describe the prevalence of the nonmedical use of prescription opioids (NMUPO) and its association with co-occurring substance use disorders in a sample of adolescents in substance treatment. Adolescents in two substance treatment programs were recruited for participation between 2009 and 2013. The Composite International Diagnostic Interview-Substance Abuse Module (CIDI-SAM) was administered to assess substance use patterns and lifetime abuse or dependence. A total of 378 adolescents completed the CIDI-SAM (mean age 16.1 [standard deviation = 1.1], 78% male, 50% white, non-Hispanic). Of the 378 adolescents, 62 (16.4%) reported NMUPO and 59 (15.6%) were diagnosed with opioid/heroin abuse or dependence. The mean age at first NMUPO was 14.3 (standard deviation = 1.4). NMUPO was associated with a 3.31-fold (95% confidence interval: 2.83-3.79) increase in having three or more co-occurring substance use diagnoses. NMUPO is quite prevalent among adolescents in substance use treatment. Intervention to interrupt NMUPO from progressing to heroin use or developing into a disorder is critical. Copyright © 2017 The Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

  15. Rules of co-occurring mutations characterize the antigenic evolution of human influenza A/H3N2, A/H1N1 and B viruses.

    Science.gov (United States)

    Chen, Haifen; Zhou, Xinrui; Zheng, Jie; Kwoh, Chee-Keong

    2016-12-05

    The human influenza viruses undergo rapid evolution (especially in hemagglutinin (HA), a glycoprotein on the surface of the virus), which enables the virus population to constantly evade the human immune system. Therefore, the vaccine has to be updated every year to stay effective. There is a need to characterize the evolution of influenza viruses for better selection of vaccine candidates and the prediction of pandemic strains. Studies have shown that the influenza hemagglutinin evolution is driven by the simultaneous mutations at antigenic sites. Here, we analyze simultaneous or co-occurring mutations in the HA protein of human influenza A/H3N2, A/H1N1 and B viruses to predict potential mutations, characterizing the antigenic evolution. We obtain the rules of mutation co-occurrence using association rule mining after extracting HA1 sequences and detect co-mutation sites under strong selective pressure. Then we predict the potential drifts with specific mutations of the viruses based on the rules and compare the results with the "observed" mutations in different years. The sites under frequent mutations are in antigenic regions (epitopes) or receptor binding sites. Our study demonstrates the co-occurring site mutations obtained by rule mining can capture the evolution of influenza viruses, and confirms that cooperative interactions among sites of HA1 protein drive the influenza antigenic evolution.

  16. Insight among people with severe mental illness, co-occurring PTSD and elevated psychotic symptoms: Correlates and relationship to treatment participation.

    Science.gov (United States)

    Yanos, Philip T; Vayshenker, Beth; Pleskach, Pavel; Mueser, Kim T

    2016-07-01

    There is a dearth of research on what factors are predictive of insight among people with severe mental illness and co-occurring PTSD. Data were drawn from 146 participants with severe mental illness, co-occurring PTSD and elevated psychotic symptoms participating in a randomized controlled trial comparing two interventions for PTSD among people with severe mental illness. We examined the clinical and demographic correlates of insight at baseline, the relationship between baseline insight and treatment participation, the relationship between treatment participation and post-treatment insight, and the relationship between change in insight and change in other clinical variables. Impaired insight was relatively common, with roughly half the sample demonstrating mild or moderate impairment at baseline. Baseline insight was associated with fewer psychotic and disorganized symptoms, and greater emotional discomfort and PTSD knowledge, but was not associated with negative symptoms, PTSD symptoms, depression/anxiety, or treatment participation. Participation in PTSD treatment was associated with increased insight at post-treatment. Improved insight was associated with improvements in disorganization and negative symptoms, but not with knowledge of PTSD or positive symptoms. The findings suggest that engagement in treatment that includes educating people about PTSD may lead to improvements in insight and related improvements in other psychiatric symptoms. Copyright © 2016 Elsevier Inc. All rights reserved.

  17. Health care utilization by United Nations peacekeeping veterans with co-occurring, self-reported, post-traumatic stress disorder and depression symptoms versus those without.

    Science.gov (United States)

    Stapleton, Jennifer A; Asmundson, Gordon J G; Woods, Meghan; Taylor, Steven; Stein, Murray B

    2006-06-01

    It remains to be determined whether patients with comorbid post-traumatic stress disorder (PTSD) and depression use more health care resources than do those without. United Nations peacekeeping veterans from Canada were divided into four groups, i.e., PTSD alone (n = 23), depression alone (n = 167), comorbid PTSD and depression (n = 119), and neither (n = 164), and compared with respect to total number of visits to any health care professional in the past year. Analysis of variance revealed that the groups significantly differed in total visits. Post hoc analyses indicated that veterans with co-occurring PTSD and depression symptoms had more visits than did those in the other groups and that veterans with PTSD symptoms alone and depression symptoms alone had more visits than did those with neither PTSD nor depression. Additional analyses revealed that veterans with co-occurring PTSD and depression symptoms made more visits to general practitioners, specialists, pharmacists, and mental health professionals than did the others. Future research directions and implications for treatment planning are discussed.

  18. The Impact of the Incredible Years Parent, Child, and Teacher Training Programs on Children’s Co-Occurring Internalizing Symptoms

    Science.gov (United States)

    Herman, Keith C.; Borden, Lindsay A.; Reinke, Wendy M.; Webster-Stratton, Carolyn

    2014-01-01

    The Incredible Years (IY) Series includes separate group interventions to improve parenting interactions, teacher classroom management, and child social-emotional regulation. Although originally developed to treat early-onset conduct problems, IY targets many of the proposed mechanisms and risk factors for internalizing distress in early childhood. Prior studies have demonstrated the effects of the IY parent intervention on co-occurring depressive symptoms. We attempted to extend these findings by examining the unique and combined effects of IY interventions on children’s co-occurring internalizing symptoms. Families of 159, 4- to 8-year-old children were randomly assigned to parent training (PT); parent plus teacher training (PT +TT); child training (CT); child plus teacher training (CT + TT); parent, child, plus teacher training (PT+CT+TT); or a waiting list control group. Children who received any of the intervention components were more likely to have lower mother-rated internalizing symptoms at post-treatment compared to children in a wait-list control group. Implications for future research and for designing interventions and prevention strategies for children with internalizing symptoms are discussed. PMID:25197205

  19. Patient characteristics, comorbidities, and medication use for children with ADHD with and without a co-occurring reading disorder: A retrospective cohort study

    Directory of Open Access Journals (Sweden)

    Classi Peter M

    2011-12-01

    Full Text Available Abstract Background Children and adolescents with attention-deficit/hyperactivity disorder (ADHD often have a co-occurring reading disorder (RD. The purpose of this research was to assess differences between children with ADHD without RD (ADHD-only and those with ADHD and co-occurring RD (ADHD+RD. Methods Using data from the U.S. Thomson Reuter Marketscan® Databases for the years 2005 through 2007, this analysis compared the medical records--including patient demographics, comorbidities, and medication use--of children (age Results Patients with ADHD+RD were significantly younger, more likely to have received a procedure code associated with formal psychological or non-psychological testing, and more likely to have been diagnosed with comorbid bipolar disorder, conduct disorder, or depression. They were no more likely to have received an antidepressant, anti-manic (bipolar, or antipsychotic, and were significantly less likely to have received a prescription for a stimulant medication. Conclusions Relying on a claims database, there appear to be differences in the patient characteristics, comorbidities, and medication use when comparing children with ADHD-only to those with ADHD+RD.

  20. Prevalence and pattern of co-occurring musculoskeletal pain and its association with back-related disability among people with persistent low back pain: protocol for a systematic review and meta-analysis.

    Science.gov (United States)

    Overaas, Cecilie K; Johansson, Melker S; de Campos, Tarcisio F; Ferreira, Manuela L; Natvig, Bard; Mork, Paul J; Hartvigsen, Jan

    2017-12-16

    Individuals with persistent low back pain commonly have a broad range of other health concerns including co-occurring musculoskeletal pain, which significantly affect their quality of life, symptom severity, and treatment outcomes. The purpose of this review is to get a better understanding of prevalence and patterns of co-occurring musculoskeletal pain complaints in those with persistent low back pain and its potential association with age, sex, and back-related disability as it might affect prognosis and management. This systematic review protocol has been designed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Protocols. We will perform a comprehensive search, with no date limit, in the following bibliographic databases: MEDLINE and Embase (via Ovid), CINAHL, and Scopus for citation tracking, based on the following domains: back pain, co-occurring musculoskeletal pain, combined with a focus group that emphasizes study design. Appropriate papers will be screened against the eligibility criteria by three reviewers independently, data extracted by two independent author pairs and disagreement resolved by consensus meetings or other reviewers if required. Assessment of methodological quality and risk of bias will be conducted using a modified version of the Risk of Bias Tool for Prevalence Studies developed by Hoy and colleagues. The overall risk of bias will be determined for each included study based on the raters' consensus of the responses to the items in this tool. In case of sufficiently homogenous studies, meta-analysis will be performed. Given the lack of standard terms used to define co-occurring musculoskeletal pain, the search strategy will include the broader term "back pain," different terms for the "other co-occurring pain," and specific study designs combined with several exclusion terms. The results of this proposed review will identify the prevalence and patterns of co-occurring musculoskeletal pain among those

  1. The effectiveness of integrated treatment in patients with substance use disorders co-occurring with anxiety and/or depression--a group randomized trial.

    Science.gov (United States)

    Wüsthoff, Linda E; Waal, Helge; Gråwe, Rolf W

    2014-03-05

    Integrated Treatment (IT) has proved effective in treating patients with Substance Use Disorders (SUD) co-occurring with severe Mental Disorders (MD), less is known about the effectiveness of IT for patients with SUD co-occurring with less severe MD.The aim of this study was to investigate the effectiveness of IT for patients with SUD co-occurring with anxiety and/or depression on the following parameters:1. The use of substances, as measured by the Alcohol Use Identification Test (AUDIT), the Drug Use Identification Test (DUDIT), and the Addiction Severity Index (EuropASI).2. The severity of psychiatric symptoms, as measured by the Symptom Check List 90 r (SCL 90R).3. The client's motivation for changing his/her substance use behaviour, as measured by the Substance Abuse Treatment Scale (SATSr). This is a group randomized clinical trial comparing the effectiveness of IT to treatment as usual in Community Mental Health Centres (CMHCs). Five CMHCs were drawn to the Intervention Group (IG) and four CMHCs to the Control Group (CG). The allocation to treatment conditions was not blinded. New referrals were screened with the AUDIT and the DUDIT. Those who scored above the cut-off level of these instruments were assessed with the Structured Clinical Interview for DSM-IV 1 and 2. We included patients with anxiety and/or depression together with one or more SUDs. We included 55 patients in the IG and 21 in the CG. A linear multilevel model was used. Both groups reduced their alcohol and substance use during the trial, while there was no change in psychiatric symptoms in either group. However, the IG had a greater increase in motivation for substance use treatment after 12 months than had the CG with an estimate of 1.76, p = 0.043, CI95% (0.08; 3.44) (adjusted analyses). There were no adverse events. Integrated treatment is effective in increasing the motivation for treatment amongst patients with anxiety and/or depression together with SUD in outpatient clinics. Clinical

  2. An Online Intervention for Co-Occurring Depression and Problematic Alcohol Use in Young People: Primary Outcomes From a Randomized Controlled Trial.

    Science.gov (United States)

    Deady, Mark; Mills, Katherine L; Teesson, Maree; Kay-Lambkin, Frances

    2016-03-23

    Depression and problematic alcohol use represent two of the major causes of disease burden in young adults. These conditions frequently co-occur and this is associated with increased harm and poorer outcomes than either disorder in isolation. Integrated treatments have been shown to be effective; however, there remains a significant gap between those in need of treatment and those receiving it. The increased availability of eHealth programs presents a unique opportunity to treat these conditions. This study aimed to evaluate the feasibility and preliminary efficacy of an automated Web-based self-help intervention (DEAL Project) in treating co-occurring depressive symptoms and problematic alcohol use in young people. Young people (aged 18 to 25 years) with moderate depression symptoms and drinking at hazardous levels (recruited largely via social media) were randomly allocated to the DEAL Project (n=60) or a Web-based attention-control condition (HealthWatch; n=44). The trial consisted of a 4-week intervention phase with follow-up assessment at posttreatment and at 3 and 6 months postbaseline. The primary outcomes were change in depression severity according to the Patient Health Questionnaire-9 as well as quantity and frequency of alcohol use (TOT-AL). The DEAL Project was associated with statistically significant improvement in depression symptom severity (d=0.71) and reductions in alcohol use quantity (d=0.99) and frequency (d=0.76) in the short term compared to the control group. At 6-month follow-up, the improvements in the intervention group were maintained; however, the differences between the intervention and control groups were no longer statistically significant, such that between-group effects were in the small to moderate range at 6 months (depression symptoms: d=0.39; alcohol quantity: d=-0.09; alcohol frequency: d=0.24). Overall, the DEAL Project was associated with more rapid improvement in both depression symptoms and alcohol use outcomes in young

  3. Drivers of variability in water use of two co-occurring species in a subalpine forest in Jiuzhaigou Valley, Southwest of China

    Science.gov (United States)

    Yan, C.; Zhao, W.; Wang, Y.; Zhang, Q.; Qiu, G. Y.

    2016-12-01

    Co-occur species with different sensitivity to soil water may be particularly useful in evaluating water use by different forest stands as well as the response of species distribution, forest structure and stand composition to soil water availability in water-limited area. To clarify the species-specific water use strategy and provide insights into the possible succession trend, variations in sap flow and environmental conditions were investigated for two co-occur species (Betula albo-sinensis and Pinus tabulaeformis) in a mixed forest in Jiuzhaigou Valley in 2014. Sap flow was measured by Granier-type thermal dissipation probes and soil water content was measured by time-domain reflectometry probes for a successive period. Pinus tabulaeformis and Betua albo-sinensis species showed different responses to meteorological factors under different soil water conditions. Despite that whole tree water use was much higher for Pinus tabulaeformis due to greater sapwood area, sap flux density of the other co-occurring species Betua albo-sinensis was higher throughout the growing season. Normalized sap flux density (Fd) could be mostly well fitted to solar radiation (Rs), vapor pressure deficit (VPD), or the variable of transpiration (VT) by the exponential saturation function. Much better fitted curves were found for Fd -VPD and Fd - VT datasets than Fd - Rs datasets. For most datasets, normalized Fd increased rapidly when the environmental factors were below their threshold values, but reached an asymptote thereafter. Based on the species' differences in fitting parameters and the average maximum sap flow level under different soil water conditions, it was concluded that Pinus tabulaeformis was sensitive to soil water conditions and tolerant of low soil water availability, while Betua albo-sinensis was insensitive to soil moisture and needed to access to similarly high amount of soil water in the growing season after leaf expansion. These results indicated possible

  4. Pre- and perinatal complications in relation to Tourette syndrome and co-occurring obsessive-compulsive disorder and attention-deficit/hyperactivity disorder

    DEFF Research Database (Denmark)

    Abdulkadir, Mohamed; Tischfield, Jay A; King, Robert A

    2016-01-01

    -deficit/hyperactivity disorder (ADHD) in individuals with a tic disorder. Therefore, we aimed to investigate the role of pre- and perinatal complications in relation to the presence and symptom severity of chronic tic disorder and co-occurring OCD and ADHD using data of 1113 participants from the Tourette International...... Collaborative Genetics study. This study included 586 participants with a chronic tic disorder and 527 unaffected family controls. We controlled for age and sex differences by creating propensity score matched subsamples for both case-control and within-case analyses. We found that premature birth (OR = 1.......72) and morning sickness requiring medical attention (OR = 2.57) were associated with the presence of a chronic tic disorder. Also, the total number of pre- and perinatal complications was higher in those with a tic disorder (OR = 1.07). Furthermore, neonatal complications were related to the presence (OR = 1...

  5. Is There a Relationship Between Tic Frequency and Physiological Arousal? Examination in a Sample of Children With Co-Occurring Tic and Anxiety Disorders.

    Science.gov (United States)

    Conelea, Christine A; Ramanujam, Krishnapriya; Walther, Michael R; Freeman, Jennifer B; Garcia, Abbe M

    2014-03-01

    Stress is the contextual variable most commonly implicated in tic exacerbations. However, research examining associations between tics, stressors, and the biological stress response has yielded mixed results. This study examined whether tics occur at a greater frequency during discrete periods of heightened physiological arousal. Children with co-occurring tic and anxiety disorders (n = 8) completed two stress-induction tasks (discussion of family conflict, public speech). Observational (tic frequencies) and physiological (heart rate [HR]) data were synchronized using The Observer XT, and tic frequencies were compared across periods of high and low HR. Tic frequencies across the entire experiment did not increase during periods of higher HR. During the speech task, tic frequencies were significantly lower during periods of higher HR. Results suggest that tic exacerbations may not be associated with heightened physiological arousal and highlight the need for further tic research using integrated measurement of behavioral and biological processes. © The Author(s) 2014.

  6. Provider Experiences with Prison Care and Aftercare for Women with Co-occurring Mental Health and Substance Use Disorders: Treatment, Resource, and Systems Integration Challenges.

    Science.gov (United States)

    Johnson, Jennifer E; Schonbrun, Yael Chatav; Peabody, Marlanea E; Shefner, Ruth T; Fernandes, Karen M; Rosen, Rochelle K; Zlotnick, Caron

    2015-10-01

    Incarcerated women with co-occurring mental health and substance use disorders (COD) face complex psychosocial challenges at community reentry. This study used qualitative methods to evaluate the perspectives of 14 prison and aftercare providers about service delivery challenges and treatment needs of reentering women with COD. Providers viewed the needs of women prisoners with COD as distinct from those of women with substance use alone and from men with COD. Providers described optimal aftercare for women with COD as including contact with the same provider before and after release, access to services within 24-72 hours after release, assistance with managing multiple social service agencies, assistance with relationship issues, and long-term follow-up. Providers also described larger service system and societal issues, including systems integration and ways in which a lack of prison and community aftercare resources impacted quality of care and reentry outcomes. Practice and policy implications are provided.

  7. Referral for substance abuse treatment and depression improvement among patients with co-occurring disorders seeking behavioral health services in primary care.

    Science.gov (United States)

    Chan, Ya-Fen; Huang, Hsiang; Bradley, Katharine; Unützer, Jürgen

    2014-02-01

    This study examined the relationship between substance treatment referrals and depression improvement among 2,373 participants with concurrent substance use and depressive disorders enrolled in an integrated behavioral health program. Three groups of substance treatment referral status were identified: accessed treatment (n=780), declined treatment (n=315), and no referral for treatment (n=1278). The primary outcome is improvement in depressive symptoms (PHQ-9substance treatment were significantly more likely to achieve depression improvement than those who declined receiving treatment services (hazard ratio (HR)=1.82, 95% confidence interval (CI): 1.50-2.20, ptreatment (HR=1.13, 95% CI: 1.03-1.25, p=0.014). Each 1 week delay in initiating a referral was associated with a decreased likelihood of depression improvement (HR=0.97, 95% CI: 0.96-0.98, ptreatment contact for co-occurring substance use disorders in primary care. © 2013.

  8. Treatment Access Barriers and Disparities Among Individuals with Co-Occurring Mental Health and Substance Use Disorders: An Integrative Literature Review.

    Science.gov (United States)

    Priester, Mary Ann; Browne, Teri; Iachini, Aidyn; Clone, Stephanie; DeHart, Dana; Seay, Kristen D

    2016-02-01

    The purpose of this integrative review is to examine and synthesize extant literature pertaining to barriers to substance abuse and mental health treatment for persons with co-occurring substance use and mental health disorders (COD). Electronic searches were conducted using ten scholarly databases. Thirty-six articles met inclusion criteria and were examined for this review. Narrative review of these articles resulted in the identification of two primary barriers to treatment access for individuals with COD: personal characteristics barriers and structural barriers. Clinical implications and directions for future research are discussed. In particular, additional studies on marginalized sub-populations are needed, specifically those that examine barriers to treatment access among older, non-White, non-heterosexual populations. Copyright © 2015 Elsevier Inc. All rights reserved.

  9. Use of integrated dual disorder treatment via assertive community treatment versus clinical case management for persons with co-occurring disorders and antisocial personality disorder.

    Science.gov (United States)

    Frisman, Linda K; Mueser, Kim T; Covell, Nancy H; Lin, Hsiu-Ju; Crocker, Anne; Drake, Robert E; Essock, Susan M

    2009-11-01

    We conducted secondary analyses of data from a randomized trial testing the effectiveness of Assertive Community Treatment (ACT) in delivery of integrated dual disorder treatment (IDDT) to explore the impact of IDDT delivered through ACT teams compared with standard clinical case management for dually-disordered persons with and without antisocial personality disorder (ASPD). This analysis included 36 individuals with ASPD and 88 individuals without ASPD. Participants with ASPD assigned to ACT showed a significantly greater reduction in alcohol use and were less likely to go to jail than those in standard clinical case management, whereas participants without ASPD did not differ between the 2 case management approaches. There were no significant differences for other substance use or criminal justice outcomes. This study provides preliminary evidence that persons with co-occurring serious mental illness, substance use disorders, and ASPD may benefit from delivery of IDDT through ACT teams.

  10. Early maladaptive schema-related impairment and co-occurring current major depressive episode-related enhancement of mental state decoding ability in borderline personality disorder.

    Science.gov (United States)

    Unoka, Zsolt Szabolcs; Fogd, Dóra; Seres, Imola; Kéri, Szabolcs; Csukly, Gábor

    2015-04-01

    Disturbed interpersonal relationships specific to borderline personality disorder (BPD) suggest biased processing of social information. The goal of this study was to examine alterations in mental state decoding (MSD) and their associations with early maladaptive schemas (EMS) that may lead to the misinterpretation of incoming information. In addition, the authors' aim was to evaluate the effects of a co-occurring current major depressive episode (MDE) on the MSD performance of BPD patients. Seventy-eight BPD patients (34 with MDE) and 76 matched healthy controls (HC) were assessed for Reading the Mind in the Eyes Test (RMET) and the level of EMS. The authors found that impairment in the total RMET performance, as well as specific impairment regarding the recognition of positive and neutral items, was associated with EMS, and enhanced vigilance to negative mental states was characteristic to BPD with MDE. Results suggest that MSD ability is altered in two independent ways in BPD.

  11. Differences in Characteristics and Treatment Received among Depressed Adolescent Psychiatric Outpatients with and without Co-Occuring Alcohol Misuse: A 1-Year Follow-Up Study.

    Science.gov (United States)

    Pirkola, Tiia; Pelkonen, Mirjami; Karlsson, Linnea; Kiviruusu, Olli; Strandholm, Thea; Tuisku, Virpi; Ruuttu, Titta; Marttunen, Mauri

    2011-01-01

    Objectives. We aimed at examining the differences between depressed psychiatric adolescent outpatients with and without cooccurring alcohol misuse in psychosocial background, clinical characteristics, and treatment received during one-year followup. Furthermore, we investigated factors related to nonattendance at treatment. Materials and Methods. Consecutive 156 adolescent (13-19 years) psychiatric outpatients with a unipolar depressive disorder at baseline were interviewed using structured measures at baseline and at 12 months. Alcohol misuse was defined as having an AUDIT score of 8 or more points. The outpatients received "treatment as usual" of clinically defined duration. Results. Among depressive outpatients, poor parental support, parental alcohol use and decreased attendance at treatment associated with alcohol misuse. The severity of alcohol use as measured by AUDIT-score was the strongest factor independently predicting nonattendance at treatment in multivariate analysis. Conclusions. Alcohol misuse indicates family problems, has a deleterious effect on treatment attendance, and should be taken into account when managing treatment for depressive adolescent outpatients.

  12. Treating Co-Occurring Axis I Disorders in Recurrently Suicidal Women with Borderline Personality Disorder: A 2-Year Randomized Trial of Dialectical Behavior Therapy versus Community Treatment by Experts

    Science.gov (United States)

    Harned, Melanie S.; Chapman, Alexander, L.; Dexter-Mazza, Elizabeth T.; Murray, Angela; Comtois, Katherine A.; Linehan, Marsha M.

    2008-01-01

    This study evaluated whether dialectical behavior therapy (DBT) was more efficacious than treatment by nonbehavioral psychotherapy experts in reducing co-occurring Axis I disorders among suicidal individuals with borderline personality disorder (BPD). Women with BPD and recent and repeated suicidal and/or self-injurious behavior (n = 101) were…

  13. Differentials and trends in emergency department visits due to alcohol intoxication and co-occurring conditions among students in a U.S. public university.

    Science.gov (United States)

    Ngo, Duc Anh; Ait-Daoud, Nassima; Rege, Saumitra V; Ding, Christopher; Gallion, Lauren; Davis, Susan; Holstege, Christopher P

    2018-02-01

    Few studies have explored the epidemiology of students presenting to the emergency department (ED) as a consequence of hazardous drinking. This study examined differentials and trends in ED visits following alcohol intoxication and co-occurring conditions among students presenting to a major U.S. university health system. The ED electronic medical records from academic years 2010-2015 were queried for student visits and their records were linked to the university's student admission datasets. Student alcohol-related visits were identified based on ICD-9 codes. Student characteristics and trends in the rate of alcohol intoxication per 100 ED student visits were analyzed. A random sample of 600 student clinical records were reviewed to validate diagnostic codes. There were 9616 student ED visits (48% males) to the ED of which 1001 (10.4%) visits involved alcohol intoxication. Two thirds of ED visits with alcohol intoxication had a co-occurring diagnosis, with injuries (24%) being the most common condition. The rate of alcohol intoxication varied greatly by student demographics and campus-related factors. There was a linear increase in the rate of alcohol intoxication from 7.9% in 2009-10 to 12.3% in 2014-15 (pstudents, students below 20 years of age, Asian students, and student athletes. In the sample reviewed, only two thirds of ED visits with alcohol intoxication were recorded by diagnostic codes. The rate of ED visits following alcohol intoxication varied by student demographic characteristics and campus-related factors with a rising trend over the study period. Copyright © 2017 Elsevier B.V. All rights reserved.

  14. Use of selective-serotonin reuptake inhibitors and platelet aggregation inhibitors among individuals with co-occurring atherosclerotic cardiovascular disease and depression or anxiety

    Directory of Open Access Journals (Sweden)

    J Douglas Thornton

    2016-12-01

    Full Text Available Objective: Medications commonly used to treat heart disease, anxiety, and depression can interact resulting in an increased risk of bleeding, warranting a cautious approach in medical decision making. This retrospective, descriptive study examined the prevalence and the factors associated with the use of both selective-serotonin reuptake inhibitor and platelet aggregation inhibitor among individuals with co-occurring atherosclerotic cardiovascular disease and anxiety or depression. Methods: Respondents aged 22 years and older, alive throughout the study period, and diagnosed with co-occurring atherosclerotic cardiovascular disease and anxiety or depression (n = 1507 in years 2007 through 2013 of the Medical Expenditures Panel Survey were included. The use of treatment was grouped as follows: selective-serotonin reuptake inhibitor and platelet aggregation inhibitor, selective-serotonin reuptake inhibitor or platelet aggregation inhibitor, and neither selective-serotonin reuptake inhibitor nor platelet aggregation inhibitor. Results: Overall, 16.5% used both selective-serotonin reuptake inhibitor and platelet aggregation inhibitor, 61.2% used selective-serotonin reuptake inhibitor or platelet aggregation inhibitor, and 22.3% used neither selective-serotonin reuptake inhibitor nor platelet aggregation inhibitor. Respondents aged over 65 years (adjusted odds ratio = 1.93 (95% confidence interval = 1.08–3.45 and having a diagnosis of diabetes (adjusted odds ratio = 1.63 (95% confidence interval = 1.15–2.31 and hypertension (adjusted odds ratio = 1.84 (95% confidence interval = 1.04–3.27 were more likely to be prescribed the combination. Conclusion: The drug interaction was prevalent in patients who are already at higher risk of health disparities and worse outcomes thus requiring vigilant evaluation.

  15. Electrophysiological evidence of the time course of attentional bias in nonpatients reporting symptoms of depression with and without co-occurring anxiety

    Directory of Open Access Journals (Sweden)

    Sarah M. Sass

    2014-04-01

    Full Text Available Anxiety is characterized by attentional biases to threat, but findings are inconsistent for depression. To address this inconsistency, the present study systematically assessed the role of co-occurring anxiety in attentional bias in depression. In addition, the role of emotional valence, arousal, and gender was explored. Ninety-two nonpatients completed the Penn State Worry Questionnaire (PSWQ; Meyer et al., 1990; Molina & Borkovec, 1994 and portions of the Mood and Anxiety Symptom Questionnaire (MASQ; Watson, Clark, et al., 1995; Watson, Weber, et al., 1995. Individuals reporting high levels of depression and low levels of anxiety (depression only, high levels of depression and anxiety (combined, or low levels of both (control completed an emotion-word Stroop task during event-related brain potential (ERP recording. Pleasant and unpleasant words were matched on emotional arousal level. An attentional bias was not evident in the depression-only group. Women in the combined group had larger N200 amplitude for pleasant than unpleasant stimuli, and the combined group as a whole had larger right-lateralized P300 amplitude for pleasant than unpleasant stimuli, consistent with an early and later attentional bias that is specific to unpleasant valence in the combined group. Men in the control group had larger N200 amplitude for pleasant than unpleasant stimuli, consistent with an early attentional bias that is specific to pleasant valence. The present study indicates that the nature and time course of attention prompted by emotional valence and not arousal differentiates depression with and without anxiety, with some evidence of gender moderating early effects. Overall, results suggest that co-occurring anxiety is more important than previously acknowledged in demonstrating evidence of attentional biases in depression.

  16. An invasive clonal plant benefits from clonal integration more than a co-occurring native plant in nutrient-patchy and competitive environments.

    Science.gov (United States)

    You, Wenhua; Fan, Shufeng; Yu, Dan; Xie, Dong; Liu, Chunhua

    2014-01-01

    Many notorious invasive plants are clonal, however, little is known about the different roles of clonal integration effects between invasive and native plants. Here, we hypothesize that clonal integration affect growth, photosynthetic performance, biomass allocation and thus competitive ability of invasive and native clonal plants, and invasive clonal plants benefit from clonal integration more than co-occurring native plants in heterogeneous habitats. To test these hypotheses, two stoloniferous clonal plants, Alternanthera philoxeroides (invasive), Jussiaea repens (native) were studied in China. The apical parts of both species were grown either with or without neighboring vegetation and the basal parts without competitors were in nutrient- rich or -poor habitats, with stolon connections were either severed or kept intact. Competition significantly reduced growth and photosynthetic performance of the apical ramets in both species, but not the biomass of neighboring vegetation. Without competition, clonal integration greatly improved the growth and photosynthetic performance of both species, especially when the basal parts were in nutrient-rich habitats. When grown with neighboring vegetation, growth of J. repens and photosynthetic performance of both species were significantly enhanced by clonal integration with the basal parts in both nutrient-rich and -poor habitats, while growth and relative neighbor effect (RNE) of A. philoxeroides were greatly improved by clonal integration only when the basal parts were in nutrient-rich habitats. Moreover, clonal integration increased A. philoxeroides's biomass allocation to roots without competition, but decreased it with competition, especially when the basal ramets were in nutrient-rich sections. Effects of clonal integration on biomass allocation of J. repens was similar to that of A. philoxeroides but with less significance. These results supported our hypothesis that invasive clonal plants A. philoxeroides benefits

  17. An invasive clonal plant benefits from clonal integration more than a co-occurring native plant in nutrient-patchy and competitive environments.

    Directory of Open Access Journals (Sweden)

    Wenhua You

    Full Text Available Many notorious invasive plants are clonal, however, little is known about the different roles of clonal integration effects between invasive and native plants. Here, we hypothesize that clonal integration affect growth, photosynthetic performance, biomass allocation and thus competitive ability of invasive and native clonal plants, and invasive clonal plants benefit from clonal integration more than co-occurring native plants in heterogeneous habitats. To test these hypotheses, two stoloniferous clonal plants, Alternanthera philoxeroides (invasive, Jussiaea repens (native were studied in China. The apical parts of both species were grown either with or without neighboring vegetation and the basal parts without competitors were in nutrient- rich or -poor habitats, with stolon connections were either severed or kept intact. Competition significantly reduced growth and photosynthetic performance of the apical ramets in both species, but not the biomass of neighboring vegetation. Without competition, clonal integration greatly improved the growth and photosynthetic performance of both species, especially when the basal parts were in nutrient-rich habitats. When grown with neighboring vegetation, growth of J. repens and photosynthetic performance of both species were significantly enhanced by clonal integration with the basal parts in both nutrient-rich and -poor habitats, while growth and relative neighbor effect (RNE of A. philoxeroides were greatly improved by clonal integration only when the basal parts were in nutrient-rich habitats. Moreover, clonal integration increased A. philoxeroides's biomass allocation to roots without competition, but decreased it with competition, especially when the basal ramets were in nutrient-rich sections. Effects of clonal integration on biomass allocation of J. repens was similar to that of A. philoxeroides but with less significance. These results supported our hypothesis that invasive clonal plants A

  18. Pathways to change: Use trajectories following trauma-informed treatment of women with co-occurring post-traumatic stress disorder and substance use disorders.

    Science.gov (United States)

    López-Castro, Teresa; Hu, Mei-Chen; Papini, Santiago; Ruglass, Lesia M; Hien, Denise A

    2015-05-01

    Despite advances towards integration of care for women with co-occurring substance use disorder (SUD) and post-traumatic stress disorder (PTSD), low abstinence rates following SUD/PTSD treatment remain the norm. The utility of investigating distinct substance use trajectories is a critical innovation in the detection and refining of effective interventions for this clinical population. The present study reanalysed data from the largest randomised clinical trial to date for co-occurring SUD and PTSD in women (National Drug Abuse Treatment Clinical Trials Network; Women and Trauma Study). Randomised participants (n = 353) received one of two interventions in addition to treatment as usual for SUD: (i) trauma-informed integrative treatment for PTSD/SUD; or (ii) an active control psychoeducation course on women's health. The present study utilised latent growth mixture models (LGMM) with multiple groups to estimate women's substance use patterns during the 12-month follow-up period. Findings provided support for three different trajectories of substance use in the post-treatment year: (i) consistently low likelihood and use frequency; (ii) consistently high likelihood and use frequency; and (iii) high likelihood and moderate use frequency. Covariate analyses revealed improvement in PTSD severity was associated with membership in a specific substance use trajectory, although receiving trauma-informed treatment was not. Additionally, SUD severity, age and after-care efforts were shown to be related to trajectory membership. Findings highlight the necessity of accounting for heterogeneity in post-treatment substance use, relevance of trauma-informed care in SUD recovery and benefits of incorporating methodologies like LGMM when evaluating SUD treatment outcomes. © 2015 Australasian Professional Society on Alcohol and other Drugs.

  19. Impact of Meditation on Mental Health Outcomes of Female Trauma Survivors of Interpersonal Violence With Co-Occurring Disorders: A Randomized Controlled Trial.

    Science.gov (United States)

    Lee, Mo Yee; Zaharlick, Amy; Akers, Deborah

    2015-07-05

    This study was a randomized controlled trial that examined the impact of meditation practice on the mental health outcomes of female trauma survivors of interpersonal violence who have co-occurring disorders. Sixty-three female trauma survivors were randomly assigned to the meditation condition and the control condition. Treatment conditions consisted of a 6-week meditation curriculum that was influenced by Tibetan meditation tradition and focused on breathing, loving kindness, and compassion meditation. Clients in the meditation condition made significant changes in mental health symptoms (t = 5.252, df = 31, p = .000) and trauma symptoms (t = 6.009, df = 31, p = .000) from pre-treatment to post-treatment, whereas non-significant changes were observed among the control condition clients. There were significant group differences between clients in the meditation condition and in the control condition on their mental health symptoms, F(1, 54) = 13.438, p = .001, and trauma symptoms, F(1, 54) = 13.395, p = .001, with a generally large effect size of eta squared .127 and .146, respectively. In addition, significantly more clients in the meditation condition achieved reliable change in mental health symptoms (35.5% vs. 8.3%) and trauma symptoms (42.3% vs. 4.8%) than clients in the control condition. Significance of the study is discussed with respect to the empirical evidence of meditation practice as a complementary behavioral intervention for treating female trauma survivors of interpersonal violence who have co-occurring disorders. © The Author(s) 2015.

  20. A Randomized Controlled Trial Comparing Integrated Cognitive Behavioral Therapy Versus Individual Addiction Counseling for Co-occurring Substance Use and Posttraumatic Stress Disorders.

    Science.gov (United States)

    McGovern, Mark P; Lambert-Harris, Chantal; Alterman, Arthur I; Xie, Haiyi; Meier, Andrea

    2011-01-01

    OBJECTIVE: Co-occurring posttraumatic stress (PTSD) and substance use disorders provide clinical challenges to addiction treatment providers. Interventions are needed that are effective, well-tolerated by patients, and capable of being delivered by typical clinicians in community settings. This is a randomized controlled trial of integrated cognitive behavioral therapy for co-occurring PTSD and substance use disorders. METHODS: Fifty-three participants sampled from seven community addiction treatment programs were randomized to integrated cognitive behavioral therapy plus standard care or individual addiction counseling plus standard care. Fourteen community therapists employed by these programs delivered both manual-guided therapies. Primary outcomes were PTSD symptoms, substance use symptoms and therapy retention. Participants were assessed at baseline, 3- and 6-month follow-up. RESULTS: Integrated cognitive behavioral therapy was more effective than individual addiction counseling in reducing PTSD re-experiencing symptoms and PTSD diagnosis. Individual addiction counseling was comparably effective to integrated cognitive behavioral therapy in substance use outcomes and on other measures of psychiatric symptom severity. Participants assigned to individual addiction counseling with severe PTSD were less likely to initiate and engage in the therapy than those assigned to integrated cognitive behavioral therapy. In general, participants with severe PTSD were more likely to benefit from integrated cognitive behavioral therapy. CONCLUSIONS: The findings support the promise of efficacy of integrated cognitive behavioral therapy in improving outcomes for persons in addiction treatment with PTSD. Community counselors delivered both interventions with satisfactory adherence and competence. Despite several limitations to this research, a larger randomized controlled trial of integrated cognitive behavioral therapy appears warranted.

  1. Patterns of co-occurring addictions, posttraumatic stress disorder, and major depressive disorder in detoxification treatment seekers: Implications for improving detoxification treatment outcomes.

    Science.gov (United States)

    Anderson, RaeAnn E; Hruska, Bryce; Boros, Alec P; Richardson, Christopher J; Delahanty, Douglas L

    2018-03-01

    Poly-substance use and psychiatric comorbidity are common among individuals receiving substance detoxification services. Posttraumatic stress disorder (PTSD) and major depressive disorder (MDD) are the most common co-occurring psychiatric disorders with substance use disorder (SUD). Current treatment favors a one-size-fits-all approach to treating addiction focusing on one substance or one comorbidity. Research examining patterns of substance use and comorbidities can inform efforts to effectively identify and differentially treat individuals with co-occurring conditions. Using latent class analysis, the current study identified four patterns of PTSD, MDD, and substance use among 375 addiction treatment seekers receiving medically supervised detoxification. The four identified classes were: 1) a PTSD-MDD-Poly SUD class characterized by PTSD and MDD occurring in the context of opioid, cannabis, and tobacco use disorders; 2) an MDD-Poly SUD class characterized by MDD and alcohol, opioid, tobacco, and cannabis use disorders; 3) an alcohol-tobacco class characterized by alcohol and tobacco use disorders; and 4) an opioid-tobacco use disorder class characterized by opioid and tobacco use disorders. The observed classes differed on gender and clinical characteristics including addiction severity, trauma history, and PTSD/MDD symptom severity. The observed classes likely require differing treatment approaches. For example, people in the PTSD-MDD-Poly SUD class would likely benefit from treatment approaches targeting anxiety sensitivity and distress tolerance, while the opioid-tobacco class would benefit from treatments that incorporate motivational interviewing. Appropriate matching of treatment to class could optimize treatment outcomes for polysubstance and comorbid psychiatric treatment seekers. These findings also underscore the importance of well-developed referral networks to optimize outpatient psychotherapy for detoxification treatment-seekers to enhance long

  2. Marijuana Use from Middle to High School: Co-occurring Problem Behaviors, Teacher-Rated Academic Skills and Sixth-Grade Predictors.

    Science.gov (United States)

    Ehrenreich, Heidi; Nahapetyan, Lusine; Orpinas, Pamela; Song, Xiao

    2015-10-01

    Rising marijuana use and its lowered perceived risk among adolescents highlight the importance of examining patterns of marijuana use over time. This study identified trajectories of marijuana use among adolescents followed from middle through high school, characterized these by co-occurring problem behaviors and teacher-rated academic skills (study skills, attention problems, and learning problems), and tested sixth-grade predictors of trajectory membership. The sample consisted of a randomly-selected cohort of 619 students assessed annually from sixth to twelfth grade. Using group-based modeling, we identified four trajectories of marijuana use: Abstainer (65.6%), Sporadic (13.9%), Experimental (11.5%), and Increasing (9.0%). Compared to Abstainers, students in the Sporadic, Experimental and Increasing trajectories reported significantly more co-occurring problem behaviors of alcohol use, cigarette smoking, and physical aggression. Sporadic and Experimental users reported significantly less smoking and physical aggression, but not alcohol use, than Increasing users. Teachers consistently rated Abstainers as having better study skills and less attention and learning problems than the three marijuana use groups. Compared to Abstainers, the odds of dropping out of high school was at least 2.7 times higher for students in the marijuana use trajectories. Dropout rates did not vary significantly between marijuana use groups. In sixth grade, being male, cigarette smoking, physical aggression and attention problems increased the odds of being in the marijuana use trajectories. Multiple indicators--student self-reports, teacher ratings and high school dropout records--showed that marijuana was not an isolated or benign event in the life of adolescents but part of an overall problem behavior syndrome.

  3. Three types of self-efficacy associated with medication adherence in patients with co-occurring HIV and substance use disorders, but only when mood disorders are present

    Directory of Open Access Journals (Sweden)

    Reif S

    2013-06-01

    Full Text Available Susan Reif,1 Rae Jean Proeschold-Bell,1,2 Jia Yao,1 Sara LeGrand,1,2 Anna Uehara,2 Edgar Asiimwe,2 Evelyn Byrd Quinlivan31Duke Center for Health Policy and Inequalities Research, 2Duke Global Health Institute, Duke University, Durham, NC, 3Center for Infectious Diseases, University of North Carolina Chapel Hill, Chapel Hill, NC, USABackground: Adherence with medication regimens for human immunodeficiency virus (HIV is a life-saving behavior for people with HIV infection, yet adherence is challenging for many individuals with co-occurring substance use and/or mood disorders. Medication-taking self-efficacy, which is the confidence that one can take one's medication as prescribed, is associated with better adherence with HIV medication. However, little is known about the influence that other kinds of self-efficacy have on adherence with HIV medication, especially among HIV-infected individuals with co-occurring substance use and/or mood disorders. We sought to examine the relationship between adherence with HIV medication among substance users and three specific kinds of self-efficacy, ie, one's confidence that one can communicate with medical providers, get support, and manage one's mood. We further sought to examine whether symptoms of depression and anxiety moderate these relationships.Methods: Patients were recruited from three HIV clinics in the southeastern United States as part of an integrated study of treatment for HIV and substance use.Results: We interviewed 154 patients with HIV and substance use who reported taking HIV medications. Based on symptoms of depression and anxiety using the Patient Health Questionnaire-9 and the Hospital Anxiety and Depression Scale-Anxiety, 63% had probable depression and/or anxiety. Higher levels of self-efficacy in provider communication (β = 3.86, P < 0.01, getting needed support (β = 2.82, P < 0.01, and mood management (β = 2.29, P < 0.05 were related to better self-reported adherence with HIV

  4. Responses to the multitargeted MET/ALK/ROS1 inhibitor crizotinib and co-occurring mutations in lung adenocarcinomas with MET amplification or MET exon 14 skipping mutation.

    Science.gov (United States)

    Jorge, Susan E; Schulman, Sol; Freed, Jason A; VanderLaan, Paul A; Rangachari, Deepa; Kobayashi, Susumu S; Huberman, Mark S; Costa, Daniel B

    2015-12-01

    Genomic aberrations involving ALK, ROS1 and MET can be driver oncogenes in lung adenocarcinomas. Identification of tyrosine kinase inhibitors (TKIs) with activity against these tumors and of preclinical systems to model response are warranted. We analyzed cases with lung adenocarcinomas for representative genomic aberrations, evaluated the response to the multitargeted MET/ALK/ROS1 crizotinib TKI in cases with MET aberrations and profiled lung cancer cell lines with the aforementioned genomic changes. Lung cancer cell lines with ALK rearrangement, ROS1 rearrangement or MET amplification had expected in vitro responses to crizotinib and the ALK/ROS1 TKI ceritinib. However, a commercially-available cell line with MET exon 14 skipping mutation and co-occurring PIK3CA-p.Glu545Lys mutation did not respond to crizotinib; suggesting the latter abrogated response. 10% of MET exon 14 skipping mutation co-occurred with PIK3CA mutation in the TCGA cohort. Putative crizotinib-responsive somatic mutations (ALK rearrangements, ROS1 rearrangements, high level MET amplification or MET exon 14 skipping mutations) were present in 10% of lung adenocarcinomas analyzed at our service and in 9.5% of the TCGA lung adenocarcinoma database. One patient each whose advanced tumors harbored high level MET amplification with wild-type PIK3CA or MET exon 14 skipping mutation with PIK3CA-p.Glu542Lys had significant responses to crizotinib; suggesting that PIK3CA co-mutation did not affect clinical response. Approximately 10% of lung adenocarcinomas harbor aberrations that are targetable using the approved multitargeted TKI crizotinib. MET exon 14 skipping mutation predicts for response to MET TKIs in human lung adenocarcinomas but co-occurrence of PIK3CA mutation needs to be better evaluated as a modifier of response to TKI therapy. MET TKIs should not be omitted from MET exon 14 skipping mutated tumors until further preclinical and clinical data can confirm or refute mechanisms of primary or

  5. To live or to die? Evidence of variable drivers of wood d13C reveal different responses to disturbance in co-occurring oaks

    Science.gov (United States)

    Reed, A. S.; Stephen, F. M.; Billings, S. A.

    2011-12-01

    A major oak decline event in recent decades in Northwest Arkansas permits insight into disturbance impacts on forests, which is important for understanding global carbon, nutrient and climate cycles given projections of increasing disturbance event frequency in the future. The decline event, associated with an increase in population of a native, wood-boring insect, followed a cycle of droughts and resulted in a mosaic of apparently healthy red oaks (Quercus rubra) neighboring severely declining trees of the same species. Tree-ring evidence suggests decreased growth rates following increases in the insect's population decades prior to visible external decline symptoms (i.e. decreased crown coverage, mortality), but only in trees destined to die during the insect outbreak. Reasons why some trees experienced mortality and some remained healthy are unclear. Through analysis of stable isotopes of carbon (δ13C) and oxygen (δ18O) in wood and leaf δ13C and nitrogen among co-occurring trees, we can infer differential responses of red oaks to disturbance and associated resilience to mortality. Tree-ring a-cellulose δ13C varied from -27.3to -23.0%, and δ18O values varied from 27.5 to 31.8%. Neither δ13C nor δ18O exhibited signficant differences between healthy and declining trees. However, declining trees exhibited a significant, positive relationship between δ13C and δ18O (p insect infestation. In contrast, apparently healthy individuals did not exhibit a significant relationship between these parameters, but exhibited significant, positive relationships between current year leaf δ13C and nitrogen content (pinsect infestation. Correlation between tree-ring δ13C and δ18O in dying trees suggests that trees destined to die during the infestation regulated their δ13C values primarily via stomatal conductance, a mechanism that influences both δ13C and δ18O. In contrast, δ13C values in apparently healthy trees did not vary with δ18O, indicating that stomatal

  6. Evaluating a brief, internet-based intervention for co-occurring depression and problematic alcohol use in young people: protocol for a randomized controlled trial.

    Science.gov (United States)

    Deady, Mark; Teesson, Maree; Kay-Lambkin, Frances; Mills, Katherine L

    2014-02-27

    Depression and alcohol misuse represent two of the major causes of disease burden in young adults. These conditions frequently co-occur and this co-occurrence is associated with increased risks and poorer outcomes than either disorder in isolation. Integrated treatments have been shown to be effective, however, there remains a significant gap between those in need of treatment and those receiving it, particularly in young people. The increased availability of Internet-based programs to complement health care presents a unique opportunity in the treatment of these conditions. The objective of our study was to evaluate whether a brief, Internet-based, self-help intervention (the DEAL [DEpression-ALcohol] Project) can be effective in treating co-occurring depression and problematic alcohol use in young people (18-25 years old). The evaluation will take the form of a randomized controlled trial (RCT), comparing the DEAL Project with an attention-control condition (HealthWatch). The RCT will consist of a four-week intervention phase and a 24-week follow-up. It will be entirely Internet-based and open Australia-wide to young people 18 to 25 years old. The primary outcomes will be change in depression symptoms and alcohol use at 5, 12, and 24 weeks post baseline. Secondary outcomes include change in general functioning and quality of life, anxiety/stress symptomatology, and a number of other depression/alcohol related outcomes. Process analysis will also measure engagement across the conditions. This study is currently ongoing with preliminary results expected in late 2014. This study, to our knowledge, will be the first RCT of a Internet-based treatment for comorbid depression and problematic alcohol use in any age group. If successful, the program represents a novel and innovative approach to addressing the significant harms associated with these conditions and will be an invaluable resource to those not receiving help elsewhere. Australian New Zealand Clinical Trials

  7. Feasibility of teaching motivational interviewing to parents of young adults with recent-onset schizophrenia and co-occurring cannabis use.

    Science.gov (United States)

    Smeerdijk, Maarten; Keet, René; de Haan, Lieuwe; Barrowclough, Christine; Linszen, Don; Schippers, Gerard

    2014-03-01

    This study examined the feasibility of providing motivational interviewing (MI) training to parents of young adults with recent-onset schizophrenia and co-occurring cannabis use. The training was offered in a mental health care setting as part of a family motivational intervention (FMI). Ninety-seven parents were randomly assigned to either FMI or routine family support (RFS). To obtain a measure of parent's MI skills at baseline and 3 months after they completed FMI, their role-play interactions with an actor portraying their child were coded. The coding method had satisfactory inter-rater reliability and internal consistency. At follow-up, parents in FMI showed significantly greater adherence to (p=.03) and competence in (p=.04) MI than parents in RFS. Parents in FMI also demonstrated significantly greater increases in expressing empathy (p=.01). These results demonstrate that FMI is a feasible method for increasing MI skills in parents. Additional research is needed to better understand the unique application of MI to parent-child interactions. © 2014.

  8. Co-occurring woody species have diverse hydraulic strategies and mortality rates during an extreme drought: Belowground hydraulic failure during drought

    Energy Technology Data Exchange (ETDEWEB)

    Johnson, Daniel M. [College of Natural Resources, University of Idaho, Moscow ID 83844 USA; Domec, Jean-Christophe [Bordeaux Sciences Agro, UMR INRA-ISPA 1391, Gradignan 33195 France; Nicholas School of the Environment, Duke University, Durham NC 27708 USA; Carter Berry, Z. [College of Natural Resources, University of Idaho, Moscow ID 83844 USA; Department of Natural Resources and the Environment, University of New Hampshire, Durham NH 03824 USA; Schwantes, Amanda M. [Nicholas School of the Environment, Duke University, Durham NC 27708 USA; McCulloh, Katherine A. [Department of Botany, University of Wisconsin-Madison, Madison WI 53705 USA; Woodruff, David R. [US Forest Service, Pacific Northwest Research Station, Corvallis OR 97331 USA; Wayne Polley, H. [Grassland, Soil & Water Research Laboratory USDA-Agricultural Research Service, Temple TX 76502 USA; Wortemann, Remí [INRA Nancy, UMR INRA-UL 1137 Ecologie et Ecophysiologie Forestières, Champenoux 54280 France; Swenson, Jennifer J. [Nicholas School of the Environment, Duke University, Durham NC 27708 USA; Scott Mackay, D. [Department of Geography, State University of New York, Buffalo NY 14261 USA; McDowell, Nate G. [Pacific Northwest National Laboratory, Richland WA 99352 USA; Jackson, Robert B. [Department of Earth System Science, Woods Institute for the Environment, and Precourt Institute for Energy, Stanford University, Stanford CA 94305 USA

    2018-01-29

    From 2011 to 2013, Texas experienced its worst drought in recorded history. This event provided a unique natural experiment to assess species-specific responses to extreme drought and mortality of four co-occurring woody species: Quercus fusiformis, Diospyros texana, Prosopis glandulosa and Juniperus ashei. We examined hypothesized mechanisms that could promote these species’ diverse mortality patterns using post-drought measurements on surviving trees coupled to retrospective process modeling. The species exhibited a wide range of gas exchange responses, hydraulic strategies, and mortality rates. Multiple proposed indices of mortality mechanisms were not consistent with the observed mortality patterns across species, including measures of iso/anisohydry, photosynthesis, carbohydrate depletion, and hydraulic safety margins. Large losses of growing season whole-tree conductance (driven by belowground losses of conductance), and shallower rooting depths, were associated with species that exhibited greater mortality. Based on this retrospective analysis, we suggest that species more vulnerable to drought were more likely to have succumbed to hydraulic failure belowground.

  9. Co-Occurring Trajectory of Mothers' Substance Use and Psychological Control and Children's Behavior Problems: The Effects of a Family Systems Intervention.

    Science.gov (United States)

    Zhang, Jing; Slesnick, Natasha; Feng, Xin

    2017-02-19

    This study examined the effects of a family systems therapy (Ecologically-Based Family Therapy [EBFT]) on the co-occurring trajectory of mothers' substance use and psychological control, and its association with children's problem behaviors. Participants included 183 mothers with a substance use disorder who had at least one biological child in their care. Mothers were randomly assigned to one of the three intervention conditions: EBFT-home, n = 62; EBFT-office, n = 61; or Women's Health Education, n = 60. Participants were assessed at baseline, 3, 6, 12, and 18 months post-baseline. A dual-trajectory class growth analysis identified three groups of mothers in regard to their change trajectories. The majority of the mothers exhibited a synchronous decrease in substance use and psychological control (n = 107). In all, 46 mothers exhibited a synchronous increase in substance use and psychological control. For the remaining 30 mothers, substance use and psychological control remained stable. Mothers in the family therapy condition were more likely to show reduced substance use and psychological control compared to mothers in the control condition. Moreover, children with mothers who showed decreased substance use and psychological control exhibited lower levels of problem behaviors compared to children with mothers showing increased substance use and psychological control. The findings provide evidence for the effectiveness of family systems therapy, EBFT, in treating mothers' substance use, improving parenting behaviors, and subsequently improving child behavioral outcomes. © 2017 Family Process Institute.

  10. A prospective study examining the effects of gender and sexual/physical abuse on mood outcomes in patients with co-occurring bipolar I and substance use disorders

    Science.gov (United States)

    Meade, Christina S.; McDonald, Leah J.; Graff, Fiona S.; Fitzmaurice, Garrett M.; Griffin, Margaret L.; Weiss, Roger D.

    2010-01-01

    Objectives Prior research suggests possible gender differences in the longitudinal course of bipolar disorder (BD). This study prospectively examined gender differences in mood outcomes and tested the effects of sexual/physical abuse and posttraumatic stress disorder (PTSD). Methods Participants (49 men, 41 women) with co-occurring bipolar I and substance use disorders (92% alcohol, 42% drug) were enrolled in a group treatment trial. They were followed for 8 months, with monthly assessments, yielding 32 weeks of data. Primary outcome measures were number of weeks in each mood state, recurrences to depression or mania, and polarity shifts from depression to mania or vice versa. Negative binomial regression was used to examine the effects of gender, lifetime abuse, and PTSD on these outcomes. Results Participants met syndromal criteria for a mood episode on a mean of 27% of 32 weeks, with depression occurring most frequently. Compared to men, women reported significantly more weeks of mixed mania (RR = 8.53), fewer weeks of euthymia (RR = 0.58), more recurrences to mania (RR = 1.96), and more direct polarity shifts (RR = 1.49) (all p sexual or physical abuse (68% vs. 33%), which partially explained the relationships between gender and mixed mania and direct polarity shifts. Conclusions Participants experienced persistent mood symptoms over time. Women consistently reported poorer mood outcomes, and lifetime abuse may help explain observed gender differences in mood outcomes. Further research is necessary to better understand the treatment implications of these findings. PMID:19392857

  11. A morphological and life history comparison between desert populations of a sit-and-pursue antlion, in reference to a co-occurring pit-building antlion

    Science.gov (United States)

    Scharf, Inon; Filin, Ido; Subach, Aziz; Ovadia, Ofer

    2009-10-01

    Although most antlion species do not construct pits, the vast majority of studies on antlions focused on pit-building species. We report here on a transplant experiment aiming to test for morphological and life history differences between two desert populations of a sit-and-pursue antlion species, Lopezus fedtschenkoi (Neuroptera: Myrmeleontidae), originating from habitats, which mainly differ in plant cover and productivity. We raised the antlion larvae in environmental chambers simulating either hyper-arid or Mediterranean climate. We found significant differences in the morphology and life history of L. fedtschenkoi larvae between the two populations. For example, the larvae originating from the more productive habitat pupated faster and had a higher growth rate. In agreement with the temperature-size rule, antlions reached higher final mass in the colder Mediterranean climate and exhibited a higher growth rate, but there was no difference in their developmental time. Observed differences in morphology between populations as well as those triggered by climate growing conditions could be explained by differences in size allometry. We also provide a quantitative description of the allometric growth axis, based on 12 morphological traits. Comparing the responses of L. fedtschenkoi with those observed in a co-occurring pit-building antlion indicated that there were neither shape differences that are independent of size nor was there a difference in the plasticity level between the two species.

  12. The Dissociative Subtype of Posttraumatic Stress Disorder (PTSD) Among Adolescents: Co-Occurring PTSD, Depersonalization/Derealization, and Other Dissociation Symptoms.

    Science.gov (United States)

    Choi, Kristen R; Seng, Julia S; Briggs, Ernestine C; Munro-Kramer, Michelle L; Graham-Bermann, Sandra A; Lee, Robert C; Ford, Julian D

    2017-12-01

    The purpose of this study was to examine the co-occurrence of posttraumatic stress disorder (PTSD) and dissociation in a clinical sample of trauma-exposed adolescents by evaluating evidence for the depersonalization/derealization dissociative subtype of PTSD as defined by the DSM-5 and then examining a broader set of dissociation symptoms. A sample of treatment-seeking, trauma-exposed adolescents 12 to 16 years old (N = 3,081) from the National Child Traumatic Stress Network Core Data Set was used to meet the study objectives. Two models of PTSD/dissociation co-occurrence were estimated using latent class analysis, one with 2 dissociation symptoms and the other with 10 dissociation symptoms. After model selection, groups within each model were compared on demographics, trauma characteristics, and psychopathology. Model A, the depersonalization/derealization model, had 5 classes: dissociative subtype/high PTSD; high PTSD; anxious arousal; dysphoric arousal; and a low symptom/reference class. Model B, the expanded dissociation model, identified an additional class characterized by dissociative amnesia and detached arousal. These 2 models provide new information about the specific ways PTSD and dissociation co-occur and illuminate some differences between adult and adolescent trauma symptom expression. A dissociative subtype of PTSD can be distinguished from PTSD alone in adolescents, but assessing a wider range of dissociative symptoms is needed to fully characterize adolescent traumatic stress responses. Copyright © 2017 American Academy of Child and Adolescent Psychiatry. Published by Elsevier Inc. All rights reserved.

  13. A Flow Chart of Behavior Management Strategies for Families of Children with Co-Occurring Attention-Deficit Hyperactivity Disorder and Conduct Problem Behavior.

    Science.gov (United States)

    Danforth, Jeffrey S

    2016-03-01

    Behavioral parent training is an evidence-based treatment for problem behavior described as attention-deficit hyperactivity disorder (ADHD), oppositional defiant disorder, and conduct disorder. However, adherence to treatment fidelity and parent performance of the management skills remains an obstacle to optimum outcome. One variable that may limit the effectiveness of the parent training is that demanding behavior management procedures can be deceptively complicated and difficult to perform. Based on outcome research for families of children with co-occurring ADHD and conduct problem behavior, an example of a visual behavior management flow chart is presented. The flow chart may be used to help teach specific behavior management skills to parents. The flow chart depicts a chain of behavior management strategies taught with explanation, modeling, and role-play with parents. The chained steps in the flow chart are elements common to well-known evidence-based behavior management strategies, and perhaps, this depiction well serve as a setting event for other behavior analysts to create flow charts for their own parent training, Details of the flow chart steps, as well as examples of specific applications and program modifications conclude.

  14. [Impact of chronic hepatitis C virus (HCV) on survival of schizophrenic patients with co-occurring substance use disorders followed for ten years].

    Science.gov (United States)

    Gimelfarb, Yuri; Becalel, Ety; Wolf, Aviva; Ben-Tzarfati, Mashit; Baruch, Yehuda

    2014-11-01

    Despite disproportionately high rates of HCV infection among patients with schizophrenia and co-occurring substance use disorders, to date, scientific evidence for their survival is lacking. The objective of this study was to compare long term survival among this population with and without persisting HCV. Charts of 212 subjects admitted during a period from January 1, 2002 to December 31, 2005 were assessed. Psychiatric diagnoses have been established according to international classification of diseases and health related problems--10th edition (ICD-10). The Kaplan-Meier survival analysis was used to estimate the cumulative survival rates. The association between HCV and mortality was estimated using the Cox proportional hazard regression models, with adjustments for potential confounders. The main outcome was all-cause mortality. Median observation time was 10.0 years. Period prevalence of HCV was 16.0%. Total all-cause, unadjusted mortality was 50.0% in populations with HCV versus 12.9% in populations without HCV (p disorders patients with HCV necessitates new approaches to secondary and tertiary prevention to reduce the burden of chronic liver disease and to improve survival for those who already have evidence of liver disease. The strong adverse effect of HCV on survival should encourage clinical trials including schizophrenic patients with dual disorders, to ascertain whether patients benefit from treatment choices. It is essential that adequate resources and strategies are targeted to the schizophrenic patients with dual disorders with HCV.

  15. Co-Occurring Cyberbullying and School Bullying Victimization and Associations With Mental Health Problems Among Canadian Middle and High School Students.

    Science.gov (United States)

    Sampasa-Kanyinga, Hugues

    2017-08-01

    This study examined the associations between co-occurring cyberbullying and school bullying victimization with poor self-rated mental health, psychological distress, and suicidal ideation and attempts among 4,886 Canadian students in Grades 7-12 and tested whether these associations differed between middle and high school students. There are 12.2% of students who were victims of both cyberbullying and school bullying. After adjusting for covariates, victims of both cyberbullying and school bullying presented the highest odds of poor self-rated mental health (odds ratio [OR] = 5.02; 95% CI [3.75, 6.74]), psychological distress (OR = 5.91; 95% CI [4.38, 7.96]), and suicidal ideation (OR = 6.17; 95% CI [4.44, 8.56]) and attempts (OR = 7.68; 95% CI [3.95, 14.93]). These associations were stronger among middle-school youth than their high school counterparts. Results suggest that victims of both cyberbullying and school bullying may constitute the most vulnerable group and that there is a need for intervention programs addressing both forms of bullying simultaneously, particularly among middle school students.

  16. Syndemic theory and HIV-related risk among young transgender women: the role of multiple, co-occurring health problems and social marginalization.

    Science.gov (United States)

    Brennan, Julia; Kuhns, Lisa M; Johnson, Amy K; Belzer, Marvin; Wilson, Erin C; Garofalo, Robert

    2012-09-01

    We assessed whether multiple psychosocial factors are additive in their relationship to sexual risk behavior and self-reported HIV status (i.e., can be characterized as a syndemic) among young transgender women and the relationship of indicators of social marginalization to psychosocial factors. Participants (n = 151) were aged 15 to 24 years and lived in Chicago or Los Angeles. We collected data on psychosocial factors (low self-esteem, polysubstance use, victimization related to transgender identity, and intimate partner violence) and social marginalization indicators (history of commercial sex work, homelessness, and incarceration) through an interviewer-administered survey. Syndemic factors were positively and additively related to sexual risk behavior and self-reported HIV infection. In addition, our syndemic index was significantly related to 2 indicators of social marginalization: a history of sex work and previous incarceration. These findings provide evidence for a syndemic of co-occurring psychosocial and health problems in young transgender women, taking place in a context of social marginalization.

  17. Phenotypic evidence that the function of the [Fe]-hydrogenase Hmd in Methanococcus maripaludis requires seven hcg (hmd co-occurring genes) but not hmdII.

    Science.gov (United States)

    Lie, Thomas J; Costa, Kyle C; Pak, Daniel; Sakesan, Varun; Leigh, John A

    2013-06-01

    The H2 -dependent methylene-tetrahydromethanopterin dehydrogenase (Hmd), also known as the [Fe]-hydrogenase, is found only in methanogens without cytochromes. In contrast to the binuclear metal centers of the [NiFe]- and [FeFe]-hydrogenases, the [Fe]-hydrogenase contains only a single Fe atom, which is coordinated by a novel guanylylpyridinol cofactor in the active site. The biosynthesis of the cofactor is not well understood and the responsible genes are unknown. However, seven genes (hmd co-occurring genes, hcg) encoding proteins of unknown function are always associated with the hmd gene. In the model methanogen Methanococcus maripaludis, we used a genetic background in which a deletion of hmd had a distinct growth phenotype, and made null-mutations in each hcg gene as well as in a gene encoding the Hmd paralog HmdII, which is hypothesized to function as a scaffold for cofactor synthesis. Deletions in all seven hcg genes resulted in the same growth phenotype as a deletion in hmd, suggesting they are required for Hmd function. In all cases, genetic complementation of the mutation restored the wild-type phenotype. A deletion in hmdII had no effect. © 2013 Federation of European Microbiological Societies. Published by John Wiley & Sons Ltd. All rights reserved.

  18. Seeking Safety Group Therapy for Co-Occurring Substance Use Disorder and PTSD among Transgender Women Living with HIV: A Pilot Study.

    Science.gov (United States)

    Empson, Susannah; Cuca, Yvette P; Cocohoba, Jennifer; Dawson-Rose, Carol; Davis, Katy; Machtinger, Edward L

    2017-01-01

    Transgender women living with HIV experience high rates of substance use, violence, and post-traumatic stress disorder (PTSD). Seeking Safety is a manualized, present-focused, cognitive-behavioral therapy program designed to address co-occurring substance use and PTSD. Seeking Safety has evidence of efficacy in a variety of populations but had not been evaluated specifically with people living with HIV or transgender women. We pilot-tested a 12-session Seeking Safety program with a group of transgender women living with HIV who reported substance use and a history of violence. Seven transgender women living with HIV were recruited from two HIV primary care clinics in San Francisco and completed pre- and post-intervention assessments. Participants attended an average of 8 of the 12 sessions. Mean scores for all three outcome measures improved: PTSD symptom scores declined 17.5%, alcoholism screening scores declined 23.9%, and drug abuse screening scores declined 68.8%, on average. Despite the small sample, this pilot study showed Seeking Safety to be a promising intervention among transgender women living with HIV. The findings are encouraging and justify larger studies of Seeking Safety among transgender women and other people living with HIV who experience high rates of substance use and PTSD.

  19. Dimensions of personality structure among patients with substance use disorders and co-occurring personality disorders: a comparison with psychiatric outpatients and healthy controls.

    Science.gov (United States)

    Di Pierro, Rossella; Preti, Emanuele; Vurro, Nicoletta; Madeddu, Fabio

    2014-08-01

    Although dual diagnosis has been a topic of great scientific interest for a long time, few studies have investigated the personality traits that characterize patients suffering from substance use disorders and co-occurring personality disorders through a dimensional approach. The present study aimed to evaluate structural personality profiles among dual-diagnosis inpatients to identify specific personality impairments associated with dual diagnosis. The present study involved 97 participants divided into three groups: 37 dual-diagnosis inpatients, 30 psychiatric outpatients and 30 nonclinical controls. Dimensions of personality functioning were assessed and differences between groups were tested using Kernberg's dimensional model of personality. Results showed that dual diagnosis was associated with the presence of difficulties in three main dimensions of personality functioning. Dual-diagnosis inpatients reported a poorly integrated identity with difficulties in the capacity to invest, poorly integrated moral values, and high levels of self-direct and other-direct aggression. The present study highlighted that a dimensional approach to the study of dual diagnosis may clarify the personality functioning of patients suffering from this pathological condition. The use of the dimensional approach could help to advance research on dual diagnosis, and it could have important implications on clinical treatment programs for dual-diagnosis inpatients. Copyright © 2014 Elsevier Inc. All rights reserved.

  20. Effect of the co-occurring olive oil and thyme extracts on the phenolic bioaccessibility and bioavailability assessed by in vitro digestion and cell models.

    Science.gov (United States)

    Rubió, Laura; Macià, Alba; Castell-Auví, Anna; Pinent, Montserrat; Blay, M Teresa; Ardévol, Anna; Romero, Maria-Paz; Motilva, Maria-José

    2014-04-15

    Olive oils flavoured with edible herbs have grown in popularity because of their added value and potential health benefits. However, the combined presence of different phytochemicals from olive oil and herbs requires study of their possible interactions during intestinal transport and metabolism. The aim of this study was firstly to evaluate the effect on bioaccessibility of the co-occurring bioactive compounds from olive oil and thyme through an in vitro digestion model of three extracts: olive extract (OE), thyme extract (TE) and a combination of both (OTE). The bioaccessible fractions were exposed to Caco-2 and HepG-2 cell models, as well as to a co-culture of both of these. Results indicated that the bioaccessibility of hydroxytyrosol was enhanced when OTE was digested. After Caco-2 cells exposure, no significant differences were observed in hydroxytyrosol transport, whereas the main flavonoids from thyme seemed to undergo an enhanced basolateral permeation when both phenolic sources where exposed. Copyright © 2013 Elsevier Ltd. All rights reserved.

  1. Differences in Characteristics and Treatment Received among Depressed Adolescent Psychiatric Outpatients with and without Co-Occuring Alcohol Misuse: A 1-Year Follow-Up Study

    Directory of Open Access Journals (Sweden)

    Tiia Pirkola

    2011-01-01

    Full Text Available Objectives. We aimed at examining the differences between depressed psychiatric adolescent outpatients with and without cooccurring alcohol misuse in psychosocial background, clinical characteristics, and treatment received during one-year followup. Furthermore, we investigated factors related to nonattendance at treatment. Materials and Methods. Consecutive 156 adolescent (13–19 years psychiatric outpatients with a unipolar depressive disorder at baseline were interviewed using structured measures at baseline and at 12 months. Alcohol misuse was defined as having an AUDIT score of 8 or more points. The outpatients received “treatment as usual” of clinically defined duration. Results. Among depressive outpatients, poor parental support, parental alcohol use and decreased attendance at treatment associated with alcohol misuse. The severity of alcohol use as measured by AUDIT-score was the strongest factor independently predicting nonattendance at treatment in multivariate analysis. Conclusions. Alcohol misuse indicates family problems, has a deleterious effect on treatment attendance, and should be taken into account when managing treatment for depressive adolescent outpatients.

  2. Spatial Mnemonic Encoding: Theta Power Decreases and Medial Temporal Lobe BOLD Increases Co-Occur during the Usage of the Method of Loci.

    Science.gov (United States)

    Fellner, Marie-Christin; Volberg, Gregor; Wimber, Maria; Goldhacker, Markus; Greenlee, Mark W; Hanslmayr, Simon

    2016-01-01

    The method of loci is one, if not the most, efficient mnemonic encoding strategy. This spatial mnemonic combines the core cognitive processes commonly linked to medial temporal lobe (MTL) activity: spatial and associative memory processes. During such processes, fMRI studies consistently demonstrate MTL activity, while electrophysiological studies have emphasized the important role of theta oscillations (3-8 Hz) in the MTL. However, it is still unknown whether increases or decreases in theta power co-occur with increased BOLD signal in the MTL during memory encoding. To investigate this question, we recorded EEG and fMRI separately, while human participants used the spatial method of loci or the pegword method, a similarly associative but nonspatial mnemonic. The more effective spatial mnemonic induced a pronounced theta power decrease source localized to the left MTL compared with the nonspatial associative mnemonic strategy. This effect was mirrored by BOLD signal increases in the MTL. Successful encoding, irrespective of the strategy used, elicited decreases in left temporal theta power and increases in MTL BOLD activity. This pattern of results suggests a negative relationship between theta power and BOLD signal changes in the MTL during memory encoding and spatial processing. The findings extend the well known negative relation of alpha/beta oscillations and BOLD signals in the cortex to theta oscillations in the MTL.

  3. Psychoeducational Psychotherapy and Omega-3 Supplementation Improve Co-Occurring Behavioral Problems in Youth with Depression: Results from a Pilot RCT.

    Science.gov (United States)

    Young, Andrea S; Arnold, L Eugene; Wolfson, Hannah L; Fristad, Mary A

    2017-07-01

    This pilot randomized controlled trial (RCT) investigated benefits of omega-3 fatty acid supplementation and Individual-Family Psychoeducational Psychotherapy (PEP; a family-focused, cognitive-behavioral therapy) for behavior problems among youth with depression. Participants aged 7-14 with DSM-IV-TR depressive disorders (N = 72; 56.9 % male) were randomized to 1 of 4 treatment conditions: PEP + omega-3, PEP monotherapy (with pill placebo), omega-3 monotherapy, or placebo (without active intervention). At screen, baseline, and 2, 4, 6, 9, and 12 weeks post-baseline, parents completed the SNAP-IV, which assesses attention-deficit/hyperactivity disorder symptoms, oppositional defiant disorder symptoms, and overall behavior problems. At screen, baseline (randomization), 6 and 12 weeks, parents completed the Eyberg Child Behavior Inventory (ECBI), which includes Intensity and Problem scales for child behavior problems. Youth who had a completed SNAP-IV or ECBI for at least two assessments during treatment (n = 48 and 38, respectively) were included in analyses of the respective outcome. ClinicalTrials.gov.:NCT01341925. Linear mixed effects models indicated a significant effect of combined PEP + omega-3 on SNAP-IV Total (p = 0.022, d = 0.80) and Hyperactivity/Impulsivity trajectories (p = 0.008, d = 0.80), such that youth in the combined group saw greater behavioral improvement than those receiving only placebo. Similarly, youth in combined treatment had more favorable ECBI Intensity trajectories than youth who received no active treatment (p = 0.012, d = 1.07). Results from this pilot RCT suggest that combined PEP + omega-3 is a promising treatment for co-occurring behavior symptoms in youth with depression.

  4. Evidence-based treatment and supervision practices for co-occurring mental and substance use disorders in the criminal justice system.

    Science.gov (United States)

    Peters, Roger H; Young, M Scott; Rojas, Elizabeth C; Gorey, Claire M

    2017-07-01

    Over seven million persons in the United States are supervised by the criminal justice system, including many who have co-occurring mental and substance use disorders (CODs). This population is at high risk for recidivism and presents numerous challenges to those working in the justice system. To provide a contemporary review of the existing research and examine key issues and evidence-based treatment and supervision practices related to CODs in the justice system. We reviewed COD research involving offenders that has been conducted over the past 20 years and provide an analysis of key findings. Several empirically supported frameworks are available to guide services for offenders who have CODs, including Integrated Dual Disorders Treatment (IDDT), the Risk-Need-Responsivity (RNR) model, and Cognitive-Behavioral Therapy (CBT). Evidence-based services include integrated assessment that addresses both sets of disorders and the risk for criminal recidivism. Although several evidence-based COD interventions have been implemented at different points in the justice system, there remains a significant gap in services for offenders who have CODs. Existing program models include Crisis Intervention Teams (CIT), day reporting centers, specialized community supervision teams, pre- and post-booking diversion programs, and treatment-based courts (e.g., drug courts, mental health courts, COD dockets). Jail-based COD treatment programs provide stabilization of acute symptoms, medication consultation, and triage to community services, while longer-term prison COD programs feature Modified Therapeutic Communities (MTCs). Despite the availability of multiple evidence-based interventions that have been implemented across diverse justice system settings, these services are not sufficiently used to address the scope of treatment and supervision needs among offenders with CODs.

  5. How Diverse Detrital Environments Influence Nutrient Stoichiometry between Males and Females of the Co-Occurring Container Mosquitoes Aedes albopictus, Ae. aegypti, and Culex quinquefasciatus.

    Science.gov (United States)

    Yee, Donald A; Kaufman, Michael G; Ezeakacha, Nnaemeka F

    2015-01-01

    Allocation patterns of carbon and nitrogen in animals are influenced by food quality and quantity, as well as by inherent metabolic and physiological constraints within organisms. Whole body stoichiometry also may vary between the sexes who differ in development rates and reproductive allocation patterns. In aquatic containers, such as tree holes and tires, detrital inputs, which vary in amounts of carbon and nitrogen, form the basis of the mosquito-dominated food web. Differences in development times and mass between male and female mosquitoes may be the result of different reproductive constraints, which could also influence patterns of nutrient allocation. We examined development time, survival, and adult mass for males and females of three co-occurring species, Aedes albopictus, Ae. aegypti, and Culex quinquefasciatus, across environments with different ratios of animal and leaf detritus. We quantified the contribution of detritus to biomass using stable isotope analysis and measured tissue carbon and nitrogen concentrations among species and between the sexes. Development times were shorter and adults were heavier for Aedes in animal versus leaf-only environments, whereas Culex development times were invariant across detritus types. Aedes displayed similar survival across detritus types whereas C. quinquefasciatus showed decreased survival with increasing leaf detritus. All species had lower values of 15N and 13C in leaf-only detritus compared to animal, however, Aedes generally had lower tissue nitrogen compared to C. quinquefasciatus. There were no differences in the C:N ratio between male and female Aedes, however, Aedes were different than C. quinquefasciatus adults, with male C. quinquefasciatus significantly higher than females. Culex quinquefasciatus was homeostatic across detrital environments. These results allow us to hypothesize an underlying stoichiometric explanation for the variation in performance of different container species under similar

  6. Longitudinal Course of Clients With Co-occurring Schizophrenia-Spectrum and Substance Use Disorders in Urban Mental Health Centers: A 7-Year Prospective Study.

    Science.gov (United States)

    Drake, Robert E; Luciano, Alison E; Mueser, Kim T; Covell, Nancy H; Essock, Susan M; Xie, Haiyi; McHugo, Gregory J

    2016-01-01

    A previous longitudinal study in rural New Hampshire showed that community mental health center clients with co-occurring schizophrenia-spectrum and substance use disorders (SZ/SUD) improved steadily and substantially over 10 years. The current study examined 7 years of prospective clinical and functional outcomes among inner-city Connecticut (CT) community mental health center clients with SZ/SUD. Participants were 150 adults with SZ/SUD, selected for high service needs, in 2 inner-city mental health centers in CT. Initially, all received integrated mental health and substance abuse treatments for at least the first 3 years as part of a clinical trial. Assessments at baseline and yearly over 7 years measured progress toward 6 target clinical and functional outcomes: absence of psychiatric symptoms, remission of substance abuse, independent housing, competitive employment, social contact with non-users of substances, and life satisfaction. The CT SZ/SUD participants improved significantly on 5 of the 6 main outcomes: absence of psychiatric symptoms (45%-70%), remission of substance use disorders (8%-61%), independent housing (33%-47%), competitive employment (14%-28%), and life satisfaction (35%-53%). Only social contact with nonusers of substances was unimproved (14%-17%). Many urban community mental health center clients with SZ/SUD and access to integrated treatment improve significantly on clinical, vocational, residential, and life satisfaction outcomes over time, similar to clients with SZ/SUD in rural areas. Thus, the long-term course for people with SZ/SUD is variable but often quite positive. © The Author 2015. Published by Oxford University Press on behalf of the Maryland Psychiatric Research Center. All rights reserved. For permissions, please email: journals.permissions@oup.com.

  7. Enhancing health-care workers' understanding and thinking about people living with co-occurring mental health and substance use issues through consumer-led training.

    Science.gov (United States)

    Roussy, Véronique; Thomacos, Nikos; Rudd, Annette; Crockett, Belinda

    2015-10-01

    Stigma and judgemental assumptions by health workers have been identified as key barriers to accessing health care for people living with co-occurring mental health and substance use issues (dual diagnosis). To evaluate the effectiveness of consumer-led training by people with dual diagnosis in improving the knowledge, understanding and role adequacy of community health staff to work with this consumer group. A controlled before-and-after study design with four waves of quantitative data collection was used. Qualitative data were collected to explore participants' views about training. Participants were staff from two community health services from Victoria, Australia. Recruitment occurred across various work areas: reception, oral health, allied health, counselling and health promotion. At baseline, all participants attended a 4-h clinician-led training session. The intervention consisted of a 3-h consumer-led training session, developed and delivered by seven individuals living with dual diagnosis. Outcome measures included understanding of dual diagnosis, participants' feelings of role adequacy and role legitimacy, personal views, and training outcomes and relevance. Consumer-led training was associated with a significant increase in understanding. The combination of clinician-led and consumer-led training was associated with a positive change in role adequacy. Consumer-led training is a promising approach to enhance primary health-care workers' understanding of the issues faced by dual-diagnosis consumers, with such positive effects persisting over time. Used alongside other organizational capacity building strategies, consumer-led training has the potential to help address stigma and judgemental attitudes by health workers and improve access to services for this consumer group. © 2013 John Wiley & Sons Ltd.

  8. Intraspecific relationships among wood density, leaf structural traits and environment in four co-occurring species of Nothofagus in New Zealand.

    Directory of Open Access Journals (Sweden)

    Sarah J Richardson

    Full Text Available Plant functional traits capture important variation in plant strategy and function. Recent literature has revealed that within-species variation in traits is greater than previously supposed. However, we still have a poor understanding of how intraspecific variation is coordinated among different traits, and how it is driven by environment. We quantified intraspecific variation in wood density and five leaf traits underpinning the leaf economics spectrum (leaf dry matter content, leaf mass per unit area, size, thickness and density within and among four widespread Nothofagus tree species in southern New Zealand. We tested whether intraspecific relationships between wood density and leaf traits followed widely reported interspecific relationships, and whether variation in these traits was coordinated through shared responses to environmental factors. Sample sites varied widely in environmental variables, including soil fertility (25-900 mg kg(-1 total P, precipitation (668-4875 mm yr(-1, temperature (5.2-12.4 °C mean annual temperature and latitude (41-46 °S. Leaf traits were strongly correlated with one another within species, but not with wood density. There was some evidence for a positive relationship between wood density and leaf tissue density and dry matter content, but no evidence that leaf mass or leaf size were correlated with wood density; this highlights that leaf mass per unit area cannot be used as a surrogate for component leaf traits such as tissue density. Trait variation was predicted by environmental factors, but not consistently among different traits; e.g., only leaf thickness and leaf density responded to the same environmental cues as wood density. We conclude that although intraspecific variation in wood density and leaf traits is strongly driven by environmental factors, these responses are not strongly coordinated among functional traits even across co-occurring, closely-related plant species.

  9. A randomized, double-blind, placebo-controlled study of ziprasidone monotherapy in bipolar disorder with co-occurring lifetime panic or generalized anxiety disorder.

    Science.gov (United States)

    Suppes, Trisha; McElroy, Susan L; Sheehan, David V; Hidalgo, Rosario B; Cosgrove, Victoria E; Gwizdowski, Iola S; Feldman, Natalie S

    2014-01-01

    Bipolar disorder often co-occurs with anxiety disorders. Evidence suggests that second-generation antipsychotics (SGAs) may be useful in treating both conditions. This study examined the efficacy of ziprasidone in the treatment of these disorders. This 3-site, randomized, double-blind, placebo-controlled, parallel group, 8-week trial of ziprasidone monotherapy examined 49 subjects with bipolar disorder and lifetime panic disorder (with or without agoraphobia) or generalized anxiety disorder (GAD) experiencing moderately severe anxiety symptoms at entrance into the study. Both bipolar disorder and anxiety diagnoses were based on DSM-IV-TR criteria. Patients were screened and randomized from June 25, 2010, through August 23, 2011. Primary outcome measures were the Clinical Global Impressions-21 Anxiety Scale (CGI-21 Anxiety) and the Sheehan Disability Scale (SDS), with secondary measures monitoring anxiety and mood symptoms. Last-observation-carried-forward analyses demonstrated that patients in the ziprasidone group did not improve significantly more than those in the placebo group on the CGI-21 Anxiety (F1 = 0.34; P = .564) or SDS (F1 = 0.26; P = .611). Secondary analysis using hierarchical linear modeling found similar results (CGI-21 Anxiety: F1 = 1.82; P = .178; and SDS: F1 = 0.70; P = .408). Regardless of group, time in the study was associated with significant decrease in anxiety (F1 = 11.08; P = .001) and total disability (F1 = 26.16; P serious adverse events, or side effects were in the ziprasidone group. Results suggest that ziprasidone monotherapy was not associated with a clinically significant improvement in anxiety symptoms or improved function for patients with bipolar disorder, lifetime panic disorder or GAD, and concurrent moderately severe anxiety symptoms, and it was associated with a more negative side-effect profile relative to placebo. ClinicalTrials.gov identifier: NCT01172652. © Copyright 2014 Physicians Postgraduate Press, Inc.

  10. Electronic Nicotine Delivery Systems (E-cigarette/Vape) use and Co-Occurring Health-Risk Behaviors Among an Ethnically Diverse Sample of Young Adults.

    Science.gov (United States)

    Lanza, H Isabella; Teeter, Heather

    2018-01-02

    Prevalence rates of electronic nicotine delivery systems (ENDS; i.e., e-cigarette/vape) use has grown exponentially in the past few years. College students present a particularly vulnerable group for ENDS use. The current study sought to expand the literature by examining the context in which college students use ENDS, co-occurring health risks beyond traditional tobacco use, and the role of ethnicity in ENDS use. Health-risk behavior survey data was collected from 452 undergraduates attending a large, public urban university during the 2015-2016 academic year. Ever ENDS users vs. non-ENDS users were compared across potential demographic, health-risk, and other health-related correlates. Almost 40% of participants reported lifetime use of ENDS. No ethnic or sex differences were found. The primary source for obtaining ENDS was friends and ENDS were most often used with friends vs. alone or with others not considered friends. Participants engaging in risky alcohol use and cigarette smoking had a higher likelihood of endorsing ENDS use. Conclusions/Importance: The current study indicated that a large proportion of college students have tried ENDS irrespective of ethnicity or sex. An increasingly normative social context may inform the popularity of ENDS use across ethnicity and sex, but additional research using ethnically diverse samples is warranted. Risky alcohol use appears to be a significant correlate of ENDS use, even after accounting for the robust relationship between ENDS use and cigarette smoking. The robust relationship between alcohol and tobacco use likely extends to ENDS use.

  11. A comprehensive examination of hookah smoking in college students: use patterns and contexts, social norms and attitudes, harm perception, psychological correlates and co-occurring substance use.

    Science.gov (United States)

    Heinz, Adrienne J; Giedgowd, Grace E; Crane, Natania A; Veilleux, Jennifer C; Conrad, Megan; Braun, Ashley R; Olejarska, Natalia A; Kassel, Jon D

    2013-11-01

    The practice of waterpipe smoking (hookah) has rapidly increased in popularity among young adults yet burgeoning research suggests that its use is associated with nicotine dependence and other negative smoking-related health consequences. Moreover, descriptive studies indicate that consumers may hold the belief that hookah smoking is safer than smoking cigarettes. The current study extended previous work by conducting a comprehensive assessment of patterns and contexts of hookah use, psychological correlates of use, co-occurring substance use as well as social norms and health perceptions surrounding the practice. Participants were 143 ethnically diverse undergraduate students at a large urban US university. Approximately half of the sample (48%) reported life-time use of hookah and 22% reported use within the past 30days. Relative to cigarette smoking, hookah smoking was associated with less perceived harm and addiction potential and higher social approval. Participants who reported life-time hookah use, as compared to those who did not, perceived less associated harm, had a greater number of friends who had tried and approved of hookah, were more likely to use cigarettes, marijuana, and alcohol and in higher frequencies and quantities and were at higher risk for problem tobacco and alcohol use. Among participants who were not current smokers, those with hookah experience were more likely to endorse intent to try a cigarette soon. Hookah users did not differ from non-users on measures of trait anxiety, depression and impulsivity though they were more likely to drink alcohol for coping, social and enhancement purposes than non-users. Implications are discussed for public health initiatives to educate young adults about the potential consequences of hookah smoking. © 2013 Elsevier Ltd. All rights reserved.

  12. Understanding marijuana's effects on functional connectivity of the default mode network in patients with schizophrenia and co-occurring cannabis use disorder: A pilot investigation.

    Science.gov (United States)

    Whitfield-Gabrieli, Susan; Fischer, Adina S; Henricks, Angela M; Khokhar, Jibran Y; Roth, Robert M; Brunette, Mary F; Green, Alan I

    2018-04-01

    Nearly half of patients with schizophrenia (SCZ) have co-occurring cannabis use disorder (CUD), which has been associated with decreased treatment efficacy, increased risk of psychotic relapse, and poor global functioning. While reports on the effects of cannabis on cognitive performance in patients with SCZ have been mixed, study of brain networks related to executive function may clarify the relationship between cannabis use and cognition in these dual-diagnosis patients. In the present pilot study, patients with SCZ and CUD (n=12) and healthy controls (n=12) completed two functional magnetic resonance imaging (fMRI) resting scans. Prior to the second scan, patients smoked a 3.6% tetrahydrocannabinol (THC) cannabis cigarette or ingested a 15mg delta-9-tetrahydrocannabinol (THC) pill. We used resting-state functional connectivity to examine the default mode network (DMN) during both scans, as connectivity/activity within this network is negatively correlated with connectivity of the network involved in executive control and shows reduced activity during task performance in normal individuals. At baseline, relative to controls, patients exhibited DMN hyperconnectivity that correlated with positive symptom severity, and reduced anticorrelation between the DMN and the executive control network (ECN). Cannabinoid administration reduced DMN hyperconnectivity and increased DMN-ECN anticorrelation. Moreover, the magnitude of anticorrelation in the controls, and in the patients after cannabinoid administration, positively correlated with WM performance. The finding that DMN brain connectivity is plastic may have implications for future pharmacotherapeutic development, as treatment efficacy could be assessed through the ability of therapies to normalize underlying circuit-level dysfunction. Copyright © 2017. Published by Elsevier B.V.

  13. Prefrontal Engagement and Reduced Default Network Suppression Co-occur and Are Dynamically Coupled in Older Adults: The Default-Executive Coupling Hypothesis of Aging.

    Science.gov (United States)

    Turner, Gary R; Spreng, R Nathan

    2015-12-01

    Reduced executive control is a hallmark of neurocognitive aging. Poor modulation of lateral pFC activity in the context of increasing task challenge in old adults and a "failure to deactivate" the default network during cognitive control tasks have been observed. Whether these two patterns represent discrete mechanisms of neurocognitive aging or interact into older adulthood remains unknown. We examined whether altered pFC and default network dynamics co-occur during goal-directed planning over increasing levels of difficulty during performance on the Tower of London task. We used fMRI to investigate task- and age-related changes in brain activation and functional connectivity across four levels of task challenge. Frontoparietal executive control regions were activated and default network regions were suppressed during planning relative to counting performance in both groups. Older adults, unlike young, failed to modulate brain activity in executive control and default regions as planning demands increased. Critically, functional connectivity analyses revealed bilateral dorsolateral pFC coupling in young adults and dorsolateral pFC to default coupling in older adults with increased planning complexity. We propose a default-executive coupling hypothesis of aging. First, this hypothesis suggests that failure to modulate control and default network activity in response to increasing task challenge are linked in older adulthood. Second, functional brain changes involve greater coupling of lateral pFC and the default network as cognitive control demands increase in older adults. We speculate that these changes reflect an adaptive shift in cognitive approach as older adults come to rely more upon stored representations to support goal-directed task performance.

  14. Opioid pharmacovigilance: A clinical-social history of the changes in opioid prescribing for patients with co-occurring chronic non-cancer pain and substance use.

    Science.gov (United States)

    Knight, Kelly R; Kushel, Margot; Chang, Jamie S; Zamora, Kara; Ceasar, Rachel; Hurstak, Emily; Miaskowski, Christine

    2017-08-01

    There is growing concern among US-based clinicians, patients, policy makers, and in the media about the personal and community health risks associated with opioids. Perceptions about the efficacy and appropriateness of opioids for the management of chronic non-cancer pain (CNCP) have dramatically transformed in recent decades. Yet, there is very little social scientific research identifying the factors that have informed this transformation from the perspectives of prescribing clinicians. As part of an on-going ethnographic study of CNCP management among clinicians and their patients with co-occurring substance use, we interviewed 23 primary care clinicians who practice in safety-net clinical settings. In this paper, we describe the clinical and social influences informing three historic periods: (1) the escalation of opioid prescriptions for CNCP; (2) an interim period in which the efficacy of and risks associated with opioids were re-assessed; and (3) the current period of "opioid pharmacovigilance," characterized by the increased surveillance of opioid prescriptions. Clinicians reported that interpretations of the evidence-base in favor of and opposing opioid prescribing for CNCP evolved within a larger clinical-social context. Historically, pharmaceutical marketing efforts and clinicians' concerns about racialized healthcare disparities in pain treatment influenced opioid prescription decision-making. Clinicians emphasized how patients' medical complexity (e.g. multiple chronic health conditions) and structural vulnerability (e.g. poverty, community violence) impacted access to opioids within resource-limited healthcare settings. This clinical-social history of opioid prescribing practices helps to elucidate the ongoing challenges of CNCP treatment in the US healthcare safety net and lends needed specificity to the broader, nationwide conversation about opioids. Copyright © 2017 Elsevier Ltd. All rights reserved.

  15. Seasonal dynamics of radial growth and stem water deficit in co-occurring saplings and mature conifers under drought: Canopy density affects water stress experienced by saplings

    Science.gov (United States)

    Oberhuber, Walter

    2017-04-01

    Size-mediated climate sensitivity of trees will affect forest structure, composition and productivity under a warmer and drier climate. Therefore, the influence of tree size (saplings vs. mature trees) and site conditions on radial stem growth and stem water deficit of Picea abies (dry-mesic site; canopy cover [CC]: 70 %) and Pinus sylvestris (xeric site; CC: 30 %) were evaluated in a drought-prone inner Alpine environment (c. 750 m a.s.l.). Stem radius variations (SRVs) of saplings (mean stem diameter [SDM]: 2.3 cm) and co-occurring mature trees (SDM: 24 cm) were continuously recorded by dendrometers during two years (n = 6 - 8 individuals per species and size class). Growth-detrended SRVs (SSRV), which represent reversible shrinkage and swelling of tissues outside the cambium and contribute most to stem water storage capacity, were calculated by removing the Gompertz-modeled daily growth from SRVs. Dendrometer records revealed that irrespective of tree size, radial growth in Pinus sylvestris occurred in April-May, whereas the main growing period of Picea abies was April-June and May-June in saplings and mature trees, respectively. Growth-detrended SRVs were approximately twice as large in Pinus sylvestris compared to Picea abies indicating more intense exploitation of stem water reserves at the xeric site. Linear relationships between SSRVs of mature trees vs. saplings and climate-SSRV relationships revealed greater use of stem water reserves by mature Picea abies compared to saplings. This suggests that the strikingly depressed radial growth of Picea abies saplings was primarily caused by reduced carbon availability beneath the dense canopy. In contrast, a tree size effect on the seasonal dynamics of radial growth, stem water deficit and climate-SSRV relationships was mostly lacking in Pinus sylvestris, indicating comparable water status in mature trees and saplings under an open canopy. Results of this study provide evidence that development of a buffered

  16. Large-scale impacts of multiple co-occurring invaders on monkey puzzle forest regeneration, native seed predators and their ecological interactions

    Directory of Open Access Journals (Sweden)

    José L. Tella

    2016-04-01

    Full Text Available Most ecosystems of the world are being increasingly invaded by a variety of alien species. However, little is known about the combined ecological impacts of multiple co-occurring invaders. We assessed the impact of a community of exotic mammals (five domestic and four wild on forests of monkey puzzle (Araucaria araucana, a globally endangered tree restricted to ca 400 km2 on the slopes of the Andes in Chile and Argentina. Seeds of monkey puzzles provide food during winter to a small community of native mice and Austral parakeets (Enicognathus ferrugineus. We recorded the number of uneaten seeds and the number of young seedlings at the end of winter under 516 female monkey puzzle trees located across the species’ distribution, and identified the signals of native and exotic species that visited the under-canopy of each tree. Moreover, we studied the diet and foraging behavior of Austral parakeets to explore the potential indirect effects of exotic mammals through the disruption of a key ecosystem service (seed dispersal supposedly provided by parakeets. All but one tree were visited by at least one seed predator species. Austral parakeets and mice predated seeds from 85% and at least 45% of the trees, respectively, and both the number of remaining seeds and seedlings were significantly larger when only parakeets or mice predated seeds than when exotic mammals also visited the trees. At least 90% of trees were visited by one or more exotic species, and the number of seeds and seedlings dropped drastically when at least two and four exotic species visited the tree, respectively. Austral parakeets mostly foraged on monkey puzzle trees during the winter period and dispersed their seeds in most feeding instances once seeds fell to the ground. The proliferation of exotic mammals may reduce the populations of native seed-predators in the long-term as well as the regeneration of monkey puzzle forests, directly through a reduction of seed availability

  17. Protein evolution in two co-occurring types of Symbiodinium: an exploration into the genetic basis of thermal tolerance in Symbiodinium clade D.

    Science.gov (United States)

    Ladner, Jason T; Barshis, Daniel J; Palumbi, Stephen R

    2012-11-12

    The symbiosis between reef-building corals and photosynthetic dinoflagellates (Symbiodinium) is an integral part of the coral reef ecosystem, as corals are dependent on Symbiodinium for the majority of their energy needs. However, this partnership is increasingly at risk due to changing climatic conditions. It is thought that functional diversity within Symbiodinium may allow some corals to rapidly adapt to different environments by changing the type of Symbiodinium with which they partner; however, very little is known about the molecular basis of the functional differences among symbiont groups. One group of Symbiodinium that is hypothesized to be important for the future of reefs is clade D, which, in general, seems to provide the coral holobiont (i.e., coral host and associated symbiont community) with elevated thermal tolerance. Using high-throughput sequencing data from field-collected corals we assembled, de novo, draft transcriptomes for Symbiodinium clades C and D. We then explore the functional basis of thermal tolerance in clade D by comparing rates of coding sequence evolution among the four clades of Symbiodinium most commonly found in reef-building corals (A-D). We are able to highlight a number of genes and functional categories as candidates for involvement in the increased thermal tolerance of clade D. These include a fatty acid desaturase, molecular chaperones and proteins involved in photosynthesis and the thylakoid membrane. We also demonstrate that clades C and D co-occur within most of the sampled colonies of Acropora hyacinthus, suggesting widespread potential for this coral species to acclimatize to changing thermal conditions via 'shuffling' the proportions of these two clades from within their current symbiont communities. Transcriptome-wide analysis confirms that the four main Symbiodinium clades found within corals exhibit extensive evolutionary divergence (18.5-27.3% avg. pairwise nucleotide difference). Despite these evolutionary

  18. Protein evolution in two co-occurring types of Symbiodinium: an exploration into the genetic basis of thermal tolerance in Symbiodinium clade D

    Directory of Open Access Journals (Sweden)

    Ladner Jason T

    2012-11-01

    Full Text Available Abstract Background The symbiosis between reef-building corals and photosynthetic dinoflagellates (Symbiodinium is an integral part of the coral reef ecosystem, as corals are dependent on Symbiodinium for the majority of their energy needs. However, this partnership is increasingly at risk due to changing climatic conditions. It is thought that functional diversity within Symbiodinium may allow some corals to rapidly adapt to different environments by changing the type of Symbiodinium with which they partner; however, very little is known about the molecular basis of the functional differences among symbiont groups. One group of Symbiodinium that is hypothesized to be important for the future of reefs is clade D, which, in general, seems to provide the coral holobiont (i.e., coral host and associated symbiont community with elevated thermal tolerance. Using high-throughput sequencing data from field-collected corals we assembled, de novo, draft transcriptomes for Symbiodinium clades C and D. We then explore the functional basis of thermal tolerance in clade D by comparing rates of coding sequence evolution among the four clades of Symbiodinium most commonly found in reef-building corals (A-D. Results We are able to highlight a number of genes and functional categories as candidates for involvement in the increased thermal tolerance of clade D. These include a fatty acid desaturase, molecular chaperones and proteins involved in photosynthesis and the thylakoid membrane. We also demonstrate that clades C and D co-occur within most of the sampled colonies of Acropora hyacinthus, suggesting widespread potential for this coral species to acclimatize to changing thermal conditions via ‘shuffling’ the proportions of these two clades from within their current symbiont communities. Conclusions Transcriptome-wide analysis confirms that the four main Symbiodinium clades found within corals exhibit extensive evolutionary divergence (18.5-27.3% avg

  19. Contrasting secondary growth and water-use efficiency patterns in native and exotic trees co-occurring in inner Spain riparian forests

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    Noelia González-Muñoz

    2015-04-01

    Full Text Available Aim of study: The invasive trees Ailanthus altissima and Robinia pseudoacacia are widely spreading in inner Spain riparian forests, where they co-occur with the natives Fraxinus angustifolia and Ulmus minor. In a climate change context, we aimed to identify some of the species traits that are leading these species to success (Basal Area Increment (BAI and water-use efficiency (iWUE. We also aimed to describe the main environmental variables controlling studied species BAI. Area of study: Riparian forests of central Spain Material and Methods: We measured tree-ring width and converted it to basal area increment (BAI; intrinsic water-use efficiency (iWUE was estimated from tree ring carbon isotopes (δ13C. We compared the BAI and iWUE of the last 20 years between origins (native vs exotic and among species. For each species, we evaluated iWUE and BAI relationships. Linear mixed-effect models were performed to identify the main environmental variables (temperature, precipitation, river flow affecting BAI. Main result: Native trees showed higher mean BAI than invaders, mainly due to the rising growth rate of U. minor. Invaders showed higher mean iWUE than natives. We did not find significant correlations between iWUE and BAI in any case. Warm temperatures in autumn positively affected the BAI of the natives, but negatively that of the invaders. Research highlights: The contrasting effect of autumn temperatures on native and invasive species BAI suggests that invaders will be more hampered by the rising temperatures predicted for this century. The higher iWUE found for the invaders did not translate into increased radial growth, suggesting that drought stress may have prevented them of taking advantage of increased atmospheric CO2 for a faster growth. These findings point out that neither climate change nor rising CO2 seem to enhance the success of study invasive species over the natives in riparian forests of central Spain. Furthermore, the low BAI

  20. Cognitive-behavioral therapy in depressed primary care patients with co-occurring problematic alcohol use: effect of telephone-administered vs. face-to-face treatment – A secondary analysis

    OpenAIRE

    Kalapatapu, Raj K.; Ho, Joyce; Cai, Xuan; Vinogradov, Sophia; Batki, Steven L.; Mohr, David C.

    2014-01-01

    This secondary analysis of a larger study compared adherence to telephone-administered cognitive-behavioral therapy (T-CBT) vs. face-to-face CBT and depression outcomes in depressed primary care patients with co-occurring problematic alcohol use. To our knowledge, T-CBT has never been directly compared to face-to-face CBT in such a sample of primary care patients. Participants were randomized in a 1:1 ratio to face-to-face CBT or T-CBT for depression. Participants receiving T-CBT (n = 50) and...

  1. Everyday life consequences of substance use in adult patients with a substance use disorder (SUD) and co-occurring attention deficit/hyperactivity disorder (ADHD) or autism spectrum disorder (ASD): a patient's perspective.

    Science.gov (United States)

    Kronenberg, Linda M; Slager-Visscher, Karin; Goossens, Peter J J; van den Brink, Wim; van Achterberg, Theo

    2014-09-19

    Although the prevalence of substance use disorder (SUD) with co-occurring attention deficit/hyperactivity disorder (ADHD) or autism spectrum disorder (ASD) is relatively high in adult patients, there is hardly any knowledge about these dual diagnoses. A recent study reported met- and unmet needs for several life domains regarding these patient groups. To improve treatment, it is necessary to identify the everyday life consequences of SUD and co-occurring ADHD or ASD in adult patients. Qualitative study using in-depth interviews. 11 SUD + ADHD and 12 SUD + ASD patients participated in the study. The interview transcripts were coded and analysed according to the seven steps for descriptive phenomenology by Colaizzi. Both patients with ADHD and patients with ASD can get caught in a jumble of thoughts and emotions which can often lead to agitation and impulsivity in the case of ADHD or passivity and melancholia in the case of ASD with co-occurring SUD in both cases. Initially substance use ameliorates the symptoms and related problems, but both patient groups can later experience even greater problems: difficulties with the structuring of daily life due to a lack of planning (SUD + ADHD) or due to a lack of initiative (SUD + ASD). Both groups indicate that structure helps them function better. They also recognize that substance use disorganizes their lives and that an absence of structure contributes to substance use in what becomes a vicious circle which needs to be broken for effective treatment and care. This study provides insight into the daily life consequences of SUD with a co-occurring ADHD or ASD. Substance use is reported to solve some ADHD- or ASD-related problems in the short run but have negative consequences in the long run (i.e., contribute to already impaired cognitive functioning). Insight is provided into what clinicians can do to break this vicious circle and thus help ADHD patients to refrain from action and ASD patients to take

  2. Effects of therapeutic goal management (TGM) on treatment attendance and drug abstinence among men with co-occurring substance use and axis I mental disorders who are homeless: results of the Birmingham EARTH program.

    Science.gov (United States)

    Davidson, Anna; Jensen, Michael; Burgess, Emilee; Stevens, Angee; Hayes, Lauren; Sieweke, Susan; Stough, Karen; Wright, Anne; McCarty, Robin; Eddleman, Lillian; Kim, Young-Il; Milby, Jesse B; Schumacher, Joseph E

    2013-10-27

    This study describes the implementation and impact of Therapeutic Goal Management (TGM) in a Substance Abuse and Mental Health Services Administration (SAMHSA)-sponsored demonstration project entitled Enhanced Addiction Recovery through Housing (EARTH). The sample included 28 male participants followed at six months who completed some treatment. Forty-three percent were Caucasian, and 57% were African American. The average age of participants was 42 years. The relationships between TGM goal achievement, treatment attendance, and drug abstinence outcomes were studied among EARTH program participants who were homeless and met criteria for co-occurring substance use and severe DSM-IV Axis I mental disorders. The results revealed an overall drug abstinence rate of 72.4% over six months and significant positive relationships between TGM goal achievement and drug abstinence (r=0.693) and TGM goal achievement and treatment attendance (r=0.843). This research demonstrated the relationship and potential positive impact of systematically setting, monitoring, and reinforcing personalized goals in multiple life areas on drug abstinence and treatment attendance outcomes among persons who are homeless with co-occurring substance use and other Axis I disorders in a integrated community service delivery program.

  3. Treating co-occurring Axis I disorders in recurrently suicidal women with borderline personality disorder: a 2-year randomized trial of dialectical behavior therapy versus community treatment by experts.

    Science.gov (United States)

    Harned, Melanie S; Chapman, Alexander L; Dexter-Mazza, Elizabeth T; Murray, Angela; Comtois, Katherine A; Linehan, Marsha M

    2008-12-01

    This study evaluated whether dialectical behavior therapy (DBT) was more efficacious than treatment by nonbehavioral psychotherapy experts in reducing co-occurring Axis I disorders among suicidal individuals with borderline personality disorder (BPD). Women with BPD and recent and repeated suicidal and/or self-injurious behavior (n = 101) were randomly assigned to 1 year of DBT or community treatment by experts (CTBE), plus 1 year of follow-up assessment. For substance dependence disorders (SDD), DBT patients were more likely to achieve full remission, spent more time in partial remission, spent less time meeting full criteria, and reported more drug- and alcohol-abstinent days than did CTBE patients. These findings suggest that improvements in co-occurring SDD among suicidal BPD patients are specific to DBT and cannot be attributed to general factors associated with nonbehavioral expert psychotherapy. Further, group differences in SDD remission were not explained by either psychotropic medication usage or changes in BPD criterion behaviors. DBT and CTBE did not significantly differ in the reduction of anxiety disorders, eating disorders, or major depressive disorder.

  4. Life stress as a mediator and community belonging as a moderator of mood and anxiety disorders and co-occurring disorders with heavy drinking of gay, lesbian, bisexual, and heterosexual Canadians.

    Science.gov (United States)

    Pakula, Basia; Carpiano, Richard M; Ratner, Pamela A; Shoveller, Jean A

    2016-08-01

    To examine the extent to which sexual identity disparities in mental health outcomes (anxiety disorder, mood disorder, anxiety-mood disorder, and co-occurring anxiety or mood disorder and heavy drinking) are mediated by life stress or moderated by a sense of community belonging. This study pooled data from a large, national, multi-year sample of Canadians aged 18-59 years, who self-identified as lesbian, gay, bisexual, or heterosexual (N = 222,548). A series of stratified binary mediation models were fitted. Significance of the indirect effect was determined by using bootstrapping to obtain standard errors and confidence intervals. Sexual minority (versus heterosexual) respondents were significantly more likely to describe their lives as stressful, their sense of community belonging as weak, and had significantly greater odds of the negative mental health outcomes. Perceived life stress partially mediated the effects of sexual identity on the mental health outcomes. The differences between the mediated effects for the gay/lesbian and bisexual subgroups were statistically significant (all p relationship with mood disorders for the gay/lesbian group, where a strong sense of community belonging was associated with greater odds of mood disorders for gay/lesbian versus heterosexual respondents. These mediation and moderated mediation models provide further evidence for a social patterning of the mental health disparities experienced by sexual minorities in Canada.

  5. Experimental infection of Hawai'i 'Amakihi (hemignathus virens) with West Nile virus and competence of a co-occurring vector, culex quinquefasciatus: potential impacts on endemic Hawaiian avifauna.

    Science.gov (United States)

    Lapointe, Dennis A; Hofmeister, Erik K; Atkinson, Carter T; Porter, Robert E; Dusek, Robert J

    2009-04-01

    Introduced mosquito-borne avian disease is a major limiting factor in the recovery and restoration of native Hawaiian forest birds. Annual epizootics of avian pox (Avipoxvirus) and avian malaria (Plasmodium relictum) likely led to the extinction of some species and continue to impact populations of susceptible Hawaiian honeycreepers (Drepanidinae). The introduction of a novel pathogen, such as West Nile virus (WNV), could result in further population declines and extinctions. During September and October 2004, we infected Hawai'i' Amakihi (Hemignathus virens) with a North American isolate of WNV by needle inoculation and mosquito bite to observe susceptibility, mortality, and illness in this endemic passerine, and to determine the vector competence of the co-occurring, introduced mosquito Culex quinquefasciatus. All experimentally infected Hawai'i ;Amakihi became viremic, with a mean titer >10(5) plaque-forming units (PFU)/ml, and they experienced clinical signs ranging from anorexia and lethargy to ataxia. The fatality rate among needle-inoculated Hawai'i' Amakihi (n=16) was 31.3%, but mortality in free-ranging birds is likely to increase due to predation, starvation, thermal stress, and concomitant infections of avian malaria and pox. Surviving Hawai'i' Amakihi seem to clear WNV from the peripheral blood by 7-10 days postinfection (DPI), and neutralizing antibodies were detected from 9 to 46 DPI. In transmission trials, Hawaiian Cx. quinquefasciatus proved to be a competent vector and Hawai'i Amakihi an adequate amplification host of WNV, suggesting that epizootic WNV could readily become an additional limiting factor of some native Hawaiian bird populations.

  6. Experimental infection of Hawai'i 'Amakihi (hemignathus virens) with West Nile virus and competence of a co-occurring vector, culex quinquefasciatus: potential impacts on endemic Hawaiian avifauna.

    Science.gov (United States)

    Lapointe, Dennis; Hofmeister, Erik K.; Atkinson, C.T.; Porter, R.E.; Dusek, Robert J.

    2009-01-01

    Introduced mosquito-borne avian disease is a major limiting factor in the recovery and restoration of native Hawaiian forest birds. Annual epizootics of avian pox (Avipoxvirus) and avian malaria (Plasmodium relictum) likely led to the extinction of some species and continue to impact populations of susceptible Hawaiian honeycreepers (Drepanidinae). The introduction of a novel pathogen, such as West Nile virus (WNV), could result in further population declines and extinctions. During September and October 2004, we infected Hawai'i' Amakihi (Hemignathus virens) with a North American isolate of WNV by needle inoculation and mosquito bite to observe susceptibility, mortality, and illness in this endemic passerine, and to determine the vector competence of the co-occurring, introduced mosquito Culex quinquefasciatus. All experimentally infected Hawai'i ;Amakihi became viremic, with a mean titer >10(5) plaque-forming units (PFU)/ml, and they experienced clinical signs ranging from anorexia and lethargy to ataxia. The fatality rate among needle-inoculated Hawai'i' Amakihi (n=16) was 31.3%, but mortality in free-ranging birds is likely to increase due to predation, starvation, thermal stress, and concomitant infections of avian malaria and pox. Surviving Hawai'i' Amakihi seem to clear WNV from the peripheral blood by 7-10 days postinfection (DPI), and neutralizing antibodies were detected from 9 to 46 DPI. In transmission trials, Hawaiian Cx. quinquefasciatus proved to be a competent vector and Hawai'i Amakihi an adequate amplification host of WNV, suggesting that epizootic WNV could readily become an additional limiting factor of some native Hawaiian bird populations.

  7. Co-occurring mycotoxins in animal feeds

    African Journals Online (AJOL)

    STORAGESEVER

    2008-07-04

    Jul 4, 2008 ... Mycotoxin contamination of feeds results in economic loss and transmission of toxins in the food chain. Animal feeds, the raw ingredients used in their manufacture, namely, maize, wheat, sunflower seeds, cottonseeds, bagasse, wheaten bran, gluten feed and pet foods from South Africa were surveyed for.

  8. Down Syndrome: Co-Occuring Conditions

    Science.gov (United States)

    Become an All-Star with NDSS & Zac Stacy! Learn more ! Skip to content Toggle navigation Home Our Story Mission Say Hello to Our ... a part of the 200+ advocates on the hill meeting with elected officials was inspiring and powerful. ...

  9. Co-occurring mycotoxins in animal feeds

    African Journals Online (AJOL)

    STORAGESEVER

    2008-07-04

    Jul 4, 2008 ... Toxins were extracted and analysed by high performance liquid chromatography and fluorometry. Twenty-one of the ... mycotoxins have been identified, the toxicology of a few have been established for .... determined with the fluorometer and that of fumonisins by HPLC and were respectively 4 µg/kg for ...

  10. Interactions between Cooccurring Lactic Acid Bacteria in Honey Bee Hives.

    Science.gov (United States)

    Rokop, Z P; Horton, M A; Newton, I L G

    2015-10-01

    In contrast to the honey bee gut, which is colonized by a few characteristic bacterial clades, the hive of the honey bee is home to a diverse array of microbes, including many lactic acid bacteria (LAB). In this study, we used culture, combined with sequencing, to sample the LAB communities found across hive environments. Specifically, we sought to use network analysis to identify microbial hubs sharing nearly identical operational taxonomic units, evidence which may indicate cooccurrence of bacteria between environments. In the process, we identified interactions between noncore bacterial members (Fructobacillus and Lactobacillaceae) and honey bee-specific "core" members. Both Fructobacillus and Lactobacillaceae colonize brood cells, bee bread, and nectar and may serve the role of pioneering species, establishing an environment conducive to the inoculation by honey bee core bacteria. Coculture assays showed that these noncore bacterial members promote the growth of honey bee-specific bacterial species. Specifically, Fructobacillus by-products in spent medium supported the growth of the Firm-5 honey bee-specific clade in vitro. Metabolic characterization of Fructobacillus using carbohydrate utilization assays revealed that this strain is capable of utilizing the simple sugars fructose and glucose, as well as the complex plant carbohydrate lignin. We tested Fructobacillus for antibiotic sensitivity and found that this bacterium, which may be important for establishment of the microbiome, is sensitive to the commonly used antibiotic tetracycline. Our results point to the possible significance of "noncore" and environmental microbial community members in the modulation of honey bee microbiome dynamics and suggest that tetracycline use by beekeepers should be limited. Copyright © 2015, American Society for Microbiology. All Rights Reserved.

  11. Co-occurring Disorders in Children Who Stutter.

    Science.gov (United States)

    Blood, Gordon W.; Ridenour Jr., Victor J.; Qualls, Constance Dean; Hammer, Carol Scheffner

    2003-01-01

    A survey of 1,184 speech language pathologists found that of 2,628 children (grades 1-12) who stuttered, 62.6% had other concurring speech disorders, language disorders, or non-speech-language disorders. Articulation disorders (33.5%) and phonology disorders (12.7%) were the most frequently reported. Males were more likely to exhibit co-occurring…

  12. Co-occurence of Invasive Species on Priority TES Installations

    Science.gov (United States)

    2006-05-01

    Nutrient mineralization rate Nutrient immobilization rate Soil and water chemistry Altered disturbance regime Type ...with installation. Scientific name Scientific name of NIS. Form Life form of NIS. Habitat Habitat type species is most likely to occur in; F... Herbarium , Bruce Baldwin, 510-643-7008 Sea Grant, http://endeavor.des.ucdavis.edu/weeds/countylist.asp California Exotic Pest Plant Council, http

  13. Does adolescent gambling co-occur with young fatherhood?

    Science.gov (United States)

    Lee, Grace P; Storr, Carla L; Ialongo, Nicholas S; Martins, Silvia S

    2013-01-01

    Young fatherhood is associated with various adverse outcomes. This study aims to describe the relationship of adolescent gambling with young fatherhood (by age 20) while adjusting for several young fatherhood antecedents. Data were from 294 males who have been followed for 16 years since entering first grade in nine inner city public schools (86% African Americans, 81% of the original male cohort). Self-reports of impregnation (including age) and gambling were collected during late adolescence. Nelson-Aalen curves and Cox regression models assessed the hazard of young fatherhood among adolescent nongamblers, social gamblers, and problem gamblers. More young fathers than nonfathers reported adolescent social (49.2% vs. 42.5%) and problem gambling (28.3% vs. 13.2%, p fatherhood, followed by social gambling (aHR = 1.95, 95% CI = 1.30, 2.94, p = .001), high school dropout (aHR = 1.75, 95% CI = 1.14, 2.70, p = .01), and subsidized lunch status (aHR = 1.69, 95% CI = 1.01, 2.38, p = .04). Adolescent male gamblers, particularly problem gamblers, were more likely than their nongambling peers to become fathers by the age of 20. Such a result shows that there is a subpopulation of males who are at high risk for adverse outcomes such as young parenthood and problem behaviors. Only through further studies could the needs of this subpopulation be better assessed so that appropriate assistance could be delivered to better the lives of such individuals. Copyright © American Academy of Addiction Psychiatry.

  14. Co-occurring mycotoxins in animal feeds | Mngadi | African Journal ...

    African Journals Online (AJOL)

    Mycotoxin contamination of feeds results in economic loss and transmission of toxins in the food chain. Animal feeds, the raw ingredients used in their manufacture, namely, maize, wheat, sunflower seeds, cottonseeds, bagasse, wheaten bran, gluten feed and pet foods from South Africa were surveyed for contaminating ...

  15. WORDS WITH REGARD TO HOUSING IN DEDE QORQUT STORIES AND ON OVERVIEW TO CO-OCCURENCE OF THIS WORDS DEDE KORKUT HİKÂYELERİNDE BARINMA İLE İLGİLİ SÖZLER VE BU SÖZLERİN BİRLİKTELİK KULLANIMLARI ÜZERİNE

    Directory of Open Access Journals (Sweden)

    Yeter TORUN

    2011-09-01

    Full Text Available Dede Qorqut Stories is one of the most important works in history of Turkic culture and Turkic languages. The life style and understanding life of societies can be seen on languages of societies. Accordingly it is possible to determine the cultural values of nomadic Oguzs in Dede Qorqut Stories. What kind of features did Oguzs’s houses have and which words did they use to refer? From this point of view, it has been defined and discussed the vocabulary with regard to housing in Dede Qorqut Stories according to co-occurence. It has been also divided into two sub-classes such as nomadic life and permanent settlement the words with regard to housing conceptual field in the stories. In the result of research, it has been realized that the words with regard to nomadic life were used more than permanent settlement. In the words related to tent-type houses, it has been deternined that color adjectives are used with tent-type houses more often. Also, in the places where tent-type houses are pitched, it is obvious that color adjectives are used frequently. The nouns related to nomadic life are widely used with the verbs dik- “to erect / to pitch” and kur- “to put up / to set up”, besides it is apparent that the nouns with regard to permanent settlement are used with verb yap- “to do”. Dede Korkut hikâyeleri Türk kültür tarihi ve Türk dili için en önemli eserlerden biridir. Toplumların yaşam biçimleri, dünyayı algılayışları o toplumun dilinde de kendini gösterir. Bu doğrultuda Dede Korkut hikâyelerinde göçebe Oğuzların maddi ve manevi kültür değerlerini belirlemek mümkündür. Acaba Oğuzların barındıkları evleri ne gibi özellikler taşıyordu ve bu yapıları adlandırmak için hangi sözleri kullanıyorlardı? Bu sorulardan hareketle Dede Korkut hikâyelerindeki barınmayla ilgili söz varlığı tespit edilmiş ve bu sözler metin bağlamı içinde birliktelik kullanımlarına göre de

  16. Tricyclic Antidepressants and Tetracyclic Antidepressants

    Science.gov (United States)

    ... 2016. Amoxapine (prescribing information). Verna, Salcette Goa, India: Watson Pharma; 2014. http://www.accessdata.fda.gov/drugsatfda_ ... mayoclinic.org/diseases-conditions/depression/in-depth/antidepressants/ART-20046983 . Mayo Clinic Footer Legal Conditions and Terms ...

  17. Decomposition and nutrient release in leaves of Atlantic Rainforest tree species used in agroforestry systems

    NARCIS (Netherlands)

    Duarte, E.M.G.; Cardoso, I.M.; Stijnen, T.; Mendonça, M.A.F.C.; Coelho, M.S.; Cantarutti, R.B.; Kuyper, T.W.; Villani, E.M.A.; Mendonça, E.S.

    2013-01-01

    Aiming to support the use of native species from the Atlantic Rainforest in local agroforestry systems, we analysed chemical and biochemical components related to leaf decomposition of Inga subnuda, Senna macranthera, Erythrina verna, Luehea grandiflora, Zeyheria tuberculosa, Aegiphila sellowiana,

  18. Improving Care for Co-Occurring Psychological Health and Substance Use Disorders: An Implementation Evaluation of the Co-Occurring Disorders Clinician Training Program

    Science.gov (United States)

    2015-01-01

    Combatant Com- mands, the Navy, the Marine Corps, the defense agencies, and the defense Intelligence Community. For more information on the RAND...12 33.3 Medications for psychiatric disorders 11 30.6 Description of Survey Participants and SARP Characteristics 33 psychotherapy . The reasons for...from the CODP. LIB is a group-oriented pro- gram that focuses primarily on substance abuse but includes sessions related to anger, negative emotions

  19. Moulinier L., Sallmann L., Verna C. et Weill-Parot N.(dir.), La juste mesure. Quantifier, évaluer, mesurer, entre Orient et Occident (VIIIe-XVIIIe siècle), Saint-Denis, Presses Universitaires de Vincennes, Collection Temps et espaces, 2005, 205

    OpenAIRE

    Verdier, Nicolas

    2005-01-01

    Ce nouveau volume de la collection Temps et espaces rassemble une série de dix textes introduits solidement et dont les réflexions et la bibliographie orienteront tous ceux qui souhaitent se faire une idée de ce champs de la recherche. Les auteurs les plus érudits et savants y sont cités, et les livres les plus problématiques y sont à juste titre accrochés. L’ensemble des textes n’intéressera pas nécessairement tous les géographes, cela même si la plupart méritent une lecture attentive, tant ...

  20. Aplicação de espectrometria de massas com ionização por elétron na análise de alcaloides do mulungu

    Directory of Open Access Journals (Sweden)

    Luís Guilherme Pereira Feitosa

    2012-01-01

    Full Text Available Erythrina verna is a medicinal plant used to calm agitation popularly known as mulungu. We purchased the barks of E. verna from a commercial producer and analyzed the alkaloid fraction of the bark by CG-MS and HRESI-MS. Five erythrinian alkaloids were identified: erysotrine, erythratidine, erythratidinone, epimer, and 11-hydroxieritratidinone. Here we report the compound 11-hydroxieritratidinone for the first time as a natural product.

  1. Application of electron ionization mass spectrometry for mulungu alkaloid analysis; Aplicacao de espectrometria de massas com ionizacao por eletron na analise de alcaloides do mulungu

    Energy Technology Data Exchange (ETDEWEB)

    Feitosa, Luis Guilherme Pereira; Guaratini, Thais; Lopes, Joao Luis Callegari; Lopes, Norberto Peporine [Universidade de Sao Paulo (FCFRP/USP), Ribeirao Preto, SP (Brazil). Fac. de Ciencias Farmaceuticas de Ribeirao Preto. Dept. de Quimica e Fisica; Bizaro, Aline Cavalli; Silva, Denise Brentan da, E-mail: npelopes@fcfrp.usp.br [Incubadora SUPERA, Ribeirao Preto, SP (Brazil). Lychnoflora Pesquisa e Desenvolvimento em Produtos Naturais

    2012-07-01

    Erythrina verna is a medicinal plant used to calm agitation popularly known as mulungu. We purchased the barks of E. verna from a commercial producer and analyzed the alkaloid fraction of the bark by CG-MS and HRESI-MS. Five erythrinian alkaloids were identified: erysotrine, erythratidine, erythratidinone, epimer, and 11-hydroxyeritratidinone. Here we report the compound 11-hydroxyeritratidinone for the first time as a natural product. (author)

  2. Psychotic experiences co-occur with sleep problems, negative affect and mental disorders in preadolescence

    DEFF Research Database (Denmark)

    Jeppesen, Pia; Clemmensen, Lars; Munkholm, Anja

    2014-01-01

    BACKGROUND: Knowledge on the significance of childhood psychotic symptoms and experiences (PE) is still limited. This study aimed to investigate the prevalence and clinical significance of PE in preadolescent children from the general population by use of in-depth psychopathological interviews...... and comprehensive diagnostic assessments. METHODS: We investigated 1,632 children from the general population-based Copenhagen Child Cohort 2000. PE were measured by semistructured interviews using the K-SADS-PL-items on psychotic and affective symptoms, each symptom scored as not present versus likely...... were examined by multivariable binomial regression analyses, adjusting for gender and onset of puberty. RESULTS: The weighted life time prevalence of PE at age 11-12 years was 10.9% (CI 9.1-12.7). The majority of children with PE (n = 172) either had a diagnosable DSM-IV-mental disorder (31.4%) or self...

  3. Interspecific variation in prey capture behavior by co-occurring Nepenthes pitcher plants

    Science.gov (United States)

    Chin, Lijin; Chung, Arthur YC; Clarke, Charles

    2014-01-01

    Pitcher plants of the genus Nepenthes capture a wide range of arthropod prey for nutritional benefit, using complex combinations of visual and olfactory signals and gravity-driven pitfall trapping mechanisms. In many localities throughout Southeast Asia, several Nepenthes different species occur in mixed populations. Often, the species present at any given location have strongly divergent trap structures and preliminary surveys indicate that different species trap different combinations of arthropod prey, even when growing at the same locality. On this basis, it has been proposed that co-existing Nepenthes species may be engaged in niche segregation with regards to arthropod prey, avoiding direct competition with congeners by deploying traps that have modifications that enable them to target specific prey types. We examined prey capture among 3 multi-species Nepenthes populations in Borneo, finding that co-existing Nepenthes species do capture different combinations of prey, but that significant interspecific variations in arthropod prey combinations can often be detected only at sub-ordinal taxonomic ranks. In all lowland Nepenthes species examined, the dominant prey taxon is Formicidae, but montane Nepenthes trap few (or no) ants and 2 of the 3 species studied have evolved to target alternative sources of nutrition, such as tree shrew feces. Using similarity and null model analyses, we detected evidence for niche segregation with regards to formicid prey among 5 lowland, sympatric Nepenthes species in Sarawak. However, we were unable to determine whether these results provide support for the niche segregation hypothesis, or whether they simply reflect unquantified variation in heterogeneous habitats and/or ant communities in the study sites. These findings are used to propose improvements to the design of field experiments that seek to test hypotheses about targeted prey capture patterns in Nepenthes. PMID:24481246

  4. Tree architecture and life-history strategies across 200 co-occurring tropical tree species

    NARCIS (Netherlands)

    Iida, Y.; Kohyama, T.S.; Kubo, T.; Kassim, A.R.; Poorter, L.; Sterck, F.J.; Potts, M.D.

    2011-01-01

    1. Tree architecture is thought to allow species to partition horizontal and vertical light gradients in the forest canopy. Tree architecture is closely related to light capture, carbon gain and the efficiency with which trees reach the canopy. Previous studies that investigated how light gradients

  5. Wood density explains architectural differentiation across 145 co-occurring tropical tree species

    NARCIS (Netherlands)

    Iida, Y.; Poorter, L.; Sterck, F.J.; Kubo, T.; Kassim, A.R.; Potts, M.D.; Kohyama, T.S.

    2012-01-01

    1. Because of its mechanical properties, wood density may affect the way that trees expand their stem and crown to exploit favourable light conditions in a mechanically stable way. From engineering theory and wood density properties, it is predicted that in terms of biomass investment, low-density

  6. Gene Flow among Populations of Two Rare Co-Occurring Fern Species Differing in Ploidy Level

    Czech Academy of Sciences Publication Activity Database

    Bucharová, Anna; Münzbergová, Zuzana

    2012-01-01

    Roč. 7, č. 9 (2012), e45855 E-ISSN 1932-6203 R&D Projects: GA MŠk 2B06178; GA ČR GA526/09/0549 Institutional support: RVO:67985939 Keywords : genetic variation * tetraploid species * diploid species Subject RIV: EF - Botanics Impact factor: 3.730, year: 2012

  7. Co-occurence of Two Invasive Species: The Banded and European Elm Bark Beetles (Coleoptera: Scolytidae)

    Science.gov (United States)

    The invasive European elm bark beetle, Scolytus multistriatus (Marsham), was first detected a century ago and now occurs in most of the continental United States. The invasive banded elm bark beetle, Scolytus schevyrewi Semenov, native to Asia, was discovered in the United States in 2003 and is now...

  8. Links between Co-Occurring Social-Communication and Hyperactive-Inattentive Trait Trajectories

    Science.gov (United States)

    St. Pourcain, Beate; Mandy, William P.; Heron, Jon; Golding, Jean; Smith, George Davey; Skuse, David H.

    2011-01-01

    Objective: There is overlap between an autistic and hyperactive-inattentive symptomatology when studied cross-sectionally. This study is the first to examine the longitudinal pattern of association between social-communication deficits and hyperactive-inattentive symptoms in the general population, from childhood through adolescence. We explored…

  9. Visualization of cancer and cardiovascular disease co-occurence with network methods

    NARCIS (Netherlands)

    Duarte, C.W.; Lindner, V.; Francis, S.A.; Schoormans, D.

    2018-01-01

    Purpose Cancer and cardiovascular disease (CVD) are common causes of morbidity and mortality, and measurement and interpretation of their co-occurrence rate have important implications for public health and patient care. Here, we present the raw and adjusted co-occurrence rates of cancer and CVD in

  10. Restorative Integral Support (RIS) for Older Adults Experiencing Co-Occurring Disorders

    Science.gov (United States)

    Larkin, Heather; MacFarland, Nicole S.

    2012-01-01

    The Restorative Integral Support (RIS) model is a whole person response that assists people to overcome adversity. The Adverse Childhood Experiences (ACE) Study conducted by Kaiser Permanente and the Centers for Disease Control and Prevention shows the association between stressors in childhood and multiple later-life health and social problems.…

  11. Psychiatric Rehabilitation of Persons with Co-Occurring Disorders and Corrections Involvement

    Science.gov (United States)

    Bernacchio, Charles; Burker, Eileen J.

    2016-01-01

    Purpose: Today, the criminal justice system is annually placing more than 300,000 people with severe mental illness (SMI) in prisons and jails which are neither equipped nor staffed to respond to the unique challenges of this population. This article provides a comprehensive overview of the literature that focuses on treating inmates with…

  12. Demoralization in patients with substance use and co-occurring psychiatric disorders

    NARCIS (Netherlands)

    Weert-van Oene, G.H. de; Markus, W.; Kissane, D.W.; Jong, C.A.J. de

    2017-01-01

    Objective. In recent years, treatment of patients with substance use disorder has rekindled emphasis on recovery which, being a gradual process, starts with remoralization. In this study, we examine the level of demoralization throughout the treatment process for patients with comorbid substance

  13. Substance Abuse Treatment for Persons with Co-Occurring Disorders. Treatment Improvement Protocol (TIP) Series 42

    Science.gov (United States)

    Substance Abuse and Mental Health Services Administration, 2005

    2005-01-01

    Treatment Improvement Protocols (TIPs), developed by the Center for Substance Abuse Treatment (CSAT), part of the Substance Abuse and Mental Health Services Administration (SAMHSA) within the U.S. Department of Health and Human Services (DHHS), are best-practice guidelines for the treatment of substance use disorders. CSAT draws on the experience…

  14. Co-occurring manic symptomatology influences HPA axis alterations in depression

    NARCIS (Netherlands)

    Jabben, Nienke; Nolen, Willem A.; Smit, Johannes H.; Vreeburg, Sophie A.; Beekman, Aartjan T. F.; Penninx, Brenda

    Although dysfunctioning of the HPA axis is considered to be a core pathophysiological process in mood disorders, the evidence with regard to depression remains conflicting. This could partly be due to the large heterogeneity within mood disorders, since HPA axis abnormalities may also be associated

  15. Intensity of Support Needs in Relation to Co-Occurring Psychiatric Disorders

    Science.gov (United States)

    Tasse, Marc J.; Wehmeyer, Michael L.

    2010-01-01

    There is a growing body of research on the construct of support needs in individuals with intellectual disability (ID). An increasing emphasis is being placed on measuring and understanding the needs for supports and the factors that drive the intensity of these support needs. Prior research has firmly established that individuals with ID are more…

  16. Co-occurring manic symptomatology as a dimension which may help explaining heterogeneity of depression

    NARCIS (Netherlands)

    Jabben, Nienke; Penninx, Brenda; Beekman, Aartjan T. F.; Smit, Johannes H.; Nolen, Willem A.

    Background: The dichotomous distinction between unipolar and bipolar disorders may be challenged by heterogeneity within diagnoses and overlap between different diagnoses. A broad mood disorder category in which patients differ as a result of variation along separate manic and depressive mood

  17. Classification of Co-Occurring Depression and Substance Abuse Symptoms Predicts Suicide Attempts in Adolescents

    Science.gov (United States)

    Effinger, Jenell M.; Stewart, David G.

    2012-01-01

    Although both depression and substance use have been found to contribute to suicide attempts, the synergistic impact of these disorders has not been fully explored. Additionally, the impact of subthreshold presentations of these disorders has not been researched. We utilized the Quadrant Model of Classification (a matrix of severity of two…

  18. Supportive Psychotherapy with the Dual Diagnosis Patient: Co-occurring Mental Illness/Intellectual Disabilities

    OpenAIRE

    Gentile, Julie P.; Jackson, Carroll S.

    2008-01-01

    Psychiatrists and other mental health professionals can offer much in the care of patients with intellectual disabilities, including state-of-the-art medication regimens, psychotherapy, and other behavior therapies. Individuals with intellectual disabilities experience the full range of mental illnesses, but are often thought to be incapable of participating in or responding to psychotherapy. The following composite cases illustrate some of the psychotherapy techniques employed in a community...

  19. Water-use strategies in two co-occurring Mediterranean evergreen oaks: surviving the summer drought.

    Science.gov (United States)

    David, T S; Henriques, M O; Kurz-Besson, C; Nunes, J; Valente, F; Vaz, M; Pereira, J S; Siegwolf, R; Chaves, M M; Gazarini, L C; David, J S

    2007-06-01

    In the Mediterranean evergreen oak woodlands of southern Portugal, the main tree species are Quercus ilex ssp. rotundifolia Lam. (holm oak) and Quercus suber L. (cork oak). We studied a savannah-type woodland where these species coexist, with the aim of better understanding the mechanisms of tree adaptation to seasonal drought. In both species, seasonal variations in transpiration and predawn leaf water potential showed a maximum in spring followed by a decline through the rainless summer and a recovery with autumn rainfall. Although the observed decrease in predawn leaf water potential in summer indicates soil water depletion, trees maintained transpiration rates above 0.7 mm day(-1) during the summer drought. By that time, more than 70% of the transpired water was being taken from groundwater sources. The daily fluctuations in soil water content suggest that some root uptake of groundwater was mediated through the upper soil layers by hydraulic lift. During the dry season, Q. ilex maintained higher predawn leaf water potentials, canopy conductances and transpiration rates than Q. suber. The higher water status of Q. ilex was likely associated with their deeper root systems compared with Q. suber. Whole-tree hydraulic conductance and minimum midday leaf water potential were lower in Q. ilex, indicating that Q. ilex was more tolerant to drought than Q. suber. Overall, Q. ilex seemed to have more effective drought avoidance and drought tolerance mechanisms than Q. suber.

  20. Clinical characteristics of children and young adults with co-occurring autism spectrum disorder and epilepsy.

    Science.gov (United States)

    El Achkar, Christelle M; Spence, Sarah J

    2015-06-01

    The association between autism spectrum disorder (ASD) and epilepsy has been described for decades, and yet we still lack the full understanding of this relationship both clinically and at the pathophysiologic level. This review evaluates the available data in the literature pertaining to the clinical characteristics of patients with autism spectrum disorder who develop epilepsy and, conversely, patients with epilepsy who develop autism spectrum disorder. Many studies demonstrate an increased risk of epilepsy in individuals with ASD, but rates vary widely. This variability is likely secondary to the different study methods employed, including the study population and definitions of the disorders. Established risk factors for an increased risk of epilepsy in patients with ASD include intellectual disability and female gender. There is some evidence of an increased risk of epilepsy associated with other factors such as ASD etiology (syndromic), severity of autistic features, developmental regression, and family history. No one epilepsy syndrome or seizure type has been associated, although focal or localization-related seizures are often reported. The age at seizure onset can vary from infancy to adulthood with some evidence of a bimodal age distribution. The severity and intractability of epilepsy in populations with ASD have not been well studied, and there is very little investigation of the role that epilepsy plays in the autism behavioral phenotype. There is evidence of abnormal EEGs (especially epileptiform abnormalities) in children with ASD even in the absence of clinical seizures, but very little is known about this phenomenon and what it means. The development of autism spectrum disorder in patients with epilepsy is less well studied, but there is evidence that the ASD risk is greater in those with epilepsy than in the general population. One of the risk factors is intellectual disability, and there is some evidence that the presence of a particular seizure type, infantile spasms, may increase risk, but some of the data are conflicting. We believe that one of the reasons that so little is known about this phenomenon is the lack of cross talk between researchers and clinicians alike in the two fields. We conclude that large systematic studies that employ strict ascertainment of samples using standardized definitions of both disorders, validated data collection tools, and appropriate longitudinal follow-up are needed to better shed light on certain clinical aspects of the comorbidity of ASD and epilepsy. Ideally, we could provide the optimal diagnostic and treatment services to these patients in a multidisciplinary setting with both epilepsy and neurobehavioral specialists. This article is part of a Special Issue entitled "Autism and Epilepsy". Copyright © 2015 Elsevier Inc. All rights reserved.

  1. Heterogeneity in autism spectrum disorder: clarifying core- and co-occurring characteristics, correlates and course

    NARCIS (Netherlands)

    M.L.J.M. Eussen (Mart)

    2015-01-01

    markdownabstractThe first aim of this thesis is to gain more insight in the phenotypical variance of core and eo-occurring symptoms of ASD. The specific research questions concerning this first aim are: 1. Do symptom profiles on core ASD symptoms support a categorical view with different

  2. Co-occurring Conditions Toolkit: Mild Traumatic Brain Injury and Psychological Health

    Science.gov (United States)

    2009-01-01

    Disorder (PTSD), Obsessive Compulsive Disorder (OCD), Panic Disorder , Bulimia and Premenstrual Dysphoric Disorder (PMDD). SSRIs, Serotonin... disorder , anorexia, bulimia , patients undergoing abrupt discon- tinuation of ethanol or seda- tives (including Benzodiaz- epines) and pa- tients...taken by 5 pm C yy In higher doses may in- duce seizures in persons with seizure disorders or eating disor- ders; Seizure risk is dose dependent

  3. Trauma Focused CBT for Children with Co-Occurring Trauma and Behavior Problems

    Science.gov (United States)

    Cohen, Judith A.; Berliner, Lucy; Mannarino, Anthony

    2010-01-01

    Objective: Childhood trauma impacts multiple domains of functioning including behavior. Traumatized children commonly have behavioral problems that therapists must effectively evaluate and manage in the context of providing trauma-focused treatment. This manuscript describes practical strategies for managing behavior problems in the context of…

  4. Demography of common toads after local extirpation of co-occurring midwife toads

    Science.gov (United States)

    Bosch, Jaime; Fernandez-Beaskoetxea, S; Scherer, R.; Amburgey, Staci; Muths, Erin L.

    2014-01-01

    Estimating demographic parameters like survival or recruitment provides insight into the state and trajectory of populations, but understanding the contexts influencing those parameters, including both biotic and abiotic factors, is particularly important for management and conservation. At a high elevation national park in Central Spain, common toads (Bufo bufo) are apparently taking advantage of the near-extirpation of the midwife toad (Alytes obstetricans), as colonization into new breeding ponds is evident. Within this scenario, we expected demographic parameters of common toad populations tobe affected favorably by the putative release from competition. However, we found the population growth rate was negative in 4 of 5 years at the long-standing population; survival probability at the long-standing population and newly-colonised breeding ponds was lower than reported for other toads living at high elevations and the probability of recruitment was inadequate to compensate for the survival rate in maintaining a positive trajectory for either of the breeding ponds. We assessed weather covariates and disease for their contribution to the context that may be limiting the common toad’s successful use of the niche vacated by the midwife toad.

  5. [Co-occurring trichinellosis and sausage poisoning: report of 4 cases].

    Science.gov (United States)

    Furmaniuk, J

    1996-01-01

    Four cases of the coexisting trichinellosis and botulism. Four cases of the coexisting trichinellosis and botulism in an epidemia of trichinellosis are presented. Botulism varied in the clinical expressing causing diagnostic especially in an index care.

  6. Neurocognitive dysfunction in problem gamblers with co-occurring antisocial personality disorder.

    Science.gov (United States)

    Blum, Austin W; Leppink, Eric W; Grant, Jon E

    2017-07-01

    Problem gamblers with symptoms of antisocial personality disorder (ASPD) may represent a distinct problem gambling subtype, but the neurocognitive profile of individuals affected by both disorders is poorly characterized. Non-treatment-seeking young adults (18-29years) who gambled ≥5 times in the preceding year were recruited from the general community. Problem gamblers (defined as those meeting ≥1 DSM-5 diagnostic criteria for gambling disorder) with a lifetime history of ASPD (N=26) were identified using the Mini International Neuropsychiatric Interview (MINI) and compared with controls (N=266) using questionnaire-based impulsivity scales and objective computerized neuropsychological tasks. Findings were uncorrected for multiple comparisons. Effect sizes were calculated using Cohen's d. Problem gambling with ASPD was associated with significantly elevated gambling disorder symptoms, lower quality of life, greater psychiatric comorbidity, higher impulsivity questionnaire scores on the Barratt Impulsiveness Scale (d=0.4) and Eysenck Impulsivity Questionnaire (d=0.5), and impaired cognitive flexibility (d=0.4), executive planning (d=0.4), and an aspect of decision-making (d=0.6). Performance on measures of response inhibition, risk adjustment, and quality of decision making did not differ significantly between groups. These preliminary findings, though in need of replication, support the characterization of problem gambling with ASPD as a subtype of problem gambling associated with higher rates of impulsivity and executive function deficits. Taken together, these results may have treatment implications. Copyright © 2017 Elsevier Inc. All rights reserved.

  7. Dyspnea and Pain Frequently Co-occur among Medicare Managed Care Recipients

    Science.gov (United States)

    Clark, Nathan; Fan, Vincent S.; Slatore, Christopher G.; Locke, Emily; Whitson, Heather E.; Nici, Linda

    2014-01-01

    Rationale: Experimental and neuroimaging studies have suggested strong associations between dyspnea and pain. The co-occurrence of these symptoms has not been examined in community samples. Objectives: We sought to ascertain the co-occurrence of pain and dyspnea by self-report in a large cohort of Medicare recipients. Methods: We analyzed data from 266,000 Medicare Managed Care recipients surveyed in 2010 and 2012. Dyspnea was defined by aggregating three questions about shortness of breath (at rest, while walking one block, and while climbing stairs). Pain was measured by four questions about pain interference, chest pain, back pain, and arthritis pain. All measures were dichotomized as high or low/none. We calculated the co-occurrence of pain and dyspnea at baseline, and generated logistic regression models to find the adjusted relative risk (RR) of their co-occurrence, adjusting for patient-level factors and three potential medical causes of dyspnea (chronic obstructive pulmonary disease/emphysema/asthma, congestive heart failure, and obesity). We modeled the simultaneous development and the simultaneous resolution of dyspnea and pain between baseline and 2 years. Measurements and Main Results: Participants with dyspnea had considerably higher prevalence of pain than those without (64 vs. 18%). In fully adjusted models, participants with any of the types of pain were substantially more likely to report dyspnea than those without these types of pain (high pain interference: relative risk [RR], 1.99; 95% confidence interval [CI], 1.92–2.07; chest pain: RR, 2.11; 95% CI, 2.04–2.18; back pain: RR, 1.76; 95% CI, 1.71–1.82; and arthritis pain: RR, 1.49; 95% CI, 1.44–1.54). The relative risks of dyspnea developing or resolving at 2 years were greatly increased (RRs of 1.5 – 4) if pain also developed or resolved. Conclusions: Pain and dyspnea commonly occurred, developed, and resolved together. Most older adults with dyspnea also reported pain. Medical conditions typically assumed to cause dyspnea did not account for this association. The most plausible explanation for the co-occurrence is physical deconditioning. PMID:24960243

  8. How Fetal Alcohol Spectrum Disorders Co-Occur with Mental Illness

    Science.gov (United States)

    ... go unrecognized or are misdiagnosed as a mental illness or brain injury. Individuals with an FASD may also receive multiple diagnoses, such as attention deficit/hyperactivity disorder (ADHD),oppositional defiant disorder, and anxiety disorder. Therefore, it is important to determine whether ...

  9. Taste assessment in normal weight and overweight individuals with co-occurring Binge Eating Disorder.

    Science.gov (United States)

    Arlt, Jean M; Smutzer, Gregory S; Chen, Eunice Y

    2017-06-01

    Taste perception influences food choice, and may contribute to both weight status and disordered eating. Relatively little work has attempted to disentangle contributions of weight status and Binge Eating Disorder (BED) to human taste perception. We predicted weight status and BED would interact, showing difference in taste perception from non-eating disorder matched groups. The four study groups included: normal weight BED (NW BED), normal weight healthy controls (NW HC), overweight BED (OW BED), and overweight healthy controls (OW HC) (N = 60). Groups were matched for age (±5 years), ethnicity, and weight status. Participants were assessed using the Structured Clinical Interview for DSM-IV Axis I Disorders, the Eating Disorder Examination Version 16.0, and the NIH Toolbox Gustatory Assessment with additional taste solutions and taste stimulus delivered with edible taste strips. Interactions were found between weight status and diagnosis on measures of regional taste intensity for quinine hydrochloride (CI 95% [44.61, 56.31], p = 0.018), sucrose (CI 95% [46.79, 56.45], p = 0.003), and 6-n-propylthiouracil (CI 95% [25.557, 39.269], p = 0.015). OW BED participants perceived these taste stimuli significantly less intensely than OW HC and NW BED. Whole mouth taste intensity tests at suprathreshold amounts did not reveal group differences. All four groups reported similar hedonic response to taste stimuli. Edible taste strips had medium to large significant correlations with NIH Gustatory Assessment taste stimuli. There were significant differences in the taste perception of OW BED relative to the other three groups. These findings may provide partial explanation as to why previous studies correlating taste and weight status have mixed results. Replication in larger samples assessed longitudinally is needed to extend this work. Copyright © 2017 Elsevier Ltd. All rights reserved.

  10. EFFECTS OF GROWTH CONDITIONS AND CO-OCCURRING BACTERIA ON BREVETOXIN ACCUMULATION IN GYMNODINIUM BREVE.

    Science.gov (United States)

    Interstitial water in the swash zone, that area of a beach where waves continuously wash up on the sand, is suspected of accumulating microbes. If pathogens are concentrated in the interstitial water or if they grow, they may pose a health risk, especially for children. This s...

  11. The visual rooting reflex in individuals with autism spectrum disorders and co-occurring intellectual disability

    NARCIS (Netherlands)

    de Bildt, Annelies; Mulder, Erik J.; Van Lang, Natasja D. J.; de With, S. A. Jytte; Minderaa, Ruud B.; Stahl, Sherin S.; Anderson, George M.

    The rooting reflex has long been studied by neurologists and developmentalists and is defined as an orientation toward tactile stimulation in the perioral region or visual stimulation near the face. Nearly, all previous reports of the visual rooting reflex (VRR) concern its presence in adults with

  12. CO-occurring exposure to perchlorate, nitrate and thiocyanate alters thyroid function in healthy pregnant women

    International Nuclear Information System (INIS)

    Horton, Megan K.; Blount, Benjamin C.; Valentin-Blasini, Liza; Wapner, Ronald; Whyatt, Robin; Gennings, Chris; Factor-Litvak, Pam

    2015-01-01

    Background: Adequate maternal thyroid function during pregnancy is necessary for normal fetal brain development, making pregnancy a critical window of vulnerability to thyroid disrupting insults. Sodium/iodide symporter (NIS) inhibitors, namely perchlorate, nitrate, and thiocyanate, have been shown individually to competitively inhibit uptake of iodine by the thyroid. Several epidemiologic studies examined the association between these individual exposures and thyroid function. Few studies have examined the effect of this chemical mixture on thyroid function during pregnancy Objectives: We examined the cross sectional association between urinary perchlorate, thiocyanate and nitrate concentrations and thyroid function among healthy pregnant women living in New York City using weighted quantile sum (WQS) regression. Methods: We measured thyroid stimulating hormone (TSH) and free thyroxine (FreeT4) in blood samples; perchlorate, thiocyanate, nitrate and iodide in urine samples collected from 284 pregnant women at 12 (±2.8) weeks gestation. We examined associations between urinary analyte concentrations and TSH or FreeT4 using linear regression or WQS adjusting for gestational age, urinary iodide and creatinine. Results: Individual analyte concentrations in urine were significantly correlated (Spearman's r 0.4–0.5, p<0.001). Linear regression analyses did not suggest associations between individual concentrations and thyroid function. The WQS revealed a significant positive association between the weighted sum of urinary concentrations of the three analytes and increased TSH. Perchlorate had the largest weight in the index, indicating the largest contribution to the WQS. Conclusions: Co-exposure to perchlorate, nitrate and thiocyanate may alter maternal thyroid function, specifically TSH, during pregnancy. - Highlights: • Perchlorate, nitrate, thiocyanate and iodide measured in maternal urine. • Thyroid function (TSH and Free T4) measured in maternal blood. • Weighted quantile sum (WQS) regression examined complex mixture effect. • WQS identified an inverse association between the exposure mixture and maternal TSH. • Perchlorate indicated as the ‘bad actor’ of the mixture.

  13. CMIP haploinsufficiency in two patients with autism spectrum disorder and co-occurring gastrointestinal issues.

    Science.gov (United States)

    Luo, Minjie; Fan, Jinbo; Wenger, Tara L; Harr, Margaret H; Racobaldo, Melissa; Mulchandani, Surabhi; Dubbs, Holly; Zackai, Elaine H; Spinner, Nancy B; Conlin, Laura K

    2017-08-01

    Autism spectrum disorder (ASD) is a genetically heterogeneous group of disorders characterized by impairments in social communication and restricted interests. Though some patients with ASD have an identifiable genetic cause, the cause of most ASD remains elusive. Many ASD susceptibility loci have been identified through clinical studies. We report two patients with syndromic ASD and persistent gastrointestinal issues who carry de novo deletions involving the CMIP gene detected by genome-wide SNP microarray and fluorescence in situ hybridization (FISH) analysis. Patient 1 has a 517 kb deletion within 16q23.2q23.3 including the entire CMIP gene. Patient 2 has a 1.59 Mb deletion within 16q23.2q23.3 that includes partial deletion of CMIP in addition to 12 other genes, none of which have a known connection to ASD or other clinical phenotypes. The deletion of CMIP is rare in general population and was not found among a reference cohort of approximately 12,000 patients studied in our laboratory who underwent SNP array analysis for various indications. A 280 kb de novo deletion containing the first 3 exons of CMIP was reported in one patient who also demonstrated ASD and developmental delay. CMIP has previously been identified as a susceptibility locus for specific language impairment (SLI). It is notable that both patients in this study had significant gastrointestinal issues requiring enteral feedings, which is unusual for patients with ASD, in addition to unusually elevated birth length, further supporting a shared causative gene. These findings suggest that CMIP haploinsufficiency is the likely cause of syndromic ASD in our patients. © 2017 Wiley Periodicals, Inc.

  14. Fire Setting Behavior in a Child Welfare System: Prevalence, Characteristics and Co-Occurring Needs

    Science.gov (United States)

    Lyons, John S.; McClelland, Gary; Jordan, Neil

    2010-01-01

    Fire setting is one of the most challenging behaviors for the child welfare system. However, existing knowledge about its prevalence and correlates has been limited to research on single programs. The Illinois Department of Children and Family Services initiated a uniform assessment process at entry into state custody using a trauma-informed…

  15. The relation of co-occurring musculoskeletal pain and depressive symptoms with work ability.

    Science.gov (United States)

    Shiri, Rahman; Kaila-Kangas, Leena; Ahola, Kirsi; Kivekäs, Teija; Viikari-Juntura, Eira; Heliövaara, Markku; Miranda, Helena; Leino-Arjas, Päivi

    2013-11-01

    To examine the relationship of musculoskeletal pain and depressive symptoms, occurring alone or both together, with self-rated current work ability and thoughts of early retirement. In a nationally representative sample drawn in 2000-2001, we studied actively working subjects aged 30 to 64 years (n = 4009). Musculoskeletal pain was associated with moderate/poor physical work ability (adjusted odds ratio [OR] = 2.9; 95% confidence interval [CI], 2.0 to 4.2) and mental work ability (OR = 1.6; 95% CI, 1.2 to 2.2). Depressive symptoms were associated with moderate/poor mental work ability only (adjusted OR = 4.2; 95% CI, 2.3 to 7.9). Moreover, only musculoskeletal pain was associated with thoughts of early retirement (OR = 1.4; 95% CI, 1.1 to 1.8). There was an interaction between musculoskeletal pain and depressive symptoms regarding physical work ability and thoughts of early retirement. Co-occurrence of musculoskeletal pain and depressive symptoms is strongly related to poor self-rated physical work ability.

  16. Photosynthetic response to globally increasing CO2 of co-occurring temperate seagrass species

    DEFF Research Database (Denmark)

    Borum, Jens; Pedersen, Ole; Kotula, Lukasz

    2016-01-01

    Photosynthesis of most seagrass species seems to be limited by present concentrations of dissolved inorganic carbon (DIC). Therefore, the ongoing increase in atmospheric CO2 could enhance seagrass photosynthesis and internal O2 supply, and potentially change species competition through differential...... responses to increasing CO2 availability among species. We used short-term photosynthetic responses of nine seagrass species from the south-west of Australia to test species-specific responses to enhanced CO2 and changes in HCO3 -. Net photosynthesis of all species except Zostera polychlamys were limited...... at pre-industrial compared to saturating CO2 levels at light saturation, suggesting that enhanced CO2 availability will enhance seagrass performance. Seven out of the nine species were efficient HCO3 - users through acidification of diffusive boundary layers, production of extracellular carbonic...

  17. All Mixed up Together: Women's Experiences of Problem Gambling, Comorbidity and Co-Occurring Complex Needs

    Science.gov (United States)

    Holdsworth, Louise; Nuske, Elaine; Breen, Helen

    2013-01-01

    While there has been minimal recent gendered gambling research conducted in Australia and elsewhere, there is some evidence to suggest that gender differences do exist in various ways including gambling motivations such as gambling used as a coping strategy to alleviate or "escape" from stress and anxiety, help-seeking and prevalence of…

  18. Sharing rotting wood in the shade: ectomycorrhizal communities of co-occurring birch and hemlock seedlings

    Science.gov (United States)

    Sarah K. Poznanovic; Erik A. Lilleskov; Christopher R. Webster

    2015-01-01

    Coarse woody debris (CWD) is an important nursery environment for many tree species. Understanding the communities of ectomycorrhizal fungi (ECMF) and the effect of ECMF species on tree seedling condition in CWD will elucidate the potential for ECMF-mediated effects on seedling dynamics. In hemlock-dominated stands, we characterized ECMF communities associated with...

  19. When Intra-Firm and Inter-Firm Collaborations Co-Occur

    DEFF Research Database (Denmark)

    Schleimer, Stephanie Christine; Sculman, Arthur D.

    2011-01-01

    There is evidence that intra-firm collaboration and inter-firm collaboration are important for new service development (NSD) and new product development (NPD) success. However, evidence of the contributions of each to innovative outcomes is inconsistent. This inconsistency is associated with the ...

  20. Response of upland oak and co-occurring competitor seedlings following single and repeated prescribed fires

    Science.gov (United States)

    Heather D. Alexander; Mary Arthur; David Loftis; Stephanie Green

    2009-01-01

    Studies within and outside the United States indicate recurring oak (Quercus spp.) regeneration problems. In deciduous forests of the eastern U.S., a prevailing explanation for this trend is that fire suppression leads to high competitor abundance and low understory light. In response, prescribed fire is increasingly used as a management tool to...