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Sample records for war seeking treatment

  1. Posttraumatic stress disorder symptoms in Korean conflict and World War II combat veterans seeking outpatient treatment.

    Science.gov (United States)

    McCranie, E W; Hyer, L A

    2000-07-01

    Given important differences in the Korean conflict and World War II, samples of treatment-seeking combat veterans from these wars (30 Korea, 83 World War II) were compared on the prevalence and severity of posttraumatic stress disorder (PTSD). With age, ethnicity, and combat exposure taken into account, the Korean veterans reported significantly more severe symptoms on both interview and self-report PTSD measures. Group differences in the prevalence of current PTSD were in a similar direction but not significant. These results are generally consistent with other studies that have found Korean combat veterans to exhibit higher rates of psychosocial maladjustment than World War II combat veterans. Based on related research with Vietnam veterans, one direction for future investigation is to examine what role stressful postmilitary homecoming experiences may have played in influencing the development and course of combat-related PTSD in the aging cohort of "forgotten" Korean conflict veterans.

  2. Treatment-seeking veterans of Iraq and Afghanistan: comparison with veterans of previous wars.

    Science.gov (United States)

    Fontana, Alan; Rosenheck, Robert

    2008-07-01

    Differences in the characteristics and mental health needs of veterans of the Iraq/Afghanistan war when compared with those of veterans who served in the Persian Gulf war and in the Vietnam war may have important implications for Veterans Affairs (VA) program and treatment planning. Subjects were drawn from administrative data bases of veterans who sought treatment from specialized VA programs for treatment of posttraumatic stress disorder (PTSD). Current Iraq/Afghanistan veterans were compared with 4 samples of outpatient and inpatient Persian Gulf and Vietnam veterans whose admission to treatment was either contemporaneous or noncontemporaneous with their admission. A series of analyses of covariance was used hierachically to control for program site and age. In analyses of contemporaneous veterans uncontrolled for age, Iraq/Afghanistan veterans differed most notably from Vietnam veterans by being younger, more likely to be female, less likely to be either married or separated/divorced, more often working, less likely to have ever been incarcerated, and less likely to report exposure to atrocities in the military. Regarding clinical status, Iraq/Afghanistan veterans were less often diagnosed with substance abuse disorders, manifested more violent behavior, and had lower rates of VA disability compensation because of PTSD. Differences are more muted in comparisons with Persian Gulf veterans, particularly in those involving noncontemporaneous samples, or those that controlled for age differences. Among recent war veterans with PTSD, social functioning has largely been left intact. There is a window of opportunity, therefore, for developing and focusing on treatment interventions that emphasize the preservation of these social assets.

  3. Seeking Peace in the War on Drugs.

    Science.gov (United States)

    Sagor, Richard

    1987-01-01

    The rate of teenage drug abuse is at one of its lowest points in 25 years. The current "war on drugs" has overlooked a set of distinctions in its policy and in the discussions occurring in the schools. Presents the distinctions between use, abuse, and dependence. (MD)

  4. Healthcare-seeking strategies among displaced children in war-ridden northern Uganda: the case of malaria

    NARCIS (Netherlands)

    Akello-Ayebare, G.; Richters, J.M.; Polderman, A.M.; Visser, L.G.

    2010-01-01

    A field study was performed to examine suffering and treatment seeking from the perspective of children aged 8-16 years living in war-affected northern Uganda. Various techniques for collecting qualitative and quantitative data were used, including a semi-structured questionnaire about illness

  5. Treating posttraumatic stress in post-conflict countries and countries that accepted refugees. Report on the STOP-study, a multi-site study on treatment seeking and treatment outcome in people suffering from posttraumatic stress following war and migration in former Yugoslavia.

    Science.gov (United States)

    Schützwolh, Matthias; Bravo-Mehmedbasic, Alma; Franciskovic, Tanja; Lecic-Tosevski, Dusica; Ljubotina, Damir; McCrone, Paul; Gavrilovic, Jelena; Stephan, Priebe; Kucukalic, Abdulah

    2004-01-01

    War and migration in the Balkans caused traumatic experiences in great parts of it's population. About four million people living in former Yugoslavia as well as about 100,000 refugees living in different European countries are estimated to suffer from on-going and severe psychological symptoms of post-traumatic stress. Although in need of treatment, many of these people do not seek treatment. Given the fact that, if untreated, post-traumatic stress reactions tend to persist for many years, often resulting in impairment and disability secondary to the symptom complex, offering appropriate care is a special challenge to health services. With regard to this context, an EC-funded multi-centre study including partners from Belgrade (SCO). Dresden (D), London (UK), Rijcka (HR), Sarajevo (BIH), and Zagreb (HR) aims (a) to provide an empirical basis for designing care programmes for people suffering from post-traumatic stress following war and migration in the Balkans who currently do not seek treatment, and (b) to improve the cost-effectiveness of treatment programmes for those patients who are cared for in specialised treatment centres. The paper presents the aims and the design of the STOP study. The first results of the study will be available in 2005.

  6. posttraumatic stress and its relationship to physical health functioning in a sample of Iraq and Afghanistan War veterans seeking postdeployment VA health care.

    Science.gov (United States)

    Jakupcak, Matthew; Luterek, Jane; Hunt, Stephen; Conybeare, Daniel; McFall, Miles

    2008-05-01

    The relationship between posttraumatic stress and physical health functioning was examined in a sample of Iraq and Afghanistan War veterans seeking postdeployment VA care. Iraq and Afghanistan War veterans (N = 108) who presented for treatment to a specialty postdeployment care clinic completed self-report questionnaires that assessed symptoms of posttraumatic stress disorder (PTSD), chemical exposure, combat exposure, and physical health functioning. As predicted, PTSD symptom severity was significantly associated with poorer health functioning, even after accounting for demographic factors, combat and chemical exposure, and health risk behaviors. These results highlight the unique influence of PTSD on the physical health in treatment seeking Iraq and Afghanistan War veterans.

  7. Childhood malaria: mothers' perception and treatment- seeking ...

    African Journals Online (AJOL)

    Context: Childhood malaria continues to be a major cause of childhood morbidity and mortality. Care- givers ability to detect the illness in children early and institute effective treatment is critical to illness outcome. The investigation of mothers' perception of malaria and treatment-seeking behaviour in childhood malaria in a ...

  8. Psychiatric disorders of patients seeking obesity treatment

    Directory of Open Access Journals (Sweden)

    Lin Hung-Yen

    2013-01-01

    Full Text Available Abstract Background Obese and overweight people have a higher risk of both chronic physical illness and mental illness. Obesity is reported to be positively associated with psychiatric disorders, especially in people who seek obesity treatment. At the same time, obesity treatment may be influenced by psychological factors or personality characteristics. This study aimed to understand the prevalence of mental disorders among ethnic Chinese who sought obesity treatment. Methods Subjects were retrospectively recruited from an obesity treatment center in Taiwan. The obesity treatments included bariatric surgery and non-surgery treatment. All subjects underwent a standardized clinical evaluation with two questionnaires and a psychiatric referral when needed. The psychiatric diagnosis was made thorough psychiatric clinic interviews using the SCID. A total of 841 patients were recruited. We compared the difference in psychiatric disorder prevalence between patients with surgical and non-surgical treatment. Results Of the 841 patients, 42% had at least one psychiatric disorder. Mood disorders, anxiety disorders and eating disorders were the most prevalent categories of psychiatric disorders. Females had more mood disorders and eating disorders than males. The surgical group had more binge-eating disorder, adjustment disorder, and sleep disorders than the non-surgical group. Conclusion A high prevalence of psychiatric disorders was found among ethnic Chinese seeking obesity treatment. This is consistent with study results in the US and Europe.

  9. Facilitators and barriers in treatment seeking for cannabis dependence

    NARCIS (Netherlands)

    van der Pol, P.; Liebregts, N.; de Graaf, R.; Korf, D.J.; van den Brink, W.; van Laar, M.

    2013-01-01

    Background Relatively few cannabis dependent people seek treatment and little is known about determinants of treatment seeking. Methods Treatment determinants were compared among 70 DSM-IV cannabis dependent patients and 241 non-treatment seeking DSM-IV cannabis dependent community subjects. In

  10. Facilitators and barriers in treatment seeking for cannabis dependence

    NARCIS (Netherlands)

    van der Pol, Peggy; Liebregts, Nienke; de Graaf, Ron; Korf, Dirk J.; van den Brink, Wim; van Laar, Margriet

    2013-01-01

    Relatively few cannabis dependent people seek treatment and little is known about determinants of treatment seeking. Treatment determinants were compared among 70 DSM-IV cannabis dependent patients and 241 non-treatment seeking DSM-IV cannabis dependent community subjects. In addition, perceived

  11. Help-Seeking Stigma and Mental Health Treatment Seeking Among Young Adult Veterans

    Science.gov (United States)

    Kulesza, Magdalena; Corrigan, Patrick; Marshall, Grant

    2015-01-01

    Veterans underutilize mental health services. We investigated the association between treatment seeking stigma and utilization of mental health services in a sample of 812 young adult veterans. Higher perceived public stigma of treatment seeking was significantly related to lower treatment utilization. Although many veterans were concerned about negative perceptions if they were to seek treatment, a much smaller number of them endorsed that they would judge a fellow veteran negatively in similar situation. Targeting perceived public stigma of treatment seeking, through perceived norms interventions, might help in narrowing the gap between the need and receipt of help among veterans. PMID:26664795

  12. Treatment of rectal war wounds

    NARCIS (Netherlands)

    O.J.F. van Waes (Oscar); J.A. Halm (Jens); J. Vermeulen (J.); McAlister, V.C. (V. C.)

    2014-01-01

    textabstractTreatment strategies for penetrating rectal injuries (PRI) in civilian settings are still not uniformly agreed, in part since high-energy transfer PRI, such as is frequently seen in military settings, are not taken into account. Here, we describe three cases of PRI, treated in a deployed

  13. A Review of 'Humanitarian Intervention and Legitimacy Wars: Seeking Peace and Justice in the 21st Century'

    Directory of Open Access Journals (Sweden)

    Leah Merchant

    2015-01-01

    Full Text Available In his book Humanitarian Intervention and Legitimacy Wars: Seeking Peace and Justice in the 21st Century, Richard Falk argues that, with the growing prevalence of soft power, historical lessons of asymmetric warfare and legitimacy wars must be taken into account. Falk rejects the realist notion that the state is the only rational actor, offering a more constructivist approach that focuses on the norms, culture and morality of the international community. He asserts that humanitarian intervention is on the decline, and legitimacy wars are increasing. Much of this legitimacy is based on international law and its relevance in the international community.

  14. Intranasal Insulin: A Novel Treatment for Gulf War Multisymptom Illness

    Science.gov (United States)

    2016-10-01

    Award Number: W81XWH-12-1-0585 TITLE: Intranasal Insulin : A Novel Treatment for Gulf War Multisymptom Illness PRINCIPAL INVESTIGATOR: Dr. Julia...TITLE AND SUBTITLE Intranasal Insulin : A Novel Treatment for Gulf War Multisymptom Illness 5a. CONTRACT NUMBER 5b. GRANT NUMBER W81XWH-12-1-0585 5c...treatments for Gulf War CMI. Objective: To test whether insulin , administered intranasally, improves the health and functioning of GWV with CMI. Specific

  15. Intranasal Insulin: A Novel Treatment for Gulf War Multisymptom Illness

    Science.gov (United States)

    2017-10-01

    selective attention). As this will be the first trial of intranasal insulin in Gulf War veterans, a dose-finding clinical trial is proposed using two...Award Number: W81XWH-12-1-0585 TITLE: Intranasal Insulin: A Novel Treatment for Gulf War Multisymptom Illness PRINCIPAL INVESTIGATOR: Dr. Julia...TITLE AND SUBTITLE Intranasal Insulin: A Novel Treatment for Gulf War Multisymptom Illness 5a. CONTRACT NUMBER 5b. GRANT NUMBER W81XWH-12-1-0585

  16. Measurement and documentation of complex PTSD in treatment seeking traumatized refugees

    DEFF Research Database (Denmark)

    Palic, Sabina

    The aim of the thesis is to study complex traumatization and its measurement in treatment seeking traumatized refugees. Historically there have been repeated attempts to create a diagnosis for complex posttraumatic stress disorder (complex PTSD) to capture the more diverse, trauma related symptoms...... to measuring symptoms of PTSD, anxiety, and depression. This renders documentation, measurement, and treatment of possible complex traumatic adaptations in traumatized refugees very difficult. The thesis comprises two studies using different measures and different samples. The first study investigated complex...... on the overall level of functional impairment and the chronicity of their symptoms. In the second article, 30% of the treatment seeking refugees from the clinical sample had pathological dissociation 16 years after their exposure to war trauma. - This makes monitoring and treatment of dissociation...

  17. Lifetime treatment contact and delay in treatment seeking after first onset of a mental disorder

    NARCIS (Netherlands)

    ten Have, M.; de Graaf, R.; van Dorsselaer, S.; Beekman, A.T.F.

    2013-01-01

    Objective: This study examined lifetime treatment contact and delays in treatment seeking, including rates for receipt of helpful treatment, after the onset of specific mental disorders and evaluated factors that predicted treatment seeking and delays in treatment seeking. Methods: Data were from

  18. Determinants of patient delay in seeking treatment among ...

    African Journals Online (AJOL)

    Patients delay in seeking care increases the transmission of pulmonary tuberculosis and hence the burden of the disease. This study investigates the pattern and determinants of patients delay in seeking treatment among pulmonary tuberculosis cases attending a Government Chest Clinic in Ibadan, Nigeria. A descriptive ...

  19. Determinants of patient delay in seeking treatment among ...

    African Journals Online (AJOL)

    lmboera

    Abstract: Patients delay in seeking care increases the transmission of pulmonary tuberculosis and hence the burden of the disease. This study investigates the pattern and determinants of patients delay in seeking treatment among pulmonary tuberculosis cases attending a Government Chest Clinic in Ibadan, Nigeria.

  20. [Surgical treatment of war posttraumatic pleural empyemas].

    Science.gov (United States)

    Cvijanović, Vlado; Stanić, Vojkan; Ristanović, Aleksandar; Gulić, Bojan; Kovacević, Snezana

    2007-12-01

    Posttraumatic pleural empyema is the most frequent septic complication of the thoracic penetrating war injuries. Surgical treatment used to be based on the experience gained in the treatment of parapneumonic empyema, the most frequent empyema, and used to be favored the pleural drainage until the nineties of the last century. Thoracotomy and decortication was performed in case of drainage failure, in early chronic phase, 4-6 weeks after injury. The aim of this study was to emphasize the necessity of different surgical approaches in the treatment of this disease which is based on the different pathophisyology of posttraumatic and other sorts of empyema. Also, to recommend on the basis of the surgical treatment results, early decortication as better method in the treatment of this septic complication. In the period between September 1991-June 1999. 1 303 thoracic injures were surgically treated. There were 1 117 penetrating injures with 675 dominant thoracic injures, and 442 thoracic injures as the following ones. In 59 (5.3%) injured people raised post traumatic empyema (PET). The patients were divided into the groups with early and late decortications regarding the interval between the injury and the surgical treatment. Almost all the patients sustained this complication in various periods before the admittance to the hospital. Surgical treatment efficiency of early and late decortication was analyzed on the basis of perioperative and postoperative study parameters and analysing postoperative complications. Thoracotomy and decortication were performed in 46 (78%) injured patients with post traumatica pleural empyema while only 13 (22%) injured patientes were successfully treated for this septic complication with drainage procedures. This study proved that there were in the group with early decortications lesser intra and postoperative blood loss, duration of operation was shorter as well as febrile postoperative period. In this group, also, hospitalisation was

  1. Articulation and oromyofunctional behavior in children seeking orthodontic treatment.

    NARCIS (Netherlands)

    E. Fonteyne; E. D'haeseleer; Anke Luyten; G. Becue; K. van Lierde; G. van Maele; G. de Pauw; P. Corthals

    2015-01-01

    OBJECTIVES: The purpose of this controlled study is to document articulation and oromyofunctional behavior in children seeking orthodontic treatment. In addition, relations between malocclusions, articulation, and oromyofunctional behavior are studied. MATERIALS AND METHODS: The study included 56

  2. Effectiveness of Acupuncture in the Treatment of Gulf War Illness

    Science.gov (United States)

    2013-01-01

    325. 7 Wigers SH, Stiles TC, Vogael PA. Effects of aerobic exercise versus stress management treatment in fibromyalgia : a 4.5 year prospective study... Treatment of Gulf War Illness PRINCIPAL INVESTIGATOR: Lisa Conboy, M.A., M.S., ScD...December 2012 4. TITLE AND SUBTITLE 5a. CONTRACT NUMBER Effectiveness of Acupuncture in the Treatment of Gulf War Illness 5b. GRANT NUMBER W81XWH

  3. Surgical treatment of war posttraumatic pleural empyemas

    Directory of Open Access Journals (Sweden)

    Cvijanović Vlado

    2007-01-01

    Full Text Available Background/Aim. Posttraumatic pleural empyema is the most frequent septic complication of the thoracic penetrating war injuries. Surgical treatment used to be based on the experience gained in the treatment of parapneumonic empyema, the most frequent empyema, and used to be favored the pleural drainage until the nineties of the last century. Thoracotomy and decortication was performed in case of drainage failure, in early chronic phase, 4-6 weeks after injury. The aim of this study was to emphasize the necessity of different surgical approaches in the treatment of this disease which is based on the different pathophisyology of posttraumatic and other sorts of empyema. Also, to recommend on the basis of the surgical treatment results, early decortication as better method in the treatment of this septic complication. Methods. In the period between September 1991-June 1999. 1 303 thoracic injures were surgically treated. There were 1 117 penetrating injures with 675 dominant thoracic injures, and 442 thoracic injures as the following ones. In 59 (5.3% injured people raised posttraumatic empyema (PET. The patients were divided into the groups with early and late decortications regarding the interval between the injury and the surgical treatment. Almost all the patients sustained this complication in various periods before the admittance to the hospital. Surgical treatment efficiency of early and late decortication was analyzed on the basis of perioperative and postoperative study parameters and analyzing postoperative complications. Results. Thoracotomy and decortication were performed in 46 (78% injured patients with post traumatic pleural empyema while only 13 (22% injured patients were successfully treated for this septic complication with drainage procedures. This study proved that there were in the group with early decortications lesser intra and postoperative blood loss, duration of operation was shorter as well as febrile postoperative period

  4. Treatment Seeking of Malaria Patients in East

    African Journals Online (AJOL)

    securing antimalarial drugs particularly for people in rural areas. Resistance of P. jalciparum to SP should be monitored and evaluated. In addition, a large proportion of malaria cases are due to P. vivax and studies on chloroquine efficacy' against its treatment should be initiated and strengthened to enable the early ...

  5. Treatment-seeking decisions of women with acute myocardial infarction.

    Science.gov (United States)

    Arslanian-Engoren, Cynthia

    2005-01-01

    Women who experience symptoms of an acute myocardial infarction (MI) are less likely than men to seek medical attention after the onset of initial symptoms. The purpose of this study was to facilitate a better understanding of the treatment-seeking decisions of women who seek emergency evaluation for symptoms suggestive of MI. A qualitative, semi-structured, feminist, post structuralist interview approach was used to explore the treatment-seeking decisions of ten women hospitalized for a MI. The oral descriptions were tape-recorded, transcribed verbatim, and analyzed using the Morse and Field method. Content analysis revealed ten important issues that influenced women's treatment-seeking decisions: associating symptoms with non-cardiac causes, minimizing symptoms, experiencing non-classic symptoms, mass media portrayal, male family member experience, knowledge deficit, family insistence, experiencing increased pain, experiencing difficulty breathing, and having expectations different from realities. Based on their language and subjectivity, participants revealed the power of the meaning of heart disease on treatment-seeking decisions.

  6. Gender Differences in Treatment-Seeking British Pathological Gamblers

    Science.gov (United States)

    Ronzitti, Silvia; Lutri, Vittorio; Smith, Neil; Clerici, Massimo; Bowden-Jones, Henrietta

    2016-01-01

    Background and aim Gambling is a widespread recreational activity in the UK. A significant percentage of gamblers develop subclinical or clinically relevant problem gambling issues, but only a low percentage of them seek treatment. Although characteristics of pathological gamblers from treatment-seeking population have been examined in some research, only a few studies have explored the differences between females and males. This study aimed to examine the gender-related differences in demographics, gambling measures, and clinical variables in an outpatient sample of pathological gamblers seeking treatment. Methods A total of 1,178 treatment-seeking individuals with gambling disorder were assessed at the National Problem Gambling Clinic in London. Sociodemographic characteristics, clinical variables, and gambling behavior habits were obtained during the assessment evaluation. Of the total sample, 92.5% were males and 7.5% were females. Results Males were more likely to be younger, white, and employed than females. In addition, compared to women, men showed a lower PGSI score, an earlier age of onset of gambling behavior, a higher gambling involvement, and preferred specific forms gambling. Female gamblers were more anxious and depressed, while men were more likely to use alcohol and illicit drugs. Conclusions Our findings support the importance of gender differences in a treatment-seeking population of pathological gamblers both in sociodemographic characteristics, gambling behavior variables, and clinical variables. Males and females might benefit from group-specific treatment. PMID:27348561

  7. [Barriers to treatment-seeking among German veterans: expert interviews].

    Science.gov (United States)

    Siegel, Stefan; Rau, Heinrich; Dors, Simone; Brants, Loni; Börner, Michaela; Mahnke, Manuel; Zimmermann, Peter L; Willmund, Gerd; Ströhle, Andreas

    2017-08-01

    The number of service members of the German armed forces suffering from deployment-related mental health problems is increasing. However, less than 50 % seek professional help, and there is little knowledge about the barriers to treatment-seeking. The article presents data gathered by the Delphi technique combined with focus groups from 55 health service experts regarding the evaluated barriers to treatment-seeking among German veterans. According to the interviewed experts, major contextual barriers to treatment-seeking include: 1) intimidating processes and structures, 2) actual stigmatization and discrimination, and 3) health service deficits. Major individual barriers to treatment were: 4) health beliefs, self-perception and fear of stigmatization, and 5) avoidance behavior related to psychopathology. In addition, there is another both contextual and individual barrier, i.e., 6) information deficits. Individual internal factors like the soldiers' self-perception and their fear of being stigmatized were considered important barriers to treatment-seeking. The experts' opinion about avoidance behavior related to psychopathology and deficits in health services and information coincides with international findings. Compared to research in other countries, actual stigmatization and discrimination were regarded to be an important barrier in itself. According to our findings daunting/intimidating processes and structures like time-consuming and complex expert medical reports rather seem to be a German phenomenon. Copyright © 2017. Published by Elsevier GmbH.

  8. Treatment seeking of malaria patients in East Shewa Zone of ...

    African Journals Online (AJOL)

    Background: Prompt access to early diagnosis and effective antimalarial treatment at health facilities is one of the major strategies for reducing the burden of malaria. Objective: To assess treatment seeking behaviour and its determinant factors among malaria patients attending malaria control laboratories (MCLs). Methods: ...

  9. Perceptions of tuberculosis and treatment seeking behaviour in Ilala ...

    African Journals Online (AJOL)

    This study was carried out in Ilala and Kinondoni Municipalities in Tanzania to explore the perceptions of Tuberculosis (TB), and treatment seeking behaviour, among patients attending healthcare facilities. The study was conducted in four randomly selected health facilities providing directly observed treatment (DOT).

  10. Seeking treatment for symptomatic malaria in Papua New Guinea

    Directory of Open Access Journals (Sweden)

    Siba Peter

    2010-10-01

    Full Text Available Abstract Background Malaria places a significant burden on the limited resources of many low income countries. Knowing more about why and where people seek treatment will enable policy makers to better allocate the limited resources. This study aims to better understand what influences treatment-seeking behaviour for malaria in one such low-income country context, Papua New Guinea (PNG. Methods Two culturally, linguistically and demographically different regions in PNG were selected as study sites. A cross sectional household survey was undertaken in both sites resulting in the collection of data on 928 individuals who reported suffering from malaria in the previous four weeks. A probit model was then used to identify the factors determining whether or not people sought treatment for presumptive malaria. Multinomial logit models also assisted in identifying the factors that determined where people sought treatments. Results Results in this study build upon findings from other studies. For example, while distance in PNG has previously been seen as the primary factor in influencing whether any sort of treatment will be sought, in this study cultural influences and whether it was the first, second or even third treatment for a particular episode of malaria were also important. In addition, although formal health care facilities were the most popular treatment sources, it was also found that traditional healers were a common choice. In turn, the reasons why participants chose a particular type of treatment differed according to the whether they were seeking an initial or subsequent treatments. Conclusions Simply bringing health services closer to where people live may not always result in a greater use of formal health care facilities. Policy makers in PNG need to consider within-country variation in treatment-seeking behaviour, the important role of traditional healers and also ensure that the community fully understands the potential implications

  11. Care-seeking behaviour for malaria treatment among community ...

    African Journals Online (AJOL)

    Care-seeking behaviour for malaria treatment among community primary school teachers ( a cross sectional study) ... Conclusion: The result of this study confirmed previous reports that irrespective of race, the ischio-pubic index for females is significantly greater than that of males and that ischio-pubic index can be ...

  12. Knowledge, treatment seeking and preventive practices in respect of ...

    African Journals Online (AJOL)

    Knowledge, treatment seeking and preventive practices in respect of malaria among patients with HIV at the Lagos University Teaching Hospital. ... A greater proportion of the patients, 321 (64.9 %) utilized hospitals, pharmacy outlets or health centres when they perceived an attack of malaria. Educational intervention may ...

  13. Why Adolescent Problem Gamblers Do Not Seek Treatment

    Science.gov (United States)

    Ladouceur, Robert; Blaszczynski, Alexander; Pelletier, Amelie

    2004-01-01

    Prevalence studies indicate that approximately 40% of adolescents participate in regular gambling with rates of problem gambling up to four times greater than that found in adult populations. However, it appears that few adolescents actually seek treatment for such problems. The purpose of this study was to explore potential reasons why…

  14. Maternal Factors Influencing Timeliness of Seeking Treatment for ...

    African Journals Online (AJOL)

    Malaria is a critical health challenge in Malawi, especially among children under the age of five. This study analyzed the factors influencing timeliness of seeking malaria treatments and preferences among health care providers. The data were the 2012 Malaria Indicator Survey. Data were analyzed using Poisson and ...

  15. Treatment Seeking of Malaria Patients in East Shewa Zone of ...

    African Journals Online (AJOL)

    Objective: To assess treatment seeking behaviour and its determinant factors among malaria .... required number for each laboratory was .... Literate 66 173 1. Cause of illness. P. falciparum 59 147 1.42(O.87,2.32). P. vivax 41 145 1. Discussion 1992 EC (1999/2000) annual report of East. This study has demonstrated that ...

  16. Articulation and oromyofunctional behavior in children seeking orthodontic treatment.

    Science.gov (United States)

    Van Lierde, K M; Luyten, A; D'haeseleer, E; Van Maele, G; Becue, L; Fonteyne, E; Corthals, P; De Pauw, G

    2015-05-01

    The purpose of this controlled study is to document articulation and oromyofunctional behavior in children seeking orthodontic treatment. In addition, relations between malocclusions, articulation, and oromyofunctional behavior are studied. The study included 56 children seeking orthodontic treatment. The control group, consisting of 54 subjects matched for age and gender, did not undergo orthodontic intervention. To determine the impact of the occlusion on speech, the Oral Health Impact Profile was used. Speech characteristics, intelligibility and several lip and tongue functions were analyzed using consensus evaluations. A significant impact of the occlusion on speech and more articulation disorders for/s,n,l,t/were found in the subjects seeking orthodontic treatment. Several other phenomena were seen more often in this group, namely more impaired lip positioning during swallowing, impaired tongue function at rest, mouth breathing, open mouth posture, lip sucking/biting, anterior tongue position at rest, and tongue thrust. Moreover, all children with a tongue thrust showed an anterior tongue position at rest. Children seeking orthodontics have articulatory and oromyofunctional disorders. To what extent a combined orthodontic and logopaedic treatment can result in optimal oral health (i.e. perfect dentofacial unit with perfect articulation) is subject for further multidisciplinary research. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  17. War and Post-conflict in Guatemala: Seeking Justice Before and After the Peace Agreements

    Directory of Open Access Journals (Sweden)

    Maira Ixchel Benítez Jiménez

    2016-08-01

    Full Text Available By suggesting that the mobilization of civil society groups has been the driving factor behind the progress of legal justice in post-war Guatemala, this article argues that the recent achievements in this field were possible by several institutional changes over time which provided some degree of access to political and legal opportunities. A review of the oral and documental sources allows tracking some transformations before and after the peace agreements, which favored or inhibited the attribution of criminal responsibility for serious human rights violations committed during the war period. These changes in the political sphere, or resulting from the interaction between pro-justice advocates and their particular context, have enabled the legal activist community to position themselves as crucial stakeholders in the peacebuilding process. In addition, it has allowed them to play a prominent role in the activation of justice through judicialization strategies in this post-conflict period.

  18. Characterization of Individuals Seeking Treatment for Caffeine Dependence

    Science.gov (United States)

    Juliano, Laura M.; Evatt, Daniel P.; Richards, Brian D.; Griffiths, Roland R.

    2013-01-01

    Previous investigations have identified individuals who meet criteria for DSM-IV-TR substance dependence as applied to caffeine, but there is little research on treatments for caffeine dependence. This study aimed to thoroughly characterize individuals who are seeking treatment for problematic caffeine use. Ninety-four individuals who identified as being psychologically or physically dependent on caffeine, or who had tried unsuccessfully to modify caffeine consumption participated in a face-to-face diagnostic clinical interview. They also completed measures concerning caffeine use and quitting history, reasons for seeking treatment, and standardized self-report measures of psychological functioning. Caffeine treatment seekers (mean age 41 yrs, 55% women) consumed an average of 548 mg caffeine per day. The primary source of caffeine was coffee for 50% of the sample and soft drinks for 37%. Eighty-eight percent reported prior serious attempts to modify caffeine use (mean 2.7 prior attempts) and 43% reported being advised by a medical professional to reduce or eliminate caffeine. Ninety-three percent met criteria for caffeine dependence when generic DSM-IV-TR substance dependence criteria were applied to caffeine use. The most commonly endorsed criteria were withdrawal (96%), persistent desire or unsuccessful efforts to control use (89%), and use despite knowledge of physical or psychological problems caused by caffeine (87%). The most common reasons for wanting to modify caffeine use were health-related (59%) and not wanting to be dependent on caffeine (35%). This investigation reveals that there are individuals with problematic caffeine use who are seeking treatment, and suggests that there is a need for effective caffeine dependence treatments. PMID:22369218

  19. Diagnosis without treatment: responding to the War on Terror | Cox ...

    African Journals Online (AJOL)

    This is like a doctor diagnosing gout and recommending to the patient that they reduce the level of uric acid in their big toe. We argue that diagnosis without treatment is endemic in literature on the War on Terror and the ills of liberal democracy. We divide this literature into five categories and examine representative works ...

  20. Assessment of dissociation in Bosnian treatment-seeking refugees in Denmark.

    Science.gov (United States)

    Palic, Sabina; Carlsson, Jessica; Armour, Cherie; Elklit, Ask

    2015-05-01

    Dissociative experiences are common in traumatized individuals, and can sometimes be mistaken for psychosis. It is difficult to identify pathological dissociation in the treatment of traumatized refugees, because there is a lack of systematic clinical descriptions of dissociative phenomena in refugees. Furthermore, we are currently unaware of how dissociation measures perform in this clinical group. To describe the phenomenology of dissociative symptoms in Bosnian treatment-seeking refugees in Denmark. As a part of a larger study, dissociation was assessed systematically in 86 Bosnian treatment-seeking refugees using a semi-structured clinical interview (Structured Interview for Disorders of Extreme Stress-dissociation subscale; SIDES-D) and a self-report scale (Dissociative Experiences Scale; DES). The SIDES-D indicated twice as high prevalence of pathological dissociation as the DES. According to the DES, 30% of the refugees had pathological dissociation 15 years after their resettlement. On the SIDES-D, depersonalization and derealization experiences were the most common. Also, questions about depersonalization and derealization at times elicited reporting of visual and perceptual hallucinations, which were unrelated to traumatic re-experiencing. Questions about personality alteration elicited spontaneous reports of a phenomenon of "split" pre- and post-war identity in the refugee group. Whether this in fact is a dissociative phenomenon, characteristic of severe traumatization in adulthood, needs further examination. Knowledge of dissociative symptoms in traumatized refugees is important in clinical settings to prevent misclassification and to better target psychotherapeutic interventions. Much development in the measurement of dissociation in refugees is needed.

  1. Patient-Perceived Access to Care When Actively Seeking Treatment.

    Science.gov (United States)

    Pruitt, Zachary; Sportsman, Susan

    2017-05-01

    To examine predictors of perceived access to care and reported barriers to care of patients with cancer actively seeking treatment.
. Retrospective secondary data analysis.
. U.S. Medical Expenditure Panel Survey, a national survey with questions about healthcare coverage and access.
. 1,170 adults with cancer actively seeking treatment.
. A retrospective analysis of data. Bivariate tests for significant association between individual characteristics and low perceived access to care were conducted using a chi-square test. 
. The dependent variable was perceived access to care. The independent variables included sex, age, race, poverty status, education level, marital status, cancer site, comorbidities, and insurance status.
. Those with Medicaid insurance or no health insurance had significantly lower perceived access to care compared to those with Medicare. Institutional barriers to treatment, such as financial or insurance, were the most common reported barriers.
. Most adults with cancer reported adequate access to medical care and medications, but a small yet vulnerable population expressed difficulties in accessing treatment.
. To effectively advocate for vulnerable populations with Medicaid or no insurance, nurses may require specialized knowledge beyond the scope of general oncology nursing.

  2. Violation of International Conventions Relatively to the Treatment of Prisoners of War during the First World War

    Science.gov (United States)

    Kokebayeva, Gulzhaukhar; Smagulov, Kadyrzhan; Mussabalina, Gulnara

    2016-01-01

    This article attempts to address the issue of prisoners of war through the prism of international law. The object of research is the work of the Commission to investigate the Entente's complaints of violation of Hague Convention on Treatment of Prisoners of War by German authorities. After the armistice, the governments of the Entente sent notes…

  3. [Stress of men and women seeking treatment for infertility].

    Science.gov (United States)

    Gradvohl, Silvia Mayumi Obana; Osis, Maria José Duarte; Makuch, Maria Yolanda

    2013-06-01

    To evaluate the level of stress in men and women seeking treatment for infertility and to identify the associated variables. A cross-sectional study with 101 men and 101 women consulting for the first time at the Human Reproduction Unit. Participants completed the Brazilian version of the Fertility Problem Inventory (FPI) based on four domains: "social relationships", "life without children"; "marital relationship/sexual" and "maternity/paternity" and a structured questionnaire with socioeconomic and reproductive variables. Bivariate analysis was performed using the Chi-square and Fisher exact tests, considering pinfertility problem, and to consider the quality of the marital relationship to be regular. In the "life without children" domain the variables that approached the high stress were: to be woman, age between 18 and 24 years, and to have the infertility problem. To be a man, to consider adoption, parents/in-laws and other people knowing about the difficulty to become pregnant, and to consider the quality of the marital relationship to be excellent were the variables associated with high level of stress in "marital/sexual relationship" domain. For "maternity/paternity" domain the variables associated were to be women, consider marital relationship quality regular, age between 25 and 35 years, be evangelical or protestant were the variables associated with a high level of stress. Men and women seeking treatment for infertility present a high level of stress and it can be suggested that psychosocial support is important and should be different for men and women.

  4. Female Veterans of Iraq and Afghanistan seeking care from VA specialized PTSD Programs: comparison with male veterans and female war zone veterans of previous eras.

    Science.gov (United States)

    Fontana, Alan; Rosenheck, Robert; Desai, Rani

    2010-04-01

    Differences in the characteristics and mental health needs of female veterans of the Iraq/Afghanistan war compared with those of veterans of other wars may have useful implications for VA program and treatment planning. Female veterans reporting service in the Iraq/Afghanistan war were compared with women reporting service in the Persian Gulf and Vietnam wars and to men reporting service in the Iraq/Afghanistan war. Subjects were drawn from VA administrative data on veterans who sought outpatient treatment from specialized posttraumatic stress disorder (PTSD) treatment programs. A series of analyses of covariance (ANCOVA) was used to control for program site and age. In general, Iraq/Afghanistan and Persian Gulf women had less severe psychopathology and more social supports than did Vietnam women. In turn, Iraq/Afghanistan women had less severe psychopathology than Persian Gulf women and were exposed to less sexual and noncombat nonsexual trauma than their Persian Gulf counterparts. Notable differences were also found between female and male veterans of the Iraq/Afghanistan war. Women had fewer interpersonal and economic supports, had greater exposure to different types of trauma, and had different levels of diverse types of pathology than their male counterparts. There appear to be sufficient differences within women reporting service in different war eras and between women and men receiving treatment in VA specialized treatment programs for PTSD that consideration should be given to program planning and design efforts that address these differences in every program treating female veterans reporting war zone service.

  5. Factors that influence the choice of seeking treatment at polyclinics.

    Science.gov (United States)

    Chow, W L; Wang, V W; Low, Y S; Tse, D W L; Lim, J F Y

    2012-02-01

    Patients in Singapore can choose their primary care provider on a per-episode basis and pay out-of-pocket for services rendered. The infrastructure of subsidised and private primary care sector facilities differs. Onsite ancillary services are available in subsidised facilities, allowing for convenience of routine investigations, while private clinics are usually standalone practices. This study sought to examine the factors influencing patients' choice of polyclinic. This was a cross-sectional survey of a convenient sample of 484 random patients who sought treatment at a polyclinic located in a new housing estate from 24-27 June 2008. The response rate was 85.4% (n = 409). 38.1% of the patients were male. Mean age was 36.2 years. Only 13.8% had a regular private family physician, while 37.3% were followed up at polyclinics. Patients on regular polyclinic follow-up were more likely to be older (p < 0.001), unemployed, retirees or housewives (p < 0.001) and were seeking treatment for chronic diseases (p < 0.001). Geographical convenience (p = 0.002), low cost of consultation (p = 0.024), and onsite laboratory (p = 0.001) and imaging services (p = 0.018) significantly influenced those on regular polyclinic follow-up to attend the polyclinic. Affordability, convenience of travel and onsite laboratory facilities influence patients' choice of seeking treatment at polyclinics. Further research examining whether the overall convenience of onsite ancillary services influences patients' choice of primary care provider would be useful in redesigning private primary care infrastructure to enhance patient convenience and encourage more patients to have a regular private family physician.

  6. Treatment-seeking behaviour and social health insurance in Africa

    DEFF Research Database (Denmark)

    Fenny, Ama P; Asante, Felix A; Enemark, Ulrika

    2014-01-01

    Health insurance is attracting more and more attention as a means for improving health care utilization and protecting households against impoverishment from out-of-pocket expenditures. Currently about 52 percent of the resources for financing health care services come from out of pocket sources...... or user fees in Africa. Therefore, Ghana serves as in interesting case study as it has successfully expanded coverage of the National Health Insurance Scheme (NHIS). The study aims to establish the treatment-seeking behaviour of households in Ghana under the NHI policy. The study relies on household data...... collected from three districts in Ghana covering the 3 ecological zones namely the coastal, forest and savannah.Out of the 1013 who sought care in the previous 4 weeks, 60% were insured and 71% of them sought care from a formal health facility. The results from the multinomial logit estimations show...

  7. Traumatic war stressors and psychiatric symptoms among World War II, Korean, and Vietnam War veterans.

    Science.gov (United States)

    Fontana, A; Rosenheck, R

    1994-03-01

    Three hypotheses regarding symptoms of war-related posttraumatic stress disorder and general psychiatric distress were tested: that symptoms are more severe the more severe the traumatic exposure, regardless of the war in question; that symptoms are less severe the older the veterans' age; and that symptom levels differ across sociocultural cohorts. A total of 5,138 war zone veterans who were seeking treatment from specialized Veterans Affairs outpatient clinical teams made up the sample: 320 World War II, 199 Korean War, and 4,619 Vietnam War veterans. All hypotheses were supported significantly. The similarity of relationships between traumatic exposure and symptoms across wars testifies to the generality of these experiences. Furthermore, the results suggest the operation of significant effects due both to aging and to cohort differences in sociocultural attitudes toward the stigma of mental illness and the popularity of the wars.

  8. [The treatment of wounds during World War I].

    Science.gov (United States)

    Sabbatani, Sergio; Fiorino, Sirio

    2017-06-01

    The First World War was a huge tragedy for mankind, but, paradoxically, it represented a source of significant progress in a broad series of human activities, including medicine, since it forced physicians to improve their knowledge in the treatment of a large number of wounded soldiers. The use of heavy artillery and machine guns, as well as chemical warfare, caused very serious and life-threatening lesions and wounds. The most frequent causes of death were not mainly related to gunshot wounds, but rather to fractures, tetanus and septic complications of infectious diseases. In the first part of this article, we describe the surgical procedures and medical therapies carried out by Italian physicians during the First World War, with the aim of treating wounded soldiers in this pre-antibiotic era. Antibacterial solutions, such as those of Dakin-Carrel and sodium hypochlorite and boric acid, the tincture of iodine as well as the surgical and dressing approaches and techniques used to remove pus from wounds, such as ignipuncture and thermocautery or lamellar drainage are reported in detail. In the second part of the paper, the organization of the Italian military hospitals network, the systems and tools useful to transport wounded soldiers both in the front lines and in the rear is amply discussed. In addition, the number of soldiers enrolling, and those dying, wounded or missing during the Great War on the Italian front is estimated.

  9. Treatment Seeking for Alcohol Use Disorders : Treatment Gap or Adequate Self-Selection?

    NARCIS (Netherlands)

    Tuithof, Marlous; Ten Have, Margreet; Van Den Brink, Wim; Vollebergh, Wilma; De Graaf, Ron

    2016-01-01

    Background/Aims: This study examines whether it is harmful that subjects with an alcohol use disorder (AUD) in the general population rarely seek treatment. Methods: Baseline and 3-year follow-up data from the Netherlands Mental Health Survey and Incidence Study-2 were used. Treatment utilization

  10. WAR

    DEFF Research Database (Denmark)

    Þórarinsson, Elfar; Lindgreen, Stinus

    2008-01-01

    We present an easy-to-use webserver that makes it possible to simultaneously use a number of state of the art methods for performing multiple alignment and secondary structure prediction for noncoding RNA sequences. This makes it possible to use the programs without having to download the code an...... into account is also calculated. This website is free and open to all users and there is no login requirement. The webserver can be found at: http://genome.ku.dk/resources/war....

  11. Impulse control disorders in non-treatment seeking hair pullers.

    Science.gov (United States)

    Schreiber, Liana R N; Lust, Katherine; Odlaug, Brian; Derbyshire, Katherine L; Grant, Jon

    2013-06-01

    Background and aims Hair pulling is a common body focused repetitive behavior. The purpose of this paper is to examine the prevalence of impulse control disorders (as defined in DSM-IV-TR) in a non-treatment seeking sample of hair pullers. Methods 1,717 college students with (n = 44) and without (n = 1673) hair pulling completed a mental health survey. The college students were sent an online survey assessing hair pulling behavior and other impulse control disorders using the Minnesota Impulsive Disorders Interview. Results Students with hair pulling were significantly more likely to have a co-occurring impulse control disorder (20.5% vs. 8.9%, p = 0.009, OR = 2.71, CI = 1.28-5.75) and were significantly more likely to meet criteria for compulsive buying, compulsive sexual behavior and intermittent explosive disorder than students without hair pulling. Differences seemed to be moderated by the male gender among students with hair pulling. Discussion and conclusions Hair pulling is often comorbid with another impulse control disorder, which suggests that elements of impulsivity may be important in our understanding of hair pulling. Furthermore, gender may moderate impulse control comorbidity in hair pulling disorder.

  12. Effects of stigma on Chinese women's attitudes towards seeking treatment for urinary incontinence.

    Science.gov (United States)

    Wang, Cuili; Li, Jingjing; Wan, Xiaojuan; Wang, Xiaojuan; Kane, Robert L; Wang, Kefang

    2015-04-01

    To examine whether and how stigma influences attitudes towards seeking treatment for urinary incontinence, and whether its effect varies by symptom severity. Urinary incontinence is prevalent among women, but few seek treatment. Negative attitudes towards urinary incontinence treatment inhibit from seeking care. Urinary incontinence is a stigmatised attribute. However, the relationship between stigma and attitudes towards seeking treatment for urinary incontinence has not been well understood. This was a cross-sectional community-based study. We enrolled a sample of 305 women aged 40-65 years with stress urinary incontinence from three communities in a Chinese city between May-October in 2011. Data were collected on socio-demographic characteristics, urinary incontinence symptoms, stigma and attitudes towards seeking treatment for urinary incontinence using a self-reported questionnaire. Effects of stigma were analysed using path analysis. Attitudes towards seeking treatment for urinary incontinence were generally negative. For the total sample, all the stigma domains of social rejection, social isolation and internalised shame had direct negative effects on treatment-seeking attitudes. The public stigma domain of social rejection also indirectly affected treatment-seeking attitudes through increasing social isolation, as well as through increasing social isolation and then internalised shame. The final model accounted for 28% of the variance of treatment-seeking attitudes. Symptom severity influenced the strength of paths: the effect of internalised shame was higher in women with more severe urinary incontinence. Stigma enhances the formation of negative attitudes towards seeking treatment for urinary incontinence; public stigma affects treatment-seeking attitudes through internalisation of social messages. Stigma reduction may help incontinent women to form positive treatment-seeking attitudes and engage them in treatment. Interventions should specifically target

  13. Posttraumatic world assumptions among treatment-seeking refugees.

    Science.gov (United States)

    Ter Heide, F Jackie June; Sleijpen, Marieke; van der Aa, Niels

    2017-01-01

    The clinical relevance of negative changes in cognitions about oneself, others, and the world is reflected in the diagnostic criteria for posttraumatic stress disorder (PTSD) in the DSM-5 and complex posttraumatic stress disorder in the ICD-11. Although such changes in cognition have been posited to be especially relevant for traumatised refugees, few studies have examined this in refugee populations. The present study used a cross-sectional design to compare negative cognitions among 213 adult treatment-seeking refugees with those in previously published samples from the general population, veterans with combat-related PTSD, and whiplash victims. Measures included the World Assumptions Scale (WAS) and the Events and DSM-IV PTSD subscales of the Harvard Trauma Questionnaire (HTQ). Path models examined the relation of the WAS subscales to five demographic and trauma-related variables. Results showed that world assumptions were especially negative with regard to Benevolence of World, Benevolence of People, and Luck subscales, on which refugees scored lower than all reference samples. Differences between the refugee sample and the reference samples were smallest with regard to self-worth and self-controllability. World assumptions were associated with gender and PTSD symptom severity but not with age, length of residence in the Netherlands, and number of traumatic event types. The DSM-5 criterion of negative changes in belief about oneself, others, and the world appears more applicable to refugees than the more narrowly formulated ICD-11 criterion of diminished and defeated sense of self. Prevention and treatment efforts with refugees may need to be especially aimed at preventing a further decline of trust as well as restoration of trust in others and the world.

  14. Who seeks bariatric surgery? Psychosocial functioning among adolescent candidates, other treatment-seeking adolescents with obesity and healthy controls.

    Science.gov (United States)

    Call, C C; Devlin, M J; Fennoy, I; Zitsman, J L; Walsh, B T; Sysko, R

    2017-12-01

    Limited data are available on the characteristics of adolescents with obesity who seek bariatric surgery. Existing data suggest that adolescent surgery candidates have a higher body mass index (BMI) than comparison adolescents with obesity, but the limited findings regarding psychosocial functioning are mixed. This study aimed to compare BMI and psychosocial functioning among adolescent bariatric surgery candidates, outpatient medical-treatment-seeking adolescents with obesity (receiving lifestyle modification), and adolescents in the normal-weight range. All adolescents completed self-report measures of impulsivity, delay discounting, depression, anxiety, stress, eating pathology, family functioning and quality of life, and had their height and weight measured. Adolescent surgical candidates had higher BMIs than both comparison groups. Surgical candidates did not differ from medical-treatment-seeking adolescents with obesity on any measure of psychosocial functioning, but both groups of adolescents with obesity reported greater anxiety and eating pathology and poorer quality of life than normal-weight adolescents. Quality of life no longer differed across groups after controlling for BMI, suggesting that it is highly related to weight status. Adolescents with obesity may experience greater anxiety, eating pathology, and quality of life impairments than their peers in the normal-weight range regardless of whether they are seeking surgery or outpatient medical treatment. Clinical implications and directions for future research are discussed. © 2017 World Obesity Federation.

  15. Differences Between Treatment-Seeking and Nontreatment-Seeking Alcohol-Dependent Research Participants: An Exploratory Analysis.

    Science.gov (United States)

    Rohn, Matthew C H; Lee, Mary R; Kleuter, Samuel B; Schwandt, Melanie L; Falk, Daniel E; Leggio, Lorenzo

    2017-02-01

    Alcoholism is a chronic relapsing disorder with complex behavioral and functional heterogeneity. To date, attempts to characterize subgroups of alcohol-dependent (AD) individuals have largely been focused on categorical distinctions based on behaviors such as ability to abstain, age of onset, and drinking motives, but these have failed to yield predictors of treatment response and disease course. The distinction between AD individuals who are or are not interested in treatment holds significant implications for interpreting results of human laboratory studies with nontreatment seekers and clinical trials with treatment-seeking AD patients. However, despite their crucial role in alcohol-related research, these 2 groups are poorly defined. In this exploratory analysis, we attempt to better define the phenotypic differences between these 2 experimentally relevant populations. We analyzed data from AD individuals who participated in screening protocols to evaluate their suitability for participation in either treatment or nontreatment research studies at NIAAA. Scores on individual measures from a battery of behavioral, neuropsychological, and blood laboratory measures were compared between those who presented seeking treatment for AD and those who were not seeking treatment. Differences in each measure were assessed between the 2 groups. In addition, we explored whether significant differences were apparent when drinking behavior was used as a covariate. Treatment seekers manifested more impairment compared to nontreatment seekers on a wide variety of measures in the following categories: alcohol drinking, personality, impulsivity, trauma/stress, cognition, aggression, mood, and liver enzyme tests. Treatment seekers endorsed a greater number of AD criteria. Several measures including elevations in liver enzyme tests remained significantly different between the 2 groups when average daily alcohol consumption per drinking day was used as a covariate. Treatment-seeking

  16. Treatment rejecting and treatment seeking personality disorders: Type R and Type S.

    Science.gov (United States)

    Tyrer, Peter; Mitchard, Sarah; Methuen, Caroline; Ranger, Maja

    2003-06-01

    An important distinguishing feature of one group of personality disorders is the wish of the sufferer to seek treatment. For another group this wish is rarely entertained. Although there is some variation between different types of personality disorder the wish to change is not confined to any one diagnostic category. A useful subclassification of personality disorders is therefore into Type R (treatment rejecting) and Type S (treatment seeking) personality disorders, and these are defined operationally. The classification of 68 personality disordered patients on the caseload of an assertive community team using a simple scale showed a 3 to 1 ratio between Type R and Type S personality disorders with Cluster C personality disorders being significantly more likely to be Type S, and paranoid and schizoid (Cluster A) personality disorders significantly more likely to be Type R than others. It is suggested that this typology is useful for those contemplating treatment with those who have personality disorders.

  17. Gender and Age Differences in Trauma and PTSD Among Dutch Treatment-Seeking Police Officers

    NARCIS (Netherlands)

    van der Meer, Christianne A. I.; Bakker, Anne; Smit, Annika S.; van Buschbach, Susanne; den Dekker, Melissa; Westerveld, Gré J.; Hutter, Renée C.; Gersons, Berthold P. R.; Olff, Miranda

    2017-01-01

    Little is known about how age and gender are associated with posttraumatic stress disorder (PTSD) symptoms and traumatic experiences in treatment-seeking police offers. In this study, we examined 967 diagnostic files of police officers seeking treatment for PTSD. Six hundred twelve (63%) of the

  18. Demand for orthodontic treatment among 9-18 year-olds seeking ...

    African Journals Online (AJOL)

    Objective: To investigate the demand for orthodontic treatment among 9-18 olds seeking dental care in Dar-es-Salaam, Tanzania. Design: Case-control, interview and clinical study. Settings: Children seeking dental care. Main outcome measures: Demand for orthodontic treatment. Results: Most of the children (85%) in the ...

  19. The predictive value of trauma-related coping self-efficacy for posttraumatic stress symptoms : Differences between treatment seeking and non-treatment seeking victims

    NARCIS (Netherlands)

    Bosmans, Mark; van der Knaap, Leontien; van der Velden, Peter

    2015-01-01

    Objective: To assess and compare the (independent) predictive value of trauma-related coping selfefficacy (CSE) for posttraumatic stress symptoms (PTSS) among a treatment sample and a comparison group of nontreatment seeking victims. Method: Both the treatment (N 54) and comparison group (N 144)

  20. The Relation Between Trait Mindfulness and Aggression in Men Seeking Residential Substance Use Treatment

    OpenAIRE

    Shorey, Ryan C.; Anderson, Scott; Stuart, Gregory L.

    2014-01-01

    There has been an abundance of research in recent years on mindfulness, including mindfulness within individuals seeking substance use treatment. However, to date, there has been no research on whether trait mindfulness is associated with increased aggression among individuals seeking substance use treatment. Past research has demonstrated that individuals in substance use treatment evidence higher levels of aggression than non-substance abusers, and preliminary research has shown that trait ...

  1. Gender differences and factors associated with treatment-seeking behaviour for infertility in Rwanda

    NARCIS (Netherlands)

    Dhont, N.; Luchters, S.; Ombelet, W.; Vyankandondera, J.; Gasarabwe, A.; van de Wijgert, J.; Temmerman, M.

    2010-01-01

    BACKGROUND: This study examines perceptions of infertility causes, treatment-seeking behaviour and factors associated with seeking medical care in an urban infertile population in Rwanda, as well as the response of health providers. METHODS: Between November 2007 and May 2009 a hospital based survey

  2. Treatment Seeking Among College Students with Comorbid Hazardous Drinking and Elevated Mood/Anxiety Symptoms.

    Science.gov (United States)

    Capron, Daniel W; Bauer, Brian W; Madson, Michael B; Schmidt, Norman B

    2017-11-27

    Hazardous drinking is prevalent among college students and often comorbid with mood and/or anxiety disorders; however, these disorders frequently go untreated. Prior studies have found that individuals with comorbid hazardous drinking are more likely to seek treatment than those with an hazardous drinking alone. The current study tested possible psychological and structural explanations to understand these treatment seeking behaviors. A sample of 222 students identified as hazardous drinkers (AUDIT ≥ 8) participated from September 2010 to April 2011. Behavioral measures designed to mimic actual treatment seeking and self-report measures were used to assess treatment seeking behaviors, and the influence of psychopathology and individual predictors on treatment interest. Students were more interested in treatment for emotional problems than for alcohol problems. Further, treatment seeking interest was significantly higher among individuals with comorbid hazardous drinking. When provided a telephone offer for a free on-campus clinic appointment, no students were interested in receiving treatment for alcohol use problems, but some were interested in an appointment for emotional problems (n = 13). Of those students expressing interest on the phone, seven attended the clinic appointment. Logistic regression analyses revealed that students with anxiety, anxiety sensitivity, and depression were more likely to attend the clinic appointment. Conclusions/Importance: In sum, targeting mood and anxiety disorders may be a viable way to increase treatment seeking rates in hazardous drinking college students.

  3. Help-seeking timeline followback for problem drinkers: preliminary comparison with agency records of treatment contacts.

    Science.gov (United States)

    Breslin, F C; Borsoi, D; Cunningham, J A; Koski-Jännes, A

    2001-03-01

    A pilot study assessed the utility of the Timeline Followback (TLFB) method to collect information on help seeking. Using the TLFB method, 34 clients (26 men) who had attended at least one session of an outpatient alcohol treatment program reported on treatment contacts, including any supplemental services (e.g., psychiatric care). TLFB reports of help seeking at that agency were compared with agency records of treatment contacts. Clients reported on their help-seeking behavior for a period of approximately 8 months after they had completed an initial assessment for the outpatient treatment. With regard to the number of outpatient sessions they attended, intraclass correlations and equivalence testing showed that the TLFB data were comparable to the agency records of treatment contacts. Analysis of week-to-week correspondence of the presence or absence of help-seeking episodes showed good agreement between TLFB and the agency records for most participants, although there was substantial variation. Degree of correspondence was not associated with the length of the recall period or individual differences (e.g., drinking pattern). Older participants, however, tended to have lower week-to-week concordance than did younger participants. These data provide preliminary support for the utility of a help-seeking TLFB instrument to assess addiction- and mental health-related contacts. This instrument may be especially useful in research in which collecting temporal patterns of help seeking is of interest (e.g., in studies examining factors influencing the delay in help seeking after relapse).

  4. Disseminating treatment for anxiety disorders step 2: peer recommendations to seek help.

    Science.gov (United States)

    Schubert, Jessica R; Coles, Meredith E; Heimberg, Richard G; Weiss, Barry D

    2014-10-01

    Despite the high prevalence of and significant psychological burden caused by anxiety disorders, as few as 25% of individuals with these disorders seek treatment, and treatment seeking by African-Americans is particularly uncommon. This purpose of the current study was to gather information regarding the public's recommendations regarding help-seeking for several anxiety disorders and to compare Caucasian and African-American participants on these variables. A community sample of 577 US adults completed a telephone survey that included vignettes portraying individuals with generalized anxiety disorder (GAD), social phobia/social anxiety disorder (SP/SAD), panic disorder (PD), and for comparison, depression. The sample was ½ Caucasian and ½ African American. Respondents were significantly less likely to recommend help-seeking for SP/SAD and GAD (78.8% and 84.3%, respectively) than for depression (90.9%). In contrast, recommendations to seek help for panic disorder were common (93.6%) and similar to rates found for depression. The most common recommendations were to seek help from a primary care physician (PCP). African Americans were more likely to recommend help-seeking for GAD than Caucasians. Findings suggested that respondents believed individuals with anxiety disorders should seek treatment. Given that respondents often recommended consulting a PCP, we recommend educating PCPs about anxiety disorders and empirically-supported interventions. Copyright © 2014 Elsevier Ltd. All rights reserved.

  5. Drawing Invisible Wounds: War Comics and the Treatment of Trauma.

    Science.gov (United States)

    Leone, Joshua M

    2017-04-08

    Since the Vietnam War, graphic novels about war have shifted from simply representing it to portraying avenues for survivors to establish psychological wellness in their lives following traumatic events. While modern diagnostic medicine often looks to science, technology, and medications to treat the psychosomatic damage produced by trauma, my article examines the therapeutic potential of the comics medium with close attention to war comics. Graphic novels draw trauma in a different light: because of the medium's particular combination of words and images in sequence, war comics represent that which is typically unrepresentable, and these books serve as useful tools to promote healing among the psychologically wounded. Graphic narratives, both fictional and non-fictional, illuminate the ways that the unseen wounds of traumatic experience affect public health by compromising the ability of communities, individuals, and survivors to create and maintain meaningful relationships with others.

  6. Treatment of Battlefield Detainees in the War on Terrorism

    Science.gov (United States)

    2006-11-14

    Battlefield Detainees” in the War on Terrorism Updated November 14, 2006 Jennifer K. Elsea Legislative Attorney American Law Division Report Documentation...War.95 It covered “[a] ll soldiers of whatever species of arms; all men who belong to the rising en masse of the hostile country; all those who are...supra note 49, at 47. 165 See Mallison and Mallison, supra note 40, at 56-57 (noting that armbands, insignia, or distinctive headgear are acceptable

  7. Binge and Emotional Eating in obese subjects seeking weight loss treatment

    OpenAIRE

    Valdo Ricca; Giovanni Castellini; Carolina Lo Sauro; Claudia Ravaldi; Francesco Lapi; Edoardo Mannucci; Carlo Maria Rotella; Carlo Faravelli

    2008-01-01

    Objective: Binge Eating Disorder (BED) is highly prevalent among individuals seeking weight loss treatment. Considering the possible trigger factors for BED, different studies focused on the role of emotional eating. The present study compared threshold, subthreshold BED, and subjects without BED in a population of overweight/obese individuals seeking weight loss treatment, considering the anamnesis, the eating disorder specific and general psychopathology, the organic and psychiatric comorbi...

  8. A joint choice model of the decision to seek depression treatment and choice of provider sector.

    Science.gov (United States)

    Fortney, J; Rost, K; Zhang, M

    1998-03-01

    Using a community-based sample of currently depressed subjects, this research modeled the joint decision to seek depression treatment and choice of provider sector (primary care or specialty mental health). The objective was to identify those subject-specific case-mix factors and those provider sector-specific access measures that significantly impacted this joint decision. A community-based sample of 435 Arkansans with current depression symptoms was compiled using random digit dialing and the Burnam depression screener. Study subjects were administered baseline and 6-month follow-up surveys. All medical, pharmaceutical, and insurance records were collected and abstracted to verify service use and depression treatment. Three discrete choice model specifications were tested: sequential binary logit models, a multinomial logit model, and a nested logit model. The nested logit model makes less restrictive assumptions about the patterns of substitution across treatment alternatives than the other model specifications. In the 6 months after baseline, 73.3% of the sample did not seek depression treatment, 18.9% sought care from a primary care provider, and 7.8% sought care from a mental health specialist. A likelihood ratio test identified the nested logit model as the preferred model specification (chi 2 < or = 0.05), indicating that the expected maximum utility of sector choice significantly affects the decision to seek treatment. Provider sector-specific access measures (e.g., insurance coverage and availability) significantly impacted sector choice and, thus, the decision to seek treatment. Subject-specific case-mix factors (e.g., age, gender, employment status, depression severity, and psychiatric comorbidity) significantly affected the decision to seek treatment. Sector-specific access measures significantly impact both provider sector choice and the decision to seek treatment. Because the primary care and specialty care treatment alternatives were more

  9. Depression Stigma, Race, and Treatment Seeking Behavior and Attitudes

    Science.gov (United States)

    Brown, Charlotte; Conner, Kyaien O.; Copeland, Valire Carr; Grote, Nancy; Beach, Scott; Battista, Deena; Reynolds, Charles F., III

    2010-01-01

    This study examined the relationship between internalized and public stigma on treatment-related attitudes and behaviors in a community sample of 449 African American and white adults aged 18 years and older. Telephone surveys were administered to assess level of depressive symptoms, demographic characteristics, stigma, and treatment-related…

  10. Childhood malaria: mothers\\' perception and treatment-seeking ...

    African Journals Online (AJOL)

    Proximity was the major factor (92.3%) for choice of the community health workers. Low cost of care and good personal experience were the main reasons for the choice of traditional healers and home treatment respectively. The mean number of days between when illness was noticed and time treatment was instituted was ...

  11. Malaria Control Practices and Treatment Seeking Patterns among ...

    African Journals Online (AJOL)

    0.0003) and unemployment (p=0.04) favoured ITN use. There were a total of 403 self-reported malaria treatments in the preceding 12 months with 68% having ≥ 2 treatments. Patent medicine dealers (42.5%) were the most patronized ...

  12. Professional help-seeking for gambling problems: awareness, barriers and motivators for treatment.

    Science.gov (United States)

    Gainsbury, Sally; Hing, Nerilee; Suhonen, Niko

    2014-06-01

    Despite the negative consequences associated with gambling, few problem gamblers seek professional help. This study aimed to examine awareness of professional sources of help and help-seeking behaviour amongst regular and problem gamblers. Australian gamblers (N = 730) were recruited from the general population, multicultural gambling venues, and gambling helplines and treatment services. Surveys measured awareness of professional help services, help-seeking behaviour and motivators and barriers to seeking help. Gamblers demonstrated low awareness of professional help services. Problem gamblers born in Australia or who were divorced were more likely to seek help. Problem gamblers who were reluctant to seek help due to a desire solve the problem on their own and feeling ashamed for themselves or their family pride were more likely to have overcome these barriers to seek help. However, significant barriers related to denial of problem severity and concerns about the ability to access low cost services that cater for multicultural populations predicted a lower likelihood of having sought help. Public education should aim to de-mystify the treatment process and educate gamblers about symptoms of problem gambling to reduce shame, stigma, and denial and encourage help-seeking. Ongoing education and promotion of help services is required to increase awareness of the resources available, including targeted promotions to increase awareness of relevant services among specific populations.

  13. Probability and predictors of treatment-seeking for prescription opioid use disorders: a national study.

    Science.gov (United States)

    Blanco, Carlos; Iza, Miren; Schwartz, Robert P; Rafful, Claudia; Wang, Shuai; Olfson, Mark

    2013-07-01

    Prescription opioid use disorders are the second most common drug use disorder behind only cannabis use disorders. Despite this, very little is known about the help-seeking behavior among individuals with these disorders. The sample included respondents of the Wave 2 of the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC) with a lifetime diagnosis of prescription drug use disorders (N=623). Unadjusted and adjusted hazard ratios are presented for time to first treatment-seeking by sociodemographic characteristics and comorbid psychiatric disorders. The lifetime cumulative probability of treatment seeking was 42% and the median delay from prescription drug use disorder onset to first treatment was 3.83 years. Having an earlier onset of prescription opioid use disorder and a history of bipolar disorder, major depression disorder, specific phobia and cluster B personality disorders predicted shorter delays to treatment. Although some comorbid psychiatric disorders increase the rate of treatment-seeking and decrease delays to first-treatment contact rates of treatment-seeking for prescription drug use disorder are low, even when compared with rates of treatment for other substance use disorders. Given the high prevalence and adverse consequences of prescription drug use disorder, there is a need to improve detection and treatment of prescription opioid use disorder. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  14. Self-stigma, personality traits, and willingness to seek treatment in a community sample.

    Science.gov (United States)

    Ingram, Paul B; Lichtenberg, James W; Clarke, Erik

    2016-08-01

    Stigma has received attention as a major barrier toward effective mental health service delivery, and previous research has demonstrated that the Five-Factor Model (FFM) domain of Openness to Experience is negatively correlated with stigmatized views of mental health. However, a lack of established relationships between personality and self-stigma, as well as how these concepts affect an individual's treatment-seeking intentions, has left a gap in the literature. To address this, our study recruited a low-income community sample and tested (a) the relationship between self-stigma of mental health treatment and the FFM, (b) the relationship between self-stigma and treatment-seeking intentions, and (c) the incremental validity of FFM personality beyond stigma in the prediction of treatment seeking. Results suggest that there is some incongruence with previous research on personality's relationship to stigma, personality does not act as an additive component in the prediction of the relationship between stigma and treatment seeking, and stigma is related only to the perceived need for mental health treatment but not to an individual's openness to seek that treatment. The discussion concludes with implications for the contextualization and treatment of stigma as a barrier for mental health treatment and a general synthesis of the personality trait profiles for those holding stigmatizing views of mental health. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

  15. Clinical Characteristics of Men Interested in Seeking Treatment for Use of Pornography.

    Science.gov (United States)

    Kraus, Shane W; Martino, Steve; Potenza, Marc N

    2016-06-01

    Background and aims This study examined the prevalence of, and factors associated with, men's interest in seeking treatment for use of pornography. Methods Using an Internet-based data-collection procedure, we recruited 1,298 male pornography users to complete questionnaires assessing demographic and sexual behaviors, hypersexuality, pornography-use characteristics, and current interest in seeking treatment for use of pornography. Results Approximately 14% of men reported an interest in seeking treatment for use of pornography, whereas only 6.4% of men had previously sought treatment for use of pornography. Treatment-interested men were 9.5 times more likely to report clinically significant levels of hypersexuality compared with treatment-disinterested men (OR = 9.52, 95% CI = 6.72-13.49). Bivariate analyses indicated that interest-in-seeking-treatment status was associated with being single/unmarried, viewing more pornography per week, engaging in more solitary masturbation in the past month, having had less dyadic oral sex in the past month, reporting a history of seeking treatment for use of pornography, and having had more past attempts to either "cut back" or quit using pornography completely. Results from a binary logistic regression analysis indicated that more frequent cut back/quit attempts with pornography and scores on the Hypersexual Behavior Inventory - Control subscale were significant predictors of interest-in-seeking-treatment status. Discussion and conclusions Study findings could be used to inform current screening practices aimed at identifying specific aspects of sexual self-control, impulsivity, and/or compulsivity associated with problematic use of pornography among treatment-seeking individuals.

  16. Seeking Drug Abuse Treatment: Know What to Ask

    Science.gov (United States)

    ... Science Adolescent Brain Comorbidity College-Age & Young Adults Criminal Justice Drugged Driving Drug Testing Drugs and the ... achieve this goal. That is why finding the right treatment for a person's specific needs is critical. ...

  17. DEPRESSION STIGMA, RACE, AND TREATMENT SEEKING BEHAVIOR AND ATTITUDES

    OpenAIRE

    Brown, Charlotte; Conner, Kyaien O; Copeland, Valire Carr; Grote, Nancy; Beach, Scott; Battista, Deena; Reynolds, Charles F.

    2010-01-01

    This study examined the relationship between internalized and public stigma on treatment-related attitudes and behaviors in a community sample of 449 African American and white adults aged 18 years and older. Telephone surveys were administered to assess level of depressive symptoms, demographic characteristics, stigma, and treatment-related attitudes and behaviors. Multiple regression analysis indicated that internalized stigma mediated the relationship between public stigma and attitudes to...

  18. Predictors of early or late treatment seeking in patients with social anxiety disorder.

    Science.gov (United States)

    Ertekin, Erhan; Çelebi, Fahri; Koyuncu, Ahmet; Uysal, Ömer; Demir, Esra Yancar; Tükel, Raşit

    2015-11-01

    Social anxiety disorder (SAD) is common in the general population and usually begins at an early age. It is well established that patients with SAD rarely seek treatment, and their first treatment contact usually takes many years after onset. The aim of this study was to determine the predictors of early and late treatment seeking in patients with SAD. This study enrolled 180 patients with generalized SAD. The mean and median durations between the emergence of SAD and first treatment contact were 15 and 14 years, respectively. Multiple linear regression with the backward elimination method was applied to assess the factors that affect the amount of time between occurrence of the disorder and first treatment contact. Older age, earlier onset of SAD, and lower level of education were associated with late treatment seeking, whereas earlier onset of comorbid major depressive episodes and lifetime history of comorbid obsessive-compulsive disorder were associated with earlier treatment seeking. Age of onset, comorbid psychiatric conditions, and level of education are associated with the timing of treatment seeking in patients with SAD. It is important to try to change the common perception that SAD is a personality trait rather than a psychiatric disorder.

  19. Early diagnosis and treatment of uncomplicated malaria and patterns of health seeking in Vietnam

    NARCIS (Netherlands)

    Giao, Phan T.; Vries, Peter J.; Binh, Tran Q.; Nam, Nguyen V.; Kager, Piet A.

    2005-01-01

    Early diagnosis and treatment of malaria (EDTM) is a key component of malaria control. The success of EDTM depends on health seeking behaviour and the quality of the health service. This study assessed self-diagnosis, treatment and treatment delay after the introduction of EDTM in 1993. In southern

  20. 1 Knowledge, treatment seeking and preventive practices in respect ...

    African Journals Online (AJOL)

    2011-10-04

    Oct 4, 2011 ... measures against malaria by people living with HIV/AIDS. It is therefore important to assess the use of preventive measures against malaria and antimalarials use by these patients with the HIV infection. Therefore, this present study was carried out to ascertain the knowledge, treatment and preventive ...

  1. Malaria prevalence and treatment seeking behaviour of young ...

    African Journals Online (AJOL)

    Background/Objective: Method: During a high transmission period in Ibadan, questionnaires on malaria management and treatment practices were administered to 307 undergraduate science majors. Follow up questionnaires were also administered to some of the students. Microscopy was done to determine parasitaemia, ...

  2. Body dysmorphic disorder in patients who seek appearance-enhancing medical treatments.

    Science.gov (United States)

    Sarwer, David B; Crerand, Canice E; Magee, Leanne

    2010-11-01

    Most patients who seek appearance-enhancing medical treatments report some degree of body image dissatisfaction, which is believed to motivate the pursuit of these treatments. However, patients with extreme body image dissatisfaction may be suffering from a psychiatric disorder known as body dysmorphic disorder (BDD). This article reviews BDD, including its clinical features and prevalence in medical settings. Although patients with BDD frequently seek cosmetic treatments to address their appearance-related distress, such treatments are rarely beneficial. The article concludes with recommendations for patient and provider safety. Copyright © 2010. Published by Elsevier Inc.

  3. Investigation of factors associated with treatment-seeking in Southern Chinese with orofacial pain.

    Science.gov (United States)

    Zheng, Jun; McMillan, Anne S; Wong, May C M; Luo, Yan; Lam, Cindy L K

    2010-01-01

    To investigate key factors associated with treatment-seeking for orofacial pain symptoms in community-dwelling adult Chinese people in Hong Kong. A cross-sectional study was conducted using a Hong Kong Hospital Authority Family Medicine Clinic as the sampling frame. People aged 35 to 70 years with recent orofacial pain symptoms participated. Standard questions were asked about orofacial pain symptoms and characteristics in the previous month, Oral Health Impact Profile (OHIP-14), General Health Questionnaire (GHQ-12), Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) depression/nonspecific physical symptoms (NPS) scales, sleep and illness behavior measures, and questions on pain disability, professional treatment-seeking, pain medication usage, and dental attendance were administered prior to a standard clinical assessment. Multiple logistic regression with a forward stepwise selection method was used for data analysis. Two hundred people with orofacial pain symptoms participated in the definitive study. Twenty-seven percent had sought professional advice. The majority had consulted a medical practitioner (66.7%) or dentist (40.7%), 16.7% had consulted a traditional Chinese medicine (TCM) practitioner, and the majority (60%) had taken pain medication. There was no significant association between different orofacial pain diagnoses and professional treatment-seeking (P = .602). Four independent factors were significantly related to an increased likelihood of treatment-seeking (P dental attendance for check-up (odds ratio [OR] > 3), time when pain was experienced during the past month (days) (OR > 5), multiple pain symptoms (OR = 4.99), and use of TCM when ill (OR = 3.31). Professional treatment-seeking for orofacial pain was low in this ethnic group. The strongest predictor of treatment-seeking for orofacial pain was an increase in the number of days when pain was experienced during the past month. Key factors associated with treatment-seeking

  4. Probability and predictors of treatment-seeking for substance use disorders in the U.S.

    Science.gov (United States)

    Blanco, Carlos; Iza, Miren; Rodríguez-Fernández, Jorge Mario; Baca-García, Enrique; Wang, Shuai; Olfson, Mark

    2015-04-01

    Little is known about to what extent treatment-seeking behavior varies across individuals with alcohol abuse, alcohol dependence, drug abuse, and drug dependence. The sample included respondents from the Wave 2 of the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC) who reported a lifetime diagnosis alcohol abuse, alcohol dependence, drug abuse, or drug dependence. Unadjusted and adjusted hazard ratios are presented for time to first treatment contact by sociodemographic characteristics and comorbid psychiatric disorders. Individuals were censored from the analyses if their condition remitted prior to seeking treatment. In the first year after disorder onset, rates of treatment-seeking were 13% for drug dependence, 5% for alcohol dependence, 2% for drug abuse, and 1% for alcohol abuse. The lifetime probability of seeking treatment among individuals who did not remit was also highest for drug dependence (90%), followed by drug abuse (60%), alcohol dependence (54%), and alcohol abuse (16%). Having had previous treatment contact for a substance use disorder (SUD) increased the probability of seeking treatment for another SUD. By contrast, an early age of SUD onset, belonging to an older cohort, and a higher level of education decreased the lifetime probability of treatment contact for SUD. The role of comorbid mental disorders was more complex, with some disorders increasing and other decreasing the probability of seeking treatment. Given high rates of SUD and their substantial health and economic burden, these patterns suggest the need for innovative approaches to increase treatment access for individuals with SUD. Copyright © 2015. Published by Elsevier Ireland Ltd.

  5. Differences between Alcoholics and Cocaine Addicts Seeking Treatment.

    Science.gov (United States)

    López-Goñi, José J; Fernández-Montalvo, Javier; Arteaga, Alfonso

    2015-03-03

    This study explored the characteristics of a representative sample of patients who were addicted to either alcohol or cocaine, comparing the profiles of both types of drug users. A sample of 234 addicted patients (109 alcoholics and 125 cocaine addicts) who sought outpatient treatment in a Spanish clinical centre was assessed. Data on socio-demographic, consumption, psychopathological and maladjustment characteristics were collected using the European Addiction Severity Index (EuropASI), the Symptom Checklist-90-Revised (SCL-90-R) and the Millon Clinical Multiaxial Inventory (MCMI-II). Demographically, differences were observed with regard to age (alcoholics were older than cocaine addicts; t = 12.2, p = .001), employment (the alcoholic group had more labor problems; χ 2 = 6.2, p = .045) and family consequences (worse in alcoholics; t = 2.3, p = .025). The EuropASI results showed statistically significant differences in addiction severity, with alcoholics showing a greater severity than cocaine addicts. In terms of psychopathology, alcoholics presented more associated symptomatology than cocaine addicts. According to these results, patients with alcohol dependence have a different profile from patients with cocaine dependence, resulting in different repercussions for important areas of their lives. These differences should be taken into account when standard treatments for addiction are implemented.

  6. Contesting the cruel treatment of abortion-seeking women.

    Science.gov (United States)

    Fletcher, Ruth

    2014-11-01

    This article draws on legal arguments made by civil society organisations to challenge the legal reasoning that apparently produced the decision in the Ms Y case in Ireland in August 2014. I show how legal standards of reasonableness and practicality ought to be interpreted in ways that are respectful of the patient's wishes and rights. The case concerned a decision by the Health Service Executive, the Irish public health authority, to refuse an abortion to a pregnant asylum seeker and rape survivor on the grounds that a caesarean section and early live delivery were practicable and reasonable alternatives justified by the need to protect fetal life. I argue that the abortion refusal may not have been a reasonable decision, as required by the terms of relevant legislation, for four different reasons. First, the alternative of a caesarean section and early live delivery was not likely to avert the risk of suicide, and in fact did not do so. Second, the consent to the caesarean section alternative may not have been a real consent in the legal sense if it was not voluntary. Third, an abortion refusal and forcible treatment fall below the norms of good medical practice as interpreted through a patient-centred perspective. Fourth, an abortion refusal that entails forms of cruel, inhumane and degrading treatment ought not to be a reasonable action under the legislation. Copyright © 2014 Reproductive Health Matters. Published by Elsevier Ltd. All rights reserved.

  7. Awareness of treatment history in family and friends, and mental health care seeking propensity.

    Science.gov (United States)

    Thériault, François L; Colman, Ian

    2017-04-01

    Many adults suffering from mental disorders never receive the care they need. The role of family and friends in overcoming mental health treatment barriers is poorly understood. We investigated the association between awareness of lifetime mental health treatment history in one's family or friends, and likelihood of having recently received mental health care for oneself. Using Canadian Community Health Survey 2012-Mental Health data, we defined care seekers as individuals who talked about mental health issues to at least one health professional in the past 12 months. Seekers were matched to non-seekers based on estimated care seeking propensity, and 1933 matched pairs were created. Reported awareness of lifetime treatment history in family and friends was compared between seekers and non-seekers. There were no differences in the distribution of any confounder of interest between seekers and non-seekers. 73% of seekers were aware of treatment history in family or friends, compared to only 56% of non-seekers (RR 1.3; 95% CI 1.2, 1.3). Awareness of treatment history in family members had nearly identical associations with care seeking as awareness of treatment history in friends. We have found a social clustering of mental health care seeking behavior; individuals who were aware of lifetime treatment history in family or friends were more likely to have recently sought care for themselves. These novel results are consistent with a social learning model of care seeking behavior, and could inform efforts to bridge the current mental health treatment gap.

  8. Gender-related clinical and neurocognitive differences in individuals seeking treatment for pathological gambling

    DEFF Research Database (Denmark)

    Grant, Jon E; Chamberlain, Samuel R; Schreiber, Liana R N

    2012-01-01

    Understanding variations in disease presentation in men and women is clinically important as differences may reflect biological and sociocultural factors and have implications for selecting appropriate prevention and treatment strategies. The aim of this study was to investigate clinical and cogn...... and cognitive differences in treatment-seeking people with pathological gambling as a function of gender....

  9. Treatment with bone-seeking radionuclides for painful bone metastases in patients with lung cancer

    DEFF Research Database (Denmark)

    Zacho, Helle D; Karthigaseu, Nita Nishanthiny; Fuglsang, Randi

    2017-01-01

    Treatment with bone-seeking radionuclides may provide palliation from pain originating from bone metastases. However, most studies have been conducted in patients with prostate cancer and patients with breast cancer. We aimed to perform a systematic review of the use of radionuclide treatment in ...

  10. Hardiness and sensation seeking as potential predictors of former prisoners of wars' posttraumatic stress symptoms trajectories over a 17-year period.

    Science.gov (United States)

    Zerach, Gadi; Karstoft, Karen-Inge; Solomon, Zahava

    2017-08-15

    Little is known about trajectories of posttraumatic stress symptoms (PTSS) among former prisoners of war (ex-POWs) and the predictors of those trajectories. This study aimed to assess long-term PTSS trajectories among ex-POWs and comparable veterans and the role of hardiness and sensation seeking in predicting PTSS trajectory. A sample of 189 Israeli ex-POWs and 160 comparable combatants participated in a 17 year longitudinal study with three waves of measurements following the 1973 Yom Kippur War (T1: 1991, T2: 2003, T3: 2008). Participants completed validated self-report measures. Latent growth mixture modeling (LGMM) identified four longitudinal PTSS trajectories. Among ex-POWs, the majority of participants were classified in trajectories with "low-increasing" or "medium-increasing" levels of PTSS. Among the comparable veterans, however, the majority of participants were classified in a trajectory with "low" levels of PTSS. Ex-POWs with high levels of hardiness were less likely to belong to the "high" or "medium-increasing" PTSS trajectories, compared to the low-fluctuating trajectory. The long-term course of PTSS is heterogeneous among both veterans and ex-POWs, with chronic and increasing symptom patterns being more prevalent amongst ex-POWs. Ex-POWs should be considered an at-risk population for exacerbated PTSS trajectories that is related to hardiness personality construct. Copyright © 2017 Elsevier B.V. All rights reserved.

  11. The Relation Between Trait Mindfulness and Aggression in Men Seeking Residential Substance Use Treatment

    Science.gov (United States)

    Shorey, Ryan C.; Anderson, Scott; Stuart, Gregory L.

    2015-01-01

    There has been an abundance of research in recent years on mindfulness, including mindfulness within individuals seeking substance use treatment. However, to date, there has been no research on whether trait mindfulness is associated with increased aggression among individuals seeking substance use treatment. Past research has demonstrated that individuals in substance use treatment evidence higher levels of aggression than non-substance abusers, and preliminary research has shown that trait mindfulness is inversely associated with aggression in non-substance-use treatment-seeking populations. The current study examined whether trait mindfulness was associated with aggression among men seeking residential substance use treatment (N = 116). Results demonstrated that lower trait mindfulness was associated with increased aggression (physical, verbal, and aggressive attitude). Moreover, this relation held for both verbal aggression and aggressive attitude after controlling for alcohol use, drug use, and age, all known predictors of aggression. Findings provide the first evidence that mindfulness is negatively associated with aggression among men in substance use treatment, which could have important implications for intervention. That is, mindfulness-based interventions may prove helpful for the treatment of both substance use and aggression. PMID:25192702

  12. A psychological study of people who seek orthodontic treatment: Comparison with untreated controls

    Directory of Open Access Journals (Sweden)

    Hamidreza Jamilian

    2015-01-01

    Full Text Available Objective: Improvement in appearance is an important motivation for orthodontic treatment; nevertheless, not all patients with malocclusion seek treatment; therefore, the aim of this study was to compare the psychological state of patients with moderate to severe malocclusion who seek orthodontic treatment with patients who suffer from similar malocclusion but do not seek treatment. Materials and Methods: Minnesota multiphasic personality inventory-2 questionnaire which assesses psychological states of people were given to 100 subject with moderate to severe malocclusion who were undergoing orthodontic treatment and 100 subjects with similar malocclusion who did not request orthodontic treatment. All subjects had similar demographic variables. Clinical scales measured by the test included: Hypochondriasis, depression, hysteria, psychopathic deviate, paranoia, psychasthenia, schizophrenia, and hypomania. The questionnaire consisted of 71 questions, and the subjects had to mark "True" or "False" in response. The scores were transformed into T-scores by a trained psychologist. The results were evaluated by independent t-test. Results and Conclusion: The results of the test showed that both treated and untreated subjects were in similar psychological state and were psychologically normal; therefore, it is likely that other factors affect patients′ willingness for seeking orthodontic treatment rather than their psychological state.

  13. The relation between trait mindfulness and aggression in men seeking residential substance use treatment.

    Science.gov (United States)

    Shorey, Ryan C; Anderson, Scott; Stuart, Gregory L

    2015-06-01

    There has been an abundance of research in recent years on mindfulness, including mindfulness within individuals seeking substance use treatment. However, to date, there has been no research on whether trait mindfulness is associated with increased aggression among individuals seeking substance use treatment. Past research has demonstrated that individuals in substance use treatment evidence higher levels of aggression than non-substance abusers, and preliminary research has shown that trait mindfulness is inversely associated with aggression in non-substance-use treatment-seeking populations. The current study examined whether trait mindfulness was associated with aggression among men seeking residential substance use treatment (N = 116). Results demonstrated that lower trait mindfulness was associated with increased aggression (physical, verbal, and aggressive attitude). Moreover, this relation held for both verbal aggression and aggressive attitude after controlling for alcohol use, drug use, and age, all known predictors of aggression. Findings provide the first evidence that mindfulness is negatively associated with aggression among men in substance use treatment, which could have important implications for intervention. That is, mindfulness-based interventions may prove helpful for the treatment of both substance use and aggression. © The Author(s) 2014.

  14. What determines whether a patient with LUTS seeks treatment? ICI-RS 2011.

    Science.gov (United States)

    Apostolidis, Apostolos; de Nunzio, Cosimo; Tubaro, Andrea

    2012-03-01

    To review the known determinants of healthcare-seeking behavior for LUTS and address unmet needs and future research priorities. The PubMed literature was searched for currently known factors affecting treatment seeking for LUTS, OAB, and incontinence in men and women. Further to the great variation in rates for treatment seeking for LUTS in both men and women, several biomedical and psychosocial factors affecting HSB have been identified in studies to date. Symptom severity and bother, age, and impact on quality of life have consistently been identified as potent determinants of treatment seeking for LUTS. Race and ethnicity also play a role. Advice from others and the media, embarrassment, personal beliefs and attitudes towards healthcare use, and subjective well-being are but a few of the psychosocial determinants which may impact on a patient's decision to seek medical advice for LUTS. Studying the role of reassurance versus medical treatment, referral patterns for LUTS in various populations, the role of comorbidities in HSB, cultural issues, bother-associated parameters and psychosocial profiles in association with healthcare-seeking, patients' expectations, HSB in relation to health economics, and development of questionnaires on HSB for patients and physicians should be amongst future research priorities. Increasing research interest has helped identify several biomedical and psychosocial factors affecting HSB for LUTS. Qualitative research is needed as well as studies to address aspects of HSB, not only in subjects attending the available healthcare services, but even more in those patients who do not seek medical advice for their LUTS. Copyright © 2012 Wiley Periodicals, Inc.

  15. The marginalisation of Indigenous students within school mathematics and the math wars: seeking resolutions within ethical spaces

    Science.gov (United States)

    Russell, Gale L.; Chernoff, Egan J.

    2013-03-01

    In mathematics education, there are (at least) two seemingly disparate and unethical issues that have been allowed to continue unresolved for decades: the math wars (traditional versus reform teaching and learning of mathematics) and the marginalisation of Indigenous students within K-12 mathematics. Willie Ermine, an Indigenous scholar, has proposed the use of ethical spaces to explore and analyse occurrences of unethical situations arising between the "intersection of Indigenous law and Canadian Legal systems" (Ermine, Indigenous Law Journal 6(1):193-203, 2007). This paper brings Ermine's notion of ethical spaces to the field of mathematics education research as the theoretical framework for analysing the aforementioned issues. The result of this analysis is a potential single theoretical resolution to both dilemmas that can also serve as a significant factor in the processes of decolonisation.

  16. Quality of life impact and treatment seeking of Chinese women with urinary incontinence.

    Science.gov (United States)

    Yu, Hong-Jeng; Wong, Wai-Yan; Chen, Jun; Chie, Wei-Chu

    2003-05-01

    The objective of this study was to investigate the quality of life (QOL) impact of urinary incontinence (UI) and to examine its relationship with treatment seeking in adult Taiwanese women. We conducted a cross-section in-person questionnaire interview of 1608 adult women living in the Taipei area. The characteristics and incontinence status were recorded. A short form incontinence impact questionnaire (IIQ-7) was used to evaluate the QOL impact of UI. Multiple logistic regression analysis was used to assess the determinative factors for treatment seeking. The mean IIQ-7 score of the 205 (12.7%) women who reported urinary leakage more than once per month in the preceding 12 months was 5.0 (range: 0-19), which showed a significant correlation with the severity of incontinence (r = 0.59, p Women with mixed type UI had a higher IIQ-7 score compared to those with stress or urge UI. Fifty-five (26.8%) incontinent women had sought medical help. Treatment seeking was highly related to IIQ-7 scores as 75% of incontinent women with an IIQ-7 score > 10 in contrast to 5% of those with an IIQ-7 score perceiving UI as a disease and a higher IIQ-7 score were independent factors predicting treatment seeking. We concluded that UI is a common problem that brings substantial QOL impact to Taiwanese women. The IIQ-7 questionnaire may provide a useful measurement to quantitate the degree of QOL impact, which is largely affected by the severity and type of incontinence. Women who perceive UI as a disease and those with a higher degree of QOL impact are more likely to seek medical help. Furthermore, treatment seeking in Taiwanese women with significant UI may be more common than thought as a great majority of women with higher IIQ-7 scores had sought medical help.

  17. Treatment-seeking behaviour in low- and middle-income countries estimated using a Bayesian model

    Directory of Open Access Journals (Sweden)

    Victor A. Alegana

    2017-04-01

    Full Text Available Abstract Background Seeking treatment in formal healthcare for uncomplicated infections is vital to combating disease in low- and middle-income countries (LMICs. Healthcare treatment-seeking behaviour varies within and between communities and is modified by socio-economic, demographic, and physical factors. As a result, it remains a challenge to quantify healthcare treatment-seeking behaviour using a metric that is comparable across communities. Here, we present an application for transforming individual categorical responses (actions related to fever to a continuous probabilistic estimate of fever treatment for one country in Sub-Saharan Africa (SSA. Methods Using nationally representative household survey data from the 2013 Demographic and Health Survey (DHS in Namibia, individual-level responses (n = 1138 were linked to theoretical estimates of travel time to the nearest public or private health facility. Bayesian Item Response Theory (IRT models were fitted via Markov Chain Monte Carlo (MCMC simulation to estimate parameters related to fever treatment and estimate probability of treatment for children under five years. Different models were implemented to evaluate computational needs and the effect of including predictor variables such as rurality. The mean treatment rates were then estimated at regional level. Results Modelling results suggested probability of fever treatment was highest in regions with relatively high incidence of malaria historically. The minimum predicted threshold probability of seeking treatment was 0.3 (model 1: 0.340; 95% CI 0.155–0.597, suggesting that even in populations at large distances from facilities, there was still a 30% chance of an individual seeking treatment for fever. The agreement between correctly predicted probability of treatment at individual level based on a subset of data (n = 247 was high (AUC = 0.978, with a sensitivity of 96.7% and a specificity of 75.3%. Conclusion We have shown

  18. Motivators for seeking gambling-related treatment among Ontario problem gamblers.

    Science.gov (United States)

    Suurvali, Helen; Hodgins, David C; Toneatto, Tony; Cunningham, John A

    2012-06-01

    A random digit dialing telephone survey was used to interview 8,467 adults in Ontario, Canada. The NODS-CLiP was used to identify a representative sample of 730 gamblers (54.3% male, mean age 45.3 years) with possible past year gambling problems in order to explore factors that might affect disordered gamblers' motivators for seeking gambling-related help. A final sample of 526 gamblers provided useable data on possible reasons for and barriers to seeking help, awareness of services, self-perception of gambling problems and experience with help-seeking. Financial and relationship issues were the most frequently volunteered motivators. However, over two-thirds of the respondents could not think of a reason for seeking help. Gamblers who had self-admitted or more severe problems, who knew how to get help, who were employed and had more education, and who identified possible barriers to seeking help were more likely to suggest motivators, especially financial ones. More research is recommended on gamblers' trajectory towards recognition of a gambling problem, the process of overcoming specific barriers to treatment, and the role of social advantage (e.g., education and employment), in order to devise educational campaigns that will encourage earlier help-seeking among disordered gamblers.

  19. Treatment seeking, vaginal discharge and psychosocial distress among women in urban Mumbai.

    Science.gov (United States)

    Kostick, Kristin M; Schensul, Stephen L; Jadhav, Kalpita; Singh, Rajendra; Bavadekar, Amruta; Saggurti, Niranjan

    2010-09-01

    Vaginal discharge (safed pani in Hindi, meaning "white water") is one of the leading symptoms for which women in India seek care. Treatment-seeking for safed pani is disproportionately high among poor women, representing a physical, emotional and financial burden for low-income families. Safed pani is only rarely indicative of a reproductive tract or sexually transmitted infection. The discrepancy between symptom reports and observed pathology has led some researchers to characterize safed pani as a culturally based expression of more generalized negative life situation. Data are drawn from two prevention intervention studies (2002-2006 and 2007-2012) conducted in economically marginal communities in Mumbai. Results show that husbands as problem generators and spousal abusers and women's greater perceived empowerment and reported tension are significantly associated with safed pani. These results provide the basis for identifying women at greater risk for psychosocial distress and providing supports at the locations at which they seek treatment.

  20. Gender differences in substance use, consequences, motivation to change, and treatment seeking in people with serious mental illness.

    Science.gov (United States)

    Drapalski, Amy; Bennett, Melanie; Bellack, Alan

    2011-01-01

    Gender differences in patterns and consequences of substance use, treatment-seeking, and motivation to change were examined in two samples of people with serious mental illness (SMI) and comorbid substance use disorders (SUDs): a community sample not currently seeking substance abuse treatment (N = 175) and a treatment-seeking sample (N = 137). In both groups, women and men demonstrated more similarities in the pattern and severity of their substance use than differences. However, treatment-seeking women showed greater readiness to change their substance use. Mental health problems and traumatic experiences may prompt people with SMI and SUD to enter substance abuse treatment, regardless of gender.

  1. The role of personality traits and barriers to mental health treatment seeking among college students.

    Science.gov (United States)

    Jennings, Kristen S; Goguen, Kandice N; Britt, Thomas W; Jeffirs, Stephanie M; Wilkes, Jack R; Brady, Ashley R; Pittman, Rebecca A; DiMuzio, Danielle J

    2017-11-01

    Many college students experience a mental health problem yet do not seek treatment from a mental health professional. In the present study, we examined how perceived barriers (stigma perceptions, negative attitudes about treatment, and perceptions of practical barriers), as well as the Big Five personality traits, relate to treatment seeking among college students reporting a current mental health problem. The sample consisted of 261 college students, 115 of which reported experiencing a current problem. Results of a series of logistic regressions revealed that perceived stigma from others (OR = .32), self-stigma (OR = .29), negative attitudes about treatment (OR = .27), and practical barriers (OR = .34) were all associated with a lower likelihood of having sought treatment among students experiencing a problem. Of the five-factor model personality traits, only Neuroticism was associated with a higher likelihood of having sought treatment when experiencing a mental health problem (OR = 2.71). When we considered all significant predictors in a final stepwise conditional model, only self-stigma, practical barriers, and Neuroticism remained significant unique predictors. Implications for addressing barriers to treatment and encouraging treatment seeking among college students are discussed. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

  2. Prediction factors for failure to seek treatment following traumatic dental injuries to primary teeth

    Directory of Open Access Journals (Sweden)

    Ramon Targino Firmino

    2014-06-01

    Full Text Available The objective of this study was to evaluate prediction factors for failure to seek treatment following a traumatic dental injury (TDI to primary teeth among preschool children in the city of Campina Grande, Brazil. A cross-sectional study was carried out involving 277 children 3 to 5 years of age, with TDI, enrolled in public and private preschools. Parents filled out a form addressing demographic data and whether or not they had sought treatment. Clinical examinations were performed by three dentists who had undergone a calibration exercise (Kappa: 0.85 to 0.90 for the evaluation of TDI. Bivariate and multivariate Poisson regression models were constructed (α = 5%. Enamel fracture was the most prevalent type of TDI (48.7% and the upper central incisors were the most affected teeth (88.4%. The frequency of seeking dental treatment was low (9.7%. The following variables were associated with failure to seek treatment following TDI: a household income greater than one minimum wage (PR = 1.170; 95%CI 1.018-1.341, parents/caregivers’ perception of a child’s oral health as poor (PR = 1.100; 95%CI 1.026-1.176, and the non-perception of TDI by parents/caregivers (PR = 1.250; 95%CI 1.142-1.360. In the present study, the frequency of seeking treatment following TDI was low, and parents/caregivers with a higher income, a poor perception of their child’s oral health and a lack of awareness regarding the trauma were more likely to fail to seek treatment following TDI to primary teeth.

  3. Sex differences in reinstatement of cocaine-seeking with combination treatments of progesterone and atomoxetine.

    Science.gov (United States)

    Swalve, Natashia; Smethells, John R; Zlebnik, Natalie E; Carroll, Marilyn E

    2016-06-01

    Two repurposed medications have been proposed to treat cocaine abuse. Progesterone, a gonadal hormone, and atomoxetine, a medication commonly used to treat attention deficit/hyperactivity disorder, have both been separately shown to reduce cocaine self-administration and reinstatement (i.e., relapse). The goal of the present study was to examine sex differences in the individual effects of PRO and ATO as well as the combination PRO+ATO treatment on cocaine (COC), caffeine (CAF), and/or cue-primed reinstatement of cocaine-seeking. Adult male and female Wistar rats lever-pressed under a FR 1 schedule for cocaine infusions (0.4mg/kg/inf). After 14 sessions of stable responding in daily 2-h sessions, rats underwent a 21-day extinction period when no drug or drug-related stimuli were present. Rats were then separated into four groups that received PRO (0.5mg/kg) alone (PRO+SAL), ATO (1.5mg/kg) alone (VEH+ATO), control (VEH+SAL) or combination (PRO+ATO) treatments prior to the reinstatement condition. Reinstatement of cocaine-seeking to cues and/or drug injections of cocaine or caffeine was tested after extinction. During maintenance, females self-administered more cocaine than males, but no sex differences were seen during extinction. Females showed greater cocaine-seeking than males after a CAF priming injection. Individual treatment with ATO did not decrease reinstatement under any priming condition; however, the combination treatment decreased cocaine-seeking under the COC+CUES priming condition in males, and both PRO alone and the combination treatment decreased cocaine-seeking in the CAF+CUES condition in females. Overall, PRO alone was only effective in reducing reinstatement in females, while the combination treatment was consistently effective in reducing reinstatement in both sexes. Copyright © 2016 Elsevier Inc. All rights reserved.

  4. Socio-economic inequalities in cost of seeking treatment for malaria ...

    African Journals Online (AJOL)

    Background: To investigate the socio-economic differentials in health seeking and costs of malaria treatment in Southeast Nigeria. Methods: A cross-sectional study design using questionnaires was conducted. The study areas are four malaria holo-endemic communities (towns) in Enugu State, Southeast Nigeria, namely ...

  5. Complex Psychiatric Comorbidity of Treatment-Seeking Youth with Autism Spectrum Disorder and Anxiety Symptoms

    Science.gov (United States)

    Hepburn, Susan L.; Stern, Jessica A.; Blakeley-Smith, Audrey; Kimel, Lila K.; Reaven, Judith A.

    2014-01-01

    This descriptive study examines the complexity of psychiatric comorbidity in treatment-seeking youth with ASD and anxiety symptoms. Forty-two parents of youth with ASD and anxiety (ages 8-14) completed a structured diagnostic interview (Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present and Lifetime Version). Youth…

  6. Brief Measures of Anxiety in Non-Treatment-Seeking Youth with Autism Spectrum Disorder

    Science.gov (United States)

    Kerns, Connor Morrow; Maddox, Brenna B.; Kendall, Philip C.; Rump, Keiran; Berry, Leandra; Schultz, Robert T.; Souders, Margaret C.; Bennett, Amanda; Herrington, John; Miller, Judith

    2015-01-01

    This study investigated the accuracy of brief anxiety scales for non-treatment-seeking youth with autism spectrum disorder. In all, 54 youth (7-17?years; IQ: 67-158) with autism spectrum disorder and their parents completed (a) an expanded version of the Anxiety Disorders Interview Schedule--Child/Parent designed to capture typical and atypical…

  7. Psychiatric comorbidity in treatment-seeking alcoholics: The role of childhood trauma and perceived parental dysfunction

    NARCIS (Netherlands)

    Langeland, Willie; Draijer, Nel; van den Brink, Wim

    2004-01-01

    Background: This study among treatment-seeking alcoholics examined the relationship between childhood abuse (sexual Abuse only [CSA], physical abuse only [CPA], or dual abuse [CDA]) and the presence of comorbid affective disorders, anxiety disorders, and suicide attempts, controlling for the

  8. Measuring Perceived Barriers to Healthful Eating in Obese, Treatment-Seeking Adults

    Science.gov (United States)

    Welsh, Ericka M.; Jeffery, Robert W.; Levy, Rona L.; Langer, Shelby L.; Flood, Andrew P.; Jaeb, Melanie A.; Laqua, Patricia S.

    2012-01-01

    Objective: To characterize perceived barriers to healthful eating in a sample of obese, treatment-seeking adults and to examine whether changes in barriers are associated with energy intake and body weight. Design: Observational study based on findings from a randomized, controlled behavioral weight-loss trial. Participants: Participants were 113…

  9. Distress and quality of life characteristics associated with seeking surgical treatment for stress urinary incontinence

    Directory of Open Access Journals (Sweden)

    Cichowski Sara

    2009-02-01

    Full Text Available Abstract Background Current research focuses on three variables in evaluating the impact of stress urinary incontinence (SUI on daily living: severity of incontinence, distress or bother resulting from incontinence, and effect on health related quality of life (HRQoL. Understanding the impact of these variables is important as they are the driving force behind women seeking surgical treatment. Given the importance of HRQoL in determining need for treatment, as well as evaluating treatment success, this review provides an assessment of the degree to which HRQoL is impaired in women seeking surgical treatment. Methods PubMed searches for the terms "quality of life and distress and urinary incontinence" and "quality of life and bother and urinary incontinence" were performed with limits of English, human and female subjects through May 2008. All studies using validated instruments were included. No time limit was placed on the search. Results Of 178 articles retrieved, 21 met the inclusion criteria, and 17 reported methods of scoring. The studies used the Urogenital Distress Inventory (UDI and the Incontinence Impact Questionnaire (IIQ. Wide ranges of mean and individual levels of severity of symptoms, UDI and IIQ scores were seen among women seeking surgical treatment. Fourteen studies reported baseline and post-surgical treatment distress and QoL data. Statistically significant improvements between baseline and post-surgical UDI and IIQ scores were reported in 12 studies. Reported cure rates ranged from 46% to 97%. Satisfaction with the procedure was reported in 4 studies and ranged from 84% to 91%. A minority of studies reported the relationship between reduction in symptoms and change in HRQoL. Conclusion HRQoL is the main reason women seek surgical treatment for incontinence and surgical treatment leads to a significant improvement in mean HRQoL scores. Assessment of HRQoL has proved less useful in identifying why individual women seek

  10. Socio-Demographic Correlates of Women’s Infertility and Treatment Seeking Behavior in India

    Science.gov (United States)

    Sarkar, Sanjit; Gupta, Pallavi

    2016-01-01

    Background: Infertility is an emergent issue in India. Until recently, very few studies have understood the patterns and consequences of infertility in India. Family planning programs in India also viewed exclusively the patterns and determinants of overfertility rather than infertility. Furthermore, there is the lack of information about treatment seeking behavior of infertile couples. Therefore, this paper aimed to examine the extent of infertility and treatment seeking behavior among infertile women in India. An attempt was also made to evaluate the effects of socio-demographic factors on treatment seeking behavior. Methods: The study used the data from the District Level Household and Facility Survey carried out in India during 2007–08. Several statistical techniques such as chi-square test, proportional hazard model and binary logistic regression model were used for the analysis. Results: Approximately, 8% of currently married women suffered from infertility in India and most of them were secondary infertile (5.8%). Within India, women’s infertility rate was the highest in west Bengal (13.9 percent) and the lowest in Meghalaya (2.5 percent). About 80% of infertile women sought treatment but a substantial proportion (33%) received non-allopathic and traditional treatment due to expensive modern treatment and lack of awareness. Conclusion: In the context of policy response, it can be said that there is a need to improve the existing services and quality of care for infertile women. Treatment for infertility should be integrated into the larger reproductive health packages. PMID:27141468

  11. Comorbid psychiatric disorders and stages of change in cannabis-dependent, treatment-seeking patients

    Directory of Open Access Journals (Sweden)

    Hercilio P. Oliveira

    2014-05-01

    Full Text Available Objectives: To determine whether and to what extent cannabis dependence is associated with comorbid psychiatric disorders and specific stages of change in treatment-seeking patients. Methods: We evaluated 80 cannabis-dependent, treatment-seeking patients residing in an urban area. Data on cannabis dependence, psychiatric disorders, and motivation were obtained using the Schedules for Clinical Assessment in Neuropsychiatry and the University of Rhode Island Change Assessment (URICA. Results: A diagnosis of schizophrenia was found to correlate with lower motivation scores (p = 0.038, which could have a negative effect on adherence to treatment. Conclusion: The high prevalence of concurrent psychiatric disorders in cannabis-dependent patients should serve as a stimulus for early screening and treatment of such disorders. Health care professionals should be aware of the magnitude of this association to increase the level of motivation in cannabis-dependent patients with severe concurrent psychiatric disorders.

  12. Comorbid psychiatric disorders and stages of change in cannabis-dependent, treatment-seeking patients.

    Science.gov (United States)

    Oliveira, Hercilio P; Malbergier, Andre

    2014-01-01

    To determine whether and to what extent cannabis dependence is associated with comorbid psychiatric disorders and specific stages of change in treatment-seeking patients. We evaluated 80 cannabis-dependent, treatment-seeking patients residing in an urban area. Data on cannabis dependence, psychiatric disorders, and motivation were obtained using the Schedules for Clinical Assessment in Neuropsychiatry and the University of Rhode Island Change Assessment (URICA). A diagnosis of schizophrenia was found to correlate with lower motivation scores (p = 0.038), which could have a negative effect on adherence to treatment. The high prevalence of concurrent psychiatric disorders in cannabis-dependent patients should serve as a stimulus for early screening and treatment of such disorders. Health care professionals should be aware of the magnitude of this association to increase the level of motivation in cannabis-dependent patients with severe concurrent psychiatric disorders.

  13. Weight Loss Expectations and Attrition in Treatment-Seeking Obese Women

    OpenAIRE

    Dalle Grave, Riccardo; Calugi, Simona; Compare, Angelo; El Ghoch, Marwan; Petroni, Maria Letizia; Tomasi, Franco; Mazzali, Gloria; Marchesini, Giulio

    2015-01-01

    Objective The analysis of the relation between weight loss goals and attrition in the treatment of obesity has produced conflicting results. The aim of the present study was to investigate the role of weight loss goals on attrition in a cohort of obese women seeking treatment at 8 Italian medical centres. Methods 634 women with obesity, consecutively enrolled in weight loss programmes, were included in the study. Weight loss goals were evaluated with the Goals and Relative Weights Questionnai...

  14. Weight loss expectations and attrition in treatment-seeking obese women

    OpenAIRE

    Riccardo Dalle Grave; Simona Calugi; Angelo Compare; Marwan El Ghoch; Maria Letizia Petroni; Franco Tomasi; Gloria Mazzali; Giulio Marchesini

    2015-01-01

    Objective: The analysis of the relation between weight loss goals and attrition in the treatment of obesity has produced conflicting results. The aim of the present study was to investigate the role of weight loss goals on attrition in a cohort of obese women seeking treatment at 8 Italian medical centres. Methods: 634 women with obesity, consecutively enrolled in weight loss programmes, were included in the study. Weight loss goals were evaluated with the Goals and Relative Weights Questionn...

  15. Use of conventional, complementary, and alternative treatments for pain among individuals seeking primary care treatment with buprenorphine-naloxone

    Science.gov (United States)

    Barry, Declan T.; Savant, Jonathan D.; Beitel, Mark; Cutter, Christopher J.; Moore, Brent A.; Schottenfeld, Richard S.; Fiellin, David A.

    2012-01-01

    Previous studies have not examined patterns of pain treatment use among patients seeking office-based buprenorphine-naloxone treatment (BNT) for opioid dependence. Objectives To examine, among individuals with pain seeking BNT for opioid dependence, the use of pain treatment modalities, perceived efficacy of prior pain treatment, and interest in pursuing pain treatment while in BNT. Methods 244 patients seeking office-based BNT for opioid dependence completed measures of demographics, pain status (i.e. “chronic pain (CP)” [pain lasting at least 3 months] vs. “some pain (SP)” [pain in the past week not meeting the duration criteria for chronic pain]), pain treatment use, perceived efficacy of prior pain treatment, and interest in receiving pain treatment while in BNT. Results In comparison to the SP group (N = 87), the CP group (N = 88) was more likely to report past-week medical use of opioid medication (AOR 3.2, 95% CI 1.2–8.4), lifetime medical use of non-opioid prescribed medication (AOR 2.2, 95% CI 1.1–4.7), and lifetime use of prayer (AOR 2.8, 95% CI 1.2–6.5), and was less likely to report lifetime use of yoga (AOR 0.2, 95% CI 0.1–0.7) to treat pain. While the two pain groups did not differ on levels of perceived efficacy of prior lifetime pain treatments, in comparison to the SP group, the CP group was more likely to report interest in receiving pain treatment while in BNT (P < 0.001). Conclusions Individuals with pain seeking BNT for opioid dependence report a wide range of conventional, complementary, and alternative pain-related treatments and are interested (especially those with CP) in receiving pain management services along with BNT. PMID:23041680

  16. Assessment of dissociation in Bosnian treatment-seeking refugees in Denmark

    DEFF Research Database (Denmark)

    Palic, Sabina; Carlsson, Jessica; Armour, Cherie

    2015-01-01

    Background: Dissociative experiences are common in traumatized individuals, and can sometimes be mistaken for psychosis. It is difficult to identify pathological dissociation in the treatment of traumatized refugees, because there is a lack of systematic clinical descriptions of dissociative...... phenomena in refugees. Furthermore, we are currently unaware of how dissociation measures perform in this clinical group. Aims: To describe the phenomenology of dissociative symptoms in Bosnian treatment-seeking refugees in Denmark. Method: As a part of a larger study, dissociation was assessed...... systematically in 86 Bosnian treatment-seeking refugees using a semi-structured clinical interview (Structured Interview for Disorders of Extreme Stress-dissociation subscale; SIDES-D) and a self-report scale (Dissociative Experiences Scale; DES). Results: The SIDES-D indicated twice as high prevalence...

  17. Psychometric evaluation of the Gamblers' Beliefs Questionnaire with treatment-seeking disordered gamblers.

    Science.gov (United States)

    Winfree, Walter R; Ginley, Meredith K; Whelan, James P; Meyers, Andrew W

    2015-04-01

    Growing evidence for the efficacy of cognitive-behavioral therapy for disordered gambling supports the need for a comprehensive set of gambling-related assessment measures that have been validated with treatment-seeking samples. The Gamblers' Beliefs Questionnaire (GBQ) is a self-report measure that was designed to identify gambling-related cognitive distortions (Steenbergh, Meyers, May, & Whelan, 2002). In this study, the GBQ demonstrated good internal consistency and adequate construct validity in a treatment-seeking sample of disordered gamblers. Additionally, scores on the measure significantly decreased across a brief cognitive-behavioral treatment, providing validity support for use of the GBQ with a clinical population. Copyright © 2014 Elsevier Ltd. All rights reserved.

  18. Musculoskeletal disorders: Epidemiology and treatment seeking behavior of secondary school students in a Nigerian community

    Directory of Open Access Journals (Sweden)

    Adegbehingbe Olayinka

    2009-01-01

    Full Text Available Background: Epidemiological information paucity exists on musculoskeletal disorders (MSD among secondary school students in Nigeria. We aimed to determine the prevalence, pattern, and treatment seeking behaviors (TSB of MSD in Southwest, Nigeria. Materials and Methods: A school-based cross-sectional study was conducted in four randomly selected secondary schools in Ile-Ife in 2007. All the students were screened for MSD using an interviewer-administered questionnaire and physical examination, which involved the use of a scoliometer and a goniometer. Affected children were recommended for follow-up treatment and a plain radiography taken. Results: A total of 133 students had 204 MSD representing a 3.0% prevalence among the 4,441students screened. Eighty-one (60.9% students had congenital disorders and 52 (39.1% were acquired. The lower limbs (93.1% were most commonly affected and 87 (65.4% students presented with a knee deformity. Other abnormalities were limb length discrepancy 6.8%, scoliosis 4.4%, Pes planus 3.9%, and poliomyelitis 2.9%. A total of 100 students (75.2% had no form of treatment, 18.8% receive treatment in the hospital, 3.7% received treatment in a traditional healing home and 2.3% received treatment in a church. Age, family, and school type were significant factors ( P < 0.05 in health-seeking behavior. The factors affecting treatment outcome were the place of treatment, hospital specific treatment, and reasons for stopping treatment. Conclusion: Treatable cases constitute a large proportion of MSD among secondary school students, but TSB was generally poor. Parental socio-economic and health services factors were related to the health-seeking behavior. Strengthening of school health services and improved linkage with orthopedic services, community education on MSD, and education of all cadres of health professionals are recommended.

  19. On being attracted to the possibility of a win: reward sensitivity (via gambling motives) undermines treatment seeking among pathological gamblers.

    Science.gov (United States)

    Sztainert, Travis; Wohl, Michael J A; McManus, Justin F; Stead, John D H

    2014-12-01

    Unfortunately, only a small percent of pathological gamblers seek the professional help they need. In the current study, we test the idea that individual differences in reward sensitivity should predict whether a pathological gambler has sought treatment-the odds of treatment seeking should decrease as reward sensitivity increases. This hypothesis rests on the proposition that reward sensitive pathological gamblers should find treatment seeking aversive because doing so would remove a route to reward. We also tested those motivations to gamble that are positively reinforcing (social affliction and self-enhancement) as a possible mechanism by which reward sensitivity undermines treatment seeking-we did not anticipate negatively reinforcing motivations (e.g., coping) to be a mechanistic variable. Ninety-two pathological gamblers completed a large-scale survey that contained the variables of interest. As predicted, pathological gamblers were less likely to have sought treatment as reward sensitivity increased. Moreover, this relationship was mediated by social affiliation motivations to gamble, but not self-enhancement or coping motives. Reward sensitive gamblers did not wish to seek treatment to the extent that they were motivated to gamble for the social interactions it provides-seeking treatment would cut this avenue of affiliation with others. In light of these results, we suggest health care professionals take reward sensitivity into account when trying to promote treatment seeking, to say nothing of the social affiliation motives that underlie the reward sensitivity-treatment seeking link.

  20. Cultural influences on willingness to seek treatment for social anxiety in Chinese- and European-heritage students.

    Science.gov (United States)

    Hsu, Lorena; Alden, Lynn E

    2008-07-01

    We examined culture-related influences on willingness to seek treatment for social anxiety in first- and second-generation students of Chinese heritage (Ns=65, 47, respectively), and their European-heritage counterparts (N=60). Participants completed measures that assessed their willingness to seek treatment for various levels of social anxiety. Results showed that participants were similar on willingness to seek treatment at low- and high-severity levels of social anxiety; however, at moderate levels, first-generation Chinese participants were significantly less willing to seek treatment compared to their European-heritage counterparts. The reluctance of first-generation Chinese participants to seek treatment was associated with greater Chinese-heritage acculturation, and was not related to perceiving symptoms of social anxiety as less impairing. The findings support the general contention that Asians in North America tend to delay treatment for mental health problems. Copyright (c) 2008 APA, all rights reserved.

  1. Factors associated with treatment seeking for malaria in Madhya Pradesh, India.

    Science.gov (United States)

    Singh, Mrigendra P; Saha, Kalyan B; Chand, Sunil K; Anvikar, Anup

    2017-11-01

    To determine household factors associated with treatment seeking for malaria. The study was carried out in four districts of Madhya Pradesh with different malaria endemicity. A total of 1470 households were interviewed in which at least one member suffered from microscopically confirmed malaria in the 3 months preceding the survey. Socio-demographic, economic, cultural characteristics, their health beliefs, knowledge and practices regarding malaria and choice of treatment seeking were explored. A total of 764 households were from high-endemic and 706 from low-endemic areas. More than half of household heads were illiterate; most are farmers. Approximately 46% sought treatment for malaria from unqualified informal providers; 19% from qualified private health practitioners and 35% from government health providers. Analysis revealed that household's area of residence, education, occupation, ethnicity, use of preventive measures, economic status, knowledge and practices, distance and delayed treatment seeking was strongly associated with the type of healthcare providers selected. Demand for formal health services among the poor, illiterate, tribal population living in remote areas is low. Accessible and affordable health services and a sensitisation programme to increase the demand for formal providers are needed. © 2017 John Wiley & Sons Ltd.

  2. Social anxiety disorder in the Chinese military: prevalence, comorbidities, impairment, and treatment-seeking.

    Science.gov (United States)

    Wang, Huaning; Zhang, Ruiguo; Chen, Yunchun; Wang, Huaihai; Zhang, Yahong; Gan, Jingli; Zhang, Liyi; Tan, Qingrong

    2014-12-30

    The objective of this work is To investigate the prevalence, comorbidities, impairment, and treatment-seeking of social anxiety disorder in the Chinese military personnel. Military personnel (n=11,527) were surveyed from May to August 2007 using a multistage whole cohort probability sampling method. A Chinese version of the World Health Organization Composite International Diagnostic Interview (CIDI) was used for assessment, and a military-related socio-demographic questionnaire was used to describe the prevalence distribution. A unified survey was performed to investigate 11 different social situations. The short-form health survey was used to assess role impairment. The 12-month and lifetime prevalence rates of social anxiety disorder were 3.34% (95% CI: 3.25-3.42%) and 6.22% (95% CI: 6.11-6.32%), respectively. Social anxiety disorder was associated with increased odds of depression, substance abuse, panic attacks/disorder, and generalized anxiety disorder. Childhood foster, female, stressful life events, younger age, and being divorced/widowed increase the incidence of social anxiety disorder. Treatment-seeking was relatively rare. Social anxiety disorder is a common disorder in military personnel in China, and it is a risk factor for subsequent depressive illness, substance abuse and other mental disorder. Early detection and treatment of social anxiety disorder are important because of the low rate of treatment-seeking. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  3. Psychosocial impact of dental esthetics regulates motivation to seek orthodontic treatment.

    Science.gov (United States)

    Lin, Feiou; Ren, Manman; Yao, Linjie; He, Yan; Guo, Jing; Ye, Qingsong

    2016-09-01

    The aim of this study was to evaluate the psychosocial impact of dental esthetics for adults seeking orthodontic treatment. The Chinese version of the Psychosocial Impact of Dental Aesthetics Questionnaire (PIDAQ) was administered to 393 adults, aged 18 to 30 years. The participants were divided into 2 groups: an intervention group (received orthodontic treatment) and a control group (rejected orthodontic treatment). Baseline malocclusion severity was assessed using the Index of Orthodontic Treatment Need (IOTN). The Wilcoxon signed rank test showed no statistically significant difference between the groups for the dental health component (DHC) of the IOTN (P = 0.134). Total and subscale PIDAQ scores of the intervention group were higher than those of the control group and differed significantly in each group among the 4 IOTN-DHC grades; self-confidence scores in the control group (F = 1.802; P >0.05) were the exception. Correlations between the PIDAQ scores and the IOTN-DHC grades were strong in each group. DHC grades, psychological impact, social impact, and aesthetic concern had significant impacts on patients accepting orthodontic treatment. The psychosocial impact of dental esthetics played an important role in the decision-making process of adults seeking orthodontic treatment. Importantly, participants with low self-awareness of the potential psychosocial impact rejected orthodontic treatment, despite the need for severe normative treatment. Copyright © 2016 American Association of Orthodontists. Published by Elsevier Inc. All rights reserved.

  4. The Efficacy of a Condensed "Seeking Safety" Intervention for Women in Residential Chemical Dependence Treatment at 30 Days Posttreatment

    Science.gov (United States)

    Cash Ghee, Anna; Bolling, Lanny C.; Johnson, Candace S.

    2009-01-01

    This study examined the efficacy of a condensed version of the "Seeking Safety" intervention in the reduction of trauma-related symptoms and improved drug abstinence rates among women in residential chemical dependence treatment. One hundred and four women were randomly assigned to treatment including a condensed (six session) "Seeking Safety"…

  5. Smoking processes, panic, and depressive symptoms among treatment-seeking smokers.

    Science.gov (United States)

    Foster, Dawn W; Langdon, Kirsten J; Schmidt, Norman B; Zvolensky, Michael

    2015-02-01

    The present study evaluated the relative contribution of panic and depressive symptoms in relation to past cessation difficulties and smoking motives among treatment-seeking daily smokers. The sample included 392 treatment-seeking daily smokers (47.07% female; Mage = 35.48; SD = 13.56), who reported smoking an average of 10 or more cigarettes daily for at least one year. Findings indicated that panic and depressive symptoms were significantly associated with quit problems as well as addictive and negative affect motives for smoking. However, depressive symptoms were not associated with habitual smoking motives. Differential patterns of associations with smoking-based processes imply that although panic and depression are related, there are important distinctions. Such data highlight the need for additional research to examine the putative role of panic and depressive symptoms in relation to smoking behaviors to further elucidate the mechanisms through which panic, depression, and smoking impact one another.

  6. Dopamine genes and nicotine dependence in treatment seeking and community smokers

    OpenAIRE

    Bergen, AW; Conti, DV; Van Den Berg, D.; Lee, W.; Liu, J.; D. Li; Guo, N; Mi, H.; Thomas, PD; Lessov-Schlaggar, CN; Krasnow, R.; He, Y.; Nishita, D; Jiang, R; McClure, JB

    2009-01-01

    We utilized a cohort of 828 treatment-seeking self-identified white cigarette smokers (50% female) to rank candidate gene single nucleotide polymorphisms (SNPs) associated with the Fagerström Test for Nicotine Dependence (FTND), a measure of nicotine dependence which assesses quantity of cigarettes smoked and time- and place-dependent characteristics of the respondent's smoking behavior. A total of 1123 SNPs at 55 autosomal candidate genes, nicotinic acetylcholine receptors and genes involved...

  7. U.S. National Football League athletes seeking unproven stem cell treatments.

    Science.gov (United States)

    Matthews, Kirstin R W; Cuchiara, Maude L

    2014-12-01

    From professionals to weekend warriors, many athletes seek unproven stem cell (SC) treatments in an effort to heal injuries nonsurgically and/or to accelerate recovery times after surgery. Among the elite athletes opting for these treatments are high-profile U.S. National Football League (NFL) players. Over the past 5 years, several NFL players have publicly advocated for SC types of treatments and credit them as a major reason they could continue their careers after injuries. In this article, we describe the current problems associated with unproven SC treatments, focusing on treatments without U.S. Food and Drug Administration approval undertaken by NFL players in the past 5 years. Specifically, we highlight the types of treatments obtained and how the clinics advertise specifically to athletes. We also review the intended and unintended consequences of high-profile players receiving and advocating for these types of therapies. Our findings suggest that NFL players increasingly seek out unproven SC therapies to help accelerate recoveries from injuries. While most seem to receive treatment within the United States, several have traveled abroad for therapies unavailable domestically.

  8. U.S. National Football League Athletes Seeking Unproven Stem Cell Treatments

    Science.gov (United States)

    Matthews, Kirstin R.W.; Cuchiara, Maude L.

    2014-01-01

    Abstract From professionals to weekend warriors, many athletes seek unproven stem cell (SC) treatments in an effort to heal injuries nonsurgically and/or to accelerate recovery times after surgery. Among the elite athletes opting for these treatments are high-profile U.S. National Football League (NFL) players. Over the past 5 years, several NFL players have publicly advocated for SC types of treatments and credit them as a major reason they could continue their careers after injuries. In this article, we describe the current problems associated with unproven SC treatments, focusing on treatments without U.S. Food and Drug Administration approval undertaken by NFL players in the past 5 years. Specifically, we highlight the types of treatments obtained and how the clinics advertise specifically to athletes. We also review the intended and unintended consequences of high-profile players receiving and advocating for these types of therapies. Our findings suggest that NFL players increasingly seek out unproven SC therapies to help accelerate recoveries from injuries. While most seem to receive treatment within the United States, several have traveled abroad for therapies unavailable domestically. PMID:25457965

  9. Decision-tree model of treatment-seeking behaviors after detecting symptoms by Korean stroke patients.

    Science.gov (United States)

    Oh, Hyo-Sook; Park, Hyeoun-Ae

    2006-06-01

    This study was performed to develop and test a decision-tree model of treatment-seeking behaviors about when Korean patients visit a doctor after experiencing stroke symptoms. The study used methodological triangulation. The model was developed based on qualitative data collected from in-depth interviews with 18 stroke patients. The model was tested using quantitative data collected from interviews and a structured questionnaire involving 150 stroke patients. The predictability of the decision-tree model was quantified as the proportion of participants who followed the pathway predicted by the model. Decision outcomes of the model were categorized into immediate and delayed treatment-seeking behavior. The model was influenced by lowered consciousness, social-group influences, perceived seriousness of symptoms, past history of hypertension or stroke, and barriers to hospital visits. The predictability of the model was found to be 90.7%. The results from this study can help healthcare personnel understand the education needs of stroke patients regarding treatment-seeking behaviors, and hence aid in the development of educational strategies for stroke patients.

  10. ADHD Is Highly Prevalent in Patients Seeking Treatment for Cannabis Use Disorders.

    Science.gov (United States)

    Notzon, Daniel P; Pavlicova, Martina; Glass, Andrew; Mariani, John J; Mahony, Amy L; Brooks, Daniel J; Levin, Frances R

    2016-03-31

    To estimate the prevalence of ADHD and determine an effective screening test for ADHD in a population-seeking treatment for cannabis use disorders. The Conners Adult ADHD Diagnostic Interview forDiagnostic and Statistical Manual of Mental Disorders, Fourth Edition(DSM-IV; CAADID) was used to generate sensitivity and specificity data for ADHD screening tests, which were then administered to 99 participants seeking treatment for cannabis use disorders to estimate ADHD prevalence. The prevalence estimated from the Wender Utah Rating Scale (WURS) was 45% (sensitivity = 0.88, sensitivity of 0.75), from the Conners Adult ADHD Rating Scale (CAARS) 34% (sensitivity = 0.80, specificity = 0.91), from the WURS + CAARS 36% (sensitivity = 0.71, specificity = 0.95), and from the Adult ADHD Self-Report Scale (ASRS) 46% (sensitivity = 0.61, specificity = 0.86). The prevalence of ADHD in adults seeking treatment for cannabis use disorders is estimated to be between 34% and 46%. The WURS paired with the CAARS provides excellent sensitivity and specificity for the diagnosis of ADHD in this population. © The Author(s) 2016.

  11. Perceptions of tuberculosis and treatment seeking behaviour in Ilala and Kinondoni Municipalities in Tanzania.

    Science.gov (United States)

    Kilale, A M; Mushi, A K; Lema, L A; Kunda, J; Makasi, C E; Mwaseba, D; Range, N S; Mfinanga, G S

    2008-04-01

    This study was carried out in Ilala and Kinondoni Municipalities in Tanzania to explore the perceptions of Tuberculosis (TB), and treatment seeking behaviour, among patients attending healthcare facilities. The study was conducted in four randomly selected health facilities providing directly observed treatment (DOT). Exit interviews were administered to 69 randomly selected TB patients. The mean age of the respondents was 33.2 years (range = 11-72 years). Forty-six (66.7%) of the patients had primary school education. Fifty-nine (84.1%) patients had good knowledge on the transmission of TB. Majority (75%) of the respondents were of the opinion that the incidence of TB was on the increase and this was mainly associated with HIV/AIDS epidemic. All respondents knew that TB was a curable disease if one complies with the treatment. Sixty-four (60%) respondents had good knowledge on the correct duration of tuberculosis treatment. The median duration before seeking treatment from a health facility was 1.5 months. The majority of the patients 47 (68%) visited public health facilities for treatment as their first action. Overall, 83.8% (57/68) respondents said females comply better with treatment than male patients. The majority of the respondents lived within a walking distance to a healthcare facility. Only 18.8% (13/69) had to spend an average of US$ 0.2-0.3 as travel costs to the healthcare facility. Most of the respondents (57.8%) said they were well attended by service providers. Half (21/42) and 59.3% (16/27) of the males and females, respectively, mentioned good patient-service provider relationship as an important reason for satisfaction of the service (chi2 = 0.57, df = 1, P > 0.005). Twenty-nine (42%) of respondents were of the opinion that female TB patients conformed better to treatment than males and a similar number thought that both of them equally conformed to treatment. Findings from this study indicate that a large population in urban settings are aware

  12. Spontaneous harm reduction: a barrier for substance-dependent individuals seeking treatment?

    Directory of Open Access Journals (Sweden)

    Fontanella Bruno José Barcellos

    2005-01-01

    Full Text Available OBJETIVE: Greater information regarding motivations and treatment barriers faced by substance-dependent individuals has clinical and public health implications. This study aimed to formulate hypotheses regarding psychological, social and family variables that can be constructed as motivations or subjective barriers for the early seeking of formal treatment. METHODS: A qualitative study was conducted in an intentional sample (selected through saturation and variety of types of 13 substance-dependent individuals who sought treatment. In-depth, semi-structured interviews were conducted using open questions, and the transcribed data were subjected to qualitative analysis. RESULTS: Four types of spontaneous harm reduction measures were identified, according to the subjective logic of each participant: having some periods at rest (not using and recovering from adverse effects; caretaking by close acquaintances (relatives, partners, drug dealers and alcoholic beverage sellers; selectivity regarding substance source, type and means of administration; establishing "healthy" limits of ingestion. CONCLUSIONS: The measures identified might represent barriers to the early seeking of treatment but might also represent spontaneous learning of abilities beneficial to future treatment. Health care professionals should take into consideration their existence and should address them in clinical settings. Issues representative of the formulated categories should be presented in structured questionnaires used in future quantitative studies of barriers to treatment in this population.

  13. Personality, attrition and weight loss in treatment seeking women with obesity.

    Science.gov (United States)

    Dalle Grave, R; Calugi, S; Compare, A; El Ghoch, M; Petroni, M L; Colombari, S; Minniti, A; Marchesini, G

    2015-10-01

    Studies on small samples or in single units applying specific treatment programmes found an association between some personality traits and attrition and weight loss in individuals treated for obesity. We aimed to investigate whether pre-treatment personality traits were associated with weight loss outcomes in the general population of women with obesity. Attrition and weight loss outcomes after 12 months were measured in 634 women with obesity (mean age, 48; body mass index (BMI), 37.8 kg m(-2)) seeking treatment at eight Italian medical centres, applying different medical/cognitive behavioural programmes. Personality traits were assessed with the Temperament and Character Inventory (TCI), eating disorder features with the Binge Eating Scale (BES) and Night Eating Questionnaire (NEQ). Within the 12-month observation period, 32.3% of cases were lost to follow-up. After adjustment for demographic confounders and the severity of eating disorders, no TCI personality traits were significantly associated with attrition, while low scores of the novelty seeking temperament scale remained significantly associated with weight loss ≥ 10% (odds ratio, 0.983; 95% confidence interval, 0.975-0.992). Additional adjustment for education and job did not change the results. We conclude that personality does not systematically influence attrition in women with obesity enrolled into weight loss programmes in the community, whereas an association is maintained between novelty seeking and weight loss outcome. Studies adapting obesity interventions on the basis of individual novelty seeking scores might be warranted to maximize the results on body weight. © 2015 World Obesity.

  14. The relationship between internalizing psychopathology and suicidality, treatment seeking, and disability in the Australian population.

    Science.gov (United States)

    Sunderland, Matthew; Slade, Tim

    2015-01-15

    Recent evidence has emerged suggesting that multiple mood and anxiety disorders may be better assessed using a single dimension representing internalizing liability. The current study seeks to demonstrate the validity and utility of internalizing liability when accounting for suicidality, treatment seeking, and disability over and above any disorder specific relationship. Data were from the 2007 Australian National Survey of Mental Health and Wellbeing. A model containing a single factor was fit to the data as a means of explaining the shared relationship across seven DSM-IV mood and anxiety disorders. The shared and specific relationships between lifetime and past 12 months internalizing and mental health consultations, suicidality, and disability were examined using Multiple Indicators, Multiple Causes models. General levels of latent internalizing were significantly related to all covariates of interest across both lifetime and past 12 months diagnoses. Models that included the specific relationship between various internalizing disorders and the clinical correlates failed to significantly improve model fit over and above a model that already included the general relationship between latent internalizing and the covariates. Limitations include the use of cross-sectional data and diagnostic assessments based on self-report lay-administered interviews. The overall internalizing latent variable sufficiently explains the majority of the relationship between multiple mood and anxiety disorders and suicidality, treatment seeking, and disability. Researchers should focus on investigating the shared or common components across all mood and anxiety disorders particularly with respect to individuals presenting with higher rates of suicidality, treatment seeking behavior, and disability. Copyright © 2014 Elsevier B.V. All rights reserved.

  15. Sex differences in cannabis withdrawal symptoms among treatment-seeking cannabis users.

    Science.gov (United States)

    Herrmann, Evan S; Weerts, Elise M; Vandrey, Ryan

    2015-12-01

    Over 300,000 individuals enter treatment for cannabis-use disorders (CUDs) in the United States annually. Cannabis withdrawal is associated with poor CUD-treatment outcomes, but no prior studies have examined sex differences in withdrawal among treatment-seeking cannabis users. Treatment-seeking cannabis users (45 women and 91 men) completed a Marijuana Withdrawal Checklist (Budney, Novy, & Hughes, 1999, Budney, Moore, Vandrey, & Hughes, 2003) at treatment intake to retrospectively characterize withdrawal symptoms experienced during their most recent quit attempt. Scores from the 14-item Composite Withdrawal Discomfort Scale (WDS), a subset of the Marijuana Withdrawal Checklist that corresponds to valid cannabis withdrawal symptoms described in the Diagnostic and Statistical Manual of Mental Disorders (5th ed.; APA, 2013) were calculated. Demographic and substance-use characteristics, overall WDS scores, and scores on individual WDS symptoms were compared between women and men. Women had higher overall WDS scores than men, and women had higher scores than men on 6 individual symptoms in 2 domains, mood symptoms (i.e., irritability, restlessness, increased anger, violent outbursts), and gastrointestinal symptoms (i.e., nausea, stomach pain). Follow-up analyses isolating the incidence and severity of WDS symptoms demonstrated that women generally reported a higher number of individual withdrawal symptoms than men, and that they reported experiencing some symptoms as more severe. This is the first report to demonstrate that women seeking treatment for CUDs may experience more withdrawal then men during quit attempts. Prospective studies of sex differences in cannabis withdrawal are warranted. (PsycINFO Database Record (c) 2015 APA, all rights reserved).

  16. [Jinn possession as an explanation of mental illness influences the treatment-seeking behaviour].

    Science.gov (United States)

    Shah, Amna; Carlsson, Jessica

    2016-07-04

    Jinn possession is used as an explanation of mental symptoms among Muslims around the world. Very few studies have examined the use of jinn as a religious explanation model for mental health problems and treatment-seeking behaviour. The majority of studies show a positive association between jinn explanations and preferred treatment by religious healers, but due to methodological limitations, results should be taken with precaution. There is a need for longitudinal studies focusing on improving cultural competence and exploring possible cooperation with healers.

  17. Survey of the Situation of Infertile Women Seeking In Vitro Fertilization Treatment in China

    Directory of Open Access Journals (Sweden)

    Xuan Jin

    2013-01-01

    Full Text Available Background. In previous studies, people’s knowledge of reproductive health and infertile women’s psychological states was surveyed in several countries. However, there has been limited information concerning the psychological states of infertile women seeking treatment and the outcomes of in vitro fertilization (IVF in China. Methods. Infertile women were asked to complete short questionnaires on the day that their oocytes were retrieved; these questionnaires covered the durations of their infertility, levels of education, sources of pressure, and psychological states. Data concerning IVF outcomes were provided by embryologists and clinicians. The correlations between the duration of infertility and educational level, psychological state and education level, and psychological state and outcome of IVF were analyzed in the cohort study. Results. The duration of infertility in more than half of the females was longer than 5 years. Compared with less-educated women, women with higher levels of education sought treatment earlier and their rates of depressive symptoms were lower. There is an association between negative emotions and outcome of IVF. Conclusions. The survey of the situations of infertile women seeking IVF treatment in China indicates the importance of popularizing knowledge concerning reproductive health. Improving medical conditions, reducing the costs of treatment, and developing social culture will aid in relieving the stress of infertile women and improving assisted reproductive treatment.

  18. Different yet similar: Examining race and ethnicity in treatment-seeking adults with binge eating disorder.

    Science.gov (United States)

    Lydecker, Janet A; Grilo, Carlos M

    2016-01-01

    This study examined racial/ethnic differences in demographic variables and the clinical presentation of treatment-seeking adults with binge eating disorder (BED) who participated in treatment research at a medical school-based program. Participants were 775 (n = 195 men, n = 560 women) treatment-seeking adults with DSM-IV-defined BED who self-identified as Black (n = 121), Hispanic (n = 54), or White (n = 580). Doctoral-level research clinicians assessed participants for BED and for eating disorder psychopathology using the Structured Clinical Interview for DSM-IV Disorders and the Eating Disorder Examination (EDE) interview, and measured height and weight. Participants also completed established self-report measures. Black participants had a greater proportion of women than White participants and White participants had higher education than Black and Hispanic participants. Black participants had higher body mass index (BMI) and reported more frequent binge eating episodes than White participants but eating-disorder psychopathology (EDE scales and Global Severity) did not significantly differ across racial/ethnic groups. Black participants had lower levels of depression than Hispanic and White participants. These differences in clinical presentation remained unchanged after adjusting for age, education, sex, and BMI. White participants had younger ages of onset for dieting, binge eating, and obesity, but not BED, than Black and Hispanic participants. There are some racial/ethnic differences in the developmental trajectories and clinical presentation of treatment-seeking adults with BED that remain unchanged after adjusting for demographic differences. Black participants presented for treatment with higher BMI and binge eating frequency than White participants and with lower depression than White and Hispanic groups, but associated eating disorder psychopathology levels were similar across racial/ethnic groups. (c) 2015 APA, all rights reserved).

  19. Treatment seeking and health financing in selected poor urban neighbourhoods in India, Indonesia and Thailand

    DEFF Research Database (Denmark)

    Seeberg, Jens; Pannarunothai, Supasit; Padmawati, Retna S

    2014-01-01

    This article presents a comparative analysis of socio-economic disparities in relation to treatment-seeking strategies and healthcare expenditures in poor neighbourhoods within larger health systems in four cities in India, Indonesia and Thailand. About 200 households in New Delhi, Bhubaneswar....... Within each site, the higher and lower income groups among the poor were compared. The lower income group was more likely than the higher income group to seek care from less qualified health providers and incur catastrophic health spending. The study recommends linking quality control mechanisms...... with universal health coverage (UHC) policies; to monitor the impact of UHC among the poorest; intervention research to reach the poorest with UHC; and inclusion of private providers without formal medical qualification in basic healthcare....

  20. Moderators of treatment effectiveness for war-affected youth with depression in northern Uganda.

    Science.gov (United States)

    Betancourt, Theresa S; Newnham, Elizabeth A; Brennan, Robert T; Verdeli, Helen; Borisova, Ivelina; Neugebauer, Richard; Bass, Judith; Bolton, Paul

    2012-12-01

    As we build the evidence base of interventions for depression among war-affected youth, it is critical to understand factors moderating treatment outcomes. The current study investigated how gender and history of abduction by Lord's Resistance Army rebels moderated treatment outcomes for war-affected youth. The study-a three-armed, randomized, controlled trial-was conducted with internally displaced war-affected adolescents in northern Uganda. Participants with significant depression symptoms (N = 304; 57% female; 14-17 years of age) were randomly assigned to an interpersonal psychotherapy group (IPT-G), a creative play/recreation group, or a wait-list control condition. Secondary analyses were conducted on data from this randomized controlled trial. A history of abduction by Lord's Resistance Army rebels was reported by 42% of the sample. Gender and abduction history interacted to moderate the effectiveness of IPT-G for the treatment of depression. In the IPT-G intervention arm, treatment effectiveness was greatest among female subjects without an abduction history, with effect size = 1.06. IPT-G was effective for the treatment of depression for both male and female subjects with a history of abduction (effect size = .92 and .50, respectively). Male subjects with no abduction history in IPT-G showed no significant improvement compared with those in the control conditions. Abduction history and gender are potentially important moderators of treatment effects, suggesting that these factors need to be considered when providing interventions for war-affected youth. IPT-G may be an effective intervention for female subjects without an abduction history, as well as for both male and female former child soldiers, but less so for male subjects without an abduction history. Copyright © 2012 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

  1. Anaesthetic and other treatments of shell shock: World War I and beyond.

    Science.gov (United States)

    McKenzie, A G

    2012-03-01

    Post-traumatic stress disorder (PTSD) is an important health risk factor for military personnel deployed in modern warfare. In World War I this condition (then known as shell shock or 'neurasthenia') was such a problem that 'forward psychiatry' was begun by French doctors in 1915. Some British doctors tried general anaesthesia as a treatment (ether and chloroform), while others preferred application of electricity. Four British 'forward psychiatric units' were set up in 1917. Hospitals for shell shocked soldiers were also established in Britain, including (for officers) Craiglockhart War Hospital in Edinburgh; patients diagnosed to have more serious psychiatric conditions were transferred to the Royal Edinburgh Asylum. Towards the end of 1918 anaesthetic and electrical treatments of shell shock were gradually displaced by modified Freudian methods psychodynamic intervention. The efficacy of 'forward psychiatry' was controversial. In 1922 the War Office produced a report on shell shock with recommendations for prevention of war neurosis. However, when World War II broke out in 1939, this seemed to have been ignored. The term 'combat fatigue' was introduced as breakdown rates became alarming, and then the value of pre-selection was recognised. At the Maudsley Hospital in London in 1940 barbiturate abreaction was advocated for quick relief from severe anxiety and hysteria, using i.v. anaesthetics: Somnifaine, paraldehyde, Sodium Amytal. 'Pentothal narcosis' and 'narco-analysis' were adopted by British and American military psychiatrists. However, by 1945 medical thinking gradually settled on the same approaches that had seemed to be effective in 1918. The term PTSD was introduced in 1980. In the UK the National Institute for Health and Clinical Excellence (NICE) guidelines for management (2005) recommend trauma-focussed Cognitive Behavioural Therapy and consideration of antidepressants.

  2. Sex Offenders Seeking Treatment for Sexual Dysfunction--Ethics, Medicine, and the Law.

    Science.gov (United States)

    Phillips, Elizabeth A; Rajender, Archana; Douglas, Thomas; Brandon, Ashley F; Munarriz, Ricardo

    2015-07-01

    The treatment of sexual dysfunction in patients with prior sexual offenses poses ethical and legal dilemmas. Sex offenders are not obligated by law to disclose this history to medical professionals. Over 20% of sex offenders experience sexual dysfunction; however, the number of sex offenders seeking evaluation for sexual dysfunction is unknown. The aims of this study were to determine the incidence and characteristics of sex offenders seeking treatment in our clinic; and to review data regarding sex offender recidivism and ethics pertaining to the issue as it relates to treating physicians. Sex offenders were identified via three methods: new patient screening in a dedicated sexual medicine clinic, chart review of those on intracavernosal injection (ICI) therapy for erectile dysfunction (ED), and review of patient's status-post placement of penile prosthesis. Charts were cross-referenced with the U.S. Department of Justice National Sex Offender Public Website. Patient characteristics and details of offenses were collected. The main outcome measures used were a self-reported sexual offense and national registry data. Eighteen male sex offenders were identified: 13 via new patient screening; 3 by review of ICI patients; 1 by review of penile prosthesis data; and 1 prior to penile prosthesis placement. All were primarily referred for ED. Of those with known offenses, 64% were level 3 offenders (most likely to re-offend). The same number had committed crimes against children. All those with complete data had multiple counts of misconduct (average 3.6). Ninety-four percent (17/18) had publicly funded health care. Twelve (67%) were previously treated for sexual dysfunction. Registered sex offenders are seeking and receiving treatment for sexual dysfunction. It is unknown whether treatment of sexual dysfunction increases the risk of recidivism of sexual offenses. Physicians currently face a difficult choice in deciding whether to treat sexual dysfunction in sex

  3. Weight-based victimization: bullying experiences of weight loss treatment-seeking youth.

    Science.gov (United States)

    Puhl, Rebecca M; Peterson, Jamie Lee; Luedicke, Joerg

    2013-01-01

    Few studies have comprehensively examined weight-based victimization (WBV) in youth, despite its serious consequences for their psychosocial and physical health. Given that obese and treatment-seeking youth may be highly vulnerable to WBV and its negative consequences, the current study provides a comprehensive assessment of WBV in a weight loss treatment-seeking sample. Adolescents (aged 14-18 years; N = 361) enrolled in 2 national weight loss camps were surveyed. An in-depth assessment of WBV was conducted by using an online survey, in which participants indicated the duration, typical locations, frequent perpetrators, and forms of WBV they had experienced. Findings indicate that 64% of the study participants reported WBV at school, and the risk of WBV increased with body weight. Most participants reported WBV enduring for 1 year (78%), and 36% were teased/bullied for 5 years. Peers (92%) and friends (70%) were the most commonly reported perpetrators, followed by adult perpetrators, including physical education teachers/sport coaches (42%), parents (37%), and teachers (27%). WBV was most frequently reported in the form of verbal teasing (75%-88%), relational victimization (74%-82%), cyberbullying (59%-61%), and physical aggression (33%-61%). WBV was commonly experienced in multiple locations at school. WBV is a prevalent experience for weight loss treatment-seeking youth, even when they are no longer overweight. Given the frequent reports of WBV from adult perpetrators in addition to peers, treatment providers and school personnel can play an important role in identifying and supporting youth who may be at risk for pervasive teasing and bullying.

  4. Lifetime prevalence of mental disorders in Lebanon: first onset, treatment, and exposure to war.

    Directory of Open Access Journals (Sweden)

    Elie G Karam

    2008-04-01

    Full Text Available There are no published data on national lifetime prevalence and treatment of mental disorders in the Arab region. Furthermore, the effect of war on first onset of disorders has not been addressed previously on a national level, especially in the Arab region. Thus, the current study aims at investigating the lifetime prevalence, treatment, age of onset of mental disorders, and their relationship to war in Lebanon.The Lebanese Evaluation of the Burden of Ailments and Needs Of the Nation study was carried out on a nationally representative sample of the Lebanese population (n = 2,857 adults. Respondents were interviewed using the fully structured WHO Composite International Diagnostic Interview 3.0. Lifetime prevalence of any Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM-IV disorder was 25.8%. Anxiety (16.7% and mood (12.6% were more common than impulse control (4.4% and substance (2.2% disorders. Only a minority of people with any mental disorder ever received professional treatment, with substantial delays (6 to 28 y between the onset of disorders and onset of treatment. War exposure increased the risk of first onset of anxiety (odds ratio [OR] 5.92, 95% confidence interval [CI] 2.5-14.1, mood (OR 3.32, 95% CI 2.0-5.6, and impulse control disorders (OR 12.72, 95% CI 4.5-35.7.About one-fourth of the sample (25.8% met criteria for at least one of the DSM-IV disorders at some point in their lives. There is a substantial unmet need for early identification and treatment. Exposure to war events increases the odds of first onset of mental disorders.

  5. Lifetime prevalence of mental disorders in Lebanon: first onset, treatment, and exposure to war.

    Science.gov (United States)

    Karam, Elie G; Mneimneh, Zeina N; Dimassi, Hani; Fayyad, John A; Karam, Aimee N; Nasser, Soumana C; Chatterji, Somnath; Kessler, Ronald C

    2008-04-01

    There are no published data on national lifetime prevalence and treatment of mental disorders in the Arab region. Furthermore, the effect of war on first onset of disorders has not been addressed previously on a national level, especially in the Arab region. Thus, the current study aims at investigating the lifetime prevalence, treatment, age of onset of mental disorders, and their relationship to war in Lebanon. The Lebanese Evaluation of the Burden of Ailments and Needs Of the Nation study was carried out on a nationally representative sample of the Lebanese population (n = 2,857 adults). Respondents were interviewed using the fully structured WHO Composite International Diagnostic Interview 3.0. Lifetime prevalence of any Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM-IV) disorder was 25.8%. Anxiety (16.7%) and mood (12.6%) were more common than impulse control (4.4%) and substance (2.2%) disorders. Only a minority of people with any mental disorder ever received professional treatment, with substantial delays (6 to 28 y) between the onset of disorders and onset of treatment. War exposure increased the risk of first onset of anxiety (odds ratio [OR] 5.92, 95% confidence interval [CI] 2.5-14.1), mood (OR 3.32, 95% CI 2.0-5.6), and impulse control disorders (OR 12.72, 95% CI 4.5-35.7). About one-fourth of the sample (25.8%) met criteria for at least one of the DSM-IV disorders at some point in their lives. There is a substantial unmet need for early identification and treatment. Exposure to war events increases the odds of first onset of mental disorders.

  6. Treatment seeking and health financing in selected poor urban neighbourhoods in India, Indonesia and Thailand.

    Science.gov (United States)

    Seeberg, Jens; Pannarunothai, Supasit; Padmawati, Retna Siwi; Trisnantoro, Laksono; Barua, Nupur; Pandav, Chandrakant S

    2014-02-01

    This article presents a comparative analysis of socio-economic disparities in relation to treatment-seeking strategies and healthcare expenditures in poor neighbourhoods within larger health systems in four cities in India, Indonesia and Thailand. About 200 households in New Delhi, Bhubaneswar, Jogjakarta and Phitsanulok were repeatedly interviewed over 12 months to relate health problems with health seeking and health financing at household level. Quantitative data were complemented with ethnographic studies involving the same neighbourhoods and a number of private practitioners at each site. Within each site, the higher and lower income groups among the poor were compared. The lower income group was more likely than the higher income group to seek care from less qualified health providers and incur catastrophic health spending. The study recommends linking quality control mechanisms with universal health coverage (UHC) policies; to monitor the impact of UHC among the poorest; intervention research to reach the poorest with UHC; and inclusion of private providers without formal medical qualification in basic healthcare. Copyright © 2013 Elsevier Ltd. All rights reserved.

  7. Domestic violence and treatment seeking: a longitudinal study of low-income women and mental health/substance abuse care.

    Science.gov (United States)

    Cheng, Tyrone C; Lo, Celia C

    2014-01-01

    A study with 591 low-income women examined domestic violence's role in treatment seeking for mental health or substance abuse problems. (The women resided in one of two California counties.) Following Aday's behavioral model of health services utilization, the secondary data analysis considered the women's need, enabling, and predisposing factors. Generalized estimating equations analyzed the women's longitudinal records of treatment seeking. Results showed that those in the sample who were likely to seek treatment had experienced three or more controlling behaviors and only one abusive behavior. Multivariate data analysis showed treatment-seeking women were likely to be white and older; responsible for few dependent children; not graduates of high school; employed; not participating in Medicaid; diagnosed; and perceiving a need for treatment. The implications of these results for services and policies are discussed.

  8. Birth characteristics in a clinical sample of women seeking infertility treatment: a case–control study

    Science.gov (United States)

    Vikström, Josefin; Hammar, Mats; Josefsson, Ann; Bladh, Marie; Sydsjö, Gunilla

    2014-01-01

    Objective To determine the distribution of low birth weight (LBW), preterm birth, small for gestational age (SGA) and large for gestational age (LGA) by main cause of infertility (female, combined, male, unexplained) in women seeking infertility treatment. Design A case–control study. Setting A Centre for Reproductive Medicine in Sweden. Participants All women (n=1293) born in Sweden in 1973 or later and who were part of heterosexual couples seeking infertility treatment at a Centre of Reproductive Medicine from 2005 to 2010 were asked to participate. Those who had not begun the diagnostic process and who declined participation in the study were excluded. In total, 1206 women (94.5%) participated in the study. Main outcome measures Main cause of infertility (female, combined, male, unexplained) collected from the patients’ medical charts. LBW (+2SD of the mean weight for the gestational length), collected from the Swedish Medical Birth Register. Results The risk of being born with LBW was increased about 2.4 times (OR=2.40, CI 1.13 to 5.07, p=0.02) in women seeking treatment for infertility due to female causes rather than for male or unexplained causes. Women with a female infertility factor were 2.7 times more likely to be born SGA (OR=2.73, CI 1.02 to 7.34, p=0.047) compared with those in whom the cause of infertility was unexplained. Conclusions Women born with LBW or SGA seem to suffer an increased risk of infertility due to a female factor. Thus, infants born with birth characteristics that deviate from the norm may be at greater risk of difficulties in childbearing later on in life. Since this study is the first of its kind, more studies are needed to verify the associations found in this study and to determine their nature. PMID:24613821

  9. Patient expectations before arthroscopic shoulder surgery: correlation with patients' reasons for seeking treatment.

    Science.gov (United States)

    Warth, Ryan J; Briggs, Karen K; Dornan, Grant J; Horan, Marilee P; Millett, Peter J

    2013-12-01

    Elevated expectations before orthopaedic procedures appear to correlate with inferior preoperative subjective measures. The purpose of this study was to evaluate preoperative patient expectations before arthroscopic shoulder surgery and to correlate them with preoperative subjective measures and patients' reasons for seeking treatment. We prospectively collected and retrospectively analyzed data from patients before elective arthroscopic shoulder surgery for a wide range of pathologic processes. Preoperative subjective data included QuickDASH scores, pain and functional components of the American Shoulder and Elbow Surgeons (ASES) score, and mental and physical components of the SF-12 score. Expectations data were collected and grouped on the basis of the reasons for seeking of medical treatment and ranked according to their relative importance. The study included 313 shoulders. There were 205 men and 108 women with a mean age at surgery of 48.7 years (range, 18-78 years). Overall, the most important expectations were for the "shoulder to be back to the way it was before the problem started" and to continue participation in sporting activities. Patients who presented with the "shoulder coming out" had fewer important expectations than did those who presented for other reasons. Those patients who indicated a desire to continue participation in sports had significantly less pain (improved ASES pain scores) compared with the rest of the population. Although return to sport was the most important expectation overall, the importance of other expectations varied by patients' reasons for seeking treatment. The current questionnaire may have limited use in patients with shoulder instability. Level III, cross-sectional design, epidemiology. Copyright © 2013 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Mosby, Inc. All rights reserved.

  10. Birth characteristics in a clinical sample of women seeking infertility treatment: a case-control study.

    Science.gov (United States)

    Vikström, Josefin; Hammar, Mats; Josefsson, Ann; Bladh, Marie; Sydsjö, Gunilla

    2014-03-10

    To determine the distribution of low birth weight (LBW), preterm birth, small for gestational age (SGA) and large for gestational age (LGA) by main cause of infertility (female, combined, male, unexplained) in women seeking infertility treatment. A case-control study. A Centre for Reproductive Medicine in Sweden. All women (n=1293) born in Sweden in 1973 or later and who were part of heterosexual couples seeking infertility treatment at a Centre of Reproductive Medicine from 2005 to 2010 were asked to participate. Those who had not begun the diagnostic process and who declined participation in the study were excluded. In total, 1206 women (94.5%) participated in the study. Main cause of infertility (female, combined, male, unexplained) collected from the patients' medical charts. LBW (+2SD of the mean weight for the gestational length), collected from the Swedish Medical Birth Register. The risk of being born with LBW was increased about 2.4 times (OR=2.40, CI 1.13 to 5.07, p=0.02) in women seeking treatment for infertility due to female causes rather than for male or unexplained causes. Women with a female infertility factor were 2.7 times more likely to be born SGA (OR=2.73, CI 1.02 to 7.34, p=0.047) compared with those in whom the cause of infertility was unexplained. Women born with LBW or SGA seem to suffer an increased risk of infertility due to a female factor. Thus, infants born with birth characteristics that deviate from the norm may be at greater risk of difficulties in childbearing later on in life. Since this study is the first of its kind, more studies are needed to verify the associations found in this study and to determine their nature.

  11. The Association between Shift Work and Treatment-seeking Migraine in Denmark

    DEFF Research Database (Denmark)

    Jakobsen, Gitte Sofie; Timm, Anne Matilde; Hansen, Åse Marie

    2017-01-01

    In Europe, the one-year prevalence of migraine is 14.9% and migraine is on the top-ten list of leading causes of years lost to disability. Sleep disturbances and irregular daily routines are considered triggers of migraine and these factors are well-known consequences of shift work. We studied...... the association between treatment-seeking migraine and shift work, categorised as fixed evening work, fixed night work and variable working hours with and without night work in a Danish working population of 5,872 participants. When compared with fixed day workers, only participants with fixed evening work were...

  12. A Comparison of Treatment-Seeking Behavioral Addiction Patients with and without Parkinson’s Disease

    Science.gov (United States)

    Sauvaget, Anne; Jiménez-Murcia, Susana; Fernández-Aranda, Fernando; Granero, Roser; Grall-Bronnec, Marie; Victorri-Vigneau, Caroline; Bulteau, Samuel; Derkinderen, Pascal; Vanelle, Jean M.; Hakansson, Anders; Mestre-Bach, Gemma; Steward, Trevor; Menchón, José M.

    2017-01-01

    The administration of dopaminergic medication to treat the symptoms of Parkinson’s disease (PD) is associated with addictive behaviors and impulse control disorders. Little is known, however, on how PD patients differ from other patients seeking treatments for behavioral addictions. The aim of this study was to compare the characteristics of behavioral addiction patients with and without PD. N = 2,460 treatment-seeking men diagnosed with a behavioral addiction were recruited from a university hospital. Sociodemographic, impulsivity [Barratt Impulsiveness Scale (BIS-11)], and personality [Temperament and Character Inventory-Revised (TCI-R)] measures were taken upon admission to outpatient treatment. Patients in the PD group were older and had a higher prevalence of mood disorders than patients without PD. In terms of personality characteristics and impulsivity traits, PD patients appeared to present a more functional profile than PD-free patients with a behavioral addiction. Our results suggest that PD patients with a behavioral addiction could be more difficult to detect than their PD-free counterparts in behavioral addiction clinical setting due to their reduced levels of impulsivity and more standard personality traits. As a whole, this suggests that PD patients with a behavioral addiction may have different needs from PD-free behavioral addiction patients and that they could potentially benefit from targeted interventions. PMID:29163234

  13. A Comparison of Treatment-Seeking Behavioral Addiction Patients with and without Parkinson’s Disease

    Directory of Open Access Journals (Sweden)

    Anne Sauvaget

    2017-11-01

    Full Text Available The administration of dopaminergic medication to treat the symptoms of Parkinson’s disease (PD is associated with addictive behaviors and impulse control disorders. Little is known, however, on how PD patients differ from other patients seeking treatments for behavioral addictions. The aim of this study was to compare the characteristics of behavioral addiction patients with and without PD. N = 2,460 treatment-seeking men diagnosed with a behavioral addiction were recruited from a university hospital. Sociodemographic, impulsivity [Barratt Impulsiveness Scale (BIS-11], and personality [Temperament and Character Inventory-Revised (TCI-R] measures were taken upon admission to outpatient treatment. Patients in the PD group were older and had a higher prevalence of mood disorders than patients without PD. In terms of personality characteristics and impulsivity traits, PD patients appeared to present a more functional profile than PD-free patients with a behavioral addiction. Our results suggest that PD patients with a behavioral addiction could be more difficult to detect than their PD-free counterparts in behavioral addiction clinical setting due to their reduced levels of impulsivity and more standard personality traits. As a whole, this suggests that PD patients with a behavioral addiction may have different needs from PD-free behavioral addiction patients and that they could potentially benefit from targeted interventions.

  14. Cross-border mobility and social networks: Laotians seeking medical treatment along the Thai border.

    Science.gov (United States)

    Bochaton, Audrey

    2015-01-01

    Drawing upon research conducted on cross-border patients living in Laos and seeking care in Thailand, this paper examines the important role played by social networks in patients' decision-making and on the itineraries they choose to seek treatment on the Thai side of the border. Due to the vastly contrasting situations between the two countries in terms of healthcare supply, and considering Laotians' increasing demand for high quality healthcare, a number of them have managed to satisfy their needs by combining cross-border treatment with the use of the healthcare facilities provided by their own country. This study consisted first of household surveys conducted in five border areas (2006-2007) in Laos in order to quantify and map out cross-border healthcare-related travel patterns. Afterwards, interviews were conducted with cross-border patients (55), Laotian and Thai medical doctors (6), Thai social workers (5), and officials working in public institutions (12). While socioeconomic and spatial factors partly explain cross-border mobility, patients' social networks significantly influence treatment itineraries throughout the decision-making process, including logistical and financial considerations. The social networks existing at different geographical levels (neighbourhood, regional and global) are therefore a powerful analytical tool not only for understanding the emergence of these cross-border movements but also for justifying them in an authoritarian political environment such as Lao PDR's. Copyright © 2014 Elsevier Ltd. All rights reserved.

  15. Use of Q methodology to assess the concerns of adult female individuals seeking orthodontic treatment

    Directory of Open Access Journals (Sweden)

    Yao L

    2015-01-01

    Full Text Available Linjie Yao,1 Xingqiao Xu,2 Zhenyu Ni,3 Minling Zheng,3 Feiou Lin3 1Department of Pedodontics, 2Department of Oral and Maxillofacial Surgery, 3Department of Orthodontics, School and Hospital of Stomatology, Wenzhou Medical University, Wenzhou, People’s Republic of China Background: Orthodontic treatment may cause functional restrictions, discomfort, and pain, which may lead to dental anxiety and noncooperation among patients. This study aimed to assess the concerns of adult female patients with respect to such treatment.Patients and methods: We conducted an explorative study using Q methodology among 40 adult female patients with different educational and social backgrounds in Wenzhou, People’s Republic of China. We asked participants to rank a set of 41 statements about seeking orthodontic treatment on an 11-point scale from “agree most” to “disagree most”. The collected data were analyzed using the PQ Method 2.35 program. We extracted significant viewpoints using centroid factor extraction and varimax rotation.Results: We identified major factors based on how the patients ranked statements. Patients in group 1 worried about lack of information about orthodontic treatment, and may have suffered from dental phobia; patients in group 2 were all single women, and they were worried that the braces might lower their chances of finding a partner; patients in group 3 worried about appearance and speech with braces; and patients in group 4 worried about cost, pain, and dental hygiene. The remaining participants who had other viewpoints did not load to any of these four groups.Conclusion: The concerns of adult female individuals seeking orthodontic treatment are complex. A significant feature of this study was using Q methodology to analyze the psychological characteristics of the patients. This study identified four typical characterizations that are associated with each group, and our findings may aid orthodontists in improving doctor

  16. Stages of change, clinical presentation, retention, and treatment outcomes in treatment-seeking outpatient problem gambling clients.

    Science.gov (United States)

    Soberay, Adam David; Grimsley, Paul; Faragher, J Michael; Barbash, Melissa; Berger, Ben

    2014-06-01

    Specific stages of change have been associated with clinical variables before and during the course of addiction treatment. However, few studies have specifically focused on these relationships for problem and pathological gamblers. The present study examined the relationships between pretreatment stages of change and clinical treatment variables in a sample of 71 treatment-seeking problem and pathological gamblers. The participants were administered the following instruments: the University of Rhode Island Change Assessment (URICA), the NORC DSM-IV Screen for Gambling Problems (NODS), and the Outcome Questionnaire 45 (OQ-45). The researchers hypothesized that there would be a relationship among pretreatment stages of change and (a) severity of gambling problems at onset of treatment, (b) severity of psychosocial problems at onset of treatment, (c) retention in treatment, and (d) level of psychosocial improvement through therapy. The results indicate that (a) precontemplation was negatively related to reported gambling problems at outset of treatment, and contemplation and maintenance were positively related to reported gambling problems at the outset of treatment; (b) action was positively associated with level of psychosocial functioning at outset of treatment; (c) action was negatively associated with retention in treatment; and (d) maintenance was negatively associated with level of improvement in psychosocial functioning through therapy. Implications for treatment of this population include the ability to adjust treatment plans and interventions with increased awareness of potential barriers and obstacles unique to pretreatment stages of change.

  17. Evaluation of QTc interval in Iranian causalities (Janbazan) of Iran-Iraq war receiving maintenance methadone treatment

    OpenAIRE

    Morteza Abdar Esfahani; Ali Akbar Vosughi; Mohamad Hossein Fatehi; Armindokht shahsanaee; Azam Teimuri

    2012-01-01

    Background: Methadone is a synthetic opioid, used in treatment of chronic pains. The current study was carried out to evaluate the QTc interval in Iranian causalities (Janbazan) of Iran-Iraq war receiving maintenance methadone treatment. Materials and Methods: In 2010, one hundred war causalities in Isfahan who chronically take daily dose of 20 mg or more of methadone (more than 2 weeks), and did not have the history of cerebrovascular or coronary artery diseases, cardiac pacemaker, congenita...

  18. Disordered eating behavior and mental health correlates among treatment seeking obese women.

    Science.gov (United States)

    Altamura, M; Rossi, G; Aquilano, P; De Fazio, P; Segura-Garcia, C; Rossetti, M; Petrone, A; Lo Russo, T; Vendemiale, G; Bellomo, A

    2015-01-01

    Previous research has suggest that obesity is associated with increased risk for psychopathological disorders, however, little is known about which obese patients are most vulnerable to psychopathological disorders. We therefore investigated 126 treatment-seeking obese women to describe eating disorder pathology and mental health correlates, and to identify disordered eating behaviors that may place obese at increased risk for psychopathological disorders. The Structured Clinical Interview for DSM-IV (SCID) was used to identify Eating Disorders (ED). A battery of psychological tests, including the Anxiety Scale Questionnaire (ASQ,) Clinical Depression Questionnaire (CDQ), Eating Disorder Inventory-2 (EDI-2) Eating Attitudes Test-26 (EAT-26) scales and structured clinical interview were administered to all the patients. We analyzed the link between psychopathological disorders and eating attitudes by using both multiple regression analysis and non-parametric correlation. Disordered eating behaviors and emotional behavioral aspects related to Anorexia Nervosa, such as ineffectiveness, are strongly linked to the depression and anxiety in obese subjects. No correlation was found between psychopathological disorders and age or anthropometric measurements. Findings corroborate earlier work indicating that psychological distress is elevated in obese treatment seeking, bolstering the need for mental health assessment of such individuals. The feeling of ineffectiveness constitutes the major predictor of psychopathological aspects. This is an important result which may inform the development of effective interventions for obese patients and prevention of psychopathological disorders.

  19. Television use and binge eating in adults seeking weight loss treatment.

    Science.gov (United States)

    Burmeister, Jacob M; Carels, Robert A

    2014-01-01

    Binge eating has a complex etiology and is likely influenced by a wide range of biological, psychological, social, and environmental factors. Among the environmental and behavioral contributors, television use has been strongly linked to obesity and unhealthy eating behaviors. The current study tested whether television use predicts binge eating symptomatology in adults seeking behavioral weight loss treatment. Participants (N=116) were adults seeking weight loss treatment in group-based behavioral weight loss programs. Average body mass index was 38.5; average age was 45.3. They completed measures of binge eating symptomatology, television use, internalized weight stigma, depression, body satisfaction, and habitual physical activity. The amount of television participants watched per week was associated with binge eating symptomatology even after controlling for relevant covariates. Binge eating symptomatology was positively associated with television use, internalized weight stigma, depression, and decreased body satisfaction. The findings of the current study support the hypothesis that television use is a significant predictor of binge eating symptomatology for adults attempting weight loss. Determining the causal nature of the relationship and whether binge eating is occurring during television viewing will be important areas of future inquiry. © 2013.

  20. Night eating in obese treatment-seeking Hispanic patients with and without binge eating disorder.

    Science.gov (United States)

    Grilo, Carlos M; Milsom, Vanessa A; Morgan, Peter T; White, Marney A

    2012-09-01

    To examine the frequency of night eating (NE) and its relation to binge eating disorder (BED), eating-disorder psychopathology, depression, and metabolic variables in treatment-seeking obese Hispanic men and women. A consecutive series of 79 obese monolingual Spanish-speaking-only Hispanic patients with BED (N = 40) and without BED (N = 39) were reliably assessed by bilingual research-clinicians using Spanish-language versions of semistructured interviews and measures. Overall, 38% (N = 30) of the 79 patients reported regular NE (≥4 days/month). NE and BED were significantly associated; 70% (21/30) of NE versus 18% (9/49) of non-NE had BED. Patients with NE reported greater frequency of binge-eating and higher levels of eating-disorder psychopathology and depression than non-NE patients; group differences in eating disorder psychopathology and depression levels persisted after controlling for BED status. The NE and non-NE groups did not differ significantly in BMI or metabolic variables. In obese treatment-seeking Hispanic patients, NE and BED were significantly associated and NE was associated with heightened eating-disorder psychopathology and depression even after controlling for BED status. Copyright © 2012 Wiley Periodicals, Inc.

  1. Presenting concerns of emerging adults seeking treatment at an early intervention outpatient mood and anxiety program.

    Science.gov (United States)

    Arcaro, Justin; Summerhurst, Carolyn; Vingilis, Evelyn; Wammes, Michael; Osuch, Elizabeth

    2017-09-01

    This study examined presenting concerns and characteristics of emerging adults (EAs) seeking treatment at an early intervention program for mood and anxiety disorders to better understand presenting concerns when treatment is needed. During an intake assessment conducted by a social worker or clinical psychologist, participants (N = 548; 62% female, 38% male) reported their top three current life concerns, which were analyzed qualitatively using thematic analysis. Participants completed a battery of questionnaires assessing demographic information, symptomatology, and daily functioning. Females presented with significantly higher levels of anxiety, and both females and younger individuals (age 16-18) presented with significantly higher levels of depression compared to males and older individuals (age 19-26), respectively. The two most commonly reported presenting concerns were problems in interpersonal relationships and academics, and females were more likely to report academic concerns than males. The majority of participants reported seeking help for a wide range of problems commonly faced by EAs (83.7%), and participants rarely expressed concerns about particular symptoms of mood and/or anxiety disorders (16.3%). EAs and those supporting EAs may benefit from learning when psychosocial concerns are indicative of mental health challenges warranting professional attention.

  2. Self-regulation, daily drinking, and partner violence in alcohol treatment-seeking men.

    Science.gov (United States)

    Schumacher, Julie A; Coffey, Scott F; Leonard, Kenneth E; O'Jile, Judith R; Landy, Noah C

    2013-02-01

    This study builds on research identifying deficits in behavioral self-regulation as risk factors for intimate partner violence (IPV). It also builds on alcohol administration research identifying these deficits as moderators of the association between acute alcohol consumption and aggression in laboratory paradigms. Participants analyzed were 97 men seeking residential treatment for alcohol dependence who were involved in a current or recent heterosexual relationship of at least 1 year. Participants completed a self-report measure of impulsivity, neuropsychological tests of executive function, and computerized delay discounting and behavioral inhibition tasks. With the exception of the self-report measure of impulsivity, performance on measures of behavioral self-regulation was not associated with the occurrence or frequency of past year IPV in this sample. Similarly, self-reported impulsivity moderated the association between daily drinking and IPV in multivariate models controlling for daily drug use, but deficits in performance on other measures did not. Performance on a tower task moderated the association between daily drinking and the occurrence of IPV, but contrary to hypotheses, better task performance was associated with greater likelihood of IPV on drinking days. These results suggest that self-perceived impulsivity is a better predictor of IPV in alcohol treatment seeking men than deficits in performance on behavioral measures of delay discounting, behavioral inhibition, and executive function. (c) 2013 APA, all rights reserved.

  3. Internalized weight stigma and its ideological correlates among weight loss treatment seeking adults.

    Science.gov (United States)

    Carels, R A; Young, K M; Wott, C B; Harper, J; Gumble, A; Hobbs, M Wagner; Clayton, A M

    2009-01-01

    There are significant economic and psychological costs associated with the negative weight-based social stigma that exists in American society. This pervasive anti-fat bias has been strongly internalized among the overweight/obese. While the etiology of weight stigma is complex, research suggests that it is often greater among individuals who embrace certain etiological views of obesity or ideological views of the world. This investigation examined 1) the level of internalized weight stigma among overweight/obese treatment seeking adults, and 2) the association between internalized weight stigma and perceived weight controllability and ideological beliefs about the world ('just world beliefs', Protestant work ethic). Forty-six overweight or obese adults (BMI >or=27 kg/m2) participating in an 18- week behavioral weight loss program completed implicit (Implicit Associations Test) and explicit (Obese Person's Trait Survey) measures of weight stigma. Participants also completed two measures of ideological beliefs about the world ("Just World Beliefs", Protestant Ethic Scale) and one measure of beliefs about weight controllability (Beliefs about Obese Persons). Significant implicit and explicit weight bias was observed. Greater weight stigma was consistently associated with greater endorsement of just world beliefs, Protestant ethic beliefs and beliefs about weight controllability. Results suggest that the overweight/obese treatment seeking adults have internalized the negative weight-based social stigma that exists in American society. Internalized weight stigma may be greater among those holding specific etiological and ideological beliefs about weight and the world.

  4. Comparing treatment-seeking codeine users and strong opioid users: Findings from a novel case series.

    Science.gov (United States)

    Nielsen, Suzanne; Murnion, Bridin; Dunlop, Adrian; Degenhardt, Louisa; Demirkol, Apo; Muhleisen, Peter; Lintzeris, Nicholas

    2015-05-01

    Few studies have described those seeking treatment for codeine dependence. This study aimed to compare patients presenting for treatment where either codeine or a strong pharmaceutical opioid (oxycodone or morphine) was the principal drug of concern to understand if codeine users may have unique treatment needs. Retrospective case review of 135 patients from three geographical areas in New South Wales, Australia. Cases where the principal drug of concern was codeine (n = 53) or a strong pharmaceutical opioid (oxycodone or morphine, n = 82) were compared. Differences in demographic characteristics, pain history, mental health, substance use history and, subsequently, the treatment that was received were examined. People whose principal drug of concern was codeine were more likely to be female (66% vs. 37%, P codeine group (mean 38.6 years) and the strong opioid group (39.3 years). Opioid substitution therapy was the most common treatment received by both groups although codeine patients were more likely to be treated with buprenorphine than methadone (odds ratio = 7.7, 95% confidence interval 2.2-27.2, P codeine-dependent patients and strong prescription opioid-dependent patients. Further work should explore the outcomes of withdrawal versus maintenance treatment for codeine users. © 2014 Australasian Professional Society on Alcohol and other Drugs.

  5. E-cigarette use among treatment-seeking smokers: Moderation of abstinence by use frequency.

    Science.gov (United States)

    Subialka Nowariak, Emily N; Lien, Rebecca K; Boyle, Raymond G; Amato, Michael S; Beebe, Laura A

    2018-02-01

    Emerging literature suggests that frequency of use of electronic cigarettes (e-cigarettes) may be an important moderating variable in the relationship between e-cigarette use and smoking cessation. However, few studies have focused specifically on treatment-seekers, a group that may differ in important ways from smokers in the general population. This study looks at the relationship between e-cigarette use frequency and abstinence among a sample of treatment-seeking tobacco users. Seven-month follow-up survey data from N=2760 treatment-seeking tobacco users who utilized statewide tobacco quitlines in three states were used to assess the relationship between 30-day point prevalence abstinence and e-cigarette use frequency at follow-up. E-cigarette use was examined in two ways. First, we looked at any use in the past 30days versus no use. Additionally, past 30-day e-cigarette use frequency was categorized into four groups: 0days, 1-5days - infrequent, 6-29days - intermediate, 30days - daily. Logistic regression models were constructed predicting 30-day point prevalence tobacco abstinence. Both infrequent (AOR=0.35; CI=0.20-0.59) and intermediate (AOR=0.50; CI=0.32-0.80) past 30-day e-cigarette use were associated with lower rates of tobacco abstinence versus no past 30-day use. However, daily e-cigarette users (AOR=1.16; CI=0.71-1.70) had similar 30-day abstinence when compared to non-users. Results from this study of treatment-seekers support findings from studies of general population tobacco users that suggest frequency of e-cigarette use is an important moderating variable in the relationship between e-cigarette use and tobacco cessation. Future studies should employ more refined measures of e-cigarette use. Copyright © 2017 Elsevier Ltd. All rights reserved.

  6. Characteristics of a treatment-seeking population in outpatient addiction treatment centers in Mexico.

    Science.gov (United States)

    Marín-Navarrete, Rodrigo; Templos-Nuñez, Liliana; Eliosa-Hernández, Angélica; Villalobos-Gallegos, Luis; Fernández-Mondragón, José; Pérez-López, Alejandro; Galván-Sosa, Diana; Verdeja, Rosa E; Alonso, Elizabeth; Feaster, Daniel J; Horigian, Viviana E

    2014-11-01

    Baseline patients' characteristics are critical for treatment planning, as these can be moderators of treatment effects. In Mexico, information on treatment seekers with substance use disorders is scarce and limited to demographic characteristics. This paper presents and analyses demographic characteristics, substance use related problems, clinical features, and addiction severity in a sample of treatment seekers from the first multi-site randomized clinical trial implemented in the Mexican Clinical Trials Network on Addiction and Mental Health. A total of 120 participants were assessed prior randomization. Chi square or F-tests were used to compare sites across variables. Spearman correlation was used to associate negative consequences of substance use and motivation to change. The majority of participants were men, and the most prevalent substances reported were alcohol, marijuana, and cocaine. Participants were predominantly on the contemplation or action stage of change, and this was correlated with the perception of the negative consequences associated with substance use. Participants reported a high prevalence of substance use related problems. Substance use related problems, clinical features, and addiction severity reported by treatment seekers are important characteristics to take into account when planning treatment as they facilitate tailoring treatment to meet patients' needs.

  7. What Matters: Quantity or Quality of Pornography Use? Psychological and Behavioral Factors of Seeking Treatment for Problematic Pornography Use.

    Science.gov (United States)

    Gola, Mateusz; Lewczuk, Karol; Skorko, Maciej

    2016-05-01

    Pornography has become popular with Internet technology. For most people, pornography use (PU) is entertainment; for some, it can result in seeking treatment for out-of-control behavior. Previous studies have suggested that PU can influence sexual behaviors, but the direct relation between frequency of PU and treatment-seeking behaviors has not been examined. To investigate whether individuals seeking treatment as a consequence of their problematic PU do so because of their quantity of pornography consumption or because of more complex psychological and behavioral factors related to PU, such as the severity of negative symptoms associated with PU and/or subjective feeling of loss of control over one's behavior. A survey study was conducted of 569 heterosexual Caucasian men 18 to 68 years old, including 132 seeking treatment for problematic PU (referred by psychotherapists after their initial visit). The main outcome measures were self-reported PU, its negative symptoms, and actual treatment-seeking behavior. We tested models explaining sources of seeking treatment for problematic PU with negative symptoms associated with PU and additional factors (eg, onset and number of years of PU, religiosity, age, dyadic sexual activity, and relationship status). Seeking treatment was significantly, yet weakly, correlated solely with the frequency of PU (r = 0.21, P pornography consumption. Thus, treatment of problematic PU should address qualitative factors, rather than merely mitigating the frequency of the behavior, because frequency of PU might not be a core issue for all patients. Future diagnostic criteria for problematic PU should consider the complexity of this issue. Copyright © 2016 International Society for Sexual Medicine. Published by Elsevier Inc. All rights reserved.

  8. Vagus Nerve Stimulation: A Non-Invasive Treatment to Improve the Health of Gulf Veterans with Gulf War Illness

    Science.gov (United States)

    2017-05-01

    Gulf War Illness (GWI) is a condition occurring in some veterans who served in the 1990-91 Gulf War . To date there is no specific treatment for it. A...major complaint of veteran subjects with GWI is widespread pain and achiness. Currently, some drugs are available to treat these symptoms, but these...complaint of Gulf War veterans with GWI using a hand-held neuro-stimulator device that activates a nerve in the neck called the vagus. This study will

  9. Treatment-seeking behaviour and associated costs for malaria in Papua, Indonesia.

    Science.gov (United States)

    Karyana, Muhammad; Devine, Angela; Kenangalem, Enny; Burdarm, Lenny; Poespoprodjo, Jeanne Rini; Vemuri, Ram; Anstey, Nicholas M; Tjitra, Emiliana; Price, Ric N; Yeung, Shunmay

    2016-11-08

    Malaria remains a significant public health issue in Eastern Indonesia, where multidrug resistant Plasmodium falciparum and Plasmodium vivax are highly prevalent. The objective of this study was to describe treatment-seeking behaviour and household costs prior to a change to a unified treatment policy of dihydroartemisinin-piperaquine in Mimika district, Papua province in 2006. In 2005 a randomized cross-sectional household survey was conducted to collect data on demographics, socio-economic status (SES), treatment-seeking, case management, and household costs. Information on the cost of illness was also collected from patients exiting health facilities, in order to compare the cost of episodes diagnosed as P. vivax compared with those diagnosed as P. falciparum. 825 households were included in the survey. Of the 764 individuals who sought treatment for fever outside the home in the last month, 46% (349/764) went to a public health facility. Of the 894 reported visits to healthcare providers, 48% (433) resulted in a blood test, of which 78% (337) were reportedly positive. Only 10% (17/177) of individuals who reported testing positive for P. falciparum or mixed infection received the first-line treatment of chloroquine with SP, and 38% (61/159) of those with a diagnosis of P. vivax reportedly received the first-line treatment of chloroquine and primaquine. Overall, public facilities were more likely to prescribe the correct prevailing first-line drug combinations than private providers (OR = 3.77 [95% CI 2.31-6.14], p < 0.001). The mean cost to the household of an episode of P. vivax was similar to the cost of P. falciparum [US$44.50 (SD: 46.23) vs US$48.58 (SD: 64.65)]. Private providers were a popular source of treatment for malaria, but adherence to the national guidelines was low and the economic burden of malaria for both P. falciparum and P. vivax infections was substantial. Engagement with the private sector is needed to ensure that patients have access

  10. Clinical, Psychopathological, and Personality Characteristics Associated with ADHD among Individuals Seeking Treatment for Gambling Disorder

    Science.gov (United States)

    Aymamí, N.; Jiménez-Murcia, S.; Granero, R.; Ramos-Quiroga, J. A.; Fernández-Aranda, F.; Claes, L.; Sauvaget, A.; Grall-Bronnec, M.; Gómez-Peña, M.; Savvidou, L. G.; Fagundo, A. B.; del Pino-Gutierrez, A.; Moragas, L.; Casas, M.; Penelo, E.; Menchón, J. M.

    2015-01-01

    Objectives. (1) To assess the current presence of ADHD symptoms among patients seeking treatment for gambling disorder; (2) to explore clinical and sociodemographic differences between patients who score high and low on the measure of ADHD symptoms; (3) to analyze whether the presence of ADHD symptoms is associated with more severe psychopathology and with specific personality traits; (4) to analyze the mediating role of ADHD symptoms in the relationship between novelty seeking and gambling severity. Method. A total of 354 consecutive patients were administered an extensive battery assessing gambling behavior, psychopathology, and personality traits. Results. Male and female gamblers did not differ significantly in their mean scores on the ADHD measure. However, younger participants aged 18–35 scored higher. Higher ADHD scores were also associated with greater severity of gambling disorder and more general psychopathology. Regarding personality traits, high persistence and self-directedness were negatively related to ADHD scores, while in women alone a positive correlation was found between ADHD scores and scores on harm avoidance and self-transcendence. Conclusion. The presence of ADHD symptoms in both male and female gambling disorder patients may act as an indicator of the severity of gambling, general psychopathology, and dysfunctional personality traits. PMID:26229967

  11. Clinical, Psychopathological, and Personality Characteristics Associated with ADHD among Individuals Seeking Treatment for Gambling Disorder.

    Science.gov (United States)

    Aymamí, N; Jiménez-Murcia, S; Granero, R; Ramos-Quiroga, J A; Fernández-Aranda, F; Claes, L; Sauvaget, A; Grall-Bronnec, M; Gómez-Peña, M; Savvidou, L G; Fagundo, A B; del Pino-Gutierrez, A; Moragas, L; Casas, M; Penelo, E; Menchón, J M

    2015-01-01

    (1) To assess the current presence of ADHD symptoms among patients seeking treatment for gambling disorder; (2) to explore clinical and sociodemographic differences between patients who score high and low on the measure of ADHD symptoms; (3) to analyze whether the presence of ADHD symptoms is associated with more severe psychopathology and with specific personality traits; (4) to analyze the mediating role of ADHD symptoms in the relationship between novelty seeking and gambling severity. A total of 354 consecutive patients were administered an extensive battery assessing gambling behavior, psychopathology, and personality traits. Male and female gamblers did not differ significantly in their mean scores on the ADHD measure. However, younger participants aged 18-35 scored higher. Higher ADHD scores were also associated with greater severity of gambling disorder and more general psychopathology. Regarding personality traits, high persistence and self-directedness were negatively related to ADHD scores, while in women alone a positive correlation was found between ADHD scores and scores on harm avoidance and self-transcendence. The presence of ADHD symptoms in both male and female gambling disorder patients may act as an indicator of the severity of gambling, general psychopathology, and dysfunctional personality traits.

  12. Microbial profiles of patients seeking treatment for periodontitis. Influence of origin, smoking and age?

    Science.gov (United States)

    Décaillet, Fabien; Giannopoulou, Catherine; Cionca, Norbert; Almaghlouth, Adnan; Mombelli, Andrea

    2012-01-01

    We assessed the potential influence of the origin, the smoking status and the age on subgingival microbial profiles of subjects seeking periodontal care in Switzerland today. Subgingival samples were obtained from 182 subjects originating from 44 countries (56 native Swiss, 64 other European, 43 African, 19 others), seeking periodontal treatment at the School of Dental Medicine at the University of Geneva. Four periodontal microorganisms were quantified by direct hybridization with specific RNA probes. Tannerella forsythia and Treponema denticola were ubiquitous (95.6%, 93.9%), and Porphyromonas gingivalis was frequently detected (89%). Counts correlated with the size of the microbial sample (total load). Aggregatibacter actinomycetemcomitans was detected in only 70 (38.4%) subjects. Counts were highly variable and unrelated to total load. Subjects less than 46.8 years old (median age) had a higher risk to be positive than older subjects. Detection frequencies and counts of all four organisms were unrelated to the origin or the smoking status. Based on a clinical diagnosis of untreated periodontitis, positive outcomes of tests for T. forsythia, T. denticola and P. gingivalis could be predicted with high confidence irrespective of a patient;'s origin, smoking status or age. Detection of A. actinomycetemcomitans was less frequent and depended on the age of the subject.

  13. Clinical, Psychopathological, and Personality Characteristics Associated with ADHD among Individuals Seeking Treatment for Gambling Disorder

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    N. Aymamí

    2015-01-01

    Full Text Available Objectives. (1 To assess the current presence of ADHD symptoms among patients seeking treatment for gambling disorder; (2 to explore clinical and sociodemographic differences between patients who score high and low on the measure of ADHD symptoms; (3 to analyze whether the presence of ADHD symptoms is associated with more severe psychopathology and with specific personality traits; (4 to analyze the mediating role of ADHD symptoms in the relationship between novelty seeking and gambling severity. Method. A total of 354 consecutive patients were administered an extensive battery assessing gambling behavior, psychopathology, and personality traits. Results. Male and female gamblers did not differ significantly in their mean scores on the ADHD measure. However, younger participants aged 18–35 scored higher. Higher ADHD scores were also associated with greater severity of gambling disorder and more general psychopathology. Regarding personality traits, high persistence and self-directedness were negatively related to ADHD scores, while in women alone a positive correlation was found between ADHD scores and scores on harm avoidance and self-transcendence. Conclusion. The presence of ADHD symptoms in both male and female gambling disorder patients may act as an indicator of the severity of gambling, general psychopathology, and dysfunctional personality traits.

  14. Study of prevalence, treatment-seeking behavior, and risk factors of women with lower urinary tract symptoms in Northern Malaysia.

    Science.gov (United States)

    Low, Bee Yean; Liong, Men Long; Yuen, Kah Hay; Chong, Wooi Loong; Chee, Christopher; Leong, Wing Seng; Teh, Chu Leong; Karim, Nurzalina; Yap, Hin Wai; Cheah, Phaik Yeong

    2006-10-01

    To determine the prevalence, severity, and quality-of-life (QOL) impact of female lower urinary tract symptoms (FLUTS); to determine the patterns, reasons, and factors contributing to the women's treatment-seeking behavior; and to describe the relationship between the social demographic characteristics and FLUTS. A total of 2732 women older than 19 years of age were recruited by a series of FLUTS Awareness Campaigns held within Northern Malaysia from January to August 2004. Trained interviewers used surveys to collect information on social demographic characteristics, International Prostate Symptom Score, and King's Health Questionnaire to determine the prevalence, severity, QOL impact, treatment-seeking behavior, and risk factors of FLUTS. The prevalence of FLUTS was 19.0% (n = 519), with 88.6% having moderate and 11.4% severe FLUTS. Using the International Prostate Symptom Score QOL assessment index, 55.3% (n = 287) scored 4 or greater. Using the King's Health Questionnaire, the most affected QOL domain was sleep/energy. The patterns of treatment-seeking behavior revealed that only 23.1% (n = 120) of patients with FLUTS actively sought treatment. The major reason for those (76.9%) who failed to seek treatment was that they did not perceive FLUTS as a major health problem (29.1%). Factors that warranted treatment were the severity, bother, and QOL impact of FLUTS (all P Malaysia (19.0%), many patients do not seek treatment, with ignorance being the major reason.

  15. Characteristics of women physically abused by their spouses and who seek treatment regarding marital conflict.

    Science.gov (United States)

    Cascardi, M; O'Leary, K D; Lawrence, E E; Schlee, K A

    1995-08-01

    Physically abused women seeking treatment for marital difficulties (abused women, n = 49) were compared with maritally discordant, nonabused women (discordant only, n = 23) and maritally satisfied nonabused women (community control, n = 25). Abused women reported significantly more fear of their spouses and reported that their spouses were significantly more coercive and psychologically aggressive than women in the 2 matched nonabused groups. Abused women did not report higher rates of abuse as a child, nor did they report higher rates of past psychopathology than women in the nonabused groups. However, abused women and nonabused discordant women reported higher rates of emotional abuse in childhood than maritally satisfied nonabused women. Furthermore, both clinical groups had a tendency to have higher lifetime rates of major depression before their current marriage than the maritally satisfied women. This result suggests that childhood abuse and a history of depression may be risk factors for women in abusive and nonabusive discordant relationships. As expected, abused women reported higher rates of posttraumatic stress disorder than women in the discordant-only and community control groups. Treatment implications for both standard treatments for marital problems and treatments for victims of physical abuse are discussed.

  16. Ethnomedical syndromes and treatment-seeking behavior among Mayan refugees in Chiapas, Mexico.

    Science.gov (United States)

    Smith, Bryce D; Sabin, Miriam; Berlin, Elois Ann; Nackerud, Larry

    2009-09-01

    This survey investigated the prevalence of ethnomedical syndromes and examined treatments and treatment-seeking in Mayan Guatemalans living in United Nations High Commissioner for Refugee (UNHCR) camps in Chiapas, Mexico. Methods included a rapid ethnographic assessment to refine survey methods and inform the cross-sectional survey, which also examined mental health outcomes; 183 households were approached for interview, representing an estimated 1,546 residents in five refugee camps and 93% of all households. One adult per household (N = 170) was interviewed regarding his or her health; an additional 9 adults in three surveyed households participated and were included in this analysis; of the 179 participants, 95 primary child-care providers also answered a children's health questionnaire for their children. Results indicated that ethnomedical syndromes were common in this sample, with 59% of adults and 48.4% of children having experienced susto (fright condition) and 34.1% of adults reporting ataques de nervios (nervous attacks); both conditions were significantly associated with symptoms consistent with posttraumatic stress disorder, anxiety and depression and are mental health conditions recognized by the American Psychiatric Association. Combining healthcare provider and indigenous treatments such as physician prescribed medication (65%), medicinal plants (65.7%), and limpias (spiritual cleansings) (40.6%) was reported. Most participants (86%) sought routine medical treatment from UNHCR trained health promoters in their camp. Assessing ethnomedical health is important for informing mental health programs among this population.

  17. The interactions between religion, religiosity, religious delusion/hallucination, and treatment-seeking behavior among schizophrenic patients in Taiwan.

    Science.gov (United States)

    Huang, Charles Lung-Cheng; Shang, Chi-Yung; Shieh, Ming-Shien; Lin, Hsin-Nan; Su, Jin Chung-Jen

    2011-05-30

    Religion could influence the psychopathology, treatment-seeking behavior, and treatment outcome in schizophrenia, but the associations between these factors have never been explored thoroughly, and the data in Han-Chinese society are scarcer still. The current study recruited 55 schizophrenic patients to explore the relationship between religion, psychopathology with religious content, treatment-seeking behavior, and outcome. Subjects with religious delusions/hallucinations had lower scores on functioning and higher scores on religiosity. The higher religiosity scores were correlated with older age, longer duration of illness, religious affiliation, lower preference of psychiatric treatment, lower functioning score, and delusion/hallucination. As to treatment-seeking behavior, patients with religious affiliation showed less preference toward psychiatric treatment. Individuals with religious delusion/hallucination were more likely to receive magico-religious healing and not to be satisfied with psychiatric treatment. A more positive view of psychiatric treatment was predicted by lower religiosity score, higher satisfaction with psychiatric treatment, and lower years of education. The religiosity level seems not directly related to clinical severity, but it seems to be a better predictor of religious delusions/hallucinations than religious affiliation status. Patients with religious delusions/hallucinations did not necessarily have more severe psychopathology. There are different profiles associated with religious affiliation/religiosity and religious delusions/hallucinations in relation to treatment-seeking behavior among schizophrenia patients in Han-Chinese society. Copyright © 2010 Elsevier Ltd. All rights reserved.

  18. Rural-Urban Differences in Household Treatment-Seeking Behaviour for Suspected Malaria in Children at Bata District, Equatorial Guinea

    Science.gov (United States)

    Romay-Barja, Maria; Jarrin, Inma; Ncogo, Policarpo; Nseng, Gloria; Sagrado, Maria Jose; Santana-Morales, Maria A.; Aparcio, Pilar; Valladares, Basilio; Riloha, Matilde; Benito, Agustin

    2015-01-01

    Background Malaria remains a major cause of morbidity and mortality among children under five years old in Equatorial Guinea. However, little is known about the community management of malaria and treatment-seeking patterns. We aimed to assess symptoms of children with reported malaria and treatment-seeking behaviour of their caretakers in rural and urban areas in the Bata District. Methodology A cross-sectional study was conducted in the district of Bata and 440 houses were selected from 18 rural villages and 26 urban neighbourhoods. Differences between rural and urban caregivers and children with reported malaria were assessed through the chi-squared test for independence of categorical variables and the t-Student or the non-parametric Mann-Whitney test for normally or not-normally distributed continuous variables, respectively. Results Differences between rural and urban households were observed in caregiver treatment-seeking patterns. Fever was the main symptom associated with malaria in both areas. Malaria was treated first at home, particularly in rural areas. The second step was to seek treatment outside the home, mainly at hospital and Health Centre for rural households and at hospital and private clinic for urban ones. Artemether monotherapy was the antimalarial treatment prescribed most often. Households waited for more than 24 hours before seeking treatment outside and delays were longest in rural areas. The total cost of treatment was higher in urban than in rural areas in Bata. Conclusions The delays in seeking treatment, the type of malaria therapy received and the cost of treatment are the principal problems found in Bata District. Important steps for reducing malaria morbidity and mortality in this area are to provide sufficient supplies of effective antimalarial drugs and to improve malaria treatment skills in households and in both public and private sectors. PMID:26284683

  19. Rural-Urban Differences in Household Treatment-Seeking Behaviour for Suspected Malaria in Children at Bata District, Equatorial Guinea.

    Directory of Open Access Journals (Sweden)

    Maria Romay-Barja

    Full Text Available Malaria remains a major cause of morbidity and mortality among children under five years old in Equatorial Guinea. However, little is known about the community management of malaria and treatment-seeking patterns. We aimed to assess symptoms of children with reported malaria and treatment-seeking behaviour of their caretakers in rural and urban areas in the Bata District.A cross-sectional study was conducted in the district of Bata and 440 houses were selected from 18 rural villages and 26 urban neighbourhoods. Differences between rural and urban caregivers and children with reported malaria were assessed through the chi-squared test for independence of categorical variables and the t-Student or the non-parametric Mann-Whitney test for normally or not-normally distributed continuous variables, respectively.Differences between rural and urban households were observed in caregiver treatment-seeking patterns. Fever was the main symptom associated with malaria in both areas. Malaria was treated first at home, particularly in rural areas. The second step was to seek treatment outside the home, mainly at hospital and Health Centre for rural households and at hospital and private clinic for urban ones. Artemether monotherapy was the antimalarial treatment prescribed most often. Households waited for more than 24 hours before seeking treatment outside and delays were longest in rural areas. The total cost of treatment was higher in urban than in rural areas in Bata.The delays in seeking treatment, the type of malaria therapy received and the cost of treatment are the principal problems found in Bata District. Important steps for reducing malaria morbidity and mortality in this area are to provide sufficient supplies of effective antimalarial drugs and to improve malaria treatment skills in households and in both public and private sectors.

  20. Adult ADHD Is Associated With Gambling Severity and Psychiatric Comorbidity Among Treatment-Seeking Problem Gamblers.

    Science.gov (United States)

    Brandt, Laura; Fischer, Gabriele

    2017-02-01

    The aim of this study is as follows: (a) exploring retrospective childhood and adult ADHD symptomatology in treatment-seeking gamblers, (b) providing detailed characteristics of the association between pathological gambling (PG) and ADHD, and (c) identifying risk factors for a history of ADHD. Eighty problem gamblers (20% female) were examined using a standardized interview (PG: Diagnostic and Statistical Manual of Mental Disorders [4th ed.; DSM-IV] criteria, Gambling Attitudes and Beliefs Survey; ADHD: Wender Utah Rating Scale- deutsche Kurzform, Adult ADHD Self-Report Scale; comorbidities: Mini International Neuropsychiatric Interview). Forty-three percentage of patients screened positive for childhood ADHD, and in 11%, ADHD persisted in adulthood. Patients with adult ADHD had more severe gambling problems ( p = .009, d = 1.03) and a higher number of psychiatric comorbidities ( p gamblers.

  1. Eating behaviour in treatment-seeking obese subjects - Influence of sex and BMI classes.

    Science.gov (United States)

    Ernst, Barbara; Wilms, Britta; Thurnheer, Martin; Schultes, Bernd

    2015-12-01

    Obese subjects frequently show an adversely altered eating behaviour. However, little is known on differences in eating behaviour across different degree of obesity. We analysed data on the three factor eating questionnaire assessing cognitive restraint, disinhibition, and hunger that were filled in by 664 obese patients (469 women) who seeked treatment in our Interdisciplinary Obesity Center. Patients were divided in five BMI classes (30 - 50 kg/m(2)). Multivariate regression analyses revealed that sex was significantly related to all three eating behaviour traits (all P eating behaviour variables between the remaining BMI classes. Data indicate profound differences in eating behaviour between women and men that persist across a wide range of obesity. Furthermore, data suggest that while grade I obese patients show higher cognitive restraint and less disinhibition and hunger scores than more severe obese patients these dimensions of eating behaviour do not systematically vary across higher BMI classes. Copyright © 2015 Elsevier Ltd. All rights reserved.

  2. Malaria treatment-seeking behaviour and related factors of Wa ethnic minority in Myanmar: a cross-sectional study

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    Xu Jian-Wei

    2012-12-01

    Full Text Available Abstract Background In Southeast Asia, data on malaria treatment-seeking behaviours and related affecting factors are rare. The population of the Wa ethnic in Myanmar has difficulty in accessing formal health care. To understand malaria treatment-seeking behaviour and household-affecting factors of the Wa people, a cross-sectional study carried out in Shan Special Region II, Myanmar. Methods The two methods, questionnaire-based household surveys to household heads and in-depth interviews to key informants, were carried out independently. The proportion of treatment-seeking patterns was calculated. Logistic regression was used to determine affecting factors of treatment-seeking. Qualitative data were analysed by using Text Analysis Markup System. Results Overall, 87.5% of the febrile population sought treatment, but only 32.0% did so within 24 hours. The proportion accessing the retail sector (79.6% was statistically significant higher (P Conclusion Malaria treatment-seeking behaviour is not appropriate, and affecting factors include health service systems, social and cultural factors in Wa State of Myanmar.

  3. Pica and rumination behavior among individuals seeking treatment for eating disorders or obesity.

    Science.gov (United States)

    Delaney, Charlotte B; Eddy, Kamryn T; Hartmann, Andrea S; Becker, Anne E; Murray, Helen B; Thomas, Jennifer J

    2015-03-01

    Pica and rumination disorder (RD)-formerly classified within DSM-IV Feeding and Eating Disorders of Infancy or Early Childhood-are now classified within DSM-5 Feeding and Eating Disorders. Though pica and RD have been studied in select populations (e.g., pregnant women, intellectually disabled persons), their typical features and overall prevalence remain unknown. This study examined the clinical characteristics and frequency of DSM-5 pica and RD among individuals seeking treatment for eating disorders and obesity. We conducted structured interviews with adolescent and young adult females from a residential eating disorder center (N = 149), and adult males and females with overweight or obesity from an outpatient weight-loss clinic (N = 100). Several participants reported ingesting non-nutritive substances (e.g., ice) for weight-control purposes. However, only 1.3% (n = 2; 95% CI: .06% to 5.1%) at the residential eating disorder center and 0% at the weight-loss clinic met DSM-5 criteria for pica, consuming gum and plastic. Although no eating disorder participants were eligible for an RD diagnosis due to DSM-5 trumping rules, 7.4% (n = 11; 95% CI: 4.0% to 12.9%) endorsed rumination behavior under varying degrees of volitional control. At the weight-loss clinic, 2.0% (n = 2; 95% CI: 0.1% to 7.4%) had RD. DSM-5 pica and RD were rare in our sample of individuals seeking treatment for eating disorders and obesity, but related behaviors were more common. The wide range of pica and rumination presentations highlights the challenges of differential diagnosis with other forms of disordered eating. © 2014 Wiley Periodicals, Inc.

  4. Seeking treatment for uncomplicated malaria: experiences from the Kintampo districts of Ghana.

    Science.gov (United States)

    Febir, Lawrence G; Asante, Kwaku Poku; Afari-Asiedu, Samuel; Abokyi, Livesy N; Kwarteng, Anthony; Ogutu, Bernhards; Gyapong, Margaret; Owusu-Agyei, Seth

    2016-02-20

    Malaria accounts for many deaths and illnesses, mostly among young children and pregnant women in sub-Saharan Africa. An integrated approach is recommended to ensure effective malaria control. Socio-cultural factors continue to serve as determinants of malaria health-seeking behaviour. An INDEPTH effectiveness and safety study platform was established to unearth issues around the use of licensed and nationally recommended anti-malarials in real life settings. This study reports on treatment-seeking behaviour for uncomplicated malaria among community members. A qualitative study was conducted in the dry and rainy seasons in purposively selected communities in Kintampo north and south districts. This was based on distances to a health facility, ethnicity and availability of medicines at the sale outlets. Twenty-four focus group discussions were conducted among adult men, women care-takers of children less than 5 years and pregnant women. Ten INDEPTH interviews were also conducted among operators of medicine sale outlets and managers of health facilities. Fifty-one illnesses narrative interviews were conducted among adult men, women, women caretakers of children less than 5 years and pregnant women. Transcripts were transferred into Nvivo 8 software for data management and analysis. The artemisinin-based combinations that were commonly known and used were artesunate-amodiaquine and artemether-lumefantrine. Use of herbal preparation to treat diseases including uncomplicated malaria is rife in the communities. Drug stores were not the main source of artemisinin-based combination sales at time of the study. Monotherapies, pain killers and other medicines were purchased from these shops for malaria treatment. Dizziness, general body weakness and sleepiness were noted among respondents who used artemisinin-based combination therapy (ACT) in the past. There is no clear cut trajectory for management of uncomplicated malaria in the study area. Different approaches are adopted

  5. Comparing perceived public stigma and personal stigma of mental health treatment seeking in a young adult sample

    OpenAIRE

    Pedersen, Eric R.; Paves, Andrew P.

    2014-01-01

    Perceived public stigma regarding seeking mental health treatment seeking can be a barrier to accessing services for young adults. While factors associating with personal stigma regarding how one would view and treat others have been identified, the discrepancies between perceived and personal stigma has received less research attention. We designed the current study to expand on previous research and examine the discrepancies between perceived public stigma and personal stigma among a sample...

  6. Determinants of health information-seeking behavior: implications for post-treatment cancer patients.

    Science.gov (United States)

    Jung, Minsoo

    2014-01-01

    Health information-seeking behavior (HISB) is active need-fulfillment behavior whereby health information is obtained from diverse sources, such as the media, and has emerged as an important issue within the transforming medical environment and the rise of medical consumers. However, little is known about the factors that affect HISB and its associations, and the health outcome of HISB. The aim of this study was to examine individual and social contextual factors associated with HISB and to systematically review their effects on health status among post- treatment cancer patients. Individual determinants of HISB included demographic factors, psychosocial factors, perceived efficacy and norms, and health beliefs. Contextual determinants of HISB encompassed community characteristics, neighborhood social capital, and media advocacy. Improving through factors on these two levels, HISB raised individuals' self-care management skills and medical treatment compliance, and enhanced shared decision-making and medical treatment satisfaction. Moreover, because HISB can differ according to individuals' social contextual conditions, it can give rise to communication inequalities. Because these can ultimately lead to health disparities between groups, social interest in HISB and balanced HISB promotion strategies are necessary.

  7. Screening for personality disorders among adults seeking speech treatment for stuttering.

    Science.gov (United States)

    Iverach, Lisa; Jones, Mark; O'Brian, Sue; Block, Susan; Lincoln, Michelle; Harrison, Elisabeth; Hewat, Sally; Menzies, Ross G; Packman, Ann; Onslow, Mark

    2009-09-01

    Stuttering is frequently associated with negative consequences which typically begin in early childhood. Despite this, no previous studies have investigated the presence of personality disorders among adults who stutter. Therefore, the aims of the present study were to screen for personality disorders among adults who stutter, and to compare these screening estimates with matched controls from a national population sample. Using a matched case-control design, participants were 94 adults seeking treatment for stuttering, 92 of whom completed the International Personality Disorders Examination Questionnaire (IPDEQ) as a first-stage screener, and 920 age- and gender-matched controls from the Australian National Survey of Mental Health and Well-Being (ANSMHWB). A conditional logistic regression model was used to estimate odds ratios for the primary outcome: first-stage presence of any personality disorder; as well as specific personality disorders. Based on first-stage screening, the presence of any personality disorder was significantly higher for adults in the stuttering group than matched controls, demonstrating almost threefold increased odds. This difference between groups remained significant for all specific personality disorders, with four- to sevenfold increased odds found for Dissocial, Anxious, Borderline, Dependent and Paranoid personality disorders, and two- to threefold increased odds found for Histrionic, Impulsive, Schizoid and Anankastic personality disorders. In conclusion, stuttering appears to be associated with a heightened risk for the development of personality disorders. These results highlight the need for research regarding the assessment and treatment of personality disorders among adults who stutter. The reader will be able to: (1) describe the nature of personality disorders, including factors thought to contribute to their development; (2) identify some of the negative consequences associated with stuttering which may contribute to the

  8. Weight Loss Expectations and Attrition in Treatment-Seeking Obese Women

    Science.gov (United States)

    Dalle Grave, Riccardo; Calugi, Simona; Compare, Angelo; El Ghoch, Marwan; Petroni, Maria Letizia; Tomasi, Franco; Mazzali, Gloria; Marchesini, Giulio

    2015-01-01

    Objective The analysis of the relation between weight loss goals and attrition in the treatment of obesity has produced conflicting results. The aim of the present study was to investigate the role of weight loss goals on attrition in a cohort of obese women seeking treatment at 8 Italian medical centres. Methods 634 women with obesity, consecutively enrolled in weight loss programmes, were included in the study. Weight loss goals were evaluated with the Goals and Relative Weights Questionnaire (GRWQ), reporting a sequence of unrealistic (‘dream’ and ‘happy’) and more realistic (‘acceptable’ and ‘disappointing’) weight loss goals. Attrition was assessed at 12 months on the basis of patients' medical records. Results At 12 months, 205/634 patients (32.3%) had interrupted their programme and were lost to follow-up. After adjustment for age, baseline weight, education and employment status, attrition was significantly associated with higher percent acceptable and disappointing weight loss targets, not with dream and happy weight loss. Conclusion In ‘real world’ clinical settings, only realistic expectations might favour attrition whenever too challenging, whereas unrealistic weight loss goals have no effect. Future studies should assess the effect of interventions aimed at coping with too challenging weight goals on attrition. PMID:26444382

  9. Weight Loss Expectations and Attrition in Treatment-Seeking Obese Women

    Directory of Open Access Journals (Sweden)

    Riccardo Dalle Grave

    2015-10-01

    Full Text Available Objective: The analysis of the relation between weight loss goals and attrition in the treatment of obesity has produced conflicting results. The aim of the present study was to investigate the role of weight loss goals on attrition in a cohort of obese women seeking treatment at 8 Italian medical centres. Methods: 634 women with obesity, consecutively enrolled in weight loss programmes, were included in the study. Weight loss goals were evaluated with the Goals and Relative Weights Questionnaire (GRWQ, reporting a sequence of unrealistic (‘dream' and ‘happy' and more realistic (‘acceptable' and ‘disappointing' weight loss goals. Attrition was assessed at 12 months on the basis of patients' medical records. Results: At 12 months, 205/634 patients (32.3% had interrupted their programme and were lost to follow-up. After adjustment for age, baseline weight, education and employment status, attrition was significantly associated with higher percent acceptable and disappointing weight loss targets, not with dream and happy weight loss. Conclusion: In ‘real world' clinical settings, only realistic expectations might favour attrition whenever too challenging, whereas unrealistic weight loss goals have no effect. Future studies should assess the effect of interventions aimed at coping with too challenging weight goals on attrition.

  10. Testing the DSM-5 severity indicator for bulimia nervosa in a treatment-seeking sample.

    Science.gov (United States)

    Dakanalis, Antonios; Clerici, Massimo; Riva, Giuseppe; Carrà, Giuseppe

    2017-03-01

    This study tested the new DSM-5 severity criterion for bulimia nervosa (BN) based on the frequency of inappropriate weight compensatory behaviors in a treatment-seeking sample. Participants were 345 adults with DSM-5 BN presenting for treatment. They were sub-grouped based on DSM-5 severity levels and compared on a range of variables of clinical interest and demographics. Based on DSM-5 severity definitions, 27.2 % of the sample was categorized with mild, 26.1 % with moderate, 24.9 % with severe, and 21.8 % with extreme severity of BN. Analyses revealed that the four (mild, moderate, severe, and extreme) severity groups of BN significantly differed from each other in eating disordered and body-related attitudes and behaviors, factors involved in the maintenance process of the disorder, comorbid psychiatric disorders, psychological distress, and psychosocial impairment (medium-to-large effect sizes). No significant between-group differences were observed in demographics, body mass index, or at the age when BN first occurred, lending some credence to recent suggestions that age-at-onset of BN may be more a disorder- than a severity-dependent variable. Collectively, our findings provide support for the severity indicator for BN introduced in the DSM-5 as a means of addressing heterogeneity and variability in the severity of the disorder.

  11. Barriers, facilitators, and survival strategies for GPs seeking treatment for distress: a qualitative study.

    Science.gov (United States)

    Spiers, Johanna; Buszewicz, Marta; Chew-Graham, Carolyn A; Gerada, Clare; Kessler, David; Leggett, Nick; Manning, Chris; Taylor, Anna Kathryn; Thornton, Gail; Riley, Ruth

    2017-10-01

    GPs are under increasing pressure due to a lack of resources, a diminishing workforce, and rising patient demand. As a result, they may feel stressed, burnt out, anxious, or depressed. To establish what might help or hinder GPs experiencing mental distress as they consider seeking help for their symptoms, and to explore potential survival strategies. The authors recruited 47 GP participants via e-mails to doctors attending a specialist service, adverts to local medical committees (LMCs) nationally and in GP publications, social media, and snowballing. Participants self-identified as either currently living with mental distress, returning to work following treatment, off sick or retired early as a result of mental distress, or without experience of mental distress. Interviews were conducted face to face or over the telephone. Transcripts were uploaded to NVivo 11 and analysed using thematic analysis. Barriers and facilitators were related to work, stigma, and symptoms. Specifically, GPs discussed feeling a need to attend work, the stigma surrounding mental ill health, and issues around time, confidentiality, and privacy. Participants also reported difficulties accessing good-quality treatment. GPs also talked about cutting down or varying work content, or asserting boundaries to protect themselves. Systemic changes, such as further information about specialist services designed to help GPs, are needed to support individual GPs and protect the profession from further damage. © British Journal of General Practice 2017.

  12. Perceptions of Mindfulness in a Low-income, Primarily African American Treatment-Seeking Sample.

    Science.gov (United States)

    Spears, Claire Adams; Houchins, Sean C; Bamatter, Wendy P; Barrueco, Sandra; Hoover, Diana Stewart; Perskaudas, Rokas

    2017-12-01

    Individuals with low socioeconomic status (SES) and members of racial/ethnic minority groups often experience profound disparities in mental health and physical well-being. Mindfulness-based interventions show promise for improving mood and health behaviors in higher-SES and non-Latino White populations. However, research is needed to explore what types of adaptations, if any, are needed to best support underserved populations. This study used qualitative methods to gain information about a) perceptions of mindfulness, b) experiences with meditation, c) barriers to practicing mindfulness, and d) recommendations for tailoring mindfulness-based interventions in a low-income, primarily African American treatment-seeking sample. Eight focus groups were conducted with 32 adults (16 men and 16 women) currently receiving services at a community mental health center. Most participants (91%) were African American. Focus group data were transcribed and analyzed using NVivo 10. A team of coders reviewed the transcripts to identify salient themes. Relevant themes included beliefs that mindfulness practice might improve mental health (e.g., managing stress and anger more effectively) and physical health (e.g., improving sleep and chronic pain, promoting healthier behaviors). Participants also discussed ways in which mindfulness might be consistent with, and even enhance, their religious and spiritual practices. Results could be helpful in tailoring mindfulness-based treatments to optimize feasibility and effectiveness for low-SES adults receiving mental health services.

  13. Does Reintegration Stress Contribute to Suicidal Ideation Among Returning Veterans Seeking PTSD Treatment?

    Science.gov (United States)

    Haller, Moira; Angkaw, Abigail C; Hendricks, Brittany A; Norman, Sonya B

    2016-04-01

    Although posttraumatic stress disorder (PTSD) and other psychiatric symptoms are well-established risk factors for suicidal ideation among returning veterans, less attention has been paid to whether the stress of reintegrating into civilian society contributes to suicidal ideation. Utilizing a sample of 232 returning veterans (95% male, mean age = 33.63 years) seeking PTSD treatment, this study tested whether reintegration difficulties contribute to suicidal ideation over and above the influence of PTSD symptoms, depression symptoms, and potential substance misuse. Logistic regressions indicated that reintegration stress had a unique effect on suicidal ideation over and above PTSD and depression symptoms. Reintegration stress interacted with substance misuse to predict suicidal ideation, such that the effect of reintegration stress on suicidal ideation was much larger for those with potential substance misuse. Exploratory analyses also examined which types of reintegration difficulties were associated with suicidal ideation, and found that difficulty maintaining military friendships, difficulty getting along with relatives, difficulty feeling like you belong in civilian society, and difficulty finding meaning/purpose in life were all significantly associated with suicidal ideation, beyond the effects of psychiatric symptoms and potential substance misuse. Findings highlight the importance of addressing reintegration stress for the prevention of suicide among returning veterans. Implications for treatment are discussed. © Published 2015. This article is a U.S. Government work and is in the public domain in the USA.

  14. Desire for a child and eating disorders in women seeking infertility treatment.

    Science.gov (United States)

    Bruneau, Mélanie; Colombel, Agnès; Mirallié, Sophie; Fréour, Thomas; Hardouin, Jean-Benoit; Barrière, Paul; Grall-Bronnec, Marie

    2017-01-01

    The purpose of this study was to evaluate the prevalence of EDs in women seeking treatment for infertility, and to better characterize their clinical profile. Sixty participants completed self-report measures that assessed EDs, desire for a child, body preoccupations, quality of life, anxiety and depression. Ten patients (17%) met criteria for a past or current ED. We showed a significant association between greater body dissatisfaction and a more ambivalent desire for a child. Furthermore, an ED was associated with (i) a lower quality of life, and (ii) more anxiety disorders. Screening for a history of ED in infertile women is recommended to plan for adapted care regarding infertility but also regarding ED and psychiatric comorbidities. Therefore, the assessment has to take into account the desire for a child and the body satisfaction, that are essential parts of the ED process on the one hand and infertility process on the other. This could help with the infertility treatment and the prevention of negative maternal and fetal outcomes.

  15. Weight Loss Expectations and Attrition in Treatment-Seeking Obese Women.

    Science.gov (United States)

    Dalle Grave, Riccardo; Calugi, Simona; Compare, Angelo; El Ghoch, Marwan; Petroni, Maria Letizia; Tomasi, Franco; Mazzali, Gloria; Marchesini, Giulio

    2015-01-01

    The analysis of the relation between weight loss goals and attrition in the treatment of obesity has produced conflicting results. The aim of the present study was to investigate the role of weight loss goals on attrition in a cohort of obese women seeking treatment at 8 Italian medical centres. 634 women with obesity, consecutively enrolled in weight loss programmes, were included in the study. Weight loss goals were evaluated with the Goals and Relative Weights Questionnaire (GRWQ), reporting a sequence of unrealistic ('dream' and 'happy') and more realistic ('acceptable' and 'disappointing') weight loss goals. Attrition was assessed at 12 months on the basis of patients' medical records. At 12 months, 205/634 patients (32.3%) had interrupted their programme and were lost to follow-up. After adjustment for age, baseline weight, education and employment status, attrition was significantly associated with higher percent acceptable and disappointing weight loss targets, not with dream and happy weight loss. In 'real world' clinical settings, only realistic expectations might favour attrition whenever too challenging, whereas unrealistic weight loss goals have no effect. Future studies should assess the effect of interventions aimed at coping with too challenging weight goals on attrition. © 2015 S. Karger GmbH, Freiburg.

  16. Food addiction in overweight and obese adolescents seeking weight-loss treatment.

    Science.gov (United States)

    Meule, Adrian; Hermann, Tina; Kübler, Andrea

    2015-05-01

    Some forms of overeating closely resemble addictive behaviour. The Yale Food Addiction Scale (YFAS) was developed to measure such addiction-like eating in humans and has been employed in numerous studies for examining food addiction in adults. Yet, little is known about food addiction in children and adolescents. Fifty adolescents were recruited at the beginning of treatment in a weight-loss hospital and completed the YFAS among other questionnaires. Nineteen participants (38%) received a YFAS diagnosis, who did not differ in age, body mass and gender distribution from those not receiving a diagnosis. However, those with food addiction reported more binge days, more frequent food cravings, higher eating, weight and shape concerns, more symptoms of depression and higher attentional and motor impulsivity. Eating restraint and nonplanning impulsivity did not differ between groups. Results replicate findings from studies in obese adults such that food addiction is not related to age, gender, body mass or eating restraint, but to higher eating pathology, more symptoms of depression and higher impulsivity. Furthermore, results highlight that particularly attentional impulsivity is related to 'food addiction'. Addiction-like eating appears to be a valid phenotype in a substantial subset of treatment-seeking, obese adolescents. Copyright © 2015 John Wiley & Sons, Ltd and Eating Disorders Association.

  17. The role of information search in seeking alternative treatment for back pain: a qualitative analysis.

    Science.gov (United States)

    McClymont, Hoda; Gow, Jeff; Perry, Chad

    2014-01-01

    Health consumers have moved away from a reliance on medical practitioner advice to more independent decision processes and so their information search processes have subsequently widened. This study examined how persons with back pain searched for alternative treatment types and service providers. That is, what information do they seek and how; what sources do they use and why; and by what means do they search for it? 12 persons with back pain were interviewed. The method used was convergent interviewing. This involved a series of semi-structured questions to obtain open-ended answers. The interviewer analysed the responses and refined the questions after each interview, to converge on the dominant factors influencing decisions about treatment patterns. Persons with back pain mainly search their memories and use word of mouth (their doctor and friends) for information about potential treatments and service providers. Their search is generally limited due to personal, provider-related and information-supply reasons. However, they did want in-depth information about the alternative treatments and providers in an attempt to establish apriori their efficacy in treating their specific back problems. They searched different sources depending on the type of information they required. The findings differ from previous studies about the types of information health consumers require when searching for information about alternative or mainstream healthcare services. The results have identified for the first time that limited information availability was only one of three categories of reasons identified about why persons with back pain do not search for more information particularly from external non-personal sources.

  18. Opioid Misuse Trends in Treatment Seeking Populations: Revised Prescription Opioid Policy and Temporally Corresponding Changes.

    Science.gov (United States)

    Hoffman, Lauren A; Lewis, Ben; Nixon, Sara Jo

    2017-12-06

    Over the last two decades, U.S. rates of prescription opioid (PO) misuse have risen drastically. In response, federal and state governments have begun to implement new PO policies. Recent legislative changes warrant up-to-date assessments of today's misuse rates. To explore potential changes in opioid misuse trends among substance-using treatment seekers, in temporal relation to legislative response. Substance-use data were collected from two cross-sectional Florida-based inpatient cohorts during periods preceding (pre-policy; n = 647) and following (post-policy; n = 396) statewide PO policy initiatives. Participants provided information concerning their most frequently used drugs before treatment. PO and illicit opioid (IO) use prevalence, frequency and route of administration were examined for pre-policy vs. post-policy cohort differences. Relative to the pre-policy cohort, a greater percentage of the post-policy cohort reported recent misuse, daily use, and intravenous administration of POs. IO use was also more frequently reported post-policy. Non-opioid drug use prevalence did not significantly differ between cohorts. Among the opioid-using subsample, equivalent percentages of the pre- and post-policy cohorts reported the use of POs without IOs, IOs without POs, and POs/IOs concurrently. Conclusions/Importance: Florida's PO policy amendments were temporally accompanied by a higher prevalence of PO misuse and IO use among treatment-seekers assessed in this study. Whether our data reflect increased awareness of and treatment seeking for opioid use disorders or insufficient efficacy of new policies to reduce opioid misuse remains in question. Regardless, findings suggest the need for enhanced emphasis on mitigating hazardous PO-use behaviors (e.g., IV use).

  19. Online working alliance predicts treatment outcome for posttraumatic stress symptoms in Arab war-traumatized patients.

    Science.gov (United States)

    Wagner, Birgit; Brand, Janine; Schulz, Wassima; Knaevelsrud, Christine

    2012-07-01

    Previous studies have shown that Internet-based interventions for posttraumatic stress disorder are feasible. However, little is known about how therapeutic process factors impact online interventions in war and conflict regions. This study aims to assess the quality of the working alliance at midtreatment and posttreatment and its relationship with therapy outcome in an Internet-based cognitive-behavioral intervention for Arabic-speaking traumatized patients. A trial was conducted from January 2009 to August 2011 with patients recruited specifically in Iraq. Fifty-five participants with posttraumatic stress symptoms completed the Working Alliance Inventory (WAI) after at least session 4. Participants' mean age was 27.7 years (SD = 6.9); 78% of participants were females. Participants received two weekly 45-min Internet-based cognitive-behavioral interventions over a 5-week period. The main outcome measures were the Posttraumatic Diagnostic Scale (PDS) and the WAI. High ratings of the therapeutic alliance were obtained early in treatment, and results remained stable from sessions 4 to 10, indicating that it was possible to establish a positive and stable online therapeutic relationship. The working alliance at both assessment points predicted treatment outcome for posttraumatic stress symptoms. Despite the instability of the settings and patients' ongoing exposure to human right violations through war and dictatorships, it was possible to establish a stable online therapeutic relationship. © 2012 Wiley Periodicals, Inc.

  20. How are perceived stigma, self-stigma, and self-reliance related to treatment-seeking? A three-path model.

    Science.gov (United States)

    Jennings, Kristen S; Cheung, Janelle H; Britt, Thomas W; Goguen, Kandice N; Jeffirs, Stephanie M; Peasley, Allison L; Lee, Abigail C

    2015-06-01

    Many college students may experience mental health problems but do not seek treatment from mental health professionals. The present study examined how perceived stigma and self-stigma toward seeking mental health treatment, as well as perceptions of self-reliance for coping with mental health problems, relate to college student treatment-seeking. In total, 246 students completed a self-report survey that included measures of perceived stigma and self-stigma for treatment-seeking, self-reliance for addressing mental health concerns, self-reported mental health problems, symptoms of depression and alcohol-related problems, attitudes toward treatment-seeking, and treatment-seeking behavior. Regression analyses revealed that higher perceived stigma, self-stigma, and self-reliance were all related to a more negative attitude toward treatment-seeking. In a 3-path mediation model, bootstrapping results indicated an indirect effect where perceived stigma was related to attitude toward treatment-seeking and treatment-seeking behaviors through self-stigma and self-reliance. Specifically, higher perceived stigma was related to higher self-stigma, higher self-stigma was related to higher self-reliance, and higher self-reliance was associated with a more negative attitude toward treatment-seeking in the overall sample, and a decreased probability of having sought treatment among those who screened positive for a mental health problem. Perceived stigma may influence whether or not college students seek treatment for mental health problems by potentially increasing stigmatizing attitudes toward themselves and increasing preferences for handling problems on their own. Researchers and practitioners are recommended to seek a better understanding of the complex treatment barriers to reduce stigma and facilitate treatment-seeking. (c) 2015 APA, all rights reserved).

  1. Recent sexual abuse, physical abuse, and suicide attempts among male veterans seeking psychiatric treatment.

    Science.gov (United States)

    Tiet, Quyen Q; Finney, John W; Moos, Rudolf H

    2006-01-01

    This study examined the rates of sexual and physical abuse and suicide attempts among male and female patients and focused on the associations between sexual and physical abuse and recent suicide attempts among men. Data were examined for a cohort of patients aged 19 years and older who were seeking treatment for substance use disorders, other psychiatric disorders, or both from the Department of Veterans Affairs (VA) between July 1997 and September 1997. Almost all the patients in the sample (more than 99 percent) had a substance use disorder. Patients were interviewed with the Addiction Severity Index about lifetime and recent (past 30 days) sexual and physical abuse and recent suicide attempts. Because of the low prevalence of suicide attempts in the past 30 days and limited representation of female patients in this sample, the data for female patients were used only to conduct descriptive analyses to compare the prevalence of sexual and physical abuse and suicide attempts between genders. The sample comprised 34,245 patients (33,236 males and 1,009 females). Compared with male patients, female patients were ten times as likely to have been sexually abused in the past 30 days and four times as likely to have been physically abused. Among male patients, bivariate analyses showed that those who had been recently sexually or physically abused were more likely than those who had not experienced such abuse to have attempted suicide recently (odds ratios of 4.8 and 3.0, respectively). After controlling for demographic and diagnostic factors, multivariate logistic regression analyses indicated that recent sexual abuse, recent physical abuse, and lifetime sexual abuse were significantly associated with a higher likelihood of a recent suicide attempt among male patients. Female patients were more likely than their male counterparts to experience sexual and physical abuse. Recent and lifetime history of sexual abuse and recent physical abuse were independent risk factors

  2. An Empirical Study of Personality Disorders Among Treatment-Seeking Problem Gamblers.

    Science.gov (United States)

    Brown, M; Oldenhof, E; Allen, J S; Dowling, N A

    2016-12-01

    The primary aims of this study were to examine the prevalence of personality disorders in problem gamblers, to explore the relationship between personality disorders and problem gambling severity, and to explore the degree to which the psychological symptoms highlighted in the biosocial developmental model of borderline personality disorder (impulsivity, distress tolerance, substance use, PTSD symptoms, psychological distress and work/social adjustment) are associated with problem gambling. A secondary aim was to explore the strength of the relationships between these symptoms and problem gambling severity in problem gamblers with and without personality disorder pathology. Participants were 168 consecutively admitted problem gamblers seeking treatment from a specialist outpatient gambling service in Australia. The prevalence of personality disorders using the self-report version of the Iowa Personality Disorders Screen was 43.3 %. Cluster B personality disorders, but not Cluster A or C personality disorders, were associated with problem gambling severity. All psychological symptoms, except alcohol and drug use, were significantly higher among participants with personality disorder pathology compared to those without. Finally, psychological distress, and work and social adjustment were significantly associated with problem gambling severity for problem gamblers with personality disorder pathology, while impulsivity, psychological distress, and work and social adjustment were significantly associated with problem gambling severity for those without personality disorder pathology. High rates of comorbid personality disorders, particularly Cluster B disorders, necessitate routine screening in gambling treatment services. More complex psychological profiles may complicate treatment for problem gamblers with comorbid personality disorders. Future research should examine the applicability of the biosocial developmental model to problem gambling in community studies.

  3. Virtual Reality Cue Reactivity Assessment: A Comparison of Treatment- vs. Nontreatment-Seeking Smokers

    Science.gov (United States)

    Bordnick, Patrick S.; Yoon, Jin H.; Kaganoff, Eili; Carter, Brian

    2013-01-01

    Objectives: The cue-reactivity paradigm has been widely used to assess craving among cigarette smokers. Seeking to replicate and expand on previous virtual reality (VR) nicotine cue-reactivity research on nontreatment-seeking smokers, the current study compared subjective reports of craving for cigarettes when exposed to smoking (proximal and…

  4. First-time admissions for opioid treatment: cross-sectional and descriptive study of new opioid users seeking treatment

    Science.gov (United States)

    Flórez, Gerardo; López-Durán, Ana; Triñanes, Yolanda; Osorio, Jesús; Fraga, Jaime; Fernández, José Manuel; Becoña, Elisardo; Arrojo, Manuel

    2015-01-01

    Background The purpose of this study was to gain an understanding of the profiles of the new treatment demands posed by opioid addicts between 2005 and 2010 at the addictive disorders assistance units in Galicia, Spain. Methods A cluster analysis was performed using data from 1,655 treatment entrants. Clusters were constructed using sociodemographic and medicolegal variables. A cluster analysis was also conducted according to age. Once clusters were defined, their association with the following variables was analyzed: age at first use of opioids, years of use, frequency of opioid use in the previous month, psychiatric treatment, cocaine use, existence of a drug-dependent partner, and source of referral. Results Four clusters were obtained in the main analysis. Cluster 1 (34.01%) consisted of young males, cluster 2 (16.19%) consisted of not-so-young males, cluster 3 (32.62%) consisted mainly of older males and a small group of females, and cluster 4 (17.18%) was made up entirely of women. With regard to age-related clusters, two clusters were obtained in those under the age of 30 years: cluster 1 (73%) without medicolegal complications and cluster 2 (27%) with medicolegal complications. For those over the age of 30 years, two clusters were obtained: cluster 1 (53.92%) with hardly any medicolegal complications and cluster 2 (46.08%) with medicolegal complications. Conclusion Cluster analysis suggests that there have been no substantial changes in variables indicating greater severity in this new group of patients. Women are likely to seek help earlier, which reduces their duration of opioid use. The younger the patient, the shorter the duration of opioid use and the greater the likelihood of cessation of intravenous use. Public health systems should use a two-pronged treatment strategy of short but intense cessation therapies for women and younger treatment entrants and longer maintenance and replacement therapies for older treatment entrants with more psychosocial

  5. A psychometric evaluation of the Posttraumatic Cognitions Inventory with Veterans seeking treatment following military trauma exposure.

    Science.gov (United States)

    Sexton, Minden B; Davis, Margaret T; Bennett, Diana C; Morris, David H; Rauch, Sheila A M

    2018-01-15

    Trauma-related beliefs have salient relationships to the development and maintenance of Posttraumatic Stress Disorder (PTSD) following stress exposure. The Posttraumatic Cognitions Inventory (PTCI) has the potential to be a standard assessment of this critical construct. However, some critical aspects of validity and reliability appear to vary by population. To date, the PTCI has not been psychometrically evaluated for use with military-specific traumas such as combat and military sexual trauma (MST). Based on exploratory and confirmatory analyses with 949 Veterans seeking trauma-focused treatment for military traumas, we found a four factor model (negative view of the self, negative view of the world, self-blame, and negative beliefs about coping competence) provided the best fit. In contrast, the original three factor model was not confirmed. Both models demonstrated convergent and discriminative validity. Although gender was associated with PTCI total and factor scores, differences did not persist after controlling for trauma type. MST was associated with higher PTCI scores even when controlling for gender, though the clinical magnitude of these differences is likely negligible. Internal reliability validity was demonstrated with PTCI total and subscale scores. Published by Elsevier B.V.

  6. Reinforcement Sensitivity Underlying Treatment-Seeking Smokers’ Affect, Smoking Reinforcement Motives, and Affective Responses

    Science.gov (United States)

    Cui, Yong; Robinson, Jason D.; Engelmann, Jeffrey M.; Lam, Cho Y.; Minnix, Jennifer A.; Karam-Hage, Maher; Wetter, David W.; Dani, John A.; Kosten, Thomas R.; Cinciripini, Paul M.

    2014-01-01

    Nicotine dependence has been suggested to be related to reinforcement sensitivity, which encompasses behavioral predispositions either to avoid aversive (behavioral inhibition) or to approach appetitive (behavioral activation) stimuli. Reinforcement sensitivity may shape motives for nicotine use and offer potential targets for personalized smoking cessation therapy. However, little is known regarding how reinforcement sensitivity is related to motivational processes implicated in the maintenance of smoking. Additionally, women and men differ in reinforcement sensitivity, and such difference may cause distinct relationships between reinforcement sensitivity and motivational processes for female and male smokers. In this study, we characterized reinforcement sensitivity in relation to affect, smoking-related reinforcement motives, and affective responses, using self-report and psychophysiological measures, in over 200 smokers before treating them. The Behavioral Inhibition/Activation Scales (BIS/BAS; Carver & White, 1994) was used to measure reinforcement sensitivity. In female and male smokers, BIS was similarly associated with negative affect and negative reinforcement of smoking. But positive affect was positively associated with BAS Drive scores in male smokers, and this association was reversed in female smokers. BIS was positively associated with corrugator electromyographic reactivity towards negative stimuli and left frontal electroencephalogram alpha asymmetry. Female and male smokers showed similar relationships for these physiological measures. These findings suggest that reinforcement sensitivity underpins important motivational processes (e.g., affect), and gender is a moderating factor for these relationships. Future personalized smoking intervention, particularly among more dependent treatment-seeking smokers, may experiment to target individual differences in reinforcement sensitivity. PMID:25621416

  7. Neurocognitive Deficits Associated with Antisocial Personality Disorder in Non-treatment-seeking Young Adults.

    Science.gov (United States)

    Chamberlain, Samuel R; Derbyshire, Katie L; Leppink, Eric W; Grant, Jon E

    2016-06-01

    Antisocial personality disorder (ASPD) is a relatively common problem, but the neuropsychological profile of affected individuals has seldom been studied outside of criminal justice recruitment settings. Non-treatment-seeking young adults (18-29 years) were recruited from the general community by media advertisements. Participants with ASPD (n = 17), free from substance use disorders, were compared with matched controls (n = 229) using objective computerized neuropsychological tasks tapping a range of cognitive domains. Compared with controls, individuals with ASPD showed significantly elevated pathological gambling symptoms, previous illegal acts, unemployment, greater nicotine consumption, and relative impairments in response inhibition (Stop-Signal Task) and decision-making (less risk adjustment, Cambridge Gamble Task). General response speed, set-shifting, working memory, and executive planning were intact. ASPD was also associated with higher impulsivity and venturesomeness on the Eysenck Questionnaire. These findings implicate impaired inhibitory control and decision-making in the pathophysiology of ASPD, even in milder manifestations of the disorder. Future work should explore the neural correlates of these impairments and use longitudinal designs to examine the temporal relationship between these deficits, antisocial behavior, and functional impairment. © 2016 American Academy of Psychiatry and the Law.

  8. The prevalence of laryngeal pathology in a treatment-seeking population with dysphonia.

    Science.gov (United States)

    Van Houtte, Evelyne; Van Lierde, Kristiane; D'Haeseleer, Evelien; Claeys, Sofie

    2010-02-01

    This article describes the prevalence of laryngeal pathology in a treatment-seeking population with dysphonia in the Flemish part of Belgium. Retrospective investigation. During a period of 5 years (2004-2008), data were collected from 882 patients who consulted with dysphonia at the ear, nose, and throat department of the University Hospital in Ghent (Belgium). Laryngeal pathology was diagnosed using videostroboscopy. Ages ranged from 4 years to 90 years. Functional voice disorders were most frequently diagnosed (30%), followed by vocal fold nodule (15%), and pharyngolaryngeal reflux (9%). The role of age, gender, and occupation was investigated. Pathologies were significantly more common in females than in males, representing 63.8% and 36.2% of the population, respectively. Professional voice users accounted for 41% of the workforce population, with teachers as main subgroup. In professional voice users, functional dysphonia occurred in 41%, vocal fold nodules in 15%, and pharyngolaryngeal reflux in 11%. Our data were compared with data from other countries. Functional voice disorders were overall the most common cause of voice disorders (except in childhood), followed by vocal fold nodules and pharyngolaryngeal reflux. Professional voice users accounted for almost one half of the active population, with functional voice disorders as the main cause of dysphonia.

  9. Anxiety, Gambling Activity, and Neurocognition: A Dimensional Approach to a Non-Treatment-Seeking Sample.

    Science.gov (United States)

    Medeiros, Gustavo C; Sampaio, Daniela G; Leppink, Eric W; Chamberlain, Samuel R; Grant, Jon E

    2016-06-01

    Background and aims Previous analyses have highlighted significant associations between gambling disorder (GD)/subsyndromal GD and increased rates of anxiety symptoms and anxiety disorders relative to the general population. However, less is known about how anxiety symptoms influence the clinical presentation of gambling problems. The objective of this study was to evaluate the association between anxiety symptoms, gambling activity, and neurocognition across the spectrum of gambling behavior. Methods The sample consisted of 143 non-treatment-seeking young adults (aged 18-29 years), in which 63 individuals (44.1%) were classified as recreational gamblers, 47 (32.9%) as having subsyndromal GD, and 33 (23.1%) met criteria for GD. Results The main findings were: (a) there was a positive correlation between anxiety severity and gambling severity measured by the number of DSM-5 GD criteria met; (b) there was a positive correlation between anxiety severity and attentional impulsiveness; (c) subjects with suicidality presented higher levels of anxiety; and (d) the severity of anxiety symptoms was negatively correlated with the quality of life. Discussion and conclusions This study suggests that anxiety may be associated with relevant clinical variables in the broad spectrum of gambling activity. Therefore, proper management of anxiety symptoms might improve the clinical presentation of gamblers in different areas.

  10. Compulsive sexual behavior and psychopathology among treatment-seeking men in São Paulo, Brazil.

    Science.gov (United States)

    Scanavino, Marco de Tubino; Ventuneac, Ana; Abdo, Carmita Helena Najjar; Tavares, Hermano; do Amaral, Maria Luiza Sant'ana; Messina, Bruna; dos Reis, Sirlene Caramello; Martins, João Paulo Lian Branco; Parsons, Jeffrey T

    2013-10-30

    This study examined compulsive sexual behavior (CSB) and psychopathology in a treatment-seeking sample of men in São Paulo, Brazil. Eighty-six men (26% gay, 17% bisexual, 57% heterosexual) who met diagnostic criteria for excessive sexual drive and sexual addiction completed assessments consisting of the Mini International Neuropsychiatric Interview, a structured clinical interview for DSM-IV Axis I Disorders-Clinical Version (segment for Impulse Control Disorder), Sexual Compulsivity Scale (SCS), and questions about problematic CSB. The average SCS score for our sample was above the cut-off score reported in other studies, and 72% of the sample presented at least one Axis I psychiatric diagnosis. There were no differences among gay, bisexual, and heterosexual men on SCS scores and psychiatric conditions, but gay and bisexual men were more likely than heterosexual men to report casual sex and sex with multiple casual partners as problematic behaviors. SCS scores were associated with psychiatric co-morbidities, mood disorder, and suicide risk, but diagnosis of a mood disorder predicted higher SCS scores in a regression analysis. The study provides important data on the mental health needs of men with CSB in São Paulo, Brazil. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  11. A speech and psychological profile of treatment-seeking adolescents who stutter.

    Science.gov (United States)

    Iverach, Lisa; Lowe, Robyn; Jones, Mark; O'Brian, Susan; Menzies, Ross G; Packman, Ann; Onslow, Mark

    2017-03-01

    The purpose of this study was to evaluate the relationship between stuttering severity, psychological functioning, and overall impact of stuttering, in a large sample of adolescents who stutter. Participants were 102 adolescents (11-17 years) seeking speech treatment for stuttering, including 86 boys and 16 girls, classified into younger (11-14 years, n=57) and older (15-17 years, n=45) adolescents. Linear regression models were used to evaluate the relationship between speech and psychological variables and overall impact of stuttering. The impact of stuttering during adolescence is influenced by a complex interplay of speech and psychological variables. Anxiety and depression scores fell within normal limits. However, higher self-reported stuttering severity predicted higher anxiety and internalizing problems. Boys reported externalizing problems-aggression, rule-breaking-in the clinical range, and girls reported total problems in the borderline-clinical range. Overall, higher scores on measures of anxiety, stuttering severity, and speech dissatisfaction predicted a more negative overall impact of stuttering. To our knowledge, this is the largest cohort study of adolescents who stutter. Higher stuttering severity, speech dissatisfaction, and anxiety predicted a more negative overall impact of stuttering, indicating the importance of carefully managing the speech and psychological needs of adolescents who stutter. Further research is needed to understand the relationship between stuttering and externalizing problems for adolescent boys who stutter. Copyright © 2016. Published by Elsevier Inc.

  12. Adverse childhood experiences and gender influence treatment seeking behaviors in obsessive-compulsive disorder.

    Science.gov (United States)

    Benedetti, Francesco; Poletti, Sara; Radaelli, Daniele; Pozzi, Elena; Giacosa, Chiara; Smeraldi, Enrico

    2014-02-01

    Exposure to adverse childhood experiences (ACE) increases the risk of adult physical and mental health disorders, including obsessive-compulsive disorder (OCD), and influences adult brain structure and function. ACE could influence the use of psychotropic drugs in adulthood, and treatment seeking behaviors. We assessed the severity of ACE in a sample of 31 healthy controls and 66 patients with OCD who were consecutively referred for hospitalization and were either drug-naïve or drug-treated. In addition, we explored the possible clinical relevance of ACE with two additional analyses: (a) a discriminant function analysis with sex and ACE as factors, and (b) a logistic regression with use of medication as dependent variable and ACE as factor. Despite comparable age, years at school, age at onset of illness, duration of illness, and severity of illness (Y-BOCS), adult drug-naïve patients reported lower exposure to ACE and later contacts with mental health professionals than drug-treated. This effect was particularly evident in female patients compared to males. The interaction of gender with factors linked with the early familial environment biased access to psychiatric care and use of medication, independent of OCD-associated factors such as severity of symptoms or duration of illness. The need for medications of patients could be higher in families where OCD symptomatology is associated with ACE. © 2014.

  13. Family violence in a sample of treatment-seeking gamblers: the effect of having dependent children.

    Science.gov (United States)

    Bellringer, Maria; Pearson, Janet; du Preez, Katie Palmer; Wilson, Denise; Koziol-McLain, Jane; Garrett, Nick; Abbott, Max

    2017-01-01

    This study investigated the effect of problem gambler gender on the relationship between the gambler having dependent children (younger than 18 years) living at home and the gambler perpetrating or being a victim of family violence. The sample comprised 164 help-seeking gamblers (43% female; 37% with dependent child/ren) recruited from three national gambling treatment services in New Zealand. Family violence was measured using a modified version of the HITS scale covering physical, psychological, verbal, emotional and sexual violence. Forty-nine percent of participants reported being a victim of violence and 43% had perpetrated violence. Multivariable logistic regression modelling was conducted, adjusting in sequence for significant socio-demographic, psychosocial and gambling factors. The relationship between having dependent children and being a victim of family violence was gender-related. Female gamblers living with dependent children reported more family violence perpetration and victimisation than male gamblers living with dependent children. Female gamblers with dependent children living at home had greater odds of being a victim of family violence than male gamblers without dependent children living at home. This relationship remained when adjusted for contextual factors of being a victim (ethnicity, income support status, and feelings of inadequacy) in this sample. A similar gender effect of having dependent children living at home on violence perpetration disappeared when known psychosocial contextual factors of violence perpetration (aggression, difficulties in emotion regulation, drug issue in the family, and interpersonal support) were taken into account. These findings suggest the value of coordinated approaches between gambling treatment services and programmes supporting vulnerable families in order to identify vulnerable families and put support mechanisms in place.

  14. Family violence in a sample of treatment-seeking gamblers: the effect of having dependent children

    Directory of Open Access Journals (Sweden)

    Maria Bellringer

    2017-10-01

    Full Text Available Abstract This study investigated the effect of problem gambler gender on the relationship between the gambler having dependent children (younger than 18 years living at home and the gambler perpetrating or being a victim of family violence. The sample comprised 164 help-seeking gamblers (43% female; 37% with dependent child/ren recruited from three national gambling treatment services in New Zealand. Family violence was measured using a modified version of the HITS scale covering physical, psychological, verbal, emotional and sexual violence. Forty-nine percent of participants reported being a victim of violence and 43% had perpetrated violence. Multivariable logistic regression modelling was conducted, adjusting in sequence for significant socio-demographic, psychosocial and gambling factors. The relationship between having dependent children and being a victim of family violence was gender-related. Female gamblers living with dependent children reported more family violence perpetration and victimisation than male gamblers living with dependent children. Female gamblers with dependent children living at home had greater odds of being a victim of family violence than male gamblers without dependent children living at home. This relationship remained when adjusted for contextual factors of being a victim (ethnicity, income support status, and feelings of inadequacy in this sample. A similar gender effect of having dependent children living at home on violence perpetration disappeared when known psychosocial contextual factors of violence perpetration (aggression, difficulties in emotion regulation, drug issue in the family, and interpersonal support were taken into account. These findings suggest the value of coordinated approaches between gambling treatment services and programmes supporting vulnerable families in order to identify vulnerable families and put support mechanisms in place.

  15. Examining Treatment-Seeking College Students with and without Military Experience and Trauma Histories

    Science.gov (United States)

    Johnson, Matthew C.; Graceffo, James M.; Hayes, Jeffrey A.; Locke, Benjamin D.

    2014-01-01

    An increasing number of veterans are returning from war, many with mental health problems. Some of these returning veterans will enroll in college, and it is important that campus counseling centers can meet the needs of this population. This study examined psychological distress among students with and without military experience. Results…

  16. Impulsivity as a Moderator and Mediator between Life Stress and Pathological Gambling among Chinese Treatment-Seeking Gamblers

    Science.gov (United States)

    Tang, Catherine So-kum; Wu, Anise M. S.

    2012-01-01

    This study examined the role of impulsivity and its interplay with gambling correlates in influencing the severity of pathological gambling in Chinese societies. It also investigated the extent to which impulsivity would moderate and/or mediate the relationship between life stress and pathological gambling in 94 Chinese treatment-seeking gamblers.…

  17. Health Seeking Behaviour and Treatment Intentions of Dengue and Fever : A Household Survey of Children and Adults in Venezuela

    NARCIS (Netherlands)

    Elsinga, Jelte; Lizarazo Forero, Erley; Vincenti Gonzalez, Maria F.; Schmidt, Masja; Velasco-Salas, Zoraida I.; Arias, Luzlexis; Bailey, Ajay; Tami, Adriana

    2015-01-01

    Background Dengue in Venezuela is a major public health problem with an increasing incidence of severe cases. Early diagnosis and timely treatment influences the outcome of dengue illness, as delay in care-seeking is significantly associated with complications leading to severe dengue. We aimed to

  18. Treatment-seeking, aspects of sexual activity and life satisfaction in men with laser-treated penile carcinoma.

    Science.gov (United States)

    Skeppner, Elisabet; Windahl, Torgny; Andersson, Swen-Olof; Fugl-Meyer, Kerstin S

    2008-09-01

    The aims were to assess the initial symptoms of penile carcinoma and patients' time frame in treatment seeking, and to describe the effect of laser treatment on sexual activity and life satisfaction. A retrospective face-to-face structured interview study of patients laser treated for localised penile carcinoma at the department of Urology in Orebro, Sweden, during 1986 to 2000. Sixty-seven was treated and 58 of them (mean age, 63 yr; range, 34-90) were alive at the time of this study. Forty-six (79%) agreed to participate. Ninety-six percent of the patients recalled their first symptom of penile carcinoma. Superficial ulceration and fissures were the most common symptoms (39%). Thirty-seven percent delayed seeking treatment for more than 6 mo. The patients had a greater lifetime number of sexual partners and a greater lifetime prevalence of STIs than a Swedish representative comparator population. Some aspects of sexual life, such as manual stimulation/caressing and fellatio, decreased markedly after laser treatment. Patient satisfaction with life as a whole was approximately the same as that of the general population. Patients delayed seeking treatment for a considerable period, despite awareness of the first local symptoms. Men with laser-treated localised penile carcinoma resume their sexual activities to a large extent after the treatment. Except for satisfaction with somatic health, similar-or even higher-proportions of patients than comparators are satisfied with life as a whole and with other domains of life including satisfaction with sexual life.

  19. Evaluation of the DSM-5 Severity Specifier for Bulimia Nervosa in Treatment-Seeking Youth.

    Science.gov (United States)

    Dakanalis, Antonios; Colmegna, Fabrizia; Zanetti, Maria Assunta; Di Giacomo, Ester; Riva, Giuseppe; Clerici, Massimo

    2017-05-16

    A new severity specifier for bulimia nervosa (BN), based on the frequency of inappropriate weight compensatory behaviours (e.g., laxative misuse, self-induced vomiting, fasting, diuretic misuse, and excessive exercise), has been added to the most recent (fifth) edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) as a means of addressing variability and heterogeneity in the severity of the disorder. While existing research provides support for the DSM-5 severity specifier for BN in adult patients, evidence for its validity and clinical utility in youth is currently lacking. To address this gap, data from 272 treatment-seeking adolescents with DSM-5 BN (94.2% female, M age = 15.3 years, SD 1.7) were analysed to examine whether these patients, sub-grouped based on the DSM-5 severity definitions, would show meaningful differences in a broad range of clinical variables and demographic and physical characteristics. Analyses revealed that participants categorized with mild, moderate, severe, and extreme severity of BN significantly differed from each other in 15 variables regarding eating disorder pathological features and putative maintenance factors (i.e., core low self-esteem, perfectionism, social appearance anxiety, body surveillance, and mood intolerance), health-related quality of life and comorbid psychiatric (i.e., affective and anxiety) disorders (large effect sizes). Between-group differences in demographics, body mass index, or age-of-BN onset were not observed. Collectively, our findings provide support for the utility of the frequency of inappropriate weight compensatory behaviours as a severity indicator for BN and suggest that age-at-onset of BN is probably more disorder- than severity-dependent. Implications for future research are outlined.

  20. Reinforcement sensitivity underlying treatment-seeking smokers' affect, smoking reinforcement motives, and affective responses.

    Science.gov (United States)

    Cui, Yong; Robinson, Jason D; Engelmann, Jeffrey M; Lam, Cho Y; Minnix, Jennifer A; Karam-Hage, Maher; Wetter, David W; Dani, John A; Kosten, Thomas R; Cinciripini, Paul M

    2015-06-01

    Nicotine dependence has been suggested to be related to reinforcement sensitivity, which encompasses behavioral predispositions either to avoid aversive (behavioral inhibition) or to approach appetitive (behavioral activation) stimuli. Reinforcement sensitivity may shape motives for nicotine use and offer potential targets for personalized smoking cessation therapy. However, little is known regarding how reinforcement sensitivity is related to motivational processes implicated in the maintenance of smoking. Additionally, women and men differ in reinforcement sensitivity, and such difference may cause distinct relationships between reinforcement sensitivity and motivational processes for female and male smokers. In this study, the authors characterized reinforcement sensitivity in relation to affect, smoking-related reinforcement motives, and affective responses, using self-report and psychophysiological measures, in over 200 smokers before treating them. The Behavioral Inhibition/Activation Scales (BIS/BAS; Carver & White, 1994) was used to measure reinforcement sensitivity. In female and male smokers, BIS was similarly associated with negative affect and negative reinforcement of smoking. However, positive affect was positively associated with BAS Drive scores in male smokers, and this association was reversed in female smokers. BIS was positively associated with corrugator electromyographic reactivity toward negative stimuli and left frontal electroencephalogram alpha asymmetry. Female and male smokers showed similar relationships for these physiological measures. These findings suggest that reinforcement sensitivity underpins important motivational processes (e.g., affect), and gender is a moderating factor for these relationships. Future personalized smoking intervention, particularly among more dependent treatment-seeking smokers, may experiment to target individual differences in reinforcement sensitivity. (PsycINFO Database Record (c) 2015 APA, all rights

  1. The Association Between Measures of Fitness and Metabolic Health in Treatment-Seeking Youth with Obesity.

    Science.gov (United States)

    Guseman, Emily Hill; Cauffman, Samuel P; Tucker, Jared M; Smith, Lucie; Eisenmann, Joey C; Stratbucker, William

    2017-04-01

    Both cardiorespiratory fitness (CRF) and measures of muscular fitness are associated with metabolic syndrome in adults. However, limited information exists about these relationships in youth with severe obesity who are at increased risk of metabolic dysfunction. The purpose of this study was to examine the relationship between fitness and metabolic health in treatment-seeking youth with obesity. Data for this analysis were collected at the time of baseline visits at a stage 3 pediatric weight management center. Maximal voluntary contractions were obtained by using isometric hand-grip dynamometry, and CRF was obtained from a maximal treadmill test. Resting blood pressure and fasting measures of blood lipids, glucose, and insulin were used to calculate a continuous metabolic syndrome score (cMetS); homeostasis model assessment of insulin resistance (HOMA-IR) was calculated from fasting insulin and glucose. Relationships between measures of fitness and metabolic health were evaluated by using partial correlations adjusted for age. Sixty-nine participants (21 boys, 48 girls) were included in this analysis. Of these, 46% (n = 32) met the criteria for metabolic syndrome. No differences were found between boys and girls for any variable analyzed. Muscular strength was positively associated with cMetS (r = 0.35), though this association weakened after adjustment for body mass index percentile. CRF was inversely associated with homeostasis model assessment of insulin resistance (HOMA-IR) (r = -0.26) and fasting insulin (r = -0.27). Body fat percentage was positively associated with insulin (r = 0.36). No significant relationship was found between CRF and cMetS. Contrary to previous studies, CRF was not associated with metabolic syndrome in this group. Muscular strength, however, was associated with cMetS. Notably, CRF was associated with elevated HOMA-IR, which may be seen as a precursor to metabolic syndrome. These results suggest that CRF and muscular

  2. Anxiety diagnoses in smokers seeking cessation treatment: relations with tobacco dependence, withdrawal, outcome and response to treatment.

    Science.gov (United States)

    Piper, Megan E; Cook, Jessica W; Schlam, Tanya R; Jorenby, Douglas E; Baker, Timothy B

    2011-02-01

    To understand the relations among anxiety disorders and tobacco dependence, withdrawal symptoms, response to smoking cessation pharmacotherapy and ability to quit smoking. Randomized placebo-controlled clinical trial. Participants received six 10-minute individual counseling sessions and either: placebo, bupropion SR, nicotine patch, nicotine lozenge, bupropion SR + nicotine lozenge or nicotine patch + nicotine lozenge. Two urban research sites. Data were collected from 1504 daily smokers (>9 cigarettes per day) who were motivated to quit smoking and did not report current diagnoses of schizophrenia or psychosis or bupropion use. Participants completed baseline assessments, the Composite International Diagnostic Interview and ecological momentary assessments for 2 weeks. A structured clinical interview identified participants who ever met criteria for a panic attack (n = 455), social anxiety (n = 199) or generalized anxiety disorder (n = 99), and those who qualified for no anxiety diagnosis (n = 891). Smokers with anxiety disorders reported higher levels of nicotine dependence and pre-quit withdrawal symptoms. Those ever meeting criteria for panic attacks or social anxiety disorder showed greater quit-day negative affect. Smokers ever meeting criteria for anxiety disorders were less likely to be abstinent at 8 weeks and 6 months post-quit and showed no benefit from single-agent or combination-agent pharmacotherapies. Anxiety diagnoses were common among treatment-seeking smokers and were related to increased motivation to smoke, elevated withdrawal, lack of response to pharmacotherapy and impaired ability to quit smoking. These findings could guide treatment assignment algorithms and treatment development for smokers with anxiety diagnoses. © 2010 The Authors, Addiction © 2010 Society for the Study of Addiction.

  3. Treatment seeking behaviors related to gonorrhea among female sex workers in 7 cities in Indonesia

    Directory of Open Access Journals (Sweden)

    Roselinda Roselinda

    2014-02-01

    Full Text Available Abstrak Latar belakang:Gonore merupakan salah satu infeksi menular seksual yang menjadi permasalahan besar kesehatan terutama pada wanita penjaja seks (WPS di Indonesia. Tujuan dari artikel ini adalah untuk melihat hubungan antara pola pencarian pengobatan gonore. Metode:Data berasal dari studi potong lintang dengan responden WPS yang dipilih secara cluster random sampling dari 7 kota (Timika, Yogyakarta, Kupang, Samarinda, Pontianak, Makassar dan Tangerang di Indonesia pada tahun 2007. Diagnosis gonore berdasarkan hasil pemeriksaan Polymerase Chain Reaction (PCR menggunakan Amplicor CT/NG dari Roche yang telah disetujui oleh World Health Orgazation (WHO sebagai alat skrining gonore. Hasil:Proporsi responden yang menderita gonore sebesar 26.1% (404/1750. Persentase penderita gonore yang melakukan upaya pengobatan terdistribusi hampir sama dengan yang mengunjungi fasilitas kesehatan / dokter dengan yang membeli obat sendiri. Subyek yeng melakukan pengobatan tradisional memiliki risiko 44% lebih tinggi menderita gonore dibandingkan dengan subyek yang melakukan pengobatan di fasilitas kesehatan / dokter [risiko relatif suaian (RRa = 1,44; P = 0.044]. Sedangkan subyek yang tidak diobati dibandingkan dengan yang berobat ke fasilitas kesehatan / dokter lebih berisiko 55% menderita gonore (RRa = 1.55; P = 0.002.Kesimpulan: Wanita penjaja seks yang melakukan maupun yang tidak pengobatan tradisional dibandingkan dengan yang mengunjungi fasilitas kesehatan/dokter memiliki risiko yang lebih tinggi menderita gonore. (Health Science Indones 2013;2:87-92Kata kunci:gonore, wanita penjaja seks, IndonesiaAbstractBackground:Gonorrhea is one of sexually transmitted infections that have become a major health problem especially among female sex workers (FSW in Indonesia. The objective of this article is to identify the relationship between treatment seeking behaviors, the sites of study and gonorrhea among FSW. Methods: The data that analyzed derived from cross

  4. Gambling and Early Maladaptive Schemas in a Treatment Seeking Sample of Male Alcohol Users: A Preliminary Investigation

    Science.gov (United States)

    Shorey, Ryan C.; Anderson, Scott; Stuart, Gregory L.

    2012-01-01

    Gambling problems are overrepresented among men seeking treatment for substance use problems, including alcohol dependence. Early maladaptive schemas are overrepresented among substance users, although no known study has examined the early maladaptive schemas of men with potential gambling problems. The current study examined the relations among potential gambling problems and early maladaptive schemas among a sample of alcohol dependent men seeking treatment at a residential substance use facility (N = 628). Using pre-existing patient records of self-report measures for early maladaptive schemas and potential gambling problems, results showed that a number of early maladaptive schemas were associated with gambling. Men with potential gambling problems scored significantly higher than non-problem gamblers on a number of early maladaptive schemas. These results suggest that early maladaptive schemas may be an important underlying characteristic for gambling problems, and that substance use treatment programs should considering screening for and targeting gambling problems and early maladaptive schemas. PMID:23493841

  5. The relationship between early maladaptive schemas and eating-disorder symptomatology among individuals seeking treatment for substance dependence.

    Science.gov (United States)

    Elmquist, JoAnna; Shorey, Ryan C; Anderson, Scott E; Stuart, Gregory L

    Numerous studies have examined early maladaptive schemas (EMS) and their relationship to psychological disorders, including eating disorders (EDs) and substance use disorders (SUDs). However, to date, there are no empirical investigations that have examined the relationship between EMS and EDs among individuals seeking treatment for substance use. In an attempt to further elucidate this relationship, the purpose of the current, exploratory study was to examine the relationship between EMS, ED symptomatology (i.e., bulimia and binge-eating but not anorexia), and substance use and to directly compare EMS among individuals with and without a probable ED diagnosis. Participants were 387 men and 132 women seeking residential treatment for substance use. Results demonstrated that 11 of the 18 EMS were significantly associated with ED. Moreover, patients with a probable ED scored significantly higher than patients without a probable ED on 8 of the 18 EMS. Results suggest that EMS are prevalent among individuals with ED pathology seeking treatment for substance use. Thus treatment programs could potentially benefit from the assessment and treatment of EMS among dually-diagnosed patients. Given the exploratory and preliminary nature of the study, continued research is needed to further examine the relationship between EMS, EDs, and substance use.

  6. After the ban of slot machines in Norway: a new group of treatment-seeking pathological gamblers?

    Science.gov (United States)

    Bu, Eli Torild Hellandsjø; Skutle, Arvid

    2013-03-01

    Changes in demographical and clinical features of treatment-seeking pathological gamblers, and their gambling preferences before and after the ban of slot machines in Norway from 1 July 2007. Is there an emergence of a new group of gamblers seeking treatment after the ban? The participants were 99 patients, 16 women and 83 men, with the mean age of 35 years. All were referred to the Bergen Clinics Foundation, Norway, for treatment of gambling addiction in the period October 2006 to October 2009. A comprehensive assessment package was applied, focusing on demographical characteristics, the severity of pathological gambling, mental health and substance use disorder. After the ban the mean age was significantly lower, and significantly more were highly educated, in regular employment, and married. Internet gambling and a sport betting game called Odds were the most common options, and gambling problems had become more severe with greater depth due to gambling, bad conscious, heavy alcohol consumption, and more suicidal thoughts and attempts. After the ban of slot machines, the characteristics of treatment-seeking gamblers have been changed, and with great implications for treatment strategies.

  7. The Effectiveness of Individualized Acupuncture Protocols in the Treatment of Gulf War Illness: A Pragmatic Randomized Clinical Trial.

    Directory of Open Access Journals (Sweden)

    Lisa Conboy

    Full Text Available Gulf War Illness is a Complex Medical Illness characterized by multiple symptoms, including fatigue, sleep and mood disturbances, cognitive dysfunction, and musculoskeletal pain affecting veterans of the first Gulf War. No standard of care treatment exists.This pragmatic Randomized Clinical Trial tested the effects of individualized acupuncture treatments offered in extant acupuncture practices in the community; practitioners had at least 5 years of experience plus additional training provided by the study. Veterans with diagnosed symptoms of Gulf War Illness were randomized to either six months of biweekly acupuncture treatments (group 1, n = 52 or 2 months of waitlist followed by weekly acupuncture treatments (group 2, n = 52. Measurements were taken at baseline, 2, 4 and 6 months. The primary outcome is the SF-36 physical component scale score (SF-36P and the secondary outcome is the McGill Pain scale.Of the 104 subjects who underwent randomization, 85 completed the protocol (82%. A clinically and statistically significant average improvement of 9.4 points (p = 0.03 in the SF-36P was observed for group 1 at month 6 compared to group 2, adjusting for baseline pain. The secondary outcome of McGill pain index produced similar results; at 6 months, group 1 was estimated to experience a reduction of approximately 3.6 points (p = 0.04 compared to group 2.Individualized acupuncture treatment of sufficient dose appears to offer significant relief of physical disability and pain for veterans with Gulf War Illness. This work was supported by the Office of the Assistant Secretary of Defense for Health Affairs through the Gulf War Illness Research Program under Award No. W81XWH-09-2-0064. Opinions, interpretations, conclusions and recommendations are those of the author and are not necessarily endorsed by the Department of Defense.ClinicalTrials.gov NCT01305811.

  8. Sociodemographic, perceived and objective need indicators of mental health treatment use and treatment-seeking intentions among primary care medical patients.

    Science.gov (United States)

    Elhai, Jon D; Voorhees, Summer; Ford, Julian D; Min, Kyeong Sam; Frueh, B Christopher

    2009-01-30

    We explored sociodemographic and illness/need associations with both recent mental healthcare utilization intensity and self-reported behavioral intentions to seek treatment. Data were examined from a community sample of 201 participants presenting for medical appointments at a Midwestern U.S. primary care clinic, in a cross-sectional survey study. Using non-linear regression analyses accounting for the excess of zero values in treatment visit counts, we found that both sociodemographic and illness/need models were significantly predictive of both recent treatment utilization intensity and intentions to seek treatment. Need models added substantial variance in prediction, above and beyond sociodemographic models. Variables with the greatest predictive role in explaining past treatment utilization intensity were greater depression severity, perceived need for treatment, older age, and lower income. Robust variables in predicting intentions to seek treatment were greater depression severity, perceived need for treatment, and more positive treatment attitudes. This study extends research findings on mental health treatment utilization, specifically addressing medical patients and using statistical methods appropriate to examining treatment visit counts, and demonstrates the importance of both objective and subjective illness/need variables in predicting recent service use intensity and intended future utilization.

  9. Biodegradable urethral stent in the treatment of post-traumatic urethral strictures in a war wound rabbit urethral model

    Energy Technology Data Exchange (ETDEWEB)

    Fu Weijun [Department of Urology, Chinese People' s Liberation Army General Hospital, Military Postgraduate Medical College, No.28 Fuxing Road, Hai dian District, Beijing 100853 (China); Zhang Binghong [Department of Urology, Chinese People' s Liberation Army General Hospital, Military Postgraduate Medical College, No.28 Fuxing Road, Hai dian District, Beijing 100853 (China); Gao Jiangping [Department of Urology, Chinese People' s Liberation Army General Hospital, Military Postgraduate Medical College, No.28 Fuxing Road, Hai dian District, Beijing 100853 (China); Hong Baofa [Department of Urology, Chinese People' s Liberation Army General Hospital, Military Postgraduate Medical College, No.28 Fuxing Road, Hai dian District, Beijing 100853 (China); Zhang Lei [Department of Urology, Chinese People' s Liberation Army General Hospital, Military Postgraduate Medical College, No.28 Fuxing Road, Hai dian District, Beijing 100853 (China); Yang Yong [Department of Urology, Chinese People' s Liberation Army General Hospital, Military Postgraduate Medical College, No.28 Fuxing Road, Hai dian District, Beijing 100853 (China); Meng Bo [Biomaterials Lab, School of Materials Science and Engineering, Tsinghua University, Beijing (China); Zhu Ning [Biomaterials Lab, School of Materials Science and Engineering, Tsinghua University, Beijing (China); Cui Fuzhai [Biomaterials Lab, School of Materials Science and Engineering, Tsinghua University, Beijing (China)

    2007-12-15

    To prevent terrorism during anti-terror war, we developed a reproducible animal model for the induction of a urethral stricture in a war wound rabbit, and to evaluate the feasibility and effect of using a biodegradable urethral stent in the prophylaxis and treatment of urethral strictures in a war wound (or traumatic) rabbit urethral model. The urethral stricture rabbit model was successfully performed by a self-control explosion destructor. New biodegradable urethral stents were placed in the urethras of 20 war wound (traumatic) rabbits, but no stent was used in the 8 rabbits which formed the control group. Follow-up investigation included assessment of procedure success, stent changes, urethrascopy and retrograde urethrography, and histological findings were obtained after sacrifice at 4, 6, 8 and 12 weeks after stent placement. The urethral stricture model owing to a war wound (trauma) was tested by tissue reactions and urethroscopy. The length of the urethral strictures was 5-10 mm; the coarctatetion of the urethral lumen was more than 50%. Biodegradable stent placement was technically successful in 20 rabbits. Urethral specimens obtained from the 4 week stent placement group showed diminished inflammatory cell infiltration and decreased thickness of the papillary projections of the epithelium. There was a strong tendency towards regression of the papillary projections and regeneration of urethral mucosa epithelium in the 8 week group. In particular, the injured urethra has recovered completely in the biodegradable stent groups compared with the control group at 12 weeks. The biodegradable urethral stent seems feasible for treating and preventing urethral strictures owing to a war wound (or traumatic) urethra. There are distinct advantages in terms of safe, effective and less-invasive treatment for the reconstruction of post-traumatic urethral strictures.

  10. Psychometric evaluation of the mini-social phobia inventory (Mini-SPIN) in a treatment-seeking sample.

    Science.gov (United States)

    Weeks, Justin W; Spokas, Megan E; Heimberg, Richard G

    2007-01-01

    The Mini-Social Phobia Inventory (Mini-SPIN) is a 3-item, self-rated screening instrument to assess social anxiety disorder, but its psychometric properties have not yet been examined in a sample seeking treatment for psychiatric disorders. We analyzed responses from 291 adults who telephoned the Adult Anxiety Clinic of Temple (AACT) seeking treatment for social anxiety or generalized anxiety and worry. The Mini-SPIN demonstrated strong internal consistency. Support for the convergent validity of the Mini-SPIN was provided by moderate correlations with several self-report measures and a clinician-administered measure of social anxiety completed by the subsample of callers who later came to the AACT for evaluation. Furthermore, the Mini-SPIN correlated significantly with two of three measures of functional disability, but not with a measure of life satisfaction. Correlations with measures of other constructs were nonsignificant, providing support for the discriminant validity of the Mini-SPIN. In addition, a cutoff score of 6 on the Mini-SPIN yielded strong sensitivity and diagnostic efficiency in the subsample of treatment seekers that later completed pretreatment evaluation, although the specificity of this cutoff score was not optimal in this sample. Overall, the Mini-SPIN demonstrated sound psychometric properties in this treatment-seeking sample. (c) 2006 Wiley-Liss, Inc.

  11. Novel Therapeutic Approaches for the Treatment of Depression and Cognitive Deficits in a Rodent Model of Gulf War Veterans Illness

    Science.gov (United States)

    2015-10-01

    in this cascade produces depressive symptoms and memory impairments, and inhibiting this system with pharmacological or genetic manipulation affords...1 AWARD NUMBER: W81XWH-14-1-0478 TITLE: Novel Therapeutic Approaches for the Treatment of Depression and Cognitive Deficits in a Rodent Model...the Treatment of Depression and Cognitive Deficits in a Rodent Model of Gulf War Veterans’ Illness 5b. GRANT NUMBER W81XWH-14-1-0478 5c

  12. Validity of the Adult ADHD Self-Report Scale (ASRS) as a screener for adult ADHD in treatment seeking substance use disorder patients

    NARCIS (Netherlands)

    van de Glind, Geurt; van den Brink, Wim; Koeter, Maarten W. J.; Carpentier, Pieter-Jan; van Emmerik-van Oortmerssen, Katelijne; Kaye, Sharlene; Skutle, Arvid; Bu, Eli-Torild H.; Franck, Johan; Konstenius, Maija; Moggi, Franz; Dom, Geert; Verspreet, Sofie; Demetrovics, Zsolt; Kapitány-Fövény, Máté; Fatséas, Melina; Auriacombe, Marc; Schillinger, Arild; Seitz, Andrea; Johnson, Brian; Faraone, Stephen V.; Ramos-Quiroga, J. Antoni; Casas, Miguel; Allsop, Steve; Carruthers, Susan; Barta, Csaba; Schoevers, Robert A.; Levin, Frances R.

    2013-01-01

    To detect attention deficit hyperactivity disorder (ADHD) in treatment seeking substance use disorders (SUD) patients, a valid screening instrument is needed. To test the performance of the Adult ADHD Self-Report Scale V 1.1(ASRS) for adult ADHD in an international sample of treatment seeking SUD

  13. Protecting Adolescents' Right to Seek Treatment for Sexually Transmitted Diseases without Parental Consent: The Arizona Experience with Senate Bill 1309

    Science.gov (United States)

    Goodwin, Kimberly D.; Taylor, Melanie M.; Brown, Erin C. Fuse; Winscott, Michelle; Scanlon, Megan; Hodge, James G.; Mickey, Tom; England, Bob

    2012-01-01

    In 2010, Senate Bill 1309 included language to repeal an existing Arizona law that enables minors younger than 18 years of age to seek diagnosis and treatment of sexually transmitted diseases (STDs) without parental consent. Numerous implications were identified that would have stemmed from parental consent provisions originally proffered in Senate Bill 1309. These implications included diminished access to essential health services among minors, exacerbated existing health disparities, increased health-care spending costs, and thwarted efforts to curb the spread of STDs. Lastly, minors would have been deprived of existing privacy protections concerning their STD-related medical information. This case study describes how collaborative advocacy efforts resulted in the successful amendment of Senate Bill 1309 to avert the negative sexual and reproductive health outcomes among adolescents stemming from the potential repeal of their existing legal right to seek STD treatment without parental consent. PMID:22547855

  14. Does Evidence-Based PTS Treatment Reduce PTS Symptoms and Suicide in Iraq and Afghanistan Veterans Seeking VA Care

    Science.gov (United States)

    2016-05-01

    AWARD NUMBER: W81XWH-15-1-0038 TITLE: Does Evidence-Based PTS Treatment Reduce PTS Symptoms and Suicide in Iraq and Afghanistan Veterans... Suicide in Iraq and Afghanistan Veterans Seeking VA Care? 5a. CONTRACT NUMBER 5b. GRANT NUMBER W81XWH-15-1-0038 5c. PROGRAM ELEMENT NUMBER 6...cohort with two or more suicide screenings during the post-deployment period. 15. SUBJECT TERMS Key words or phrases identifying major concepts in

  15. Moral worlds and therapeutic quests : a study of medical pluralism and treatment-seeking in the lower Amazon

    OpenAIRE

    Budden, Ashwin

    2010-01-01

    This dissertation is about the social and psychocultural dimensions of medical pluralism and treatment seeking in Santarém, a rapidly growing municipality in the Brazilian Amazon. Based on a year-and-a-half of ethnographic fieldwork in urban and rural settings, it comparatively examines how popular religions and cosmopolitan health institutions define and manage (or fail to manage) sickness, psychosocial impairment, and emotional distress. It also reveals lived experiences of informants who s...

  16. Effects of an acute cannabidiol treatment on cocaine self-administration and cue-induced cocaine seeking in male rats.

    Science.gov (United States)

    Mahmud, Ashraf; Gallant, Stephanie; Sedki, Firas; D'Cunha, Tracey; Shalev, Uri

    2017-01-01

    Cannabidiol is a non-psychoactive compound that is the second most abundant component of cannabis. It has been shown to have a potential therapeutic value for a wide range of disorders, including anxiety, psychosis, and depression. Recently, it was suggested that cannabidiol might be a potential treatment for heroin craving and relapse. Here we investigated the effects of an acute treatment with cannabidiol on cocaine self-administration and cue-induced cocaine seeking in rats. Rats were trained to press a lever to self-administer cocaine (0.5 mg/kg/infusion), first under a fixed interval 20 s (FI-20 s) and then under a progressive ratio (PR) schedule of reinforcement. Cocaine self-administration under a PR schedule of reinforcement was not attenuated by cannabidiol injections (5.0 mg/kg and 10.0 mg/kg; i.p.) when tested 30 min and 24 h after treatment. Cannabidiol treatment (5.0 mg/kg or 10.0 mg/kg) also did not attenuate cue-induced cocaine seeking in rats after a withdrawal period of 14 days. In contrast, treatment with cannabidiol (10.0 mg/kg; i.p.) resulted in a statistically significant anxiolytic effect in the elevated plus-maze. Our findings suggest that, under the conditions described here, an acute cannabidiol treatment has a minimal effect on a rat model of cocaine intake and relapse.

  17. Malaria in rural Burkina Faso: local illness concepts, patterns of traditional treatment and influence on health-seeking behaviour

    Directory of Open Access Journals (Sweden)

    Kouyaté Bocar

    2007-08-01

    Full Text Available Abstract Background The literature on health care seeking behaviour in sub-Saharan Africa for children suffering from malaria is quite extensive. This literature, however, is predominately quantitative and, inevitably, fails to explore how the local concepts of illness may affect people's choices. Understanding local concepts of illness and their influence on health care-seeking behaviour can complement existing knowledge and lead to the development of more effective malaria control interventions. Methods In a rural area of Burkina Faso, four local concepts of illness resembling the biomedical picture of malaria were described according to symptoms, aetiology, and treatment. Data were collected through eight focus group discussions, 17 semi-structured interviews with key informants, and through the analysis of 100 verbal autopsy questionnaires of children under-five diagnosed with malaria. Results Sumaya, dusukun yelema, kono, and djoliban were identified as the four main local illness concepts resembling respectively uncomplicated malaria, respiratory distress syndrome, cerebral malaria, and severe anaemia. The local disease categorization was found to affect both treatment and provider choice. While sumaya is usually treated by a mix of traditional and modern methods, dusukun yelema and kono are preferably treated by traditional healers, and djoliban is preferably treated in modern health facilities. Besides the conceptualization of illness, poverty was found to be another important influencing factor of health care-seeking behaviour. Conclusion The findings complement previous evidence on health care-seeking behaviour, by showing how local concepts of illness strongly influence treatment and choice of provider. Local concepts of illness need to be considered when developing specific malaria control programmes.

  18. The delay between symptom onset and seeking professional treatment for anxiety and depressive disorders in a rural Australian sample.

    Science.gov (United States)

    Green, Amanda C; Hunt, Caroline; Stain, Helen J

    2012-09-01

    Epidemiological research has revealed that the utilisation of professional mental health services is low among rural Australians, despite a similar prevalence of mental illness to urban communities. However, the extent of this unmet need and the length of delay to first seek treatment in rural communities remain unclear. The aim of this study was to investigate the delay among rural Australians in seeking treatment for anxiety and depressive disorders. A total of 124 participants with an anxiety or depressive disorder according to the Composite International Diagnostic Interview (CIDI) who were participants of the Australian Rural Mental Health Study (ARMHS) were included in this study. Multivariate methods examined the contribution of clinical (onset age, disorder type and comorbidity), attitudinal/demographic (perceived stigma and current age) and structural (rurality) variables to the delay to first seek help. The average length of the delay was 18.7 years across disorders (range 0-67). The shortest delays were in depressive disorders (10.41 years) and the longest for social phobia (28.02 years). Multivariate analysis indicated that younger onset age, older current age, diagnosis of panic disorder or depressive disorder, and living in a remote (R) or very remote area (VR) were associated with delays of more than one year. Delays to first seek treatment for anxiety and depressive disorders appear to be far more prolonged in rural compared to urban Australia. This is particularly the case for Australian residents living in R and VR areas. This is of particular concern due to the significant mental health needs of rural Australians.

  19. Community participation for malaria elimination in tafea province, vanuatu: part ii. social and cultural aspects of treatment-seeking behaviour

    Directory of Open Access Journals (Sweden)

    Riley Ian

    2011-07-01

    Full Text Available Abstract Background Early diagnosis and prompt effective case management are important components of any malaria elimination strategy. Tafea Province, Vanuatu has a rich history of traditional practices and beliefs, which have been integrated with missionary efforts and the introduction of modern constructions of health. Gaining a detailed knowledge of community perceptions of malarial symptomatology and treatment-seeking behaviours is essential in guiding effective community participation strategies for malaria control and elimination. Method An ethnographic study involving nine focus group discussions (FGD, 12 key informant interviews (KII and seven participatory workshops were carried out on Tanna Island, Vanuatu. Villages in areas of high and low malaria transmission risk were selected. Four ni-Vanuatu research officers, including two from Tanna, were trained and employed to conduct the research. Data underwent thematic analysis to examine treatment-seeking behaviour and community perceptions of malaria. Results Malaria was perceived to be a serious, but relatively new condition, and in most communities, identified as being apparent only after independence in 1980. Severe fever in the presence of other key symptoms triggered a diagnosis of malaria by individuals. Use of traditional or home practices was common: perceived vulnerability of patient and previous experience with malaria impacted on the time taken to seek treatment at a health facility. Barriers to health care access and reasons for delay in care-seeking included the availability of health worker and poor community infrastructure. Conclusion Due to programme success of achieving low malaria transmission, Tafea province has been identified for elimination of malaria by 2012 in the Government of Vanuatu Malaria Action Plans (MAP. An effective malaria elimination programme requires interactions between the community and its leaders, malaria workers and health providers for success in

  20. Posttraumatic Stress Disorder and Health Functioning in a Non-Treatment-Seeking Sample of Iraq War Veterans: A Prospective Analysis

    National Research Council Canada - National Science Library

    Vasterling, Jennifer J; Schumm, Jeremiah; Proctor, Susan P; Gentry, Elisabeth; King, Daniel W; King, Lynda A

    2007-01-01

    .... Army soldiers before and after 1-year military deployments to Iraq. As part of the Neurocognition Deployment Health Study procedures, each soldier completed at both time points self-report indexes of PTSD symptom severity, health behaviors...

  1. Malaria treatment-seeking behaviour and drug prescription practices in an area of low transmission in Uganda

    DEFF Research Database (Denmark)

    Ndyomugyenyi, Richard; Magnussen, Pascal; Clarke, Siân

    2007-01-01

    Knowledge of malaria and treatment-seeking behaviour was investigated in an area of low transmission in Uganda to help health services to plan for appropriate interventions to control malaria. Although knowledge of malaria symptoms, preventive methods and malaria risks was widespread, few were...... actually using insecticide-treated nets. Many patients (25%) had received treatment prior to visiting a health facility, with drug shops and general stores being the main sources of treatment. Some shops dispensed quinine, a second-line drug recommended for complicated malaria. Prescription practices...... of health staff often did not comply with guidelines. Only 30% of patients received treatment at a health facility within 24h of onset of symptoms. Findings indicate a need for community-level information campaigns on prompt treatment and introduction of home-based management of fever. Measures are needed...

  2. [Research and treatment of war neuroses at the Clinic for Nervous and Mental Diseases at the Jagiellonian University in Krakow before World War II in the context of psychiatry in Europe].

    Science.gov (United States)

    Rutkowski, Krzysztof; Dembińska, Edyta

    2014-01-01

    The aim of this article is to offer an overview of the research into diagnosis and treatment of war neuroses at the Clinic for Nervous and Mental Diseases at the Jagiellonian University in Krakow before the outbreak of World War II. It also includes a profile of the work of Prof. Jan Piltz, the then director of the Clinic, and his major scientific achievements. The publications cited in the article date in the main from the period of World War I, and comprise clinical analyses of the consequences of stress suffered at the front as well as a description of the ways in which they were treated. These are presented alongside other major findings related to war neuroses being made in Europe at the time. The article draws attention to the very modern thinking on treatment of war neuroses, far ahead of the average standards of the day, evinced by Prof. Piltz and his team. The most important innovative elements of their treatment of these conditions were the fact that they perceived the cause of the neurosis to lie in previous personality disorders in the patients, their recommendation of psychotherapy as the main method of treatment, and their emphasis on the need for further rehabilitation following the completion of the course of hospital treatment. They also paid significant attention to the importance of drawing up individual therapy plans for each patient.

  3. Demographic and clinical profile of substance abusing women seeking treatment at a de-addiction center in north India

    Directory of Open Access Journals (Sweden)

    Naresh Nebhinani

    2013-01-01

    Full Text Available Background: In the recent decades increasing number of women have been seeking deaddiction services. Despite that the report data is very limited from India. Objectives: The present research aimed to study the demographic and clinical profile of women seeking deaddiction treatment at a tertiary care center in North India. Materials and Methods: Retrospective structured chart review of 100 women substance abusers seeking treatment at a deaddiction center between September 1978 and December 2011. Results: A typical case was of 36.3 years age, married (65%, urban (61%, nuclear family (59% based housewife (56%, with good to fair social support (69%. The commonest substance of abuse was tobacco (60%, followed by opioids (27%, alcohol (15%, and benzodiazepines (13%. The common reasons for initiation of substance use were to alleviate frustration or stress (49% and curiosity (37%. Family history of drug dependence (43%, comorbidity (25%, and impairments in health (74%, family (57%, and social domains (56% were common. Only a third of the sample paid one or more follow visit, and of those 58% were abstinent at the last follow-up. Significant predictors identified were being non-Hindu and higher educational years for abstinent status at follow-up. Conclusion: The common substances of abuse were tobacco, opioids, and alcohol and benzodiazepines; and family history of drug abuse and comorbidity were common. The follow-up and outcome were generally poor. This profile gives us some clues to address a hidden health problem of the community.

  4. Bodily matters above and below ground: the treatment of American remains from the Korean War.

    Science.gov (United States)

    Keene, Judith

    2010-02-01

    Throughout most of the twentieth century, depending on the capabilities of the military mortuary services and the time limits set by government, the bodies of the American fallen in foreign wars have been repatriated home to their families. In the Korean War the conditions of combat posed large challenges to the recovery and returns of bodily remains. Almost half a century after that conflict, the American missing in Korea have become significant players within the government's expanding efforts that were prompted in answer to demands to locate American soldiers who remain unaccounted for from the Vietnam War. The essay traces the background to U.S. military mortuary services and the operation in the Korean War and in the subsequent joint expeditions in North Korea. The analysis concludes that in most of these ventures the outlay of resources has produced few remains.

  5. Heterogeneity in health seeking behaviour for treatment, prevention and urgent care in four districts in western Kenya.

    Science.gov (United States)

    O'Meara, W P; Karuru, S; Fazen, L E; Koech, J; Kizito, B; Tarus, C; Menya, D

    2014-11-01

    The impact of effective, life-saving health interventions is limited by access to and use of health services. Health seeking behaviour is likely to vary geographically and by type of health concern. However, little is known about the extent of this heterogeneity. A representative cluster-randomized sample of households in four districts in western Kenya was interviewed using a structured, interviewer-administered survey. GPS coordinates of all households and all local health facilities were also collected. Household surveys measured health seeking behaviour for three distinct health needs: family planning which is a form of prevention, delivery which is an urgent care need but can be planned in advance, and childhood febrile illness which is an unexpected and potentially life-threatening concern. Logistic regression models were used to explore the relationship between seeking health services and maternal and household characteristics, with special attention to geographic and financial access to care. Use of health services for these three different health issues varied between the districts and also differed from national estimates. Place of delivery was most strongly correlated with the type of health services available to the family, whereas family planning was correlated with the relationship of the mother to the head of household. There was no strong interaction between socio-economic status and distance to services. The level of services available nearest to households rather than the distance to travel influences treatment-seeking behaviour, particularly for urgent care. Maternal factors and household wealth were often important but, even within the same households, their effect changes based on the type of health concern. Generalizing from nationwide surveys may obscure important local heterogeneity, particularly in delivery location and fever treatment. Copyright © 2014 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

  6. Algeria: An Uncivilized Civil War

    National Research Council Canada - National Science Library

    Robling, Terry

    1995-01-01

    .... Moderates on both sides are seeking peace from the undeclared civil war that resulted when the military-backed regime canceled elections that Islamic fundamentalists were certain to win in 1992...

  7. Who seeks public treatment for substance abuse in Brazil? Results of a multicenter study involving four Brazilian state capitals

    Directory of Open Access Journals (Sweden)

    Sibele Faller

    2014-12-01

    Full Text Available OBJECTIVE: To assess the characteristics of alcohol and drug users who seek treatment at the Brazilian Unified Health System in Brazil.METHOD:A multicenter cross-sectional study involving five clinical and research centers located in four Brazilian state capitals was conducted with 740 in- and outpatients. The only exclusion criterion was the presence of neurological or severe psychiatric symptoms at the moment of the interview. The Addiction Severity Index (ASI-6 and the Alcohol, Smoking and Substance Involvement Screening Test (ASSIST were used to assess the severity of substance use and the problems related.RESULTS: There were significantly more men than women in the sample; mean age was 36 years. The drug most frequently used at all sites was alcohol (78%, followed by cocaine/crack (51%. Alcohol was the drug that most commonly motivated treatment seeking, at all centers. ASI-6 Summary Scores for Recent Functioning (SS-Rs were quite similar among centers. SS-Rs were compared between users who had never received treatment for psychoactive substance abuse (n = 265, 36.1% and those who had already been treated at one or more occasions (n = 470, 63.9%. This analysis revealed significant differences between the groups in the drug, psychiatric symptoms, legal, and family/social problems areas (p < 0.05.CONCLUSION: Our findings confirm previous evidence suggesting that the management of patients seeking drug abuse treatment should take several different aspects into consideration, e.g., education, employment, and family relationships, which often appear as areas of concern for these individuals.

  8. Effect of incongruence of acute myocardial infarction symptoms on the decision to seek treatment in a rural population.

    Science.gov (United States)

    Morgan, Donna M

    2005-01-01

    People are advised to obtain immediate treatment for acute myocardial infarction (AMI), yet a delay occurs between the onset of symptoms and the decision to seek treatment. The objective of the study was to determine the extent of incongruence between expected and actual symptoms of AMI, effect of incongruence on decision time to seek treatment, and predictive effect of selected variables on decision time in a rural population. Ninety-eight rural patients receiving inpatient treatment for AMI at 2 hospitals in the Northeast of the United States from August 2001 through October 2002 completed the Morgan Incongruency of Heart Attack Symptoms Index and the Response to Symptoms Questionnaire. The median decision time was 93 minutes. There were differences between men and women regarding the symptoms that were expected to occur and that actually occurred. The extent to which symptoms interfered with the ability to carry out normal activities, degree of anxiety, and type of insurance coverage explained 23% of the variance in decision time. Although the expected symptoms did not match the actual symptoms, this incongruence did not affect decision time.

  9. The Levels and Predictors of Physical Activity Engagement Within the Treatment-Seeking Transgender Population: A Matched Control Study.

    Science.gov (United States)

    Jones, Bethany Alice; Haycraft, Emma; Bouman, Walter Pierre; Arcelus, Jon

    2018-02-01

    Physical activity has been found to alleviate mental health problems and could be beneficial for at-risk populations, such as transgender people. This study had 3 aims. First, to explore the amount of physical activity that treatment-seeking transgender people engage in and to compare this to matched cisgender people. Second, to determine whether there was a difference in physical activity depending on cross-sex hormone use. Third, to determine factors that predict physical activity among treatment-seeking transgender people. Transgender (n = 360) and cisgender people (n = 314) were recruited from the United Kingdom. Participants were asked to complete questionnaires about physical activity, symptoms of anxiety and depression, self-esteem, body satisfaction, and transphobia. Transgender people engaged in less physical activity than cisgender people. Transgender people who were on cross-sex hormone treatment engaged in more physical activity than transgender people who were not. In transgender people on cross-sex hormones, high body satisfaction was the best statistical predictor of physical activity, whereas high self-esteem was the best statistical predictor in people who were not. Transgender people are less active than cisgender people. Cross-sex hormone treatment appears to be able to indirectly increase physical activity within this population, which may be beneficial for mental well-being.

  10. Determinants of Malaria Prevention and Treatment Seeking Behaviours of Pregnant Undergraduates Resident in University Hostels, South-East Nigeria

    Directory of Open Access Journals (Sweden)

    Anthonia Ukamaka Chinweuba

    2017-01-01

    Full Text Available This cross-sectional descriptive survey investigated determinants of malaria prevention and treatment seeking behaviours of pregnant undergraduates resident in university hostels, South-East Nigeria. Purposive sampling was used to enrol 121 accessible and consenting undergraduates with self-revealed and noticeable pregnancy residing in twenty-three female hostels of four university campuses in Enugu State, Nigeria. Structured interview guide developed based on reviewed literature and WHO-recommended malaria prevention and treatment measures was used to collect students’ self-report data on malaria preventive health behaviours, sick role behaviours, and clinic use using mixed methods. The WHO-recommended malaria prevention measures were sparingly used. Some believed that pregnancy does not play any role in a woman’s reaction to malaria infection. Only 41 (50.6% visited a hospital for screening and treatment. Thirty-four (28.1% used antimalaria medicine bought from chemist shop or over-the-counter medicines, while 33 (27.3% used untreated net. The students were more likely to complete their antimalaria medicine when they were sick with malaria infection than for prevention (p=0.0186. Knowledge, academic schedule, cultural influence on perception and decision-making, and accessibility of health facility were key determinants of the women’s preventive and treatment seeking behaviours. Health education on malaria prevention and dangers of drug abuse should form part of orientation lectures for all freshmen. University health centres should be upgraded to provide basic antenatal care services.

  11. Determinants of Malaria Prevention and Treatment Seeking Behaviours of Pregnant Undergraduates Resident in University Hostels, South-East Nigeria.

    Science.gov (United States)

    Chinweuba, Anthonia Ukamaka; Agbapuonwu, Noreen Ebelechukwu; Onyiapat, JaneLovena Enuma; Israel, Chidimma Egbichi; Ilo, Clementine Ifeyinwa; Arinze, Joyce Chinenye

    2017-01-01

    This cross-sectional descriptive survey investigated determinants of malaria prevention and treatment seeking behaviours of pregnant undergraduates resident in university hostels, South-East Nigeria. Purposive sampling was used to enrol 121 accessible and consenting undergraduates with self-revealed and noticeable pregnancy residing in twenty-three female hostels of four university campuses in Enugu State, Nigeria. Structured interview guide developed based on reviewed literature and WHO-recommended malaria prevention and treatment measures was used to collect students' self-report data on malaria preventive health behaviours, sick role behaviours, and clinic use using mixed methods. The WHO-recommended malaria prevention measures were sparingly used. Some believed that pregnancy does not play any role in a woman's reaction to malaria infection. Only 41 (50.6%) visited a hospital for screening and treatment. Thirty-four (28.1%) used antimalaria medicine bought from chemist shop or over-the-counter medicines, while 33 (27.3%) used untreated net. The students were more likely to complete their antimalaria medicine when they were sick with malaria infection than for prevention ( p = 0.0186). Knowledge, academic schedule, cultural influence on perception and decision-making, and accessibility of health facility were key determinants of the women's preventive and treatment seeking behaviours. Health education on malaria prevention and dangers of drug abuse should form part of orientation lectures for all freshmen. University health centres should be upgraded to provide basic antenatal care services.

  12. Determinants of Malaria Prevention and Treatment Seeking Behaviours of Pregnant Undergraduates Resident in University Hostels, South-East Nigeria

    Science.gov (United States)

    Agbapuonwu, Noreen Ebelechukwu; Onyiapat, JaneLovena Enuma; Israel, Chidimma Egbichi; Ilo, Clementine Ifeyinwa; Arinze, Joyce Chinenye

    2017-01-01

    This cross-sectional descriptive survey investigated determinants of malaria prevention and treatment seeking behaviours of pregnant undergraduates resident in university hostels, South-East Nigeria. Purposive sampling was used to enrol 121 accessible and consenting undergraduates with self-revealed and noticeable pregnancy residing in twenty-three female hostels of four university campuses in Enugu State, Nigeria. Structured interview guide developed based on reviewed literature and WHO-recommended malaria prevention and treatment measures was used to collect students' self-report data on malaria preventive health behaviours, sick role behaviours, and clinic use using mixed methods. The WHO-recommended malaria prevention measures were sparingly used. Some believed that pregnancy does not play any role in a woman's reaction to malaria infection. Only 41 (50.6%) visited a hospital for screening and treatment. Thirty-four (28.1%) used antimalaria medicine bought from chemist shop or over-the-counter medicines, while 33 (27.3%) used untreated net. The students were more likely to complete their antimalaria medicine when they were sick with malaria infection than for prevention (p = 0.0186). Knowledge, academic schedule, cultural influence on perception and decision-making, and accessibility of health facility were key determinants of the women's preventive and treatment seeking behaviours. Health education on malaria prevention and dangers of drug abuse should form part of orientation lectures for all freshmen. University health centres should be upgraded to provide basic antenatal care services. PMID:29333296

  13. Dental treatment needs and health care-seeking behaviours of patients with acute odontogenic infections in Lithuania.

    Science.gov (United States)

    Rastenienė, Rūta; Aleksejūnienė, Jolanta; Pūrienė, Alina

    2015-08-01

    To assess patients with acute odontogenic maxillofacial infections (AOMIs), regarding their functional dentition and dental treatment needs, and identify factors explaining these outcomes. During a 1-year period, 160 patients with AOMIs were treated at the specialised dental care centre of Vilnius University. Both oral status and specific dental treatment needs were evaluated for each patient. For the restorative dental treatment need, we examined if patients needed fillings, crowns or bridges. Periodontal dental treatment needs were based only on the most severe cases, and patients were allocated either to a group for which periodontal treatment was recommended or to a group that did not need periodontal treatment. Based on these clinical assessments, four ratios for specific dental treatment needs (restorations, extractions, endodontic treatment and periodontal treatment) and two summative ratios (total dental treatment needs and presence of a functional dentition) were calculated. The questionnaire included variables from various domains. Patients with AOMIs retained one-third of their functional dentition and the mean ± standard deviation of their total dental treatment needs was 46.0 ± 29.7%, of which 32.4 ± 17.1% related to the need for restorations. Higher dental treatment needs were associated with a low level of education, low income, irregular oral self-care, systemic diseases and self-treatment of acute dental conditions before seeking professional help. Patients with AOMIs retained one-third of their functional dentition, and almost half of their dentition were in need of dental treatment. © 2015 FDI World Dental Federation.

  14. Seeking alternatives to probit 9 when developing treatments for wood packaging materials under ISPM No. 15

    Science.gov (United States)

    R.A. Haack; A. Uzunovic; K. Hoover; J.A. Cook

    2011-01-01

    ISPM No. 15 presents guidelines for treating wood packaging material used in international trade. There are currently two approved phytosanitary treatments: heat treatment and methyl bromide fumigation. New treatments are under development, and are needed given that methyl bromide is being phased out. Probit 9 efficacy (100% mortality of at least 93 613 test organisms...

  15. The relation between antisocial and borderline personality symptoms and early maladaptive schemas in a treatment seeking sample of male substance users.

    Science.gov (United States)

    Shorey, Ryan C; Anderson, Scott; Stuart, Gregory L

    2014-01-01

    Individuals with substance use disorders are more likely to have antisocial and borderline personality disorder than non-substance abusers. Recently, research has examined the relations between early maladaptive schemas and personality disorders, as early maladaptive schemas are believed to underlie personality disorders. However, there is a dearth of research on the relations between early maladaptive schemas and personality disorders among individuals seeking treatment for substance abuse. The current study examined the relations among early maladaptive schemas and antisocial and borderline personality within in a sample of men seeking substance abuse treatment (n = 98). Results demonstrated that early maladaptive schema domains were associated with antisocial and borderline personality symptoms. Implications of these findings for substance use treatment and research are discussed. Antisocial (ASPD) and Borderline (BPD) personality disorder symptoms are prevalence among individuals seeking substance abuse treatment. Early maladaptive schemas are believed to underlie the development of ASPD and BPD symptoms, and are also prevalence among individuals seeking substance use treatment. Findings from the current study suggest that specific early maladaptive schema domains predict ASPD and BPD symptoms in a substance abuse treatment seeking sample of adult males. The treatment of ASPD and BPD among men seeking substance use treatment may want to focus on early maladaptive schemas. Copyright © 2013 John Wiley & Sons, Ltd.

  16. Sleep disturbances and suicidal ideation in a sample of treatment-seeking Canadian Forces members and veterans.

    Science.gov (United States)

    Don Richardson, J; Cyr, Kate St; Nelson, Charles; Elhai, Jon D; Sareen, Jitender

    2014-08-15

    This study examines the association between suicidal ideation and sleep disturbances in a sample of treatment-seeking Canadian Forces members and veterans, after controlling for probable posttraumatic stress disorder (PTSD), major depressive disorder (MDD), generalised anxiety disorder (GAD), and alcohol use disorder (AUD). Subjects included members and veterans of Canadian Forces seeking treatment at a hospital-based Operational Stress Injury Clinic (n=404). Sleep disturbances and nightmares were measured using individual items on the PTSD Checklist - Military Version (PCL - M), while the suicidality item of the Patient Health Questionnaire (PHQ-9) was used as a stand-alone item to assess presence or absence of suicidal ideation. Regression analyses were used to determine the respective impact of (1) insomnia and (2) nightmares on suicidal ideation, while controlling for presence of probable PTSD, MDD, GAD, and AUD. We found that 86.9% of patients reported having problems falling or staying asleep and 67.9% of patients reported being bothered by nightmares related to military-specific traumatic events. Neither sleep disturbances nor nightmares significantly predicted suicidal ideation; instead, probable MDD emerged as the most significant predictor. The clinical implications of these findings and their potential impact on treatment guidelines are discussed. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  17. Patterns and Determinants of Treatment Seeking among Previously Untreated Psychotic Patients in Aceh Province, Indonesia: A Qualitative Study

    Directory of Open Access Journals (Sweden)

    Marthoenis Marthoenis

    2016-01-01

    Full Text Available Immediate treatment of first-episode psychosis is essential in order to achieve a positive outcome. However, Indonesian psychiatric patients often delay accessing health services, the reason for which is not yet fully understood. The current study aimed to understand patterns of treatment seeking and to reveal determinants of the delay in accessing psychiatric care among first-time user psychotic patients. Qualitative interviews were conducted with sixteen family members who accompanied the patients to a psychiatric hospital. Many families expressed beliefs that mental illness appertains to village sickness and not hospital sickness; therefore, they usually take the patients to traditional or religious healers before taking them to a health professional. They also identified various factors that potentially delay accessing psychiatric treatment: low literacy and beliefs about the cause of the illness, stigmatisation, the role of extended family, financial problems, and long distance to the psychiatric hospital. On the other hand, the family mentioned various factors related to timely help seeking, including being a well-educated family, living closer to health facilities, previous experience of successful psychotic therapy, and having more positive symptoms of psychosis. The findings call for mental health awareness campaigns in the community.

  18. Treatment of traumatized victims of war and torture: a randomized controlled comparison of narrative exposure therapy and stress inoculation training.

    Science.gov (United States)

    Hensel-Dittmann, D; Schauer, M; Ruf, M; Catani, C; Odenwald, M; Elbert, T; Neuner, F

    2011-01-01

    The aim of the present randomized controlled trial was to compare the outcome of 2 active treatments for posttraumatic stress disorder (PTSD) as a consequence of war and torture: narrative exposure therapy (NET) and stress inoculation training (SIT). Twenty-eight PTSD patients who had experienced war and torture, most of them asylum seekers, received 10 treatment sessions of either NET or SIT at the Outpatient Clinic for Refugees, University of Konstanz, Germany. Posttests were carried out 4 weeks after treatment, and follow-up tests were performed 6 months and 1 year after treatment. The main outcome measure was the PTSD severity score according to the Clinician-Administered PTSD Scale (CAPS) at each time point. A significant reduction in PTSD severity was found for NET, but not for SIT. A symptom reduction in the NET group occurred between pretest and the 6-month follow-up examination, the effect size being d = 1.42 (for SIT: d = 0.12), and between pretest and the 1-year follow-up, the effect size being d = 1.59 (for SIT: d = 0.19). The rates and scores of major depression and other comorbid disorders did not decrease significantly over time in either of the 2 treatment groups. The results indicate that exposure treatments like NET lead to a significant PTSD symptom reduction even in severely traumatized refugees and asylum seekers. Copyright © 2011 S. Karger AG, Basel.

  19. Time limited psychodynamic group therapy: Predictors of patients seeking additional treatment

    DEFF Research Database (Denmark)

    Jensen, Hans Henrik; Mortensen, Erik Lykke; Lotz, Martin

    2010-01-01

    for psychological or psychiatric problems; the percentage was 41.6 when further treatment was defined as participating in more than 5 sessions. The majority (94.8 was treated within the public health services. Participation in additional treatment was predicted by improvement on the MCMI Antisocial personality...... disorder scale and a higher SCL-90-R Somatization end-state score. When additional treatment was defined as receiving more than 5 sessions, lack of paid work before treatment (odds ratio 8.0), lack of social network support (odds ratio 2.9), and the Antisocial pre-post difference score (odds ratio 1...

  20. Physical and sexual violence, mental health indicators, and treatment seeking among street-based population groups in Tegucigalpa, Honduras.

    Science.gov (United States)

    Rio Navarro, Javier; Cohen, Julien; Rocillo Arechaga, Eva; Zuniga, Edgardo

    2012-05-01

    To establish the prevalence of exposure to physical and sexual violence, mental health symptoms, and medical treatment-seeking behavior among three street-based subpopulation groups in Tegucigalpa, Honduras, and to assess the association between sociodemographic group, mental health indicators, and exposure to violence. An anonymous, cross-sectional survey among randomly selected street-based adolescents, adults, and commercial sex workers (CSWs) was undertaken at the end of 2010 in Tegucigalpa. Médecins Sans Frontières (MSF) mapped places where the study population gathers. Stratified probability samples were drawn for all groups, using two-stage random sampling. Trained MSF staff administered on-site standardized face-to-face questionnaires. Self-reported exposure to severe physical violence in the previous year was 20.9% among street-based adolescents, 28.8% among adults, and 30.6% among CSWs. For the physical violence event self-defined as most severe, 50.0% of the adolescents, 81.4% of the adults, and 70.6% of the CSWs sought medical treatment. Their exposure to severe sexual violence was 8.6%, 28.8%, and 59.2%, respectively. After exposure to the self-defined most severe sexual violence event, 14.3% of adolescents, 31.9% of adults, and 29.1% of CSWs sought treatment. Common mental health and substance abuse symptoms were highly prevalent and strongly associated with exposure to physical (odds ratio 4.5, P sexual (odds ratio 3.7, P = 0.0001) violence. Exposure to physical and sexual violence reached extreme levels among street-based subpopulations. Treatment-seeking behavior, particularly after severe sexual violence, was limited. The association of mental health and substance abuse symptoms with exposure to violence could lead to further victimization. Medical and psychological treatments targeting these groups are needed and could help decrease their vulnerability.

  1. Craving as an Alcohol Use Disorder Symptom in DSM-5: An Empirical Examination in a Treatment-seeking Sample

    Science.gov (United States)

    Murphy, Cara M.; Stojek, Monika K.; Few, Lauren R.; Rothbaum, Alex O.; MacKillop, James

    2014-01-01

    Craving has been added as an Alcohol Use Disorder (AUD) symptom in DSM-5 but relatively few nosological studies have directly examined the empirical basis for doing so. The current study investigated the validity of craving as an AUD symptom in a sample of heavy drinking treatment-seeking individuals. Using a semi-structured clinical interview, treatment-seeking heavy drinkers (N = 104; 62% male) were assessed for symptoms of DSM-IV AUD. The extent to which individuals endorsed pathological levels of craving in comparison to other AUD symptoms was investigated as was the association between craving and several aspects of problematic alcohol involvement. Factor analysis was utilized to examine whether craving and other AUD symptoms comprised a unidimensional syndrome. Results indicated that craving was significantly positively correlated with AUD severity, quantitative indices of drinking, and adverse consequences of alcohol abuse. In terms of frequency of endorsement, craving was present in 47% of the sample and was the 8th most frequent of the twelve symptoms evaluated. When considered with the DSM-IV AUD criteria, craving aggregated with other symptoms to form a unidimensional syndrome. Extending previous findings from epidemiological samples, these data suggest that, in a clinical sample, many relevant aspects of craving aggregate to form a diagnostic criterion that functions similarly to other AUD symptoms and is related to diverse aspects of alcohol-related impairment. PMID:24490710

  2. An examination of weight bias among treatment-seeking obese patients with and without binge eating disorder.

    Science.gov (United States)

    Barnes, Rachel D; Ivezaj, Valentina; Grilo, Carlos M

    2014-01-01

    The objective was to compare weight-bias attitudes among treatment-seeking obese patients with and without binge eating disorder (BED vs. NBO) and to explore racial and sex differences and correlates of weight-bias attitudes. Participants included 221 obese patients (169 female, 52 male) seeking treatment for weight and eating, recruited through primary care settings; of these, 168 patients met BED criteria. Patients completed semi-structured interviews and psychometrically established self-report measures of attitudes about obesity, eating pathology and depression. Main effects for group (BED vs. NBO) and race (White vs. African American) were significant. Patients with BED had significantly higher levels of negative attitudes towards obesity than NBO patients, while African American patients had significantly lower levels of weight bias than did White patients. Greater negative attitudes towards obesity were significantly correlated with higher levels of depression and eating pathology for all patients. Endorsement of negative weight bias was related to binge eating status, race, disordered eating, and depression. Primary care providers should be aware of weight biases among their patients. Copyright © 2014 Elsevier Inc. All rights reserved.

  3. An examination of weight bias among treatment-seeking obese patients with and without binge eating disorder

    Science.gov (United States)

    Barnes, Rachel D.; Ivezaj, Valentina; Grilo, Carlos M.

    2013-01-01

    Objective The objective was to compare weight-bias attitudes among treatment-seeking obese patients with and without binge eating disorder (BED vs. NBO) and to explore racial and sex differences and correlates of weight-bias attitudes. Method Participants included 221 obese patients (169 female, 52 male) seeking treatment for weight and eating, recruited through primary care settings; of these, 168 patients met BED criteria. Patients completed semi-structured interviews and psychometrically established self-report measures of attitudes about obesity, eating pathology and depression. Results Main effects for group (BED vs. NBO) and race (White vs. African American) were significant. Patients with BED had significantly higher levels of negative attitudes towards obesity than NBO patients, while African American patients had significantly lower levels of weight bias than did White patients. Greater negative attitudes towards obesity were significantly correlated with higher levels of depression and eating pathology for all patients. Conclusions Endorsement of negative weight bias was related to binge eating status, race, disordered eating, and depression. Primary care providers should be aware of weight biases among their patients. PMID:24359678

  4. Attachment dimensions and group climate growth in a sample of women seeking treatment for eating disorders.

    Science.gov (United States)

    Illing, Vanessa; Tasca, Giorgio A; Balfour, Louise; Bissada, Hany

    2011-01-01

    Adult attachment and group process research are emerging areas of research for treating eating disorders. In this study, we examined several aspects of group processes: the weekly growth of group therapy climate, the relationship between group climate growth and outcomes, and the impact of the group on individual experiences of group climate. Further, we assessed the relationship between adult attachment dimensions and these group processes. Women (n = 264) diagnosed with an eating disorder completed attachment scales pre-treatment, eating disorder symptom scales pre- and post-treatment, and group climate scales weekly during treatment. Treatment consisted of a specialized eating disorders group-based day hospital program with rolling admissions. Engaged group climate increased and Avoidance group climate decreased across weeks of treatment. Engaged group climate growth was associated with improved eating disorder symptoms post-treatment. Higher attachment avoidance at pre-treatment was related to lower Engaged group climate at week 1, and was related to a greater impact of the group on the individual's experience of group engagement. Clinicians might improve group processes and outcomes by tailoring interventions to individuals' attachment avoidance when treating women for eating disorders.

  5. [Clinical characteristics of computer game and internet addiction in persons seeking treatment in an outpatient clinic for computer game addiction].

    Science.gov (United States)

    Beutel, Manfred E; Hoch, Christina; Wölfling, Klaus; Müller, Kai W

    2011-01-01

    Since March 2008 we have offered outpatient treatment for computer game and internet addiction. This article presents the assessment and clinical characterization of the first cohort of one year. The reasons for seeking help (phone consultations, N=346) as well as sociodemographic and psychometric characteristics (N=131) (assessment of computer game addiction; SCL-90R) are presented. Consultation was initiated mainly by relatives--mostly the mothers (86%); 48% report achievement failure and social isolation, lack of control (38%) and conflicts within the family (33%). Two-thirds of the mainly male (96%) patients (N=131) with an average age of 22 (range 13-47) years met the criteria for pathological computer gaming, characterized by an excessive number of hours and preoccupation with gaming, high distress, and unemployment. Symptoms resemble those of other addiction disorders. The consequences for disorder-specific treatment concepts and research are discussed.

  6. Lifestyle-Related Factors Associated with Reproductive Health in Couples Seeking Fertility Treatments: Results of A Pilot Study

    Directory of Open Access Journals (Sweden)

    Marie-Lou Piché

    2018-01-01

    Full Text Available Background The objective of this pilot study was to evaluate the feasibility of conducting a larger prospective cohort study, which will aim at determining the independent contribution of male and female lifestyle-related factors to assisted reproductive technology (ART success. The study also examined whether couples seeking fertility treatments present lifestyle-related factors that may interfere with their reproductive health. Materials and Methods This prospective pilot study was conducted in a fertility clinic between May 2015 and February 2016. Feasibility factors evaluated were recruitment rates, compliance with the protocol, retention rate and ART outcomes at six-month follow-up. Anthropometric profile and lifestyle habits of both partners were evaluated before the beginning of infertility treatments. Results We approached 130 eligible infertile couples. Among them, 32 (25% agreed to participate and 28 (88% complied with the protocol. At six-month follow-up, seven couples (25% did not start, or stop, infertility treatments and 13 couples (62% achieved a clinical pregnancy. Among the 28 couples included in the analyses, 16% of the partners were obese and 23% had abdominal obesity. The majority of the subjects were still drinking alcohol (84%. Sixty-eight percent of women needed improvement in their diet (vs. 95% of men, P=0.05 and none of them achieved the Canadian recommendations for physical activity (vs. 33% of men, P=0.001. Moreover, 35% of the partners had a poor sleep quality. Overall, women presented a worse reproductive health profile than men, with 3.1 and 2.4 out of seven adverse factors, respectively (P=0.04. Conclusion Conducting a large prospective cohort study in our fertility clinic will be feasible but recruitment and compliance with the protocol need to be improved. Many women and men seeking fertility treatments present unfavourable lifestyle-related factors that may explain, at least partially, their difficulties in

  7. Who is the Treatment-Seeking Young Adult with Severe Obesity: A Comprehensive Characterization with Emphasis on Mental Health.

    Science.gov (United States)

    Dreber, Helena; Reynisdottir, Signy; Angelin, Bo; Hemmingsson, Erik

    2015-01-01

    To characterize treatment-seeking young adults (16-25 years) with severe obesity, particularly mental health problems. Cross-sectional study of 165 participants (132 women, 33 men) with BMI ≥35 kg/m2 or ≥30 kg/m2 with comorbidities, enrolling in a multidisciplinary obesity treatment program. Data collection at admission of present and life-time health issues including symptomatology of anxiety, depression (Hospital Anxiety and Depression Scale) and attention-deficit/hyperactivity disorder (Adult ADHD Self-Report scale); self-esteem (Rosenberg Self-Esteem Scale), suicide attempts, health-related quality of life (Short Form-36 Health Survey), psychosocial functioning related to obesity (Obesity-related Problems Scale), cardiorespiratory fitness (Astrand's bicycle ergometer test), somatic and psychiatric co-morbidities, cardiometabolic risk factors, and micronutritional status. We used multiple regression analysis to identify variables independently associated with present anxiety and depressive symptomatology. Mean body mass index was 39.2 kg/m2 (SD = 5.2). We found evidence of poor mental health, including present psychiatric diagnoses (29%), symptomatology of anxiety (47%), depression (27%) and attention-deficit/hyperactivity disorder (37%); low self-esteem (42%), attempted suicide (12%), and low quality of life (physical component score = 46, SD = 11.2; mental component score = 36, SD = 13.9, Pdepressive symptomatology (R2 = 0.38, Prelated problems (P = 0.018). The prevalence of type 2 diabetes was 3%, and hypertension 2%. Insulin resistance was present in 82%, lipid abnormality in 62%, and poor cardiorespiratory fitness in 92%. Forty-eight percent had at least one micronutritional deficiency, vitamin D being the most common (35%). A wide range of health issues, including quite severe mental health problems, was prevalent in treatment-seeking young adults with severe obesity. These are likely to constitute a major treatment challenge, including options

  8. 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).

  9. Socioeconomic characteristics of alcohol and other substance users, seeking treatment in Sikkim, North East India

    Directory of Open Access Journals (Sweden)

    Sunil Kumar Pandey

    2015-01-01

    Full Text Available Objectives: The present study was conducted to generate information for better understanding of socioeconomic and CAGE characteristics of alcohol and other substance users who were undergoing treatment in Sikkim. Subjects and Methods: Socioeconomic and CAGE questionnaire was administered to alcohol and other substance abusers of Sikkim (n = 241 who were undergoing treatment in different treatment centers of Sikkim. Information was collected on printed instrument after taking participant′s consent and data was statistically analyzed. Results: Male participants (93.8% outnumbered female (6.2%. Majority of the sample were either in the school dropout group or school completed (36.1% group. Most of the samples were occupationally unemployed, urban residents, Nepali by ethnicity, single, and Hindu (48.5% by religion. Minimum age for starting of alcohol and drug was 5 years and 7 years respectively. Knowledge about AIDS and its transmission was satisfactory. All the four CAGE characteristics were present in majority of samples. Conclusions: Climate, geographical location, wide and easy availability of alcohol in Sikkim make this state vulnerable for alcohol abuse. Alcohol drinking among parents, sibling and friends found to be important risk factor. Outreach to the community for better acceptability of treatment is an important area to fill the gap of treatment demand and treatment supply.

  10. Attachment as an organizer of behavior: implications for substance abuse problems and willingness to seek treatment

    Directory of Open Access Journals (Sweden)

    Troutman Beth

    2006-11-01

    Full Text Available Abstract Background Attachment theory allows specific predictions about the role of attachment representations in organizing behavior. Insecure attachment is hypothesized to predict maladaptive emotional regulation whereas secure attachment is hypothesized to predict adaptive emotional regulation. In this paper, we test specific hypotheses about the role of attachment representations in substance abuse/dependence and treatment participation. Based on theory, we expect divergence between levels of maladaptive functioning and adaptive methods of regulating negative emotions. Methods Participants for this study consist of a sample of adoptees participating in an ongoing longitudinal adoption study (n = 208. The Semi-Structured Assessment of the Genetics of Alcohol-II 41 was used to determine lifetime substance abuse/dependence and treatment participation. Attachment representations were derived by the Adult Attachment Interview [AAI; 16]. We constructed a prior contrasts reflecting theoretical predictions for the association between attachment representations, substance abuse/dependence and treatment participation. Results Logistic regression was used to test our hypotheses. As predicted, individuals classified as dismissing, preoccupied or earned-secure reported the highest rates of substance abuse/dependence. Individuals classified as dismissing reported significantly lower rates of treatment participation despite their high rates of substance abuse/dependence. As expected, the continuous-secure group reported lowest rates of both substance abuse/dependence and treatment participation. Conclusion The findings from this study identify attachment representations as an influential factor in understanding the divergence between problematic substance use and treatment utilization. The findings further imply that treatment may need to take attachment representations into account to promote successful recovery.

  11. A defence of the requirement to seek consent to withhold and withdraw futile treatments.

    Science.gov (United States)

    Stewart, Cameron L

    2012-04-02

    Futility assessments, which are unavoidable in end-of-life settings, need to be procedurally fair. This necessitates communication between health professionals and substitute decisionmakers regarding the decision to define treatments as futile. The common law test for whether treatment should be withheld or withdrawn is the best interests test. A futile treatment is not in any patient's best interests. While it is rare for the law to disagree with a futility determination made by health professionals, if a determination has been made without consultation and fails to reflect the patient's best interests, the courts will overturn it. The best regulatory regimes provide for a balance between the powers of health professionals and substitute decisionmakers to make decisions for incompetent patients, and for clear and efficient dispute resolution. The Queensland law and its requirement for consent to withhold or withdraw futile treatment represents a good model of futility determination, with clear powers given to substitute decisionmakers and health professionals. Disputes concerning the treatment of incompetent patients automatically trigger the appointment of the adult guardian as the decisionmaker, and there are avenues for appeal.

  12. Splitting, impulsivity, and intimate partnerships in young obese women seeking bariatric treatment

    Directory of Open Access Journals (Sweden)

    Zmolikova J

    2016-09-01

    Full Text Available Jana Zmolikova,1,2 Dita Pichlerova,3 Petr Bob,1,4 Denisa Schückova,5 Jitka Herlesova,3 Petr Weiss6 1Department of Psychiatry, First Faculty of Medicine, Center for Neuropsychiatric Research of Traumatic Stress, Charles University, 2Department of Clinical Psychology, Na Homolce Hospital, 3OB Clinic, Prague, 4Faculty of Medicine, Central European Institute of Technology, Masaryk University, Brno, 5Iscare Clinical Centre, 6Institute of Sexology, First Faculty of Medicine, Charles University, Prague, Czech Republic Background: Splitting represents a defense mechanism that describes fragmentation of conscious experience that may occur in various psychopathological conditions. The purpose of this study was to examine the relationship of splitting with disturbed cognitive and affective functions related to impulsivity and intimate partnerships in a group of obese patients indicated for bariatric treatment and compare the results with other obese patients and patients with bulimia nervosa. Methods: In this clinical study, we assessed 102 young women. The sample was divided into three subgroups: obese women (N=30, obese women indicated for bariatric treatment (N=48, and patients with bulimia nervosa (N=24. The patients were assessed using Splitting Index and Barratt Impulsivity Scale, and selected information about their intimate partnership was documented for all the participants.Results: The main results of this study indicate significant differences in the relationship of splitting and impulsivity with difficulties in intimate partnerships. These differences discriminate obese patients indicated for bariatric treatment from other obese patients and patients with bulimia nervosa.Conclusion: These findings may have significant implications for treatment of the obese patients indicated for bariatric treatment and their presurgery psychological evaluations. Keywords: splitting, impulsivity, obesity, bulimia nervosa, bariatric treatment

  13. Depression mediates and moderates effects of methamphetamine use on sexual risk taking among treatment-seeking gay and bisexual men.

    Science.gov (United States)

    Fletcher, Jesse B; Reback, Cathy J

    2015-08-01

    Mounting evidence suggests a syndemic relation between methamphetamine use and depression to increase sexual risk taking (i.e., HIV transmission risk behavior) among men who have sex with men. This prospective analysis of longitudinal data collected from an outpatient methamphetamine abuse treatment program for gay and bisexual men assessed whether symptoms of depression mediated and/or moderated the associations between methamphetamine use and unprotected insertive/receptive anal intercourse. From November 2005 through October 2007, 167 treatment-seeking gay and bisexual men (63% HIV-positive) enrolled in and attended a 16-week methamphetamine abuse outpatient treatment program. Participants' depressive symptoms, biomarker-confirmed methamphetamine use, and self-reported sexual risk taking were assessed at baseline and follow-up evaluations. Path analysis tested the mediating and moderating effects of depression on the associations between methamphetamine use and unprotected insertive/receptive anal intercourse. Methamphetamine use during the treatment period had a significant indirect (Coef. = -.15; 95% CI [-.23, -.06]), but no direct (Coef. = .11; ns) or total effect (Coef. = -.04; ns) on participants' sexual risk taking after accounting for the significant mediating (Coef. = .56; 95% CI [.33, .78]) and moderating (Coef. = -.03; 95% CI [-.04, -.02]) effects of depression. Depression fully mediated and weakly moderated associations between methamphetamine use and sexual risk taking in this sample. Interventions and treatment programs to reduce sexual risk taking among gay and bisexual men should simultaneously address methamphetamine use and depression to optimize health outcomes. (c) 2015 APA, all rights reserved).

  14. Stigma, career worry, and mental illness symptomatology: Factors influencing treatment-seeking for Operation Enduring Freedom and Operation Iraqi Freedom soldiers and veterans.

    Science.gov (United States)

    Brown, Nicholas B; Bruce, Steven E

    2016-05-01

    Mental health related stigma, as well as mental illness symptomatology, have been shown to negatively impact treatment-seeking within military populations. However, few studies have delineated the 2 forms of stigma (self-stigma and public stigma), and none have differentiated between stigma and career-related consequences (career worry). The aim of this study was to increase our understanding of low treatment-seeking rates among soldiers and veterans by expanding upon previous measurements of the stigma construct and examining factors influencing willingness to seek treatment. The sample consisted of 276 Operation Enduring Freedom and Operation Iraqi Freedom (OEF/OIF) soldiers and veterans. Individual levels of self-stigma, public stigma, and career worry were measured, as were levels of willingness to seek treatment. Symptoms of PTSD, depression, and substance abuse were also evaluated to account for the influence of mental illness on treatment-seeking. A confirmatory factor analysis indicated that a 3-factor model including self-stigma, public stigma, and career worry fit the data significantly better than a 1- or 2- factor model. A multiple regression analysis also revealed that these 3 factors, combined with mental illness symptomatology, significantly predicted individual levels of willingness to seek treatment. Career worry was the strongest predictor, particularly for individuals with no treatment history. This study confirmed that career worry is a factor independent of self-stigma and public stigma. Findings indicate that a fear of negatively affecting one's career is the most influential factor in determining willingness to seek mental health treatment for the military population. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

  15. Pre-treatment preferences and characteristics among patients seeking in vitro fertilisation.

    LENUS (Irish Health Repository)

    Walsh, Anthony Ph

    2009-01-01

    BACKGROUND: This study sought to describe patient features before beginning fertility treatment, and to ascertain their perceptions relative to risk of twin pregnancy outcomes associated with such therapy. METHODS: Data on readiness for twin pregnancy outcome from in vitro fertilisation (IVF) was gathered from men and women before initiating fertility treatment by anonymous questionnaire. RESULTS: A total of 206 women and 204 men were sampled. Mean (+\\/- SD) age for women and men being 35.5 +\\/- 5 and 37.3 +\\/- 7 yrs, respectively. At least one IVF cycle had been attempted by 27.2% of patients and 33.9% of this subgroup had initiated >\\/=3 cycles, reflecting an increase in previous failed cycles over five years. Good agreement was noted between husbands and wives with respect to readiness for twins from IVF (77% agreement; Cohen\\'s K = 0.61; 95% CI 0.53 to 0.70). CONCLUSION: Most patients contemplating IVF already have ideas about particular outcomes even before treatment begins, and suggests that husbands & wives are in general agreement on their readiness for twin pregnancy from IVF. However, fertility patients now may represent a more refractory population and therefore carry a more guarded prognosis. Patient preferences identified before IVF remain important, but further studies comparing pre- and post-treatment perceptions are needed.

  16. When Problem Gambling Is the Primary Reason for Seeking Addiction Treatment

    Science.gov (United States)

    Jamieson, John; Mazmanian, Dwight; Penney, Alexander; Black, Nancy; Nguyen, An

    2011-01-01

    An existing database was used to compare problem gamblers (N = 138) who presented for treatment of their gambling problem to two other groups: alcohol and/or drug addiction clients who also had a gambling problem (N = 280) or who did not have a gambling problem (N = 2178). Clients with gambling as their primary problem were more likely to be…

  17. Hepatitis B virus infection status and infertility causes in couples seeking fertility treatment-Indicator of impaired immune response?

    Science.gov (United States)

    Lao, Terence T; Mak, Jennifer S M; Li, Tin-Chiu

    2017-04-01

    The relationship between hepatitis B (HBV) infection in infertile couples seeking in vitro fertilization (IVF) treatment and infertility causes is unknown. A total of 831 infertile couples attending our unit seeking IVF during January to December 2015 were recruited. HBV infection was found in 6.3% and 7.3% of female and male partners, respectively, and infection in one or both partners was associated with less primary infertility (44.2% vs 55.1%, P=.038). Infected female partners had increased tubal (69.2% vs 43.2%, Pinfertility, while infected male partners were associated with increased tubal (62.3% vs 43.4%, P=.004) causes and reduced endometriosis (62.3% vs 73.9%, P=.050). Our results suggest HBV infection in either partner was associated with tubal infertility. HBV infection in either partner probably increases the risk of pelvic infection in female partner through impaired immune response to sexually transmitted infections, with consequent tubal damage and infertility. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  18. Health Seeking Behaviour and Treatment Intentions of Dengue and Fever: A Household Survey of Children and Adults in Venezuela.

    Science.gov (United States)

    Elsinga, Jelte; Lizarazo, Erley F; Vincenti, Maria F; Schmidt, Masja; Velasco-Salas, Zoraida I; Arias, Luzlexis; Bailey, Ajay; Tami, Adriana

    2015-12-01

    Dengue in Venezuela is a major public health problem with an increasing incidence of severe cases. Early diagnosis and timely treatment influences the outcome of dengue illness, as delay in care-seeking is significantly associated with complications leading to severe dengue. We aimed to understand patterns of health seeking behaviour (HSB) in individuals exposed to high dengue incidence in order to improve early attendance to health centres. Between September 2013 and February 2014 a cross-sectional household survey was performed in Maracay, Venezuela. Intended HSB of adults and children's parents/guardians was assessed with respect to fever or suspected dengue. Data was collected through structured questionnaires from 105 individuals. Most individuals felt at risk of dengue and believed it could be a deadly disease. In the case of suspected dengue, the majority (60%) would choose to first seek medical help versus first treating at home, in contrast to 11% in the case of fever. Amongst those who decided to visit a doctor, a suspected dengue infection would prompt them to search medical help earlier than if having only fever (pdengue were feeling at risk (OR = 3.29; p = 0.042) and being an adult (as opposed to caring for a child as a parent/guardian; OR = 3.33, p = 0.021), while having had a previous dengue infection (OR = 0.29; p = 0.031) and living in the neighbourhood Caña de Azúcar (OR = 0.28, p = 0.038) were negatively associated with seeking medical care as their first action. Knowledge of HSB related to dengue is scarce in the Americas, our study attempts to contribute to a better understanding of HSB in this region. Improving early dengue disease recognition and awareness may enhance prompt attendance to medical care in affected populations and thereby reduce mortality and severity of dengue. Especially for those with a previous dengue infection, efforts have to be made to promote prompt health centre attendance.

  19. Fighting the Drug War.

    Science.gov (United States)

    The Journal of State Government, 1990

    1990-01-01

    All nine articles in this periodical issue focus on the theme of the war against illegal drug use, approaching the topic from a variety of perspectives. The articles are: "The Drug War: Meeting the Challenge" (Stanley E. Morris); "Ways to Fight Drug Abuse" (Bruce A. Feldman); "Treatment Key to Fighting Drugs" (Stan…

  20. Dispositional mindfulness, spirituality, and substance use in predicting depressive symptoms in a treatment-seeking sample.

    Science.gov (United States)

    Shorey, Ryan C; Gawrysiak, Michael J; Anderson, Scott; Stuart, Gregory L

    2015-04-01

    It is imperative that research identifies factors related to depression among individuals in substance use treatment, as depression is associated with substance use relapse. Dispositional mindfulness and spirituality may bear an important role in the relationship between depression and substance use. Using preexisting patient medical records (N = 105), the current study investigated dispositional mindfulness and spirituality in relation to depressive symptom clusters (affective, cognitive, and physiological) among men in residential substance use treatment. The mean age of the sample was 41.03 (standard deviation = 10.75). Findings demonstrated that dispositional mindfulness and spirituality were negatively associated with depressive symptoms. After controlling for age, alcohol use, and drug use, dispositional mindfulness remained negatively associated with all of the depression clusters. Spirituality only remained associated with the cognitive depression cluster. Mindfulness-based interventions may hold promise as an effective intervention for reducing substance use and concurrent depressive symptoms. © 2014 Wiley Periodicals, Inc.

  1. Sleep disturbance and pain in an obese residential treatment-seeking population.

    Science.gov (United States)

    Wachholtz, Amy; Binks, Martin; Suzuki, Ayako; Eisenson, Howard

    2009-09-01

    The relationships between body mass index (BMI) and sleep disturbance, sleep disturbance and pain, and obesity and pain are documented; however, there is a paucity of research exploring how sleep relates to pain in obese populations. The participants comprized 386 (234 women, 152 men) obese (BMI M=40.7) adult (age M=51.0 y) patients enrolling in a 4-week residential obesity treatment program. All information was gathered as part of the initial program evaluation. The prevalence of patients reporting at least 1 disturbed sleep symptom was 84.8%. The prevalence of patients reporting at least 1 type of pain was 83.4%. After controlling for depression, anxiety, BMI, age, and sleep apnea treatment, regression analyses showed that daytime sleepiness, night sweats (Pfirst step in better understanding this relationship.

  2. Measures of psychophysiological arousal among resettled traumatized Iraqi refugees seeking psychological treatment.

    Science.gov (United States)

    Slewa-Younan, Shameran; Chippendale, Kerenze; Heriseanu, Andreea; Lujic, Sanja; Atto, John; Raphael, Beverley

    2012-06-01

    Resettled refugees living in Western countries frequently report high levels of posttraumatic stress disorder (PTSD) and depression. This study sought to measure levels of physiological arousal in a group of resettled Iraqi refugees in Australia receiving psychological treatment. A continuous recording of electrocardiogram (ECG) data was used to examine baseline heart rate (HR) and heart rate variability (HRV) in refugees (n = 25) and healthy age- and sex-matched controls (n = 23). Descriptively, PTSD (48%) was the most commonly noted disorder followed equally by major depressive episode (36%) and dysthymia (36%) in the refugees. Examination of the physiological data indicated that the refugee group had increased resting HR compared with healthy controls (78.84 vs. 60.08 beats per minute, p education included in the model. This finding highlights the importance of examining levels of arousal in refugees presenting with mental health complaints to provide appropriate treatment strategies. Copyright © 2012 International Society for Traumatic Stress Studies.

  3. Predictors of six month change in the voice handicap index in a treatment seeking population

    Science.gov (United States)

    Moore, Jaime; Greenberg, Caprice

    2016-01-01

    Objective To evaluate predictors of longitudinal change in patient-perceived voice impact as determined by the Voice Handicap Index (VHI). Study Design Prospective, survey study. Methods Patients consented to the UW Voice and Swallow Clinics Outcomes Database with voice, breathing and/or cough concerns with a baseline clinic visit from November 2012 to January 2014 were eligible for the study. VHI was sent to patients six months post-clinic visit to determine change in voice handicap from baseline. General health was screened using the SF-12v2 survey, using physical component (PCS) and mental component summary (MCS) scores. Predictor variables included – treatment (medical and/or behavioral), dysphonia sub-diagnosis, GRBAS rating, age, sex, socioeconomic factors, smoking history, and comorbidity score. Results Two-hundred thirty-seven patients met study criteria and were followed longitudinally. Eighty-two patients returned six month surveys. VHI was significantly correlated with MCS scores. Patients with a higher grade in baseline GRBAS score were more likely to receive voice intervention (p = .04). Six-month improvement in VHI score was associated with both higher initial VHI score and higher education level in both univariate (p < .01, p = .04) and multivariate analyses (p < .01, p = .02). Voice treatment (medical and/or behavioral) was not a significant factor for improvement in VHI. Conclusions Our results suggest it is important to consider baseline self-perceived voice impact measures and education level in setting expectations for voice treatment. Future studies examining the relationship between treatment patterns and voice-related patient outcomes are warranted. PMID:26952321

  4. Exposure to Traumatic Events Among Treatment-Seeking, Alcohol Dependent Women and Men without PTSD

    OpenAIRE

    Johnson, Candace S.; Heffner, Jaimee L; Blom, Thomas J.; Anthenelli, Robert M.

    2010-01-01

    We examined lifetime exposure to a range of traumatic events in 106 abstinent, treatment-engaged (85% residential; 15% outpatient), alcohol dependent women (n = 53) and men without current or lifetime posttraumatic stress disorder. Alcohol dependent women reported greater severity of childhood trauma, but similar lifetime exposure to traumatic events compared with men. Alcohol dependent women without cocaine abuse or dependence (n = 10) reported greater severity of childhood trauma than women...

  5. Early Maladaptive Schemas and Aggression in Men Seeking Residential Substance Use Treatment

    OpenAIRE

    Shorey, Ryan C.; Elmquist, Joanna; Anderson, Scott; Stuart, Gregory L.

    2015-01-01

    Social-cognitive theories of aggression postulate that individuals who perpetrate aggression are likely to have high levels of maladaptive cognitive schemas that increase risk for aggression. Indeed, recent research has begun to examine whether early maladaptive schemas may increase the risk for aggression. However, no known research has examined this among individuals in substance use treatment, despite aggression and early maladaptive schemas being more prevalent among individuals with a su...

  6. Sex differences in reinstatement of cocaine-seeking with combination treatments of progesterone and atomoxetine

    OpenAIRE

    Swalve, Natashia; Smethells, John R.; Zlebnik, Natalie E.; Carroll, Marilyn E.

    2016-01-01

    Two repurposed medications have been proposed to treat cocaine abuse. Progesterone, a gonadal hormone, and atomoxetine, a medication commonly used to treat attention deficit/hyperactivity disorder, have both been separately shown to reduce cocaine self-administration and reinstatement (i.e. relapse). The goal of the present study was to examine sex differences in the individual effects of PRO and ATO as well as the combination PRO+ATO treatment on cocaine (COC), caffeine (CAF), and/or cue-pri...

  7. Perceived control and hot flashes in treatment-seeking breast cancer survivors and menopausal women.

    Science.gov (United States)

    Carpenter, Janet S; Wu, Jingwei; Burns, Debra S; Yu, Menggang

    2012-01-01

    Lower perceived control over hot flashes has been linked to fewer coping strategies, more catastrophizing, and greater hot flash severity and distress in midlife women, yet this important concept has not yet been studied in breast cancer survivors. The aim of this study was to explore perceived control over hot flashes and hot flashes in breast cancer survivors compared with midlife women without cancer. Ninety-nine survivors and 138 midlife women completed questionnaires and a prospective, electronic hot flash diary. All data were collected at a baseline assessment before randomization in a behavioral intervention study. Both groups had moderate perceived control over hot flashes. Control was not significantly related to hot flash frequency but was significantly related to hot flash severity, bother, and interference in both groups. A significantly stronger association between control and hot flash interference was found for survivors than for midlife women. Survivors using hot flash treatments perceived less control than did survivors not using hot flash treatments, whereas the opposite was true in midlife women. Findings extend our knowledge of perceived control over hot flashes in both survivors and midlife women. Findings emphasize the importance of continued menopausal symptom assessment and management, support the importance of continuing nursing care even for survivors who are already using hot flash treatment, and suggest that nursing interventions aimed at improving perceived control over hot flashes may be more helpful for survivors than for midlife women.

  8. Recognition and treatment of psychological disorders during military service in the UK armed forces: a study of war pensioners.

    Science.gov (United States)

    Brewin, Chris R; Andrews, Bernice; Hejdenberg, Jennie

    2012-12-01

    Little is known about the detection and treatment of psychological disorders arising during military service. We investigated whether personnel who developed disorders while serving in the UK armed forces came to the attention of medical services for these problems, received corresponding diagnoses, and were treated. For this retrospective record-based study 132 veterans in receipt of a war pension for psychological or physical problems received a lifetime diagnostic interview. Those with onsets of PTSD, depression, or alcohol abuse while in service were compared with those who never developed any condition or only developed it after discharge. Their medical records were inspected for contemporaneous contacts, diagnoses, and treatment. PTSD and depression, but not alcohol abuse, were independently associated with mental health contacts while in service. The median time from PTSD onset to first contact was 1 month. Under half of personnel meeting criteria for these disorders received a corresponding diagnosis, and alcohol abuse was more likely to be recognised in the context of comorbid PTSD. PTSD was as well recognised in earlier as in later years covered by the study. Most personnel with disorders received treatment, and those treated were more likely to be medically downgraded or discharged. War pensioners are more likely than not to have had their psychological problems acknowledged and treated while in service. The fact that these problems are still largely present 10 years later raises questions over the continuity of care associated with the transition to civilian life.

  9. Experiences of ex-ex-gay individuals in sexual reorientation therapy: reasons for seeking treatment, perceived helpfulness and harmfulness of treatment, and post-treatment identification.

    Science.gov (United States)

    Flentje, Annesa; Heck, Nicholas C; Cochran, Bryan N

    2014-01-01

    Therapy meant to change someone's sexual orientation, or reorientation therapy, is still in practice despite statements from the major mental health organizations of its potential for harm. This qualitative study used an inductive content analysis strategy (Patton, 2002) to examine the experiences of thirty-eight individuals (31 males and seven females) who have been through a total of 113 episodes of reorientation therapy and currently identify as gay or lesbian. Religious beliefs were frequently cited as the reason for seeking reorientation therapy. Frequently endorsed themes of helpful components of reorientation therapy included connecting with others and feeling accepted. Harmful aspects of reorientation therapy included experiences of shame and negative impacts on mental health. Common reasons for identifying as LGB after the therapy included self-acceptance and coming to believe that sexual orientation change was not possible. The findings of this study were consistent with recommendations by the American Psychological Association Task Force on Appropriate Therapeutic Responses to Sexual Orientation (2009), which concluded that helpful aspects of reorientation therapy could be achieved through affirmative treatment methods while avoiding potential harms that may be associated with reorientation therapy. Limitations of the findings, including a small, self-selected sample, are discussed.

  10. Comparing perceived public stigma and personal stigma of mental health treatment seeking in a young adult sample.

    Science.gov (United States)

    Pedersen, Eric R; Paves, Andrew P

    2014-09-30

    Perceived public stigma regarding seeking mental health treatment can be a barrier to accessing services for young adults. While factors associating with personal stigma regarding how one would view and treat others have been identified, the discrepancies between perceived and personal stigma have received less research attention. We designed the current study to expand on previous research and examine the discrepancies between perceived public stigma and personal stigma among a sample of 386 primarily White and Asian college students. Participants completed surveys of mental health symptoms, treatment experience and attitudes, perceived public, and personal stigma. Overall, participants generally reported greater perceived public stigma than personal stigma; an effect that was particularly evident for women and those with mental health symptoms. The majority of participants disagreed with items assessing personal stigma. Negative attitudes toward treatment and anxiety symptoms associated with perceived public stigma, while male gender, Asian ethnicity, and negative attitudes toward treatment associated with personal stigma. Findings have implications for interventions and marketing programs to help change perceptions about mental health stigma to encourage utilization of services for those young people who could benefit from care. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  11. Seek, test, treat: substance-using women in the HIV treatment cascade in South Africa.

    Science.gov (United States)

    Wechsberg, Wendee M; van der Horst, Charles; Ndirangu, Jacqueline; Doherty, Irene A; Kline, Tracy; Browne, Felicia A; Belus, Jennifer M; Nance, Robin; Zule, William A

    2017-04-26

    Women in South Africa who use alcohol and other drugs face multiple barriers to HIV care. These barriers make it difficult for women to progress through each step in the HIV treatment cascade from diagnosis to treatment initiation and adherence. This paper examines correlates of HIV status, newly diagnosed HIV status, and use of antiretroviral therapy (ART). Outreach workers recruited sexually active Black African women who used substances in Pretoria as part of a U.S. National Institutes of Health-funded geographically clustered randomized trial examining the effect of an intervention to reduce alcohol and drug use as well as sexual risk behaviors. To address the question of interest in the current investigation, cross-sectional baseline data were used. At study enrollment, all participants (N = 641) completed an interview, and underwent rapid HIV testing and biological drug screening. Those who tested positive for HIV and were eligible for ART were asked about their barriers to initiating or adhering to ART. Bivariate and multivariable logistic regression analyses were conducted to determine correlates of HIV status, newly diagnosed HIV, and ART use. At enrollment, 55% of participants tested positive for HIV, and 36% of these women were newly diagnosed. In multivariable analyses of the entire sample, women who had completed 10th grade were less likely to be living with HIV (OR 0.69; CI 0.48, 0.99) and those from the inner city were more likely to be living with HIV (OR 1.83; CI 1.26, 2.67). Among HIV-positive participants, women were less likely to be newly diagnosed if they had ever been in substance abuse treatment (OR 0.15; CI 0.03, 0.69) or used a condom at last sex (OR 0.58; CI 0.34, 0.98) and more likely to be newly diagnosed if they were physically assaulted in the past year (OR 1.97; CI 1.01, 3.84). Among women eligible for ART, fewer were likely to be on treatment (by self-report) if they had a positive urine test for opiates or cocaine (OR 0.27; CI 0

  12. Alcohol use disorder severity and reported reasons not to seek treatment: a cross-sectional study in European primary care practices.

    Science.gov (United States)

    Probst, Charlotte; Manthey, Jakob; Martinez, Alicia; Rehm, Jürgen

    2015-08-12

    Alcohol use disorders are among the mental disorders with the lowest treatment rates. Increasing the treatment rates requires insight on the reasons why patients do not seek treatment. This study examined self-reported reasons for not seeking treatment and their association with alcohol use disorder severity among primary health care patients diagnosed with an alcohol use disorder. Alcohol use disorders, health service utilization, and reasons for not seeking treatment were assessed via interviews on regionally representative samples of primary care patients from 6 European countries (Italy, Germany, Hungary, Latvia, Poland and Spain, total N = 9,098). Additionally, general practitioners had to fill in a questionnaire assessing their patients' alcohol use and alcohol use disorders. A multinomial logistic regression was performed to investigate the association between reasons for not seeking treatment and alcohol use disorder severity. Of 1,008 patients diagnosed with an alcohol use disorder (via general practitioner or patient interview) in the past 12 months, the majority (N = 810) did not receive treatment and 251 of those gave a reason for not seeking treatment. The most frequent reason was 'lack of problem awareness' (55.3% of those who responded), the second most common response was 'stigma or shame' (28.6%), followed by 'encounter barriers' (22.8%) and 'cope alone' (20.9%). The results indicated lower probabilities of reporting 'denial' and higher probabilities to report 'encounter barriers' as alcohol use disorders severity increases. However, both trends were discontinued for patients with severe alcohol use disorders. Particularly at lower levels of alcohol use disorder severity, a lack of problem awareness prevents patients from seeking treatment. Routinely alcohol consumption monitoring in primary care practices could help primary and secondary prevention of alcohol use disorders and increase treatment coverage.

  13. Treatment of ’Battlefield Detainees’ in the War on Terrorism

    Science.gov (United States)

    2007-01-23

    American Law Division Report Documentation Page Form ApprovedOMB No. 0704-0188 Public reporting burden for the collection of information is estimated to...War.95 It covered “[a] ll soldiers of whatever species of arms; all men who belong to the rising en masse of the hostile country; all those who are...distinctive headgear are acceptable according to some military manuals). up portions of their forces.”162 However, in response to a reporter who asked

  14. COMPI Fertility Problem Stress Scales is a brief, valid and reliable tool for assessing stress in patients seeking treatment

    DEFF Research Database (Denmark)

    Sobral, Maria P.; Costa, Maria E.; Schmidt, Lone

    2017-01-01

    STUDY QUESTION Are the Copenhagen Multi‐Centre Psychosocial Infertility research program Fertility Problem Stress Scales (COMPI-FPSS) a reliable and valid measure across gender and culture? SUMMARY ANSWER The COMPI-FPSS is a valid and reliable measure, presenting excellent or good fit...... comparability of fertility-related stress across genders and countries. STUDY DESIGN SIZE, DURATION Cross-sectional study. First, we tested the structure of the COMPI-FPSS. Then, reliability and validity (convergent and discriminant) were examined for the final model. Finally, measurement invariance both across...... the validation of the COMPI-FPSS cannot be made regarding infertile individuals not seeking treatment, or non-European patients. This study did not investigate predictive validity, and hence the capability of this instrument in detecting changes in fertility-specific adjustment over time and predicting...

  15. Factor structure and clinical correlates of the Food Thought Suppression Inventory within treatment seeking obese women with binge eating disorder

    Science.gov (United States)

    Barnes, Rachel D.; Sawaoka, Takuya; White, Marney A.; Masheb, Robin M.; Grilo, Carlos M.

    2013-01-01

    Prior research on the relations among eating behaviors and thought suppression is limited to a measure of general thought suppression, the White Bear Suppression Inventory. To address this limitation, researchers recently validated the Food Thought Suppression Inventory (FTSI). Analyses using this measure suggest that food thought suppression is distinct from and is more predictive of eating disorder psychopathology than is general thought suppression. The FTSI, however, has not yet been validated in clinical samples. The purpose of the current study is to examine the factor structure and clinical correlates of the FTSI within treatment seeking obese women with binge eating disorder (BED; N = 128). Analyses revealed a valid and reliable one-factor measure of food thought suppression that was related to higher levels of eating and general psychopathology. The findings provide evidence for the use of the FTSI with obese women with BED. Future research should examine the psychometric properties of the FTSI within larger and more diverse samples. PMID:23265399

  16. Brief Motivational Intervention in a Non-Treatment Seeking Population of Heavy Drinkers - a Randomized Controlled Trial

    DEFF Research Database (Denmark)

    Hansen, Anders Blædel Gottlieb; Becker, Ulrik; Søgaard Nielsen, Anette

    2010-01-01

    : To determine whether a brief motivational intervention resulted in lowering of self-reported alcohol use in a non-treatment seeking population of heavy drinkers. Method: Before participating in a Danish Health Examination Survey study all participants completed a mailed questionnaire. Systematic screening...... (approx. 10 minute) motivational intervention and two leaflets about alcohol. The control group received two leaflets about alcohol. Follow-up took place after 6/12 months on 670/612 persons. Outcome measure was self-reported reduction in alcohol consumption. Results : At 6 and 12 month follow......-up, the difference in weekly alcohol use between the two groups was non-significant (1.4/0.8 standard drink, P=0.17 / P=0.26). Discussion: We found no evidence indicating that a brief motivational intervention could lead to a reduction in self-reported alcohol consumption....

  17. Predictors, help-seeking behaviour and treatment coverage for depression in adults in Sehore district, India.

    Science.gov (United States)

    Shidhaye, Rahul; Lyngdoh, Tanica; Murhar, Vaibhav; Samudre, Sandesh; Krafft, Thomas

    2017-09-01

    National Mental Health Survey found that in India, the point prevalence of major depressive disorder (MDD) was 2.7% and the treatment gap was 85.2%, whereas in Madhya Pradesh the point prevalence of MDD was 1.4% and the treatment gap was 80%. To describe the baseline prevalence of depression among adults, association of various demographic and socioeconomic variables with depression and estimation of contact coverage for the same. Population-based cross-sectional survey of 3220 adults in Sehore district of Madhya Pradesh, India. The outcome of interest was a probable diagnosis of depression that was measured using the Patient Health Questionnaire (PHQ-9) and the proportion of individuals with depression (PHQ-9>9) who sought care for the same. The data were analysed using simple and multiple log-linear regression. Low educational attainment, unemployment and indebtedness were associated with both moderate/severe depression (PHQ-9 score >9) and severe depression only (PHQ-9 score >14), whereas age, caste and marital status were associated with only moderate or severe depression. Religion, type of house, land ownership and amount of loan taken were not associated with either moderate/severe or only severe depression. The contact coverage for moderate/severe depression was 13.08% (95% CI 10.2-16.63). There is an urgent need to bridge the treatment gap by targeting individuals with social vulnerabilities and integrating evidence-based interventions in primary care. None. © The Royal College of Psychiatrists 2017. This is an open access article distributed under the terms of the Creative Commons Non-Commercial, No Derivatives (CC BY-NC-ND) license.

  18. How Do We Assess Dissociation in Treatment Seeking Refugees in the West?

    DEFF Research Database (Denmark)

    Palic, Sabina; Elklit, Ask; Armour, Cherie

    Not enough attention is paid to dissociation in treatment of traumatized refugees in western countries. Knowledge about the assessment, the extent, and the content of dissociation in this group is lacking. An evaluation of measures and description of dissociative symptoms was carried out in 86......-D but they showed only moderate classification agreement. The DES was found to be the preferred measure since the SIDES-D seemed to partly tap correlates of lasting psychiatric illness. The DES-Taxon functioned well as an abbreviated version of the DES. Thirty percent of the group was estimated to have pathological...

  19. The emotional-psychological consequences of infertility among infertile women seeking treatment: Results of a qualitative study.

    Science.gov (United States)

    Hasanpoor-Azghdy, Seyede Batool; Simbar, Masoumeh; Vedadhir, Abouali

    2014-02-01

    Infertility is a major life event that brings about social and psychological problems. The type and rate these problems in the context of socio-cultural of different geographical areas and sex of people is different. The aim of this qualitative study was to explain the psychological consequences of infertility in Iranian infertile women seeking treatment. This qualitative study was done using qualitative content analysis on 25 women affected by primary and secondary infertility with no surviving children in 2012. They were purposefully selected with maximum sample variation from a large Fertility Health Research Center in Tehran, Iran. Data were collected using 32 semi-structured interviews and analyzed by the conventional content analysis method. The findings of this study include four main themes: 1. Cognitive reactions of infertility (mental engagement; psychological turmoil). 2. Cognitive reactions to therapy process (psychological turmoil; being difficult to control in some situations; reduced self-esteem; feelings of failure). 3. Emotional-affective reactions of infertility (fear, anxiety and worry; loneliness and guilt; grief and depression; regret). 4. Emotional-affective reactions to therapy process (fear, anxiety and worry; fatigue and helplessness; grief and depression; hopelessness). This study revealed that Iranian infertile women seeking treatment face several psychological-emotional problems with devastating effects on the mental health and well-being of the infertile individuals and couples, while the infertility is often treated as a biomedical issue in Iranian context with less attention on the mental-emotional, social and cultural aspects. This article extracted from Ph.D. thesis. (Seyede Batool Hasanpoor-Azghady).

  20. Emotion dysregulation explains associations between anxiety sensitivity and hazardous drinking and drinking motives among adult treatment-seeking smokers.

    Science.gov (United States)

    Paulus, Daniel J; Valadka, Jaclyn; Businelle, Michael S; Gallagher, Matthew W; Viana, Andres G; Schmidt, Norman B; Zvolensky, Michael J

    2017-03-01

    Smoking and drinking frequently co-occur. For example, alcohol use is associated with smoking lapses during quit attempts. However, little is known regarding psychological factors explaining drinking among smokers. Anxiety sensitivity is a risk factor associated with hazardous drinking and drinking to cope and/or conform, although little is known about mechanisms underlying such associations. One potential explanatory factor is emotion dysregulation. The current study examined emotion dysregulation as an explanatory factor underlying Anxiety Sensitivity and 5 alcohol-related outcomes: hazardous drinking, alcohol consumption, alcohol problems, coping-oriented drinking, and drinking to conform. Participants for this study were 467 treatment-seeking adult, daily smokers (48.2% women; Mage = 36.7 years, SD = 13.6) who reported smoking an average of 16.5 cigarettes per day. Results indicate significant indirect effects of Anxiety Sensitivity on hazardous drinking via emotion dysregulation, alcohol consumption, alcohol problems, drinking to cope, and drinking to conform. Effects were medium in size. Alternative models testing indirect effects of emotion dysregulation through Anxiety Sensitivity on outcomes, and Anxiety Sensitivity through outcomes on emotion dysregulation were nonsignificant and all had small effect sizes. Follow-up tests examined the path of effects from Anxiety Sensitivity through specific emotion-dysregulation subfactors. Thus, among treatment-seeking smokers, emotion dysregulation may explain the associations of Anxiety Sensitivity with alcohol-related outcomes. This pattern of findings highlights the potential importance of interventions targeting emotion dysregulation among hazardous-drinking smokers. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

  1. Early Maladaptive Schemas and Aggression in Men Seeking Residential Substance Use Treatment.

    Science.gov (United States)

    Shorey, Ryan C; Elmquist, Joanna; Anderson, Scott; Stuart, Gregory L

    2015-09-01

    Social-cognitive theories of aggression postulate that individuals who perpetrate aggression are likely to have high levels of maladaptive cognitive schemas that increase risk for aggression. Indeed, recent research has begun to examine whether early maladaptive schemas may increase the risk for aggression. However, no known research has examined this among individuals in substance use treatment, despite aggression and early maladaptive schemas being more prevalent among individuals with a substance use disorder than the general population. Toward this end, we examined the relationship between early maladaptive schemas and aggression in men in a residential substance use treatment facility ( N = 106). Utilizing pre-existing patient records, results demonstrated unique associations between early maladaptive schema domains and aggression depending on the type of aggression and schema domain examined, even after controlling for substance use, antisocial personality, age, and education. The Impaired Limits domain was positively associated with verbal aggression, aggressive attitude, and overall aggression, whereas the Disconnection and Rejection domain was positively associated with physical aggression. These findings are consistent with social-cognitive models of aggression and advance our understanding of how early maladaptive schemas may influence aggression. The implications of these findings for future research are discussed.

  2. Treatment-seeking for febrile illness in north-east India: an epidemiological study in the malaria endemic zone

    Directory of Open Access Journals (Sweden)

    Mahanta Jagadish

    2009-12-01

    Full Text Available Abstract Background This paper studies the determinants of utilization of health care services, especially for treatment of febrile illness in the malaria endemic area of north-east India. Methods An area served by two districts of Upper Assam representing people living in malaria endemic area was selected for household survey. A sample of 1,989 households, in which at least one member of household suffered from febrile illness during last three months and received treatment from health service providers, were selected randomly and interviewed by using the structured questionnaire. The individual characteristics of patients including social indicators, area of residence and distance of health service centers has been used to discriminate or group the patients with respect to their initial and final choice of service providers. Results Of 1,989 surveyed households, initial choice of treatment-seeking for febrile illness was self-medication (17.8%, traditional healer (Vaidya(39.2%, government (29.3% and private (13.7% health services. Multinomial logistic regression (MLR analysis exhibits the influence of occupation, area of residence and ethnicity on choice of health service providers. The traditional system of medicine was commonly used by the people living in remote areas compared with towns. As all the febrile cases finally received treatment either from government or private health service providers, the odds (Multivariate Rate Ratio was almost three-times higher in favour of government services for lower households income people compared to private. Conclusion The study indicates the popular use of self-medication and traditional system especially in remote areas, which may be the main cause of delay in diagnosis of malaria. The malaria training given to the paramedical staff to assist the health care delivery needs to be intensified and expanded in north-east India. The people who are economically poor and living in remote areas mainly

  3. Prevailing Status and Treatment Seeking Awareness Among Patients Attending in The Orthodontics Department of Bangabandhu Sheikh Mujib Medical University

    Directory of Open Access Journals (Sweden)

    Tanzila Rafique

    2011-09-01

    Full Text Available Background: Malocclusion is problem since antiquity. But people’s perception about the problem varies with their geographical location and cultural background. The problem seems to be more acute in developing countries like Bangladesh. Objectives: The present study was undertaken to assess the awareness about aesthetic problem of malocclusion and treatment seeking behavior among the patients attending in orthodontic department of BSMMU. Methods: The present cross-sectional study was carried out in the Department of Orthodontic, Faculty of Dentistry, BSMMU, over a period 24 months from January 2008 to December 2009. A total of 110 participants who were suffering from malocclusion and came for dental treatment were the study population. Results: The mean age of the patients was 21 years and the youngest and the oldest patients were 8 and 32 years old respectively with female to male ratio being roughly 3:2. Graduate or postgraduate level educated patients were predominant (53.6%. Over 70% of the respondents viewed malocclusion as an aesthetic problem, 50% as functional problem, 55.5% social problem and 69.1% oral problem. Two-third (67% told that malocclusion was a treatable condition. Approximately 43% of the patients identified trauma as a cause of malocclusion, 40% gingivitis or periodontitis and 35.5% dental caries. About one-third (32.7% of the respondents was of the opinion that certain habits should be avoided to prevent malocclusion, 15.5% told timely treatment of malocclusion, 30% told prevention of early loss of teeth due to caries, 12.7% were in favour of the use of a space maintainer in places of premature loss of a deciduous tooth. Over 90% of the respondents held the view that symptoms of malocclusion, its prevention and different treatment options should get the priority in educating the society about malocclusion. However, 80% of the respondents told that causative factors should discussed. Regarding ways of behaviour change

  4. Prevalence of sleep breathing complaints reported by treatment-seeking chronic insomnia disorder patients on presentation to a sleep medical center: a preliminary report.

    Science.gov (United States)

    Krakow, Barry; Ulibarri, Victor A

    2013-03-01

    Few studies have examined the co-morbidity between insomnia and sleep-disordered breathing in the clinical setting. This study evaluated treatment-seeking insomnia patients and their self-report of sleep breathing complaints. A retrospective chart review was conducted on 1,035 consecutive treatment-seeking, chronic insomnia patients who reported insomnia as their primary problem upon seeking care at a private, community-based sleep medical center. Measurements included the insomnia severity index, standard subjective sleep measures as well as rankings, attributions, and self-reports about sleep breathing disorders, problems, and symptoms. A total of 1,035 adult, treatment-seeking insomnia patients indicated insomnia interfered with daytime functioning, and their average insomnia severity was in the range of a clinically relevant problem: total sleep time (5.50 h, SD = 1.60), sleep efficiency (71.05 %, SD = 18.26), wake time after sleep onset (120.70 min, SD = 92.56), and an insomnia severity index (18.81, SD = 5.09). Of these 1,035 insomnia patients, 42 % also ranked a sleep breathing disorder among their list of reasons for seeking treatment, another 13 % revealed a concern about a sleep breathing problem, and another 26 % reported awareness of sleep breathing symptoms. Only 19 % of this clinical insomnia sample reported no awareness or concerns about sleep breathing disorders, problems, or symptoms. A greater proportion of men than women reported significantly more sleep breathing disorders, problems, or symptoms. Sleep breathing complaints were extremely common among a large sample of treatment-seeking, self-identified, adult chronic insomnia patients. Prospective prevalence research is needed to corroborate or revise these findings, and polysomnography should be considered in appropriate cohorts to determine the clinical relevance of treatment-seeking chronic insomnia patients' sleep breathing complaints.

  5. Intergenerational and cross-cultural differences in emotional wellbeing, mental health service utilisation, treatment-seeking preferences and acceptability of psychological treatments for Arab Australians.

    Science.gov (United States)

    Kayrouz, Rony; Dear, Blake F; Johnston, Luke; Keyrouz, Liliane; Nehme, Edmond; Laube, Roy; Titov, Nickolai

    2015-08-01

    Little is known about the intergenerational and cross-cultural differences in emotional wellbeing and acceptability of psychological treatments for Arab Australians. To contribute to the emerging data about the mental health status and needs of Arab Australians. An Internet survey examined psychological distress and functional impairment as measured by the Kessler 10 Item scale (K-10) and the Sheehan Disability Scale (SDS) among Arab Australians. Additional questions enquired about their help-seeking behaviours, barriers to accessing psychological treatments and preferences for delivery of psychological treatments. A total of 252 participants were recruited through public talks, media and online promotions. Forty-three percent of the respondents reported moderate-to-severe functional impairment (M = 9.5; standard deviation (SD) = 1.8), 32% reported high psychological distress (M = 28.5; SD = 5.4) and 30% were born overseas. First-generation Arab Australians experiencing high psychological distress (i.e. K-10 ≥ 22), reported a greater preference for Internet-delivered treatment when compared to their second-generation counterparts. Only 18% of the sample reported seeking help from a mental health professional in the past year. The significant barriers reported by respondents with high psychological distress were poor mental health literacy, lack of time and stigma. Respondents preferred face-to-face (90%) over Internet-delivered treatment (55%). Finally, Arab Australians experienced higher psychological distress and underutilised mental health services when compared to the Australian population. Targeted public health campaigns that make culturally relevant interventions such as modifying existing Internet-delivered treatment for Arab Australians may reduce barriers and increase treatment options for this population. © The Author(s) 2014.

  6. Gender by Preferred Gambling Activity in Treatment Seeking Problem Gamblers: A Comparison of Subgroup Characteristics and Treatment Outcomes.

    Science.gov (United States)

    Khanbhai, Yasmin; Smith, David; Battersby, Malcolm

    2017-03-01

    Problem gambling is a growing public health concern and treatment incompletion levels remain high. The study aims to support and extend previous studies in relation to the heterogeneity of the gambling population based on gender and gambling type, and the implications of subgroup differences on treatment outcomes. Additionally, the concept of drop-out is addressed in terms of categorical treatment measures. The empirical findings are examined in the context of the theoretical framework of the pathways model. Participants were recruited from the Statewide Gambling Therapy Service and stratified into subgroups based on gender and gambling mode preference [Electronic Gambling Machines (EGM) or track race betters]. Baseline predictors collected and analysed using multinomial logistical regression included demographic information as well as gambling variables, while treatment outcomes consisted of three therapist rated measures. Significant differences between the subgroups were found for age, marital and employment status, gambling duration, alcohol use and the Kessler 10 measure of psychological distress. Specifically, male track race gamblers were younger, married, employed, had a longer duration of gambling, higher alcohol use and lower psychological distress relative to EGM users. No difference was found in any of the treatment outcomes, however, consistent with previous studies, all subgroups had high treatment incompletion levels. The findings demonstrate the importance of screening, assessing and treating problem gamblers as a heterogeneous group with different underlying demographics and psychopathologies. It is also hoped future studies will continue to address treatment incompletion with a re-conceptualisation of the term drop-out.

  7. Exposure to traumatic events among treatment-seeking, alcohol-dependent women and men without PTSD.

    Science.gov (United States)

    Johnson, Candace S; Heffner, Jaimee L; Blom, Thomas J; Anthenelli, Robert M

    2010-10-01

    The authors examined lifetime exposure to a range of traumatic events in 106 abstinent, treatment-engaged (85% residential; 15% outpatient), alcohol-dependent women (n = 53) and men without current or lifetime posttraumatic stress disorder. Alcohol-dependent women reported greater severity of childhood trauma, but similar lifetime exposure to traumatic events compared with men. Alcohol-dependent women without cocaine abuse or TB (n = 10) reported greater severity of childhood trauma than women with (n = 43), and men with (n = 21) or without (n = 32) cocaine abuse or dependence. Results extend previously observed gender differences in trauma histories among alcohol-dependent adults and point to potential gender- and substance-specific drug co-addiction effects that may have been influenced by trauma exposure.

  8. Impact of Distance to Treatment Center on Care Seeking for Pelvic Floor Disorders.

    Science.gov (United States)

    English, Emily; Rogo-Gupta, Lisa

    The aim of this study was to evaluate the impact of distance from residence to treatment center on access to care for female pelvic floor disorders at an academic institution. A retrospective cross-sectional study was conducted of women seen for pelvic floor disorders at an academic institution from 2008 to 2014. Patient characteristics were extracted from charts. Geographical and US census data was obtained from public records and used to calculate distance from patient residence to physician office. Statistical analysis was performed using R Software (Version 0.98.1102) and Microsoft Excel (Version 14.4.7). Statistical significance was defined as a 2-sided P value of less than 0.05, and the χ test was used to determine associations of categorical variables. A total of 3015 patients were included in the analysis. The mean distance traveled was 93 miles. Thirty percent of patients traveled more than 50 miles. Many patients (43%) reported having the symptoms for more than 2 years. Patients who traveled farther were significantly more likely to be white, English-speaking, and with pelvic organ prolapse as primary complaint. These patients were more likely to plan surgery at the first visit than patients who traveled less far (29% vs 14%). Patients who traveled farther were also more likely to live in counties with a low percentage of persons older than 65 years and low percentage of female inhabitants. Women who travel the farthest for treatment of pelvic floor disorders have experienced the symptoms for longer duration and are more willing to plan surgery at presentation. These women also come from counties with fewer elderly women, suggesting future outreach care should focus on similar geographic areas.

  9. Positive affect and processes of recovery among treatment-seeking methamphetamine users.

    Science.gov (United States)

    Carrico, Adam W; Woods, William J; Siever, Michael D; Discepola, Michael V; Dilworth, Samantha E; Neilands, Torsten B; Miller, Nicole; Moskowitz, Judith Tedlie

    2013-10-01

    Revised Stress and Coping Theory proposes that positive affect serves adaptive functions, independent of negative affect. However, scant research has examined whether, how, and under what circumstances positive affect is associated with decreased substance use. Eighty-eight methamphetamine-using men who have sex with men (MSM) completed the baseline assessment for substance abuse treatment outcome study which included measures of positive and negative affect, cognitive-behavioral change processes (i.e., approach-oriented coping, self-efficacy for managing methamphetamine triggers, and abstinence-related action tendencies), abstinence-specific social support, and self-reported substance use. Participants also provided a urine sample for toxicology screening. After controlling for demographic characteristics and negative affect, higher positive affect was independently associated with greater approach-oriented coping, abstinence-related action tendencies, and abstinence-specific social support. Positive affect was also independently associated with greater self-efficacy for managing methamphetamine triggers, but only at lower levels of negative affect. Through these cognitive-behavioral and social pathways, positive affect was indirectly associated with lower frequency of stimulant use in the past 30 days, lower odds of reporting stimulant use two or more days in a row, and lower odds of providing a urine sample that was reactive for stimulant metabolites. On the other hand, negative affect was not indirectly associated with any measure of stimulant use. Clinical research is needed to examine the pathways whereby positive affect may predict better substance abuse treatment outcomes. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  10. The Prevalence of Comorbid Personality Disorders in Treatment-Seeking Problem Gamblers: A Systematic Review and Meta-Analysis.

    Science.gov (United States)

    Dowling, Nicki A; Cowlishaw, S; Jackson, A C; Merkouris, S S; Francis, K L; Christensen, D R

    2015-12-01

    The aim of this study was to systematically review and meta-analyze the prevalence of comorbid personality disorders among treatment-seeking problem gamblers. Almost one half (47.9%) of problem gamblers displayed comorbid personality disorders. They were most likely to display Cluster B disorders (17.6%), with smaller proportions reporting Cluster C disorders (12.6%) and Cluster A disorders (6.1%). The most prevalent personality disorders were narcissistic (16.6%), antisocial (14.0%), avoidant (13.4%), obsessive-compulsive (13.4%), and borderline (13.1%) personality disorders. Sensitivity analyses suggested that these prevalence estimates were robust to the inclusion of clinical trials and self-selected samples. Although there was significant variability in reported rates, subgroup analyses revealed no significant differences in estimates of antisocial personality disorder according to problem gambling severity, measure of comorbidity employed, and study jurisdiction. The findings highlight the need for gambling treatment services to conduct routine screening and assessment of co-occurring personality disorders and to provide treatment approaches that adequately address these comorbid conditions.

  11. Social cognition deficits and psychopathic traits in young people seeking mental health treatment.

    Science.gov (United States)

    van Zwieten, Anita; Meyer, Johanna; Hermens, Daniel F; Hickie, Ian B; Hawes, David J; Glozier, Nicholas; Naismith, Sharon L; Scott, Elizabeth M; Lee, Rico S C; Guastella, Adam J

    2013-01-01

    Antisocial behaviours and psychopathic traits place an individual at risk for criminality, mental illness, substance dependence, and psychosocial dysfunction. Social cognition deficits appear to be associated with psychopathic traits and are believed to contribute to interpersonal dysfunction. Most research investigating the relationship of these traits with social cognition has been conducted either in children or adult forensic settings. We investigated whether psychopathic traits were associated with social cognition in 91 young people presenting for mental healthcare (aged between 15 and 25 years). Participants completed symptom severity measures, neuropsychological tests, the Reading the Mind in the Eyes Test of social cognition (RMET), and the Antisocial Process Screening Device (APSD) to assess psychopathic personality traits. Correlation analyses showed poorer social cognition was associated with greater psychopathic traits (r = -.36, p = .01). Interestingly, social cognition performance predicted unique variance in concurrent psychopathic personality traits above gender, IQ sustained attention, and working memory performance. These findings suggest that social cognitive impairments are associated with psychopathic tendencies in young people presenting for community mental healthcare. Research is needed to establish the directionality of this relationship and to determine whether social cognition training is an effective treatment amongst young people with psychopathic tendencies.

  12. Disseminating treatment for anxiety disorders: step 1: recognizing the problem as a precursor to seeking help.

    Science.gov (United States)

    Coles, Meredith E; Schubert, Jessica R; Heimberg, Richard G; Weiss, Barry D

    2014-12-01

    Untreated mental illness is a substantial public health issue in the United States, with only approximately 1/3 of the estimated 46 million adults in the US with mental illness receiving treatment. Many of the individuals with mental illness suffer from excessive anxiety, as over 25% of Americans experience an anxiety disorder during their lifetime and most of these individuals remain untreated. Building from the premise that recognizing one's symptoms precedes requests for help, the current paper presents data from 577 adults (50% Caucasian, 50% African American) in the US regarding their ability to recognize anxiety disorders. Findings from a national survey showed that when presented with detailed vignettes portraying symptoms and their impact, 50% of respondents correctly recognized depression, whereas less than 20% correctly recognized the anxiety disorders. Recognition that the symptoms were a cause for concern was much more common, with 75% or more of the sample noting concern. Responses were surprisingly similar across the two races, and few consistent moderators were found. In conclusion, increasing recognition of anxiety disorders may be a useful first step toward increasing service utilization. Copyright © 2014 Elsevier Ltd. All rights reserved.

  13. Social cognition deficits and psychopathic traits in young people seeking mental health treatment.

    Directory of Open Access Journals (Sweden)

    Anita van Zwieten

    Full Text Available Antisocial behaviours and psychopathic traits place an individual at risk for criminality, mental illness, substance dependence, and psychosocial dysfunction. Social cognition deficits appear to be associated with psychopathic traits and are believed to contribute to interpersonal dysfunction. Most research investigating the relationship of these traits with social cognition has been conducted either in children or adult forensic settings. We investigated whether psychopathic traits were associated with social cognition in 91 young people presenting for mental healthcare (aged between 15 and 25 years. Participants completed symptom severity measures, neuropsychological tests, the Reading the Mind in the Eyes Test of social cognition (RMET, and the Antisocial Process Screening Device (APSD to assess psychopathic personality traits. Correlation analyses showed poorer social cognition was associated with greater psychopathic traits (r = -.36, p = .01. Interestingly, social cognition performance predicted unique variance in concurrent psychopathic personality traits above gender, IQ sustained attention, and working memory performance. These findings suggest that social cognitive impairments are associated with psychopathic tendencies in young people presenting for community mental healthcare. Research is needed to establish the directionality of this relationship and to determine whether social cognition training is an effective treatment amongst young people with psychopathic tendencies.

  14. Personality Pathology Predicts Outcomes in a Treatment-Seeking Sample with Bipolar I Disorder

    Directory of Open Access Journals (Sweden)

    Susan J. Wenze

    2014-01-01

    Full Text Available We conducted a secondary analysis of data from a clinical trial to explore the relationship between degree of personality disorder (PD pathology (i.e., number of subthreshold and threshold PD symptoms and mood and functioning outcomes in Bipolar I Disorder (BD-I. Ninety-two participants completed baseline mood and functioning assessments and then underwent 4 months of treatment for an index manic, mixed, or depressed phase acute episode. Additional assessments occurred over a 28-month follow-up period. PD pathology did not predict psychosocial functioning or manic symptoms at 4 or 28 months. However, it did predict depressive symptoms at both timepoints, as well as percent time symptomatic. Clusters A and C pathology were most strongly associated with depression. Our findings fit with the literature highlighting the negative repercussions of PD pathology on a range of outcomes in mood disorders. This study builds upon previous research, which has largely focused on major depression and which has primarily taken a categorical approach to examining PD pathology in BD.

  15. Who is the Treatment-Seeking Young Adult with Severe Obesity: A Comprehensive Characterization with Emphasis on Mental Health.

    Directory of Open Access Journals (Sweden)

    Helena Dreber

    Full Text Available To characterize treatment-seeking young adults (16-25 years with severe obesity, particularly mental health problems.Cross-sectional study of 165 participants (132 women, 33 men with BMI ≥35 kg/m2 or ≥30 kg/m2 with comorbidities, enrolling in a multidisciplinary obesity treatment program.Data collection at admission of present and life-time health issues including symptomatology of anxiety, depression (Hospital Anxiety and Depression Scale and attention-deficit/hyperactivity disorder (Adult ADHD Self-Report scale; self-esteem (Rosenberg Self-Esteem Scale, suicide attempts, health-related quality of life (Short Form-36 Health Survey, psychosocial functioning related to obesity (Obesity-related Problems Scale, cardiorespiratory fitness (Astrand's bicycle ergometer test, somatic and psychiatric co-morbidities, cardiometabolic risk factors, and micronutritional status. We used multiple regression analysis to identify variables independently associated with present anxiety and depressive symptomatology.Mean body mass index was 39.2 kg/m2 (SD = 5.2. We found evidence of poor mental health, including present psychiatric diagnoses (29%, symptomatology of anxiety (47%, depression (27% and attention-deficit/hyperactivity disorder (37%; low self-esteem (42%, attempted suicide (12%, and low quality of life (physical component score = 46, SD = 11.2; mental component score = 36, SD = 13.9, P<0.001 for difference. Variables independently associated with present anxiety symptomatology (R2 = 0.33, P<0.001 included low self-esteem (P<0.001 and pain (P = 0.003, whereas present depressive symptomatology (R2 = 0.38, P<0.001 was independently associated with low self-esteem (P<0.001, low cardiorespiratory fitness (P = 0.009 and obesity-related problems (P = 0.018. The prevalence of type 2 diabetes was 3%, and hypertension 2%. Insulin resistance was present in 82%, lipid abnormality in 62%, and poor cardiorespiratory fitness in 92%. Forty-eight percent had at

  16. Reduced frontal brain volume in non-treatment-seeking cocaine-dependent individuals: exploring the role of impulsivity, depression, and smoking

    NARCIS (Netherlands)

    Crunelle, C.L.; Kaag, A.M.; Wingen, G. van; Munkhof, H.E. van den; Homberg, J.R.; Reneman, L.; Brink, W. van den

    2014-01-01

    In cocaine-dependent patients, gray matter (GM) volume reductions have been observed in the frontal lobes that are associated with the duration of cocaine use. Studies are mostly restricted to treatment-seekers and studies in non-treatment-seeking cocaine abusers are sparse. Here, we assessed GM

  17. Reduced frontal brain volume in non-treatment-seeking cocaine-dependent individuals : Exploring the role of impulsivity, depression, and smoking

    NARCIS (Netherlands)

    Crunelle, C.L.; Kaag, A.M.; van Wingen, G.A.; van den Munkhof, H.E.; Homberg, J.R.; Reneman, L.; van den Brink, W.

    2014-01-01

    In cocaine-dependent patients, gray matter (GM) volume reductions have been observed in the frontal lobes that are associated with the duration of cocaine use. Studies are mostly restricted to treatment-seekers and studies in non-treatment-seeking cocaine abusers are sparse. Here, we assessed GM

  18. Trends in psychological distress, depressive episodes and mental health treatment-seeking in the United States: 2001-2012.

    Science.gov (United States)

    Mojtabai, Ramin; Jorm, Anthony F

    2015-03-15

    There has been an increase in the use of mental health services in a number of industrialized countries over the past two decades with little impact on mental health status of the populations. Few studies, however, have examined recent trends in mental health status in the US. Using data from three large general annual population surveys in the US-the National Health Interview Survey, Behavioral Risk Factor Surveillance System, and National Survey on Drug Use and Health-we examined temporal trends in non-specific psychological distress, depressive episodes and mental health treatment seeking over the 2001-2012 period. Prevalence of past-month significant psychological distress and past-year depressive symptoms changed little over time. However, a larger percentage of participants reported poor mental health for ≥15 days or 30 days in the past month in 2011-2012 (8.7% and 5.7%, respectively) than in 2001-2002 (6.6% and 4.6%). A larger percentage of participants in the later period also reported receiving mental health treatments. Possible changes in mental health status may have been missed due to the limited scope of assessments or the small magnitude of changes. Potential reciprocal influences between service use and mental health status could not be investigated because of cross-sectional data. Despite increasing use of mental health treatments in the US in the first decade of this century, there is no evidence of decrease in prevalence of psychological distress or depression. Poor match between need for treatment and actual treatments received in usual care settings may partly explain the findings. Copyright © 2014 Elsevier B.V. All rights reserved.

  19. Clinical consequences of the revised DSM-5 definition of agoraphobia in treatment-seeking anxious youth

    Science.gov (United States)

    Cornacchio, Danielle; Chou, Tommy; Sacks, Hayley; Pincus, Donna; Comer, Jonathan

    2015-01-01

    Background In DSM-5, the agoraphobia core symptom criterion has been revised to require fear about multiple situations from across at least two distinct domains in which escape might be difficult or panic-like symptoms might develop. The present study examined patterns and correlates of the recent change in a sample of anxious youth with symptom presentations consistent with the DSM-IV agoraphobia definition and/or specific phobia (SP) to consider how the recent diagnostic change impacts the prevalence and composition of agoraphobia in children and adolescents. Method Analyses (N=151) evaluated impairment and correlates of agoraphobic youth who no longer meet the DSM-5 agoraphobia criteria relative to agoraphobic youth who do meet the new DSM-5 criteria. Secondary analyses compared agoraphobic youth not meeting DSM-5 criteria to SP youth. Results One-quarter of youth with symptom presentations consistent with the DSM-IV agoraphobia definition no longer met criteria for DSM-5 agoraphobia, but showed comparable severity and impairment across most domains to youth who do meet criteria for DSM-5 agoraphobia. Further, these youth showed higher levels of anxiety sensitivity and internalizing psychopathology relative to youth with SP. Conclusions A substantial proportion of impaired youth with considerable agoraphobic symptom presentations have been left without a specified anxiety diagnosis by the DSM-5, which may affect their ability to receive and/or get coverage for services and their representation in treatment evaluations. Future DSM iterations may do well to include a “circumscribed” agoraphobia specifier that would characterize presentations of fear or anxiety about multiple situations, but that do not span across at least two distinct situational domains. PMID:25845579

  20. Pathological gambling in treatment-seeking alcoholics: a national survey in France.

    Science.gov (United States)

    Nalpas, Bertrand; Yguel, Jacques; Fleury, Benoît; Martin, Sandrine; Jarraud, Delphine; Craplet, Michel

    2011-01-01

    To estimate the prevalence of pathological gambling (pG) in people addicted to alcohol and drugs, particularly those with alcohol use disorders (AUDs), including new forms of gambling such as video and on-line games; and to update the socio-demographic profile of people suffering from both AUD and pG. A cross-sectional survey was conducted in 1 week of 2009 in 55 French addiction treatment centres, including all consecutive patients attending that centre, using an anonymous questionnaire which included a tool specific for pG screening, the DEBA-jeu questionnaire (Détection et Besoin d'Aide en regard du Jeu Excessif). A total of 2790 patients entered the study. The most frequent reason for attending the Addiction Centres was AUD (77%). According to the DEBA test, 6.5% of the patients were pathological gamblers and 12% were subsyndromal gamblers. pG affected all age groups and did not decrease with abstinence from alcohol. pG was significantly associated with male sex [relative risk (RR) = 2.4; P < 0.001)] and, at a lower level of significance, with homelessness (RR = 1.52; P = 0.03) and unemployment (RR = 1.47; P = 0.04). pG appears to be a common feature of the French people with alcohol and drug disorders. Apart from male sex, no parameter had discriminatory power sufficient to target pG screening on a specific subgroup. Therefore, any patient attending a centre for drug or AUD should be asked about his gambling. Moreover, clinical teams should be trained to treat this addiction.

  1. Comparison of treatment seeking compulsive buyers in Germany and the United States.

    Science.gov (United States)

    Mueller, Astrid; Mitchell, James E; Mertens, Christian; Mueller, Ulrike; Silbermann, Andrea; Burgard, Melissa; de Zwaan, Martina

    2007-07-01

    The aim of this pilot study was to compare a German (Bavaria) and an American (North Dakota) sample of women suffering from compulsive buying. Thirty-eight German and 39 American female compulsive buyers were screened with the Compulsive Buying Scale (CBS), and the Yale-Brown Obsessive Compulsive Scale-Shopping Version (Y-BOCS-SV) prior to entering a group treatment study. Psychiatric co-morbidity was assessed with the Structured Clinical Interview for DSM-IV Axis I disorders (SCID). There were no statistically significant differences between the German sample and the American sample with regard to age (mean 43.7 and 45 years, respectively), and with regard to the scores on the CBS and the Y-BOCS-SV. A high lifetime co-morbidity rate with Axis I disorders, especially mood disorders, anxiety disorders, substance use disorders, OCD, and binge eating disorder was detected in both samples. Almost all participants met criteria for at least one lifetime Axis I disorder. However, German compulsive buyers showed significantly higher current prevalence rates of any affective disorder, and higher current and lifetime prevalence rates of any anxiety disorder and somatoform disorder. In addition, German compulsive buyers were significantly more likely to have more than one Axis I disorder. The groups did not differ with regard to age and with regard to the severity of compulsive buying and showed a high co-morbidity with Axis I disorders. However, the German compulsive buying sample presented with significantly more psychiatric co-morbidity compared to the American sample. Further research is needed to provide a better understanding of this disorder in general and cross-culturally.

  2. CLINICAL CONSEQUENCES OF THE REVISED DSM-5 DEFINITION OF AGORAPHOBIA IN TREATMENT-SEEKING ANXIOUS YOUTH.

    Science.gov (United States)

    Cornacchio, Danielle; Chou, Tommy; Sacks, Hayley; Pincus, Donna; Comer, Jonathan

    2015-07-01

    In DSM-5, the agoraphobia core symptom criterion has been revised to require fear about multiple situations from across at least two distinct domains in which escape might be difficult or panic-like symptoms might develop. The present study examined patterns and correlates of the recent change in a sample of anxious youth with symptom presentations consistent with the DSM-IV agoraphobia definition and/or specific phobia (SP) to consider how the recent diagnostic change impacts the prevalence and composition of agoraphobia in children and adolescents. Analyses (N = 151) evaluated impairment and correlates of agoraphobic youth who no longer meet the DSM-5 agoraphobia criteria relative to agoraphobic youth who do meet the new DSM-5 criteria. Secondary analyses compared agoraphobic youth not meeting DSM-5 criteria to SP youth. One-quarter of youth with symptom presentations consistent with the DSM-IV agoraphobia definition no longer met criteria for DSM-5 agoraphobia, but showed comparable severity and impairment across most domains to youth who do meet criteria for DSM-5 agoraphobia. Further, these youth showed higher levels of anxiety sensitivity and internalizing psychopathology relative to youth with SP. A substantial proportion of impaired youth with considerable agoraphobic symptom presentations have been left without a specified anxiety diagnosis by the DSM-5, which may affect their ability to receive and/or get coverage for services and their representation in treatment evaluations. Future DSM iterations may do well to include a "circumscribed" agoraphobia specifier that would characterize presentations of fear or anxiety about multiple situations, but that do not span across at least two distinct situational domains. © 2015 Wiley Periodicals, Inc.

  3. Priorities for family building among patients and partners seeking treatment for infertility.

    Science.gov (United States)

    Duthie, Elizabeth A; Cooper, Alexandra; Davis, Joseph B; Sandlow, Jay; Schoyer, Katherine D; Strawn, Estil; Flynn, Kathryn E

    2017-04-05

    Infertility treatment decisions require people to balance multiple priorities. Within couples, partners must also negotiate priorities with one another. In this study, we assessed the family-building priorities of couples prior to their first consultations with a reproductive specialist. Participants were couples who had upcoming first consultations with a reproductive specialist (N = 59 couples (59 women; 59 men)). Prior to the consultation, couples separately completed the Family-Building Priorities Tool, which tasked them with ranking from least to most important 10 factors associated with family building. We describe the highest (top three) and lowest (bottom three) priorities, the alignment of priorities within couples, and test for differences in prioritization between men and women within couples (Wilcoxon signed rank test). Maintaining a close and satisfying relationship with one's partner was ranked as a high priority by majorities of men and women, and in 25% of couples, both partners ranked this factor as their most important priority for family building. Majorities of men and women also ranked building a family in a way that does not make infertility obvious to others as a low priority, and in 27% of couples, both partners ranked this factor as the least important priority for family building. There were also differences within couples that involved either men or women ranking a particular goal more highly than their partners. More women ranked two factors higher than did their partners: 1) that I become a parent one way or another (p = 0.015) and 2) that I have a child in the next year or two (p building paths should be aware that: (1) patients balance multiple priorities as a part of, or beside, becoming a parent; and (2) patients and their partners may not be aligned in their prioritization of achieving parenthood. For infertility patients who are in relationships, clinicians should encourage the active participation of both partners as

  4. Evaluation of QTc interval in Iranian causalities (Janbazan of Iran-Iraq war receiving maintenance methadone treatment

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    Morteza Abdar Esfahani

    2012-01-01

    Full Text Available Background: Methadone is a synthetic opioid, used in treatment of chronic pains. The current study was carried out to evaluate the QTc interval in Iranian causalities (Janbazan of Iran-Iraq war receiving maintenance methadone treatment. Materials and Methods: In 2010, one hundred war causalities in Isfahan who chronically take daily dose of 20 mg or more of methadone (more than 2 weeks, and did not have the history of cerebrovascular or coronary artery diseases, cardiac pacemaker, congenital prolonged QTC, or taking drugs affecting QTc, or having electrolyte abnormalities, were selected for the study. An electrocardiogram was taken from each patient using cardiofax instrument, and QTC was calculated manually. The data was analyzed using SPSS software with descriptive statistical methods and Pearson′s correlation coefficient. Findings: All patients were male and had the mean age of 45.6 ΁ 6.1 years. The patients received 20-240 mg methadone daily for 1 to 108 months. The QTc was prolonged in 25% of the patients (QTc 5 450 ms, with the mean of 472.72 ΁ 18.5 ms (range 450-508 ms and the mean daily dose of methadone 85.2 ΁ 59.0 mg. No significant relationship was observed between QTC interval on the one hand, and methadone dose (R = 0.025, P = 0.8, duration of treatment (R =-0.048, P = 0.68, age (R = 0.037, P = 0.71, and weight (R = 0.1, P = 0.21 of the patients, on the other hand. None of the patients had faint, syncope, arrhythmia, or sudden death. Conclusion: Oral methadone causes prolongation of QTC interval. However, the dosage of methadone and duration of treatment were not statistically related to QTC interval.

  5. Evaluation of QTc interval in Iranian causalities (Janbazan) of Iran-Iraq war receiving maintenance methadone treatment.

    Science.gov (United States)

    Esfahani, Morteza Abdar; Vosughi, Ali Akbar; Fatehi, Mohamad Hossein; Shahsanaee, Armindokht; Teimuri, Azam

    2012-03-01

    Methadone is a synthetic opioid, used in treatment of chronic pains. The current study was carried out to evaluate the QTc interval in Iranian causalities (Janbazan) of Iran-Iraq war receiving maintenance methadone treatment. In 2010, one hundred war causalities in Isfahan who chronically take daily dose of 20 mg or more of methadone (more than 2 weeks), and did not have the history of cerebrovascular or coronary artery diseases, cardiac pacemaker, congenital prolonged QTC, or taking drugs affecting QTc, or having electrolyte abnormalities, were selected for the study. An electrocardiogram was taken from each patient using cardiofax instrument, and QTC was calculated manually. The data was analyzed using SPSS software with descriptive statistical methods and Pearson's correlation coefficient. All patients were male and had the mean age of 45.6 ± 6.1 years. The patients received 20-240 mg methadone daily for 1 to 108 months. The QTc was prolonged in 25% of the patients (QTc 5 450 ms), with the mean of 472.72 ± 18.5 ms (range 450-508 ms) and the mean daily dose of methadone 85.2 ± 59.0 mg. No significant relationship was observed between QTC interval on the one hand, and methadone dose (R = 0.025, P = 0.8), duration of treatment (R =-0.048, P = 0.68), age (R = 0.037, P = 0.71), and weight (R = 0.1, P = 0.21) of the patients, on the other hand. None of the patients had faint, syncope, arrhythmia, or sudden death. Oral methadone causes prolongation of QTC interval. However, the dosage of methadone and duration of treatment were not statistically related to QTC interval.

  6. Expertise seeking

    DEFF Research Database (Denmark)

    Hertzum, Morten

    2014-01-01

    used sources. Studies repeatedly show the influence of the social network – of friendships and personal dislikes – on the expertise-seeking network of organisations. In addition, people are no less prominent than documentary sources, in work contexts as well as daily-life contexts. The relative......Expertise seeking is the activity of selecting people as sources for consultation about an information need. This review of 72 expertise-seeking papers shows that across a range of tasks and contexts people, in particular work-group colleagues and other strong ties, are among the most frequently...

  7. Predictors of treatment seeking intention among people with cough in East Wollega, Ethiopia based on the theory of planned behavior: a community based cross-sectional study.

    Science.gov (United States)

    Addisu, Yohannes; Birhanu, Zewdie; Tilahun, Dejen; Assefa, Tsion

    2014-04-01

    Early treatment seeking for cough is crucial in the prevention and control of Tuberculosis. This study was intended to assess treatment seeking intention of people with cough of more than two weeks, and to identify its predictors. A community based cross-sectional study was conducted among 763 individuals with cough of more than two weeks in East Wollega Zone from March 10 to April 16, 2011. Study participants were selected from eighteen villages by cluster sampling method. Data collection instruments were developed according to the standard guideline of the theory of planned behavior. The data were analyzed with SPSS 16.0. Multiple linear regression was used to identify predictors. Mean score of intention was found to be 12.6 (SD=2.8) (range of possible score=3-15). Knowledge (β=0.14, 95%CI: 0.07-0.2), direct attitude (β=0.31, 95%CI: 0.25-0.35), belief-based attitude (β=0.03, 95%CI: 0.02-0.06) and perceived subjective norm (β=0.22, 95%CI: 0.13-0.31) positively predicted treatment seeking intention. However, perceived behavioral control and control belief were not significantly associated with treatment seeking intention (p>0.05). Being smoker (β=-0.97, 95%CI:-1.65 (-0.37)) and higher family income (β=-0.06, 95%CI:-0.07-(-0.01) were significantly associated with lower treatment seeking intention. TPB significantly predicted treatment seeking intention among the study participants. Attitude and silent beliefs held by the respondents play an important role and should be given emphasize in prevention and control of Tuberculosis.

  8. 'War neurosis' during the Spanish Civil War (1936-39).

    Science.gov (United States)

    Villasante, Olga

    2010-12-01

    The aim of this contribution is to analyse the incidence and treatment of war neurosis in Madrid during the Spanish Civil War. First, the scientific papers published on war neurosis during and after the war are examined. Then the work of Gregorio Bermann (1894-1972), a member of the International Brigades who organized the frontline Neuropsychiatric Service at the Hospital de Chamartín de La Rosa (Madrid), is analysed. Las neurosis en la guerra, published in 1941, which recounts Bermann's personal experience in the care of war neurosis in Spain, is also discussed.

  9. Form and formulation: Examining the distinctiveness of body image constructs in treatment-seeking patients with binge-eating disorder.

    Science.gov (United States)

    Lydecker, Janet A; White, Marney A; Grilo, Carlos M

    2017-11-01

    Body-image disturbance is a core aspect of eating disorders, yet the clinical manifestations of individuals' weight and shape concerns are complex, vary considerably, and are poorly understood by clinicians and researchers. This study aimed to distinguish different aspects of body-image disturbance-including weight/shape dissatisfaction, weight/shape overvaluation, weight/shape preoccupation, and fear of weight gain-in patients with binge-eating disorder (BED). Examining how each specific body image construct relates to biopsychosocial features of BED could contribute to the refinement of conceptualization and treatment planning. The current study assessed body-image disturbance and eating-disorder psychopathology in 748 treatment-seeking patients with BED using established investigator-based interviews reliably administered by doctoral clinicians. The 4 body image constructs, although related to one another, showed some important similarities in associations with biopsychosocial clinical features, as well as some important distinctions. The relation between overvaluation and self-esteem was, as conceptualized, more strongly negative than for other body image variables, and preoccupation was more associated than other body image variables with eating concerns. Biopsychosocial features of BED were associated with different forms of body-image disturbance, but associations of body image variables with body mass index (BMI) were not significant and associations with binge-eating frequency did not differ across body image variables. Manifestations of body-image disturbance in BED are complex and understanding the distinctions between different body image constructs can contribute to treatment formulation. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

  10. Assessment of Malawian Mothers’ Malaria Knowledge, Healthcare Preferences and Timeliness of Seeking Fever Treatments for Children Under Five

    Directory of Open Access Journals (Sweden)

    Abayomi Samuel Oyekale

    2015-01-01

    Full Text Available Malaria is one of the major public health problems in Malawi, contributing to the majority of morbidity and mortality among children under five. Ignorance of malaria symptoms results in delayed treatment, which often degenerates into fatal emergencies. This study analyzed the impact of maternal malaria knowledge on healthcare preferences and timeliness of treating children with reported fever. The Malaria Indicator Survey data for 2012, which were adequately weighted, were analyzed using multinomial logit and Poisson regression models. The results showed low maternal average years of formal education (3.52 and average mothers’ age was 27.97 years. Majority of the women (84.98% associated fever with malaria, while 44.17% associated it with chilling. Also, 54.42% and 32.43% of the children were treated for fever on the same day and the following day that fever started, respectively. About 9.70% paid for fever treatment from their regular incomes, while 51.38% sought treatment from either public or private health centers. Multinomial Logit regression results showed that relative to using of other treatments, probabilities of selecting private hospitals and public health centers increased with age of the household heads, resident in urban areas, mothers’ years of education, number of days taken off for treatment, paying medical bills from regular, occasional and borrowed incomes, and knowledge of diarrhea and shivering as symptoms of malaria. In the Poisson regression results, timeliness of seeking treatment was significantly enhanced by knowledge of fever as malaria symptom, residence in northern and central regions of Malawi and use of income from sale of assets to pay medical bills (p < 0.10.However, delays in treating children was motivated by age of the household heads, number of days taken off to care for sick child and usage of regular, borrowed and other incomes to pay medical bills. (p < 0.05. It was concluded that efficiency of public

  11. A pilot study of screening, brief intervention, and referral for treatment (SBIRT) in non-treatment seeking smokers with HIV.

    Science.gov (United States)

    Cropsey, Karen L; Hendricks, Peter S; Jardin, Bianca; Clark, C Brendan; Katiyar, Nandan; Willig, James; Mugavero, Michael; Raper, James L; Saag, Michael; Carpenter, Matthew J

    2013-10-01

    PLHIV have higher rates of smoking and lower motivation to quit smoking; thus to impact smoking rates, cessation interventions need to be acceptable to a wider range of PLHIV smokers as well as feasible to implement in a busy clinical setting. The purpose of this study was to evaluate the acceptability, feasibility, and effects of a Screening, Brief Intervention, and Referral for Treatment (SBIRT) model in an HIV/AIDS clinic among a sample of PLHIV. PLHIV smokers (N=40) were randomized at baseline, irrespective of their self-reported discrete smoking cessation motivation status, to receive either 8-weeks of combination nicotine replacement therapy (NRT) in conjunction with brief counseling (SBIRT framework) (n=23) or usual care (n=17). Smoking outcome measures included cigarettes smoked per day, nicotine dependence, smoking urge, and smoking withdrawal symptoms. The SBIRT intervention appeared to be acceptable and feasible, and produced medium to large reductions in cigarettes smoked per day, physical nicotine dependence, smoking urge, and smoking withdrawal symptoms, even for smokers not ready to quit within 6months. Findings provide preliminary support for the integration of an SBIRT model in an HIV/AIDS clinic setting to screen and provide active treatment to all smokers, regardless of readiness to quit smoking. Given the high prevalence and incredible health burden of continued smoking in this population, identifying brief and effective interventions that are easily translated into clinical practice represents an enormous challenge that if met, will yield significant improvements to overall patient outcomes. Copyright © 2013 Elsevier Ltd. All rights reserved.

  12. Prevalence of psychiatric co-morbidity in treatment-seeking problem gamblers: A systematic review and meta-analysis

    Science.gov (United States)

    Cowlishaw, Sean; Jackson, Alun C; Merkouris, Stephanie S; Francis, Kate L; Christensen, Darren R

    2015-01-01

    Objective: The aim of this paper was to systematically review and meta-analyse the prevalence of co-morbid psychiatric disorders (DSM-IV Axis I disorders) among treatment-seeking problem gamblers. Methods: A systematic search was conducted for peer-reviewed studies that provided prevalence estimates of Axis I psychiatric disorders in individuals seeking psychological or pharmacological treatment for problem gambling (including pathological gambling). Meta-analytic techniques were performed to estimate the weighted mean effect size and heterogeneity across studies. Results: Results from 36 studies identified high rates of co-morbid current (74.8%, 95% CI 36.5–93.9) and lifetime (75.5%, 95% CI 46.5–91.8) Axis I disorders. There were high rates of current mood disorders (23.1%, 95% CI 14.9–34.0), alcohol use disorders (21.2%, 95% CI 15.6–28.1), anxiety disorders (17.6%, 95% CI 10.8–27.3) and substance (non-alcohol) use disorders (7.0%, 95% CI 1.7–24.9). Specifically, the highest mean prevalence of current psychiatric disorders was for nicotine dependence (56.4%, 95% CI 35.7–75.2) and major depressive disorder (29.9%, 95% CI 20.5–41.3), with smaller estimates for alcohol abuse (18.2%, 95% CI 13.4–24.2), alcohol dependence (15.2%, 95% CI 10.2–22.0), social phobia (14.9%, 95% CI 2.0–59.8), generalised anxiety disorder (14.4%, 95% CI 3.9–40.8), panic disorder (13.7%, 95% CI 6.7–26.0), post-traumatic stress disorder (12.3%, 95% CI 3.4–35.7), cannabis use disorder (11.5%, 95% CI 4.8–25.0), attention-deficit hyperactivity disorder (9.3%, 95% CI 4.1–19.6), adjustment disorder (9.2%, 95% CI 4.8–17.2), bipolar disorder (8.8%, 95% CI 4.4–17.1) and obsessive-compulsive disorder (8.2%, 95% CI 3.4–18.6). There were no consistent patterns according to gambling problem severity, type of treatment facility and study jurisdiction. Although these estimates were robust to the inclusion of studies with non-representative sampling biases, they should

  13. Cushing and the treatment of brain wounds during World War I.

    Science.gov (United States)

    Carey, Michael E

    2011-06-01

    Harvey Cushing, perhaps the most important founder of American neurosurgery, was an Army neurosurgeon in France from 1917 to 1918. Over a 3-month period in 1917 he and his team operated on 133 soldiers with a brain wound. The operative mortality rate for their last 45 patients was 29%, considerably lower than the usual postoperative mortality rate of approximately 50% for those with a brain wound. This accomplishment was lauded at the time and eventually, for some, it was Cushing who was responsible for lowering the postoperative mortality rate of brain wounds during World War I. As the decades passed he was eventually credited as the "originator of brain wound care." This report shows that these attributions are misplaced. Cushing merely followed the enlightened surgical precepts of the time developed by Continental (European) surgeons. It also examines Cushing's writings to ascertain how these misperceptions concerning his originality might have been generated.

  14. Clinical Profile and Psychiatric Comorbidity of Treatment-Seeking Individuals with Pathological Gambling in South-Africa.

    Science.gov (United States)

    Sinclair, Heidi; Pasche, Sonja; Pretorius, Adele; Stein, Dan J

    2015-12-01

    Pathological gambling is a prevalent and disabling mental illness, which is frequently associated with mood, anxiety, and substance use disorders. However, there is relatively little data on comorbidity in individuals with pathological gambling from low and middle income countries such as South-Africa. The Mini-International Neuropsychiatric Interview was used to assess the frequency of DSM-IV-TR disorders among 100 male and 100 female treatment-seeking individuals with pathological gambling in South-Africa. The Sheehan Disability Scale was used to assess functional impairment. In a South-African sample of individuals with pathological gambling, the most frequent current comorbid psychiatric disorders were major depressive disorder (28%), anxiety disorders (25.5%) and substance use disorders (10.5 %). Almost half of the individuals had a lifetime diagnosis of major depressive disorder (46%). Female pathological gamblers were significantly more likely to be diagnosed with a comorbid major depressive disorder or generalised anxiety disorder than their male counterparts. Data from South-Africa are consistent with previously published data from high income countries. Psychiatric comorbidity is common among individuals with pathological gambling.

  15. Is compulsive buying related to materialism, depression or temperament? Findings from a sample of treatment-seeking patients with CB.

    Science.gov (United States)

    Müller, Astrid; Claes, Laurence; Georgiadou, Ekaterini; Möllenkamp, Maike; Voth, Eva M; Faber, Ron J; Mitchell, James E; de Zwaan, Martina

    2014-04-30

    The aim of the present work was to examine the influence of reactive and regulatory temperament on compulsive buying (CB) in a sample of 102 patients (79 women, 23 men) with clinical CB. All participants answered the Compulsive Buying Scale (CBS), the Behavioral Inhibition System and Behavioral Activation System Scales (BIS/BAS), and the Effortful Control subscale (ATQ-EC) of the Adult Temperament Questionnaire-Short Form. Based on previous studies demonstrating that depression and materialism are linked with CB, in addition, the Patient Health Questionnaire depression scale (PHQ-9) and the Materialistic Values Scale (MVS) were administered. CBS scores were significantly correlated with the MVS, PHQ-9, and BAS scores. The findings of the hierarchical regression analysis, however, indicated that in the present sample of treatment-seeking patients the only significant association was found between CB and depression. The results highlight the prominent role of depression in CB. There is a need for longitudinal studies in order to answer the question whether depression is the cause or the consequence of CB. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  16. An internet forum analysis of stigma power perceptions among women seeking fertility treatment in the United States.

    Science.gov (United States)

    Jansen, Natalie Anne; Saint Onge, Jarron M

    2015-12-01

    Infertility is a condition that affects nearly 30 percent of women aged 25-44 in the United States. Though past research has addressed the stigmatization of infertility, few have done so in the context of stigma management between fertile and infertile women. In order to assess evidence of felt and enacted stigma, we employed a thematic content analysis of felt and enacted stigma in an online infertility forum, Fertile Thoughts, to analyze 432 initial threads by women in various stages of the treatment-seeking process. We showed that infertile women are frequently stigmatized for their infertility or childlessness and coped through a variety of mechanisms including backstage joshing and social withdrawal. We also found that infertile women appeared to challenge and stigmatize pregnant women for perceived immoral behaviors or lower social status. We argue that while the effects of stigma power are frequently perceived and felt in relationships between infertile women and their fertile peers, the direction of the enacted stigma is related to social standing and feelings of fairness and reinforces perceived expressions of deserved motherhood in the United States. Copyright © 2015 Elsevier Ltd. All rights reserved.

  17. The functional exercise capacity and its correlates in obese treatment-seeking people with binge eating disorder: an exploratory study.

    Science.gov (United States)

    Vancampfort, Davy; De Herdt, Amber; Vanderlinden, Johan; Lannoo, Matthias; Adriaens, An; De Hert, Marc; Stubbs, Brendon; Soundy, Andrew; Probst, Michel

    2015-01-01

    The primary aim was to compare the functional exercise capacity between obese treatment-seeking people with and without binge eating disorder (BED) and non-obese controls. The secondary aim was to identify clinical variables including eating and physical activity behaviour, physical complaints, psychopathology and physical self-perception variables in obese people with BED that could explain the variability in functional exercise capacity. Forty people with BED were compared with 20 age-, gender- and body mass index (BMI)-matched obese persons without BED and 40 age and gender matched non-obese volunteers. A 6-minute walk test (6MWT), the Baecke physical activity questionnaire, the Symptom Checklist-90, the Physical Self-Perception Profile and the Eating Disorder Inventory were administered. Physical complaints before and after the 6MWT were also documented. The distance achieved on the 6MWT was significantly lower in obese participants with BED (512.1 ± 75.8 m versus 682.7 ± 98.4, p binge eating disorder should incorporate a functional exercise capacity assessment. Clinicians involved in the rehabilitation of people with binge eating disorder should consider depression and lower self-esteem as potential barriers. Clinicians should take into account the frequently observed physical discomfort when developing rehabilitation programmes for people with binge eating disorder.

  18. Potential link between body dysmorphic disorder symptoms and alexithymia in an eating-disordered treatment-seeking sample.

    Science.gov (United States)

    Fenwick, Andrea Siân; Sullivan, Karen Anne

    2011-09-30

    This study aimed to explore the manifestation of body dysmorphic disorder symptoms in a sample of people with eating disorders and to investigate possible associations between body dysmorphia and alexithymia. Forty patients currently seeking treatment for an eating disorder completed a battery of six measures assessing alexithymia, mood, eating behaviours, weight-related body image, body dysmorphia and non-weight related body image. Significant moderate positive correlations (Pearson's r) between selected variables were found, suggesting that participants with high levels of dysmorphic concern (imagined ugliness) have more difficulty with the affective elements of alexithymia, that is, identifying and describing feelings. When depression, eating attitudes, and weight-related body image concerns were controlled for, significant moderate positive correlations between this alexithymia factor and dysmorphic concerns remained present. An independent-samples t-test between eating-disordered participants with and without symptoms of body dysmorphic disorder (BDD) revealed significant group differences in difficulties identifying feelings. This pattern of results was replicated when the groups were identified on the basis of dysmorphic concerns, as opposed to BDD symptoms. This study highlights the associations between alexithymia and body dysmorphia that have not previously been demonstrated. Copyright © 2011 Elsevier Ltd. All rights reserved.

  19. Prevalence, correlates, attitude and treatment seeking of erectile dysfunction among type 2 diabetic Chinese men attending primary care outpatient clinics

    Directory of Open Access Journals (Sweden)

    Wai Hon Lo

    2014-10-01

    Full Text Available To investigate the prevalence, correlates, attitude and treatment seeking behavior of erectile dysfunction (ED in type 2 diabetes mellitus (T2DM patients in the primary care setting, a multi-center cross-sectional survey using a structured anonymous self-administered questionnaire was performed in 10 general outpatient clinics. Of the 603 subjects (91% response rate, the prevalence of ED men, as defined by the International Index of Erectile Function, was 79.1%. Most subjects had mild ED (28.9%, followed by mild-to-moderate ED (27.9%, then moderate ED (13.4% and severe ED (9%. Nearly 55% of those with ED did not consider themselves as having ED. Less than 10% of them had ever sought medical treatment, although 76.1% of them wished to receive management from doctor(s should they be diagnosed with ED. They considered the most important management from doctors to be clinical assessment (41.7%, followed by management of potential underlying cause (37.8%, referral to specialist (27.5%, education (23.9%, prescription of phosphodiesterase type 5 inhibitors (16.9% and referral to counseling service (6.7%. The prevalence of ED was strongly associated with subjects who thought they had ED (odds ratio (OR = 90.49 (20.00-409.48, P< 0.001 and were from the older age group (OR = 1.043 (1.011-1.076, P= 0.008. In conclusion, ED is highly prevalent among T2DM men. The majority of them wanted management from doctors should they have ED, but only a minority would actually voice out the request. Screening of ED among T2DM men using structural questionnaire allowed the diagnosis of more than half of the ED cases, which otherwise would have gone undiagnosed.

  20. Psychosocial, demographic, and treatment-seeking strategic behavior, including faith healing practices, among patients with epilepsy in northwest India.

    Science.gov (United States)

    Pal, Surender Kumar; Sharma, Krishan; Prabhakar, Sudesh; Pathak, Ashis

    2008-08-01

    The data on sociocultural, demographic, and psychosocial aspects and types of treatment strategies adopted by families of patients with epilepsy in northwestern India were collected by the interview schedule method from 400 patients (200 idiopathic and 200 symptomatic) at the outpatient department of the Neurology and Epilepsy Clinic of the Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India. Epilepsy was classified as idiopathic or symptomatic on the basis of clinical tests (EEG, CT scan, and MRI). It was observed that socioeconomic factors had no bearing on epilepsy in the present sample. Early onset, that is, before 20 years of age, reduced the chances of patients' finding a spouse among those who disclosed the disease information, thereby impacting the nuptial and fertility rates of patients with epilepsy. The present sample of patients was well informed about and sensitized to the efficacy of the modern system of medicine, as 80% of patients sought medical treatment on the very same day as or within a week of onset of seizures. The data were compatible with the framed hypothesis that well-being and safety of the patient would override the stigma burden factor, as 94% of the affected families made no attempt to hide the disease from their neighbors, friends, and colleagues, and teachers of the affected patients. Surprisingly, only 7.5% of the families admitted that they consulted a faith healer. Families did adopt some culturally prevalent methods to control involuntary movements during seizures. It can be concluded that trust in faith healers exists strongly as an undercurrent, but is not overtly admitted by the majority of patients. Some families concurrently visited modern hospitals and occult healers seeking a cure for the disease. The fear of having a child with epilepsy or other abnormalities discouraged married patients from becoming pregnant after developing epilepsy.

  1. Caregivers' perception of malaria and treatment-seeking behaviour for under five children in Mandura District, West Ethiopia: a cross-sectional study.

    Science.gov (United States)

    Mitiku, Israel; Assefa, Adane

    2017-04-08

    Early diagnosis and prompt malaria treatment is essential to reduce progression of the illness to severe disease and, therefore, decrease mortality particularly among children under 5 years of age. This study assessed perception of malaria and treatment-seeking behaviour for children under five with fever in the last 2 weeks in Mandura District, West Ethiopia. A community based cross-sectional study was conducted among 491 caregivers of children under five in Mandura District, West Ethiopia in December 2014. Data were collected using interviewer-administered questionnaires. Data were entered into Epi Info version 7 and analysed using SPSS version 20. Multiple logistic regression analyses were conducted to identify the determinants of caregivers' treatment-seeking behaviour. Overall, 94.1% of the respondents perceived that fever is the most common symptom and 70% associated mosquito bite with the occurrence of malaria. Of 197 caregivers with under five children with fever in the last 2 weeks preceding the study 87.8% sought treatment. However, only 38.7% received treatment within 24 h of onset of fever. Determinants of treatment-seeking include place of residence (rural/urban) (AOR 2.80, 95% CI 1.01-7.70), caregivers age (AOR 3.40, 95% CI 1.27-9.10), knowledge of malaria (AOR 4.65, 95% CI 1.38-15.64), perceived susceptibility to malaria (AOR 3.63, 95% CI 1.21-10.88), and perceived barrier to seek treatment (AOR 0.18, 95% CI 0.06-0.52). Majority of the respondents of this study sought treatment for their under five children. However, a considerable number of caregivers first consulted traditional healers and tried home treatment, thus, sought treatment late. Living in rural village, caregivers' age, malaria knowledge, perceived susceptibility to malaria and perceived barrier to seek treatment were important factors in seeking health care. There is a need to focus on targeted interventions, promote awareness and prevention, and address misconceptions about

  2. Testing a DSM-5 reformulation of posttraumatic stress disorder: impact on prevalence and comorbidity among treatment-seeking civilian trauma survivors

    NARCIS (Netherlands)

    van Emmerik, A.A.P.; Kamphuis, J.H.

    2011-01-01

    The authors investigated a recent reformulation (Brewin, Lanius, Novac, Schnyder, & Galea, 2009) of posttraumatic stress disorder (PTSD) in treatment-seeking civilian trauma survivors. Diagnostic data from a randomized controlled trial (N = 170) were subjected to the criteria according to the

  3. Validity of the Adult ADHD Self-Report Scale (ASRS) as a screener for adult ADHD in treatment seeking substance use disorder patients

    NARCIS (Netherlands)

    van de Glind, Geurt; van den Brink, Wim; Koeter, Maarten W. J.; Carpentier, Pieter-Jan; van Emmerik-van Oortmerssen, Katelijne; Kaye, Sharlene; Skutle, Arvid; Bu, Eli-Torild H.; Franck, Johan; Konstenius, Maija; Moggi, Franz; Dom, Geert; Verspreet, Sofie; Demetrovics, Zsolt; Kapitany-Foeveny, Mate; Fatseas, Melina; Auriacombe, Marc; Schillinger, Arild; Seitz, Andrea; Johnson, Brian; Faraone, Stephen V.; Ramos-Quiroga, J. Antoni; Casas, Miguel; Allsop, Steve; Carruthers, Susan; Bartar, Csaba; Schoevers, Robert A.; Levin, Frances R.

    2013-01-01

    Background: To detect attention deficit hyperactivity disorder (ADHD) in treatment seeking substance use disorders (SUD) patients, a valid screening instrument is needed. Objectives: To test the performance of the Adult ADHD Self-Report Scale V 1.1(ASRS) for adult ADHD in an international sample of

  4. Psychiatric comorbidity in treatment-seeking substance use disorder patients with and without attention deficit hyperactivity disorder : results of the IASP study

    NARCIS (Netherlands)

    van Emmerik-van Oortmerssen, Katelijne; van de Glind, Geurt; Koeter, Maarten W. J.; Allsop, Steve; Auriacombe, Marc; Barta, Csaba; Bu, Eli Torild H.; Burren, Yuliya; Carpentier, Pieter-Jan; Carruthers, Susan; Casas, Miguel; Demetrovics, Zsolt; Dom, Geert; Faraone, Stephen V.; Fatseas, Melina; Franck, Johan; Johnson, Brian; Kapitany-Foeveny, Mate; Kaye, Sharlene; Konstenius, Maija; Levin, Frances R.; Moggi, Franz; Moller, Merete; Ramos-Quiroga, J. Antoni; Schillinger, Arild; Skutle, Arvid; Verspreet, Sofie; van den Brink, Wim; Schoevers, Robert A.

    AimsTo determine comorbidity patterns in treatment-seeking substance use disorder (SUD) patients with and without adult attention deficit hyperactivity disorder (ADHD), with an emphasis on subgroups defined by ADHD subtype, taking into account differences related to gender and primary substance of

  5. Psychiatric comorbidity in treatment-seeking substance use disorder patients with and without attention deficit hyperactivity disorder: results of the IASP study

    NARCIS (Netherlands)

    Emmerik-van Oortmerssen, K. van; Glind, G. van de; Koeter, M.W.; Allsop, S.; Auriacombe, M.; Barta, C.; Bu, E.T.; Burren, Y.; Carpentier, P.J.; Carruthers, S.; Casas, M.; Demetrovics, Z.; Dom, G.; Faraone, S.V.; Fatseas, M.; Franck, J.; Johnson, B.; Kapitany-Foveny, M.; Kaye, S.; Konstenius, M.; Levin, F.R.; Moggi, F.; Moller, M.; Ramos-Quiroga, J.A.; Schillinger, A.; Skutle, A.; Verspreet, S.; Brink, W. van den; Schoevers, R.A.; Gaag, R.J. van der; et al.,

    2014-01-01

    AIMS: To determine comorbidity patterns in treatment-seeking substance use disorder (SUD) patients with and without adult attention deficit hyperactivity disorder (ADHD), with an emphasis on subgroups defined by ADHD subtype, taking into account differences related to gender and primary substance of

  6. Some Aspects of War and Peace Treatment by Roman Church Pontifices at the End of the XX and at the Beginning of the XXI Centuries

    Directory of Open Access Journals (Sweden)

    G I Bykova

    2012-03-01

    Full Text Available The article is dedicated to the Christian comprehension of war and peace in Roman Catholic Church. It focuses on the treatment of these problems in speeches and articles of John Paul II and of Benedict XVI. The most considered is Catholic reason for peacemaking policy.

  7. Profile of female patients seeking in-patient treatment for prescription opioid abuse from a tertiary care drug dependence treatment centre from India.

    Science.gov (United States)

    Dayal, Prabhoo; Balhara, Yatan Pal Singh

    2016-01-01

    There has been a limited focus on prescription drug abuse among women in the country. Choice of psychoactive substance, reasons for initiation and co-occurring disorders have been found to be different among men and women. The current study was aimed at studying the profile of female patients seeking in-patient treatment for prescription drug use over a period of five years at a tertiary care drug dependence treatment centre in India. Case records of all female patients admitted with substance use disorder at a national level drug dependence treatment centre in north India across five years (between January 2008 and December 2012) were reviewed retrospectively to study their socio-demographic and clinical profile. The information was gathered using a semi-structured proforma and detailed case records. Abstinence, relapse and retention rates were calculated. Over the five years, 31 female patients were admitted with prescription drug abuse. Of them, 12 (39%) used prescription opioids and 11 (36%) used prescription opioid along with benzodiazepines. Commonest prescription opioid was pentazocine used by 87 per cent of the women. Twenty two (71%) women were introduced to opioid by medical practitioners and commonest reason for introduction was pain (among 48%). Common co-occurring psychiatric diagnoses were depressive disorder (26%), cluster B traits/disorder (19%) and somatoform disorder (13%). Eight women did not complete treatment and left against medical advice. Thirteen women were advised maintenance treatment, and 70 per cent of them were retained for at least six months. Our findings revealed a link between mental illness, pain and non-medical use of prescription opioids among women. Majority of these women received opioids as a legitimate prescription form physician. Therefore, these legitimate prescribers should be trained for pain management to facilitate proper treatment of pain and to prevent the subsequent misuse of these medicines. Female patients with

  8. The association between whole body sagittal balance and risk of falls among elderly patients seeking treatment for back pain.

    Science.gov (United States)

    Kim, J; Hwang, J Y; Oh, J K; Park, M S; Kim, S W; Chang, H; Kim, T-H

    2017-05-01

    The objective of this study was to assess the association between whole body sagittal balance and risk of falls in elderly patients who have sought treatment for back pain. Balanced spinal sagittal alignment is known to be important for the prevention of falls. However, spinal sagittal imbalance can be markedly compensated by the lower extremities, and whole body sagittal balance including the lower extremities should be assessed to evaluate actual imbalances related to falls. Patients over 70 years old who visited an outpatient clinic for back pain treatment and underwent a standing whole-body radiograph were enrolled. Falls were prospectively assessed for 12 months using a monthly fall diary, and patients were divided into fallers and non-fallers according to the history of falls. Radiological parameters from whole-body radiographs and clinical data were compared between the two groups. A total of 144 patients (120 female patients and 24 male patients) completed a 12-month follow-up for assessing falls. A total of 31 patients (21.5%) reported at least one fall within the 12-month follow-up. In univariate logistic regression analysis, the risk of falls was significantly increased in older patients and those with more medical comorbidities, decreased lumbar lordosis, increased sagittal vertical axis, and increased horizontal distance between the C7 plumb line and the centre of the ankle (C7A). Increased C7A was significantly associated with increased risk of falls even after multivariate adjustment. Whole body sagittal balance, measured by the horizontal distance between the C7 plumb line and the centre of the ankle, was significantly associated with risk of falls among elderly patients with back pain.Cite this article: J. Kim, J. Y. Hwang, J. K. Oh, M. S. Park, S. W. Kim, H. Chang, T-H. Kim. The association between whole body sagittal balance and risk of falls among elderly patients seeking treatment for back pain. Bone Joint Res 2017;6:-344. DOI: 10

  9. Unknotting night-time muscle cramp: a survey of patient experience, help-seeking behaviour and perceived treatment effectiveness

    Directory of Open Access Journals (Sweden)

    Blyton Fiona

    2012-03-01

    Full Text Available Abstract Background Night-time calf cramping affects approximately 1 in 3 adults. The aim of this study was to explore the experience of night-time calf cramp; if and where people seek treatment advice; and perceived treatment effectiveness. Methods 80 adults who experienced night-time calf cramp at least once per week were recruited from the Hunter region, NSW, Australia through newspaper, radio and television advertisements. All participants completed a pilot-tested survey about muscle cramp. Quantitative data were analysed with independent-sample t-tests, Chi square tests and Fisher's tests. Qualitative data were transcribed and sorted into categories to identify themes. Results Median recalled age of first night-time calf cramp was 50 years. Most participants recalled being awoken from sleep by cramping, and experiencing cramping of either calf muscle, calf-muscle soreness in the days following cramp and cramping during day-time. Despite current therapies, mean usual pain intensity was 66 mm on a 100 mm visual analogue scale. Participants described their cramps as being 'unbearable', 'unmanageable' and 'cruel'. One participant stated that 'sometimes I just wish I could cut my legs open' and another reported 'getting about 2 h sleep a night due to cramps'. Most participants had sought advice about their night-time calf cramps from a health professional. Participants identified 49 different interventions used to prevent night-time calf cramp. Of all treatment ratings, 68% described the intervention used to prevent cramp as being 'useless' or of 'a little help'. Of 14 participants who provided additional information regarding their use of quinine, eight had a current prescription of quinine for muscle cramp at the time of the survey. None had been asked by their prescribing doctor to stop using quinine. Conclusion Night time calf cramps typically woke sufferers from sleep, affected either leg and caused ongoing pain. Most participants

  10. Aerobic exercise training reduces cannabis craving and use in non-treatment seeking cannabis-dependent adults.

    Directory of Open Access Journals (Sweden)

    Maciej S Buchowski

    2011-03-01

    Full Text Available Cannabis dependence is a significant public health problem. Because there are no approved medications for this condition, treatment must rely on behavioral approaches empirically complemented by such lifestyle change as exercise.To examine the effects of moderate aerobic exercise on cannabis craving and use in cannabis dependent adults under normal living conditions.Participants attended 10 supervised 30-min treadmill exercise sessions standardized using heart rate (HR monitoring (60-70% HR reserve over 2 weeks. Exercise sessions were conducted by exercise physiologists under medical oversight.Sedentary or minimally active non-treatment seeking cannabis-dependent adults (n = 12, age 25±3 years, 8 females met criteria for primary cannabis dependence using the Substance Abuse module of the Structured Clinical Interview for DSM-IV (SCID.Self-reported drug use was assessed for 1-week before, during, and 2-weeks after the study. Participants viewed visual cannabis cues before and after exercise in conjunction with assessment of subjective cannabis craving using the Marijuana Craving Questionnaire (MCQ-SF.Daily cannabis use within the run-in period was 5.9 joints per day (SD = 3.1, range 1.8-10.9. Average cannabis use levels within the exercise (2.8 joints, SD = 1.6, range 0.9-5.4 and follow-up (4.1 joints, SD = 2.5, range 1.1-9.5 periods were lower than during the run-in period (both P<.005. Average MCQ factor scores for the pre- and post-exercise craving assessments were reduced for compulsivity (P  = .006, emotionality (P  = .002, expectancy (P  = .002, and purposefulness (P  = .002.The findings of this pilot study warrant larger, adequately powered controlled trials to test the efficacy of prescribed moderate aerobic exercise as a component of cannabis dependence treatment. The neurobiological mechanisms that account for these beneficial effects on cannabis use may lead to understanding of the physical and

  11. Terror Weapons: The British Experience of Gas and Its Treatment in the First World War.

    Science.gov (United States)

    Jones, Edgar

    2014-07-01

    Chemical weapons accounted for only 1 per cent of the 750,000 British troops killed in the First World War and yet caused disproportionate casualties (estimated at 180,100). The considerable investment in the development of new toxins and methods of delivery was designed to maintain the elements of surprise and uncertainty as these accentuated their psychological effect. Soldiers were continually challenged on the battlefield by combinations of different types of agent designed to undermine their confidence in respirators, disorientate them, and erode their morale. At first, army doctors practised defensive medicine, invaliding their patients for protracted periods to the UK or base hospitals. By 1917, progressive study of the physical and psychological effects of different types of toxin allowed physicians to design new management strategies. Borrowing ideas from shell shock, specialist units were set up closer to the front line and medical officers taught to identify crucial points in the course of illness to accelerate recovery times and forestall the accretion of psychosomatic symptoms.

  12. Anxiety sensitivity predicts increased perceived exertion during a 1-mile walk test among treatment-seeking smokers.

    Science.gov (United States)

    Farris, Samantha G; Uebelacker, Lisa A; Brown, Richard A; Price, Lawrence H; Desaulniers, Julie; Abrantes, Ana M

    2017-12-01

    Smoking increases risk of early morbidity and mortality, and risk is compounded by physical inactivity. Anxiety sensitivity (fear of anxiety-relevant somatic sensations) is a cognitive factor that may amplify the subjective experience of exertion (effort) during exercise, subsequently resulting in lower engagement in physical activity. We examined the effect of anxiety sensitivity on ratings of perceived exertion (RPE) and physiological arousal (heart rate) during a bout of exercise among low-active treatment-seeking smokers. Adult daily smokers (n = 157; M age  = 44.9, SD = 11.13; 69.4% female) completed the Rockport 1.0 mile submaximal treadmill walk test. RPE and heart rate were assessed during the walk test. Multi-level modeling was used to examine the interactive effect of anxiety sensitivity × time on RPE and on heart rate at five time points during the walk test. There were significant linear and cubic time × anxiety sensitivity effects for RPE. High anxiety sensitivity was associated with greater initial increases in RPE during the walk test, with stabilized ratings towards the last 5 min, whereas low anxiety sensitivity was associated with lower initial increase in RPE which stabilized more quickly. The linear time × anxiety sensitivity effect for heart rate was not significant. Anxiety sensitivity is associated with increasing RPE during moderate-intensity exercise. Persistently rising RPE observed for smokers with high anxiety sensitivity may contribute to the negative experience of exercise, resulting in early termination of bouts of prolonged activity and/or decreased likelihood of future engagement in physical activity.

  13. Characterization and epidemiology of influenza viruses in patients seeking treatment for influenza-like illnesses in rural Bangladesh

    Directory of Open Access Journals (Sweden)

    M A Fally

    2012-01-01

    Full Text Available Context: Infections caused by influenza viruses are a major health burden, both in developed and developing countries worldwide. Nevertheless, the overwhelming majority of influenza reports originate from industrialized countries in northern and southern temperate zones. Aims: The aim of this study was to determine the epidemiology of influenza viruses in patients seeking treatment for acute febrile illnesses in rural Bangladesh. Settings and Design: As part of our research on the causes of febrile illnesses in rural Bangladesh, nasopharyngeal swabs from patients with signs and symptoms consistent with influenza were collected from 2008 onwards. Materials and Methods: Viral infection was established using two independent rapid diagnostic tests (RDTs and later confirmed by RT-PCR. Results: A total of 314 fever cases were enrolled in a survey of febrile illnesses carried out in Bandarban District in southeastern Bangladesh, out of whom 38 (12.1% tested positive by RDT. Molecular subtyping showed that seasonal H3 strains (N=22; 7.0% as well as the new H1N1v pandemic influenza subtype (N=13; 4.1% had been circulating at the time of our investigations resulting in a PCR-adjusted positivity rate of 11.1% (95% CI 8.0 - 15.3. The positive predictive values for the RDTs used were 90.9% and 94.4%, respectively. Conclusions: This study provides a first insight into influenza epidemics in one of the most remote parts of Asia. Our findings suggest that respiratory illnesses due to influenza viruses are underreported in areas with limited access to health care and show a distinct seasonality also in rural areas of tropical countries.

  14. Psychometric properties of the dimensional anxiety scales for DSM-V in an unselected sample of German treatment seeking patients.

    Science.gov (United States)

    Beesdo-Baum, Katja; Klotsche, Jens; Knappe, Susanne; Craske, Michelle G; Lebeau, Richard T; Hoyer, Jürgen; Strobel, Anja; Pieper, Lars; Wittchen, Hans-Ulrich

    2012-12-01

    Dimensional assessments are planned to be included as supplements to categorical diagnoses in DSM-V. The aim of this study was to examine the unidimensionality, reliability, validity, and clinical sensitivity of brief self-rated scales for specific anxiety disorders in an unselected German sample of consecutive attendees to a psychological clinic. These scales use a common template to assess core constructs of fear and anxiety. Dimensional scales for social anxiety disorder, specific phobia, agoraphobia, panic disorder, and generalized anxiety disorder were administered along with established scales to 102 adults seeking treatment for mental health problems at a German university outpatient clinic for psychotherapy. The computer-assisted clinical version of the Munich-Composite International Diagnostic Interview was used to assess mental disorders according to DSM-IV criteria. Dimensionality and scale reliability were examined using confirmatory factor analyses. Convergent and discriminant validity were examined by testing differences in the size of correlations between each dimensional anxiety scale and each of the previously validated scales. Each dimensional scale's ability to correctly differentiate between individuals with versus without an anxiety diagnosis was examined via the area under the curve. Analyses revealed unidimensionality for each scale, high reliability, and convergent and discriminant validity. Classification performance was good to excellent for all scales except for specific phobia. The application of the dimensional anxiety scales may be an effective way to screen for specific anxiety disorders and to supplement categorical diagnoses in DSM-V, although further evaluation and refinement of the scales (particularly the specific phobia scale) is needed. © 2012 Wiley Periodicals, Inc.

  15. Associations Between Pain, Current Tobacco Smoking, Depression, and Fibromyalgia Status Among Treatment-Seeking Chronic Pain Patients.

    Science.gov (United States)

    Goesling, Jenna; Brummett, Chad M; Meraj, Taha S; Moser, Stephanie E; Hassett, Afton L; Ditre, Joseph W

    2015-07-01

    As smoking impacts physiological pathways in the central nervous system, it is important to consider the association between smoking and fibromyalgia, a pain condition caused predominantly by central nervous system dysfunction. The objectives were to assess the prevalence of current smoking among treatment-seeking chronic pain patients with (FM+) and without (FM-) a fibromyalgia-like phenotype; test the individual and combined influence of smoking and fibromyalgia on pain severity and interference; and examine depression as a mediator of these processes. Questionnaire data from 1566 patients evaluated for a range of conditions at an outpatient pain clinic were used. The 2011 Survey Criteria for Fibromyalgia were used to assess the presence of symptoms associated with fibromyalgia. Current smoking was reported by 38.7% of FM+ patients compared to 24.7% of FM- patients. FM+ smokers reported higher pain and greater interference compared to FM+ nonsmokers, FM- smokers, and FM- nonsmokers. There was no interaction between smoking and fibromyalgia. Significant indirect effects of fibromyalgia and smoking via greater depression were observed for pain severity and interference. Current smoking and positive fibromyalgia status were associated with greater pain and impairment among chronic pain patients, possibly as a function of depression. Although FM+ smokers report the most negative clinical symptomatology (i.e., high pain, greater interference) smoking does not appear to have a unique association with pain or functioning in FM+ patients, rather the effect is additive. The 38.7% smoking rate in FM+ patients is high, suggesting FM+ smokers present a significant clinical challenge. © 2015 American Academy of Pain Medicine.

  16. Treatment seeking adults with autism or ADHD and co-morbid substance use disorder: prevalence, risk factors and functional disability.

    Science.gov (United States)

    Sizoo, Bram; van den Brink, Wim; Koeter, Maarten; Gorissen van Eenige, Marielle; van Wijngaarden-Cremers, Patricia; van der Gaag, Rutger Jan

    2010-02-01

    Little is known about Autism Spectrum Disorder (ASD) in adults, especially not about ASD with co-morbid Substance Use Disorder (SUD). We wanted to examine how adults with ASD compare to adults with ADHD on prevalence and risk factors for co-morbid SUD, and on disability levels associated with SUD. We stratified 123 treatment seeking adults with ASD (n=70) or ADHD (n=53), into current, former and no history of SUD (SUD+, SUD(wedge), and SUD-), and conducted interviews to explore associated risk factors and current levels of disability. Prevalence of co-morbid SUD was higher in ADHD than in ASD in our sample (58% versus 30%, p=0.001). There was no statistically significant difference between ASD and ADHD in risk factors or disability scores. Patients with lifetime SUD started regular smoking earlier in life (OR=5.69, C(95%) 2.3-13.8), reported more adverse family events (OR=2.68; CI(95%) 1.2-6.1), and had more parental SUD (OR=5.36; CI(95%) 1.0-14.5). Disability scores were significantly lower in SUD- and SUD(wedge) groups compared to the SUD+ group. These findings suggest that ASD and ADHD share similar risk factors for SUD. High disability in ASD and ADHD with SUD may normalize after prolonged abstinence. Early onset of SUD was not associated with more severe disability scores than later onset. Results suggest that a subgroup of patients with former SUD may have a higher level of functioning before the onset of SUD in comparison to those without lifetime SUD. Copyright (c) 2009 Elsevier Ireland Ltd. All rights reserved.

  17. Ground Wars

    DEFF Research Database (Denmark)

    Nielsen, Rasmus Kleis

    Political campaigns today are won or lost in the so-called ground war--the strategic deployment of teams of staffers, volunteers, and paid part-timers who work the phones and canvass block by block, house by house, voter by voter. Ground Wars provides an in-depth ethnographic portrait of two...... of ground war tactics for how we understand political campaigns and what it means to participate in them. He shows how ground wars are waged using resources well beyond those of a given candidate and their staff. These include allied interest groups and civic associations, party-provided technical...... of professionals. Yet he also quashes the romantic idea that canvassing is a purer form of grassroots politics. In today's political ground wars, Nielsen demonstrates, even the most ordinary-seeming volunteer knocking at your door is backed up by high-tech targeting technologies and party expertise. Ground Wars...

  18. Respondent-driven sampling on the Thailand-Cambodia border. II. Knowledge, perception, practice and treatment-seeking behaviour of migrants in malaria endemic zones

    Directory of Open Access Journals (Sweden)

    Kaewkungwal Jaranit

    2011-05-01

    Full Text Available Abstract Background Population movements along the Thailand-Cambodia border, particularly among highly mobile and hard-to-access migrant groups from Cambodia and Myanmar, are assumed to play a key role in the spread of artemisinin resistance. Data on treatment-seeking behaviours, knowledge and perceptions about malaria, and use of preventive measures is lacking as characteristics of this population prevent them from being represented in routine surveillance and the lack of a sampling frame makes reliable surveys challenging. Methods A survey of migrant populations from Cambodia and Myanmar was implemented in five selected rural locations in Thailand along the Thai-Cambodian border using respondent driven sampling (RDS to determine demographic characteristics of the population, migratory patterns, knowledge about malaria, and health-care -seeking behaviours. Results The majority of migrants from Myanmar are long-term residents (98% with no plans to move back to Myanmar, understand spoken Thai (77% and can therefore benefit from health messages in Thai, have Thai health insurance (99% and accessed public health services in Thailand (63% for their last illness. In comparison, the majority of Cambodian migrants are short-term (72%. Of the short-term Cambodian migrants, 92% work in agriculture, 18% speak Thai, 3.4% have Thai health insurance, and the majority returned to Cambodia for treatment (45%, self-treated (11%, or did not seek treatment for their last illness (27%. Conclusion Most highly mobile migrants along the Thai-Cambodia border are not accessing health messages or health treatment in Thailand, increasing their risk of malaria and facilitating the spread of potentially resistant Plasmodium falciparum as they return to Cambodia to seek treatment. Reaching out to highly mobile migrants with health messaging they can understand and malaria diagnosis and treatment services they can access is imperative in the effort to contain the spread of

  19. WAR HORSES:

    DEFF Research Database (Denmark)

    War Horses: Helhesten and the Danish Avant-Garde During World War II This exhibition is the first to explore the history and significance of the accomplishments of Danish artists working during the Nazi occupation of their country (1940-45), who called themselves Helhesten, such as Ejler Bille......-1951), which they became part of. Cobra greatly influenced the development of European modern art after World War II. The exhibition includes over 100 works and reconstructs for the first time the most important exhibition these artists staged in Denmark during the war, 13 Artists in a Tent (1941). It draws...

  20. The effect of performance-based financing on illness, care-seeking and treatment among children: an impact evaluation in Rwanda.

    Science.gov (United States)

    Skiles, Martha Priedeman; Curtis, Siân L; Basinga, Paulin; Angeles, Gustavo; Thirumurthy, Harsha

    2015-09-14

    Performance-based financing (PBF) strategies are promoted as a supply-side, results-based financing mechanism to improve primary health care. This study estimated the effects of Rwanda's PBF program on less-incentivized child health services and examined the differential program impact by household poverty. Districts were allocated to intervention and comparison for PBF implementation in Rwanda. Using Demographic Health Survey data from 2005 to 2007-08, a community-level panel dataset of 5781 children less than 5 years of age from intervention and comparison districts was created. The impacts of PBF on reported childhood illness, facility care-seeking, and treatment received were estimated using a difference-in-differences model with community fixed effects. An interaction term between poverty and the program was estimated to identify the differential effect of PBF among children from poorer families. There was no measurable difference in estimated probability of reporting illness with diarrhea, fever or acute respiratory infections between the intervention and comparison groups. Seeking care at a facility for these illnesses increased over time, however no differential effect by PBF was seen. The estimated effect of PBF on receipt of treatment for poor children is 45 percentage points higher (p = 0.047) compared to the non-poor children seeking care for diarrhea or fever. PBF, a supply-side incentive program, improved the quality of treatment received by poor children conditional on patients seeking care, but it did not impact the propensity to seek care. These findings provide additional evidence that PBF incentivizes the critical role staff play in assuring quality services, but does little to influence consumer demand for these services. Efforts to improve child health need to address both supply and demand, with additional attention to barriers due to poverty if equity in service use is a concern.

  1. Seeking ambulance treatment for 'primary care' problems: a qualitative systematic review of patient, carer and professional perspectives.

    Science.gov (United States)

    Booker, Matthew J; Purdy, Sarah; Shaw, Alison R G

    2017-08-03

    To understand the reasons behind, and experience of, seeking and receiving emergency ambulance treatment for a 'primary care sensitive' condition. A comprehensive, qualitative systematic review. Medline, Embase, PsychInfo, Cumulative Index of Nursing and Allied Health, Health Management Information Systems, Healthcare Management Information Consortium, OpenSigle, EThOS and Digital Archive of Research Theses databases were systematically searched for studies exploring patient, carer or healthcare professional interactions with ambulance services for 'primary care sensitive' problems. Studies using wholly qualitative approaches or mixed-methods studies with substantial use of qualitative techniques in both the methods and analysis sections were included. An analytical thematic synthesis was undertaken, using a line-by-line qualitative coding method and a hierarchical inductive approach. Of 1458 initial results, 33 studies met the first level (relevance) inclusion criteria, and six studies met the second level (methodology and quality) criteria. The analysis suggests that patients define situations worthy of 'emergency' ambulance use according to complex socioemotional factors, as well as experienced physical symptoms. There can be a mismatch between how patients and professionals define 'emergency' situations. Deciding to call an ambulance is a process shaped by practical considerations and a strong emotional component, which can be influenced by the views of caregivers. Sometimes the value of a contact with the ambulance service is principally in managing this emotional component. Patients often wish to hand over responsibility for decisions when experiencing a perceived emergency. Feeling empowered to take control of a situation is a highly valued aspect of ambulance care. When responding to a request for 'emergency' help for a low-acuity condition, urgent-care services need to be sensitive to how the patient's emotional and practical perception of the situation

  2. The distribution of patients who seek treatment for the complaint of ejaculating prematurely according to the four premature ejaculation syndromes.

    Science.gov (United States)

    Serefoglu, Ege Can; Cimen, Haci Ibrahim; Atmaca, Ali Fuat; Balbay, M Derya

    2010-02-01

    ). The majority of patients who seek treatment for the complaint of ejaculating prematurely describes lifelong PE. Further population-based studies are required to determine the actual prevalences of these four PE syndromes.

  3. The utility of attention-deficit/hyperactivity disorder screening instruments in individuals seeking treatment for substance use disorders.

    Science.gov (United States)

    Dakwar, Elias; Mahony, Amy; Pavlicova, Martina; Glass, Andrew; Brooks, Daniel; Mariani, John J; Grabowski, John; Levin, Frances Rudnick

    2012-11-01

    Several screening tools for attention-deficit/hyperactivity disorder (ADHD) have been validated in non-substance-abusing populations, but limited data are available regarding their utility in adults with current substance use disorders. The aim of this study was to determine the sensitivity, specificity, and positive and negative predictive values of 3 commonly used ADHD screening instruments in cocaine-dependent individuals. Adults seeking treatment for cocaine dependence (N = 102) were administered 3 self-report instruments between May 2009 and April 2011: the Conners Adult ADHD Rating Scale (CAARS), the Wender Utah Rating Scale (WURS), and the Adult ADHD Self-Report Scale-Version 1.1 (ASRS-V1.1). They then met with master's-level clinicians who administered the Conners Adult ADHD Diagnostic Interview for DSM-IV (CAADID). With the CAADID serving as the gold standard, the validity of the screening instruments was determined, both singly and in combination. Twenty-five (25%) of the 102 patients met DSM-IV criteria for ADHD or ADHD not otherwise specified (NOS) based on the CAADID. Kappa scores determining agreement between the screening tools and the CAADID (with ADHD NOS labeled as ADHD or labeled as not ADHD) ranged from 0.37 to 0.69. Sensitivity scores for the broadest range of ADHD cases were 80.0%, 87.5%, and 60.9% for the CAARS, WURS, and ASRS-V1.1, respectively. Positive predictive value was highest for the CAARS, at 74.1%, and negative predictive value was highest for the WURS, at 95.1%. The highest sensitivity (96.0%) was found with coadministration of the WURS and CAARS. While all of the screening instruments were found to have adequate sensitivity and specificity, the CAARS outperformed the other instruments in regard to agreement with the CAADID and positive predictive values. However, the WURS, with the highest sensitivity in regard to the broadest range of ADHD cases, may be the single best instrument for preliminary screening purposes. Further

  4. Helping Peers Seek Professional Treatment for Depression among Young South Koreans: An Application of the Theory of Planned Behavior

    Science.gov (United States)

    Lee, Sun Hae; Choi, Jung Ah; Park, Ji Hye

    2015-01-01

    This study examined the applicability of the theory of planned behavior to understand factors that influence whether young South Koreans help peers with depression to seek professional counseling services. The structural equation modeling on the survey data collected from 191 South Korean students suggests that subjective norms and behavioral…

  5. Effectiveness of Acupressure Treatment for Pain Management and Fatigue Relief in Gulf War Veterans

    Science.gov (United States)

    2017-12-01

    fatigue relief in veterans with GWI. Pain scale and fatigue scale decreased during the intervention . EMG data in both groups shows increased mean EMG...advancements in acupressure intervention for veterans with GWI. 15. SUBJECT TERMS 16. SECURITY CLASSIFICATION OF: 17. LIMITATION OF ABSTRACT 18...conclusive treatment. Veterans with GWI rely on pharmaceutical treatment, physical therapy, and/or nutritional supplements to temporarily alleviate their

  6. Carcinogenicity and teratogenicity vs. psychogenicity: Psychological characteristics associated with self-reported Agent Orange exposure among Vietnam combat veterans who seek treatment for substance abuse

    Energy Technology Data Exchange (ETDEWEB)

    Robinowitz, R.; Roberts, W.R.; Dolan, M.P.; Patterson, E.T.; Charles, H.L.; Atkins, H.G.; Penk, W.E. (Univ. of Texas Health Science Center, Dallas (USA))

    1989-09-01

    This study asked, What are the psychological characteristics of Vietnam combat veterans who claim Agent Orange exposure when compared with combat-experienced cohorts who do not report such contamination The question was researched among 153 heroin addicts, polydrug abusers, and chronic alcoholics who were seeking treatment: 58 reported moderate to high defoliant exposure while in combat; 95 reported minimal to no exposure while in Vietnam. The null hypothesis was accepted for measures of childhood and present family social climate, premilitary backgrounds, reasons for seeking treatment, patterns and types of illicit drug and alcohol use, interpersonal problems, intellectual functioning, and short-term memory. The null hypothesis was rejected for personality differences, however, those who self-reported high Agent Orange exposure scored significantly higher on MMPI scales F, Hypochondriasis, Depression, Paranoia, Psychasthenia, Schizophrenia, Mania, and Social interoversion. The results suggest that clinicians carefully assess attributional processing of those who report traumatic experience.

  7. Factors driving customers to seek health care from pharmacies for acute respiratory illness and treatment recommendations from drug sellers in Dhaka city, Bangladesh.

    Science.gov (United States)

    Chowdhury, Fahmida; Sturm-Ramirez, Katharine; Mamun, Abdullah Al; Iuliano, A Danielle; Bhuiyan, Mejbah Uddin; Chisti, Mohammod Jobayer; Ahmed, Makhdum; Haider, Sabbir; Rahman, Mahmudur; Azziz-Baumgartner, Eduardo

    2017-01-01

    Pharmacies in Bangladesh serve as an important source of health service. A survey in Dhaka reported that 48% of respondents with symptoms of acute respiratory illness (ARI) identified local pharmacies as their first point of care. This study explores the factors driving urban customers to seek health care from pharmacies for ARI, their treatment adherence, and outcome. A cross-sectional study was conducted among 100 selected pharmacies within Dhaka from June to December 2012. Study participants were patients or patients' relatives aged >18 years seeking care for ARI from pharmacies without prescription. Structured interviews were conducted with customers after they sought health service from drug sellers and again over phone 5 days postinterview to discuss treatment adherence and outcome. We interviewed 302 customers patronizing 76 pharmacies; 186 (62%) sought care for themselves and 116 (38%) sought care for a sick relative. Most customers (215; 71%) were males. The majority (90%) of customers sought care from the study pharmacy as their first point of care, while 18 (6%) had previously sought care from another pharmacy and 11 (4%) from a physician for their illness episodes. The most frequently reported reasons for seeking care from pharmacies were ease of access to pharmacies (86%), lower cost (46%), availability of medicine (33%), knowing the drug seller (20%), and convenient hours of operation (19%). The most commonly recommended drugs were acetaminophen dispensed in 76% (228) of visits, antihistamine in 69% (208), and antibiotics in 42% (126). On follow-up, most (86%) of the customers had recovered and 12% had sought further treatment. People with ARI preferred to seek care at pharmacies rather than clinics because these pharmacies were more accessible and provided prompt treatment and medicine with no service charge. We recommend raising awareness among drug sellers on proper dispensing practices and enforcement of laws and regulations for drug sales.

  8. Subjective and Objective Binge Eating in Relation to Eating Disorder Symptomatology, Depressive Symptoms, and Self-Esteem Among Treatment-Seeking Adolescents with Bulimia Nervosa

    OpenAIRE

    Fitzsimmons-Craft, Ellen E.; Ciao, Anna C.; Accurso, Erin C.; Pisetsky, Emily M.; Peterson, Carol B.; Byrne, Catherine E.; Le Grange, Daniel

    2014-01-01

    This study investigated the importance of the distinction between objective (OBE) and subjective binge eating (SBE) among 80 treatment-seeking adolescents with bulimia nervosa (BN). We explored relationships among OBEs, SBEs, eating disorder (ED) symptomatology, depression, and self-esteem using two approaches. Group comparisons showed that OBE and SBE groups did not differ on ED symptoms or self-esteem; however, the SBE group had significantly greater depression. Examining continuous variabl...

  9. High Rates of Tramadol Use among Treatment-Seeking Adolescents in Malmö, Sweden: A Study of Hair Analysis of Nonmedical Prescription Opioid Use

    Directory of Open Access Journals (Sweden)

    Martin O. Olsson

    2017-01-01

    Full Text Available Background. Nonmedical prescription opioid use (NMPOU is a growing problem and tramadol has been suggested as an emerging problem in young treatment-seeking individuals. The aim of the present study was to investigate, through hair analysis, NMPOU in this group and, specifically, tramadol use. Methods. In a study including 73 treatment-seeking adolescents and young adults at an outpatient facility for young substance users, hair specimens could be obtained from 59 subjects. Data were extracted on sociodemographic background variables and psychiatric diagnoses through MINI interviews. Results. In hair analysis, tramadol was by far the most prevalent opioid detected. Thirty-two percent screened positive for opioids, and of those, all but one were positive for tramadol. Ninety-eight percent reported problematic cannabis use. Significantly more opioid-positive patients also screened positive for other (noncannabis drugs, compared to nonopioid users. Sixty-four percent fulfilled criteria of DSM-IV psychiatric disorders, other than substance use disorders according to MINI. Fifty-three percent met the symptom criteria count of ADHD above cut-off level. Conclusion. In the present setting, tramadol, along with high rates of cannabis use, may represent a novel pattern of substance use among young treatment-seeking subjects with problematic substance use and high rates of concurrent psychiatric problems.

  10. Electronic gaming machines and gambling disorder: A cross-cultural comparison between treatment-seeking subjects from Brazil and the United States.

    Science.gov (United States)

    Medeiros, Gustavo C; Leppink, Eric W; Yaemi, Ana; Mariani, Mirella; Tavares, Hermano; Grant, Jon E

    2015-12-15

    The objective of this paper is to perform a cross-cultural comparison of gambling disorder (GD) due to electronic gaming machines (EGM), a form of gambling that may have a high addictive potential. Our goal is to investigate two treatment-seeking samples of adults collected in Brazil and the United States, countries with different socio-cultural backgrounds. This comparison may lead to a better understanding of cultural influences on GD. The total studied sample involved 733 treatment-seeking subjects: 353 men and 380 women (average age=45.80, standard deviation ±10.9). The Brazilian sample had 517 individuals and the American sample 216. Subjects were recruited by analogous strategies. We found that the Brazilian sample was younger, predominantly male, less likely to be Caucasian, more likely to be partnered, tended to have a faster progression from recreational gambling to GD, and were more likely to endorse chasing losses. This study demonstrated that there are significant differences between treatment-seeking samples of adults presenting GD due to EGM in Brazil and in the United States. These findings suggest that cultural aspects may have a relevant role in GD due to EGM. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  11. Assessment and Treatment of Combat-Related PTSD in Returning War Veterans

    Science.gov (United States)

    2011-01-01

    massage therapy, Reiki, and others. Some of these programs have been implemented in military settings including intensive treatment programs lasting...with a therapeutic approach and with expert supervision available can alleviate such clinical concerns. In addition, trainers can address concerns

  12. War liver injuries

    Directory of Open Access Journals (Sweden)

    Stanković Nebojša

    2005-01-01

    Full Text Available Aim. To provide a retrospective analysis of our results and experience in primary surgical treatment of subjects with war liver injuries. Methods. From July 1991 to December 1999, 204 subjects with war liver injuries were treated. A total of 82.8% of the injured were with the liver injuries combined with the injuries of other organs. In 93.7%, the injuries were caused by fragments of explosive devices or bullets of various calibers. In 140 (68.6% of the injured there were minor lesions (grade I to II, treated with simple repair or drainage. There were complex injuries of the liver (grade III-V in 64 (31.4% of the injured. Those injuries required complex repair (hepatorrhaphy, hepatotomy, resection debridement, resection, packing alone. The technique of perihepatic packing and planned reoperation had a crucial and life-saving role when severe bleeding was present. Routine peritoneal drainage was applied in all of the injured. Primary management of 74.0% of the injured was performed in war hospitals. Results. After primary treatment, 72 (35.3% of the injured were with postoperative complications. Reoperation was done in 66 injured. Total mortality rate in 204 injured was 18.1%. All the deceased had significant combined injuries. Mortality rates due to the liver injury of the grade III, IV and V were 16.6%, 70.0% and 83.3%, respectively. Conclusion. Complex liver injuries caused very high mortality rate and the management of the injured was delicate under war circumstances (if the injured reached the hospital alive. Our experience under war circumstances and with war surgeons of limited knowledge of the liver surgery and war surgery, confirmed that it was necessary to apply compressive abdominal packing alone or in combination with other techniques for hemostasis in the treatment of liver injuries grade III-V, resuscitation and rapid transportation to specialized hospitals.

  13. Assessment of the feasibility of anaerobic composting for treatment of perchlorate - contaminated soils in a war zone

    National Research Council Canada - National Science Library

    Mohammad Amin; Majid Giahi; Marjan Mansourian

    2015-01-01

      Aims: The objectives of this study were to determine the perchlorate concentrations in surface soils and assess feasibility of anaerobic bioremediation in full-scale for perchlorate-contaminated soils in a war zone...

  14. Traditional medicine for the rich and knowledgeable: challenging assumptions about treatment-seeking behaviour in rural and peri-urban Nepal.

    Science.gov (United States)

    Thorsen, Rikke Stamp; Pouliot, Mariève

    2016-04-01

    Traditional medicine is commonly assumed to be a crucial health care option for poor households in developing countries. However, little research has been done in Asia to quantify the reliance on traditional medicine and its determinants. This research contributes to filling in this knowledge gap using household survey data collected from 571 households in three rural and peri-urban sites in Nepal in 2012. Questions encompassed household socioeconomic characteristics, illness characteristics, and treatment-seeking behaviour. Treatment choice was investigated through bivariate analyses. Results show that traditional medicine, and especially self-treatment with medicinal plants, prevail as treatment options in both rural and peri-urban populations. Contrarily to what is commonly assumed, high income is an important determinant of use of traditional medicine. Likewise, knowledge of medicinal plants, age, education, gender and illness chronicity were also significant determinants. The importance of self-treatment with medicinal plants should inform the development of health policy tailored to people's treatment-seeking behaviour. © The Author 2015. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine.

  15. Traditional medicine for the rich and knowledgeable: challenging assumptions about treatment-seeking behaviour in rural and peri-urban Nepal

    Science.gov (United States)

    Thorsen, Rikke Stamp; Pouliot, Mariève

    2016-01-01

    Traditional medicine is commonly assumed to be a crucial health care option for poor households in developing countries. However, little research has been done in Asia to quantify the reliance on traditional medicine and its determinants. This research contributes to filling in this knowledge gap using household survey data collected from 571 households in three rural and peri-urban sites in Nepal in 2012. Questions encompassed household socioeconomic characteristics, illness characteristics, and treatment-seeking behaviour. Treatment choice was investigated through bivariate analyses. Results show that traditional medicine, and especially self-treatment with medicinal plants, prevail as treatment options in both rural and peri-urban populations. Contrarily to what is commonly assumed, high income is an important determinant of use of traditional medicine. Likewise, knowledge of medicinal plants, age, education, gender and illness chronicity were also significant determinants. The importance of self-treatment with medicinal plants should inform the development of health policy tailored to people’s treatment-seeking behaviour. PMID:26130610

  16. Eye movement desensitization and reprocessing (EMDR) in the treatment of war veterans.

    Science.gov (United States)

    Silver, Steven M; Rogers, Susan; Russell, Mark

    2008-08-01

    Recent practice guidelines and meta-analyses have designated eye movement desensitization and reprocessing (EMDR) as a first-line treatment for trauma. Eye movement desensitization and reprocessing is an eight-phase therapeutic approach guided by an information-processing model that addresses the combat veteran's critical incidents, current triggers, and behaviors likely to prove useful in his or her future. Two case examples of combat veterans illustrate the ability of EMDR to achieve symptom reduction in a variety of clinical domains (e.g., anxiety, depression, anger, physical pain) simultaneously without requiring the patient to carry out homework assignments or discuss the details of the event. The treatment of phantom limb pain and other somatic presentations is also reviewed. The ability of EMDR to achieve positive effects without homework indicates that it can be effectively employed on consecutive days, making it especially useful during combat situations. (c) 2008 Wiley Periodicals, Inc.

  17. Effectiveness of Acupressure Treatment for Pain Management and Fatigue Relief in Gulf War Veterans

    Science.gov (United States)

    2016-10-01

    pharmaceutical treatment, physical therapy , and/or nutritional supplements to temporarily alleviate their symptoms, with limited effect. The severity of...listed in table 1 for the Acupressure group and Reiki group. A 6-week Acupressure intervention produced fatigue relief and pain alleviation...management in veterans with GWI. The results from the four subjects who have completed the intervention look promising and are indicative of the

  18. Pain and Associated Substance Use among Opioid Dependent Individuals Seeking Office-Based Treatment with Buprenorphine-Naloxone: A Needs Assessment Study

    Science.gov (United States)

    Barry, Declan T.; Savant, Jonathan D.; Beitel, Mark; Cutter, Christopher J.; Moore, Brent A.; Schottenfeld, Richard S.; Fiellin, David A.

    2012-01-01

    Background and Objectives A paucity of studies has examined the pain experiences of opioid dependent individuals seeking office-based buprenorphine-naloxone treatment (BNT). We set out to examine, among those seeking BNT: (a) the prevalence of pain types (i.e., recent pain, chronic pain), (b) the characteristics of pain (intensity, frequency, duration, interference, location, and genesis), and (c) substance use to alleviate pain. Methods We surveyed 244 consecutive individuals seeking office-based buprenorphine-naloxone treatment (BNT) for opioid dependence about physical pain and associated substance use. Results Thirty-six percent of respondents reported chronic pain (CP) (i.e., pain lasting at least 3 months) and 36% reported “some pain” (SP) (i.e., past week pain not meeting the threshold for CP). In comparison to SP respondents, those with CP were, on average, older; reported greater current pain intensity, pain frequency, typical pain duration, typical pain intensity, and typical pain interference; were more likely to report shoulder or pelvis and less likely to report stomach or arms as their most bothersome pain location; and were more likely to report accident or nerve damage and less likely to report opioid withdrawal as the genesis of their pain. Both pain subgroups reported similarly high rates of past-week substance use to alleviate pain. Conclusions and Scientific Significance The high rates of pain and self-reported substance use to manage pain suggest the importance of assessing and addressing pain in BNT patients. PMID:23617861

  19. Prevalence and correlates of erectile dysfunction (ED) and treatment seeking for ED in Asian Men: the Asian Men's Attitudes to Life Events and Sexuality (MALES) study.

    Science.gov (United States)

    Tan, Hui-Meng; Low, Wah Yun; Ng, Chirk Jenn; Chen, Kuang-Kuo; Sugita, Minoru; Ishii, Nobuhisa; Marumo, Ken; Lee, Sung Won; Fisher, William; Sand, Michael

    2007-11-01

    There have been limited multiregional studies in Asia examining the parameters of men's general and sexual health and quality of life in the general population vs. those in clinical cohorts of patients with erectile dysfunction (ED). The aims of the Asian Men's Attitudes to Life Events and Sexuality (Asian MALES) study were to investigate the prevalence of ED, associated health conditions, and ED treatment-seeking patterns in the general male population in five regions of Asia (China, Japan, Korea, Malaysia, and Taiwan). Standardized questionnaire previously used in a similar multiregional study and modified to ensure culturally appropriate content for Asia. Phase I of the study involved 10,934 adult men, aged 20-75 years, who were interviewed using the standardized questionnaire. Phase II of the study involved men with self-reported ED recruited from Phase I and via physician referral, invitations in general practitioner offices, and street interception (total Phase II sample, N = 1,209). The overall prevalence of self-reported ED in the Phase I study population was 6.4%. ED prevalence varied by region and significantly increased with age (P quality of life (P = 0.0001), compared with men without ED. Phase II of the study revealed that fewer than half of men with self-reported ED had sought treatment for their problem. Men were more likely to seek help for erection difficulties from Western doctors than from traditional medicine practitioners (P = 0.0001). A man's partner/spouse was the most common influencer of treatment seeking in all regions except Malaysia. The findings confirm those of existing research on ED in both Asian and non-Asian males: ED is a prevalent condition; the prevalence of ED increases with age and is strongly associated with comorbid conditions; and the majority of men have never sought treatment for their condition. This study highlights a substantial need for the evaluation and treatment of ED in Asian men.

  20. New wars, new morality?

    NARCIS (Netherlands)

    Akkerman, T.

    2009-01-01

    Has war fundamentally changed? If so, it may be time for reconsidering accepted moral standards for waging wars and for conduct in war. The new war thesis holds that wars have fundamentally altered since the end of the Cold War. Proponents such as Kaldor and Weiss hold that wars today are intrastate

  1. What role do traditional beliefs play in treatment seeking and delay for Buruli ulcer disease?--insights from a mixed methods study in Cameroon.

    Directory of Open Access Journals (Sweden)

    Koen Peeters Grietens

    Full Text Available BACKGROUND: Victims of Buruli ulcer disease (BUD frequently report to specialized units at a late stage of the disease. This delay has been associated with local beliefs and a preference for traditional healing linked to a reportedly mystical origin of the disease. We assessed the role beliefs play in determining BUD sufferers' choice between traditional and biomedical treatments. METHODS: Anthropological fieldwork was conducted in community and clinical settings in the region of Ayos and Akonolinga in Central Cameroon. The research design consisted of a mixed methods study, triangulating a qualitative strand based on ethnographic research and quantitative data obtained through a survey presented to all patients at the Ayos and Akonolinga hospitals (N = 79 at the time of study and in four endemic communities (N = 73 belonging to the hospitals' catchment area. RESULTS: The analysis of BUD sufferers' health-seeking behaviour showed extremely complex therapeutic itineraries, including various attempts and failures both in the biomedical and traditional fields. Contrary to expectations, nearly half of all hospital patients attributed their illness to mystical causes, while traditional healers admitted patients they perceived to be infected by natural causes. Moreover, both patients in hospitals and in communities often combined elements of both types of treatments. Ultimately, perceptions regarding the effectiveness of the treatment, the option for local treatment as a cost prevention strategy and the characteristics of the doctor-patient relationship were more determinant for treatment choice than beliefs. DISCUSSION: The ascription of delay and treatment choice to beliefs constitutes an over-simplification of BUD health-seeking behaviour and places the responsibility directly on the shoulders of BUD sufferers while potentially neglecting other structural elements. While more efficacious treatment in the biomedical sector is likely to

  2. Effect of Physical Violence on Sexually Transmitted Infections and Treatment Seeking Behaviour among Female Sex Workers in Thane District, Maharashtra, India.

    Directory of Open Access Journals (Sweden)

    Ravi Prakash

    Full Text Available Violence against sex workers can heighten their vulnerability to HIV and other sexually transmitted infections (STIs. Evidence suggests the risk of acquiring STI/HIV infections among female sex workers (FSWs who have experienced violence to be almost three-times higher than FSWs, who have not experienced violence. Moreover, an experience of physical and sexual violence makes it difficult for them to negotiate safer sex with their partners and often act as a barrier to utilization of prevention services.This study utilizes data from 2785 FSWs aged 18 years and above who participated in a cross-sectional behavioural study conducted during 2013-14 in Thane district, Maharashtra. A probability-based two-stage cluster sampling method was used for data collection. This study assesses the effect of physical violence on self-reported STI symptoms (any STI and multiple STIs and treatment seeking for the last STI symptom using propensity score matching method.About 18% of sampled FSWs reported physical violence at the time of the survey. The likelihood of experiencing such violence was significantly higher among FSWs who solicited clients at public places, engaged in other economic activities apart from sex work, had savings, and reported high client volume per week. FSWs experiencing violence were also inconsistent condom users while engaging in sex with regular partners and clients. The average adjusted effect of violence clearly depicted an increase in the risk of any STI (11%, p<0.05 and multiple STIs (8%, p<0.10 and reduction in treatment seeking (10%, p<0.05.This study demonstrates a significant effect of physical violence on reporting of any STI symptom and treatment seeking. Findings call for the immediate inclusion of strategies aimed to address violence related challenges in HIV prevention program currently being provided at Thane district. Such strategies would further help in enhancing the access to tailored STI prevention and care services

  3. Understanding and promoting treatment-seeking for eating disorders and body image concerns on college campuses through online screening, prevention and intervention.

    Science.gov (United States)

    Lipson, Sarah Ketchen; Jones, J Megan; Taylor, C Barr; Wilfley, Denise E; Eichen, Dawn M; Fitzsimmons-Craft, Ellen E; Eisenberg, Daniel

    2017-04-01

    While there have been important recent advances in the development of effective universal prevention and intervention programs, it is not yet clear how to engage large numbers of students in these programs. In this paper, we report findings from a two-phase pilot study. In the first phase, we used a population-level, online survey to assess eating disorder symptom level and habits/attitudes related to service utilization (N=2180). Using validated screening tools, we found that roughly one in three students has significant symptoms of eating disorders or elevated weight concerns, the vast majority of whom (86.5%) have not received treatment. In the second phase, we referred students to online prevention and selective/indicated intervention programs based on symptom classification (N=1916). We find that program enrollment is highest for students in the indicated intervention (18.1%) and lowest for students in the universal prevention (4.1%). We find that traditionally-emphasized barriers such as stigma, misinformation, and financial limitations do not appear to be the most important factors preventing treatment-seeking. Rather students report not seeking help for reasons such as lack of time, lack of perceived need, and a desire to deal with the issue "on my own." Findings offer insight into the treatment-seeking habits and attitudes of college students, including those barriers that may be overcome by offering online programs and those that persist despite increased access to and convenience of relevant resources. Copyright © 2016 Elsevier Ltd. All rights reserved.

  4. Testing a maintenance model for eating disorders in a sample seeking treatment at a tertiary care center: a structural equation modeling approach.

    Science.gov (United States)

    Tasca, Giorgio A; Presniak, Michelle D; Demidenko, Natasha; Balfour, Louise; Krysanski, Valerie; Trinneer, Anne; Bissada, Hany

    2011-01-01

    Fairburn et al (Fairburn, CG, Cooper, Z, Shafran, R. Behav Res Ther 2003;41:509-528) proposed additional maintenance mechanisms (ie, interpersonal difficulties, mood intolerance, low self-esteem, and perfectionism) for some individuals with eating disorders in addition to core eating disorder psychopathology (ie, overevaluation of eating, weight, and shape and their control). This is the first study to both elaborate and test this maintenance model as a structural model. Adults seeking treatment of an eating disorder (N = 1451) at a specialized tertiary care center were included in this cross-sectional study. In the first part of the study, diagnostically heterogeneous participants (n = 406) were randomly selected to test a structural model based on the maintenance model. In the second part of the study, remaining participants (n = 1045) were grouped according to eating disorder diagnosis to test for invariance of the structural paths of the final model across diagnoses. Overall, the structural model with core and additional mechanisms fit the data well and, with 1 exception, represented maintenance processes for each of the diagnostic groups. Treatment models based on both core and additional maintenance factors for those seeking therapy at a specialized tertiary care center may result in improved treatment outcomes for these patients with eating disorders. Copyright © 2011 Elsevier Inc. All rights reserved.

  5. Patient characteristics, HIV serostatus, and risk behaviors among gay and bisexual males seeking treatment for methamphetamine abuse and dependence in Los Angeles.

    Science.gov (United States)

    Shoptaw, Steven; Reback, Cathy J; Freese, Thomas E

    2002-01-01

    Methamphetamine, a drug used at alarming rates among gay/bisexual males in the West, is often combined with sexual activities, thereby increasing HIV-related risks in an already high-risk group. Findings from 68 gay/bisexual men seeking treatment for methamphetamine dependence in Hollywood, California were analyzed to predict HIV serostatus based on demographic, drug use, or sexual behavior variables. Results showed that more HIV-infected participants than non-infected men reported medical problems (97.6% versus 46.2%; X2 = 24.7, df = 1, p sexual partners with unprotected receptive anal intercourse in the 30 days prior to intake (5.9 versus 0.7; separate t = 3.5, df = 43.7, p sexual partners with unprotected receptive anal intercourse and prior methamphetamine treatment. Findings provide information that may prove helpful in tailoring culturally relevant treatment and prevention messages.

  6. Getting by with a little help from your friends: the impact of peer networks on criminality in a cohort of treatment-seeking drug users.

    Science.gov (United States)

    Best, David; Hernando, Rosa; Gossop, Michael; Sidwell, Clare; Strang, John

    2003-04-01

    This study investigates the links between social networks of drug users and criminal activity. Opiate misusers (n=128) receiving in-patient treatment were interviewed about substance use, social networks, and crime in the month before treatment. Almost 60% of participants reported an average of more than 70 crimes each. Less than one-fifth of the subjects spent no time with other users, while just over half spent either "quite a lot" or "a lot" of time with drug users. Time with users increased the risk of crime. Spending no time with users provided a protective effect. Time with criminally involved drug users was associated with greater levels of crime. Social networks represent an important marker for integration in criminal networks in treatment-seeking drug users and a long-term barrier to rehabilitation.

  7. Narrative Exposure Therapy as a treatment for child war survivors with posttraumatic stress disorder: Two case reports and a pilot study in an African refugee settlement

    Directory of Open Access Journals (Sweden)

    Neuner Frank

    2005-02-01

    Full Text Available Abstract Background Little data exists on the effectiveness of psychological interventions for children with posttraumatic stress disorder (PTSD that has resulted from exposure to war or conflict-related violence, especially in non-industrialized countries. We created and evaluated the efficacy of KIDNET, a child-friendly version of Narrative Exposure Therapy (NET, as a short-term treatment for children. Methods Six Somali children suffering from PTSD aged 12–17 years resident in a refugee settlement in Uganda were treated with four to six individual sessions of KIDNET by expert clinicians. Symptoms of PTSD and depression were assessed pre-treatment, post-treatment and at nine months follow-up using the CIDI Sections K and E. Results Important symptom reduction was evident immediately after treatment and treatment outcomes were sustained at the 9-month follow-up. All patients completed therapy, reported functioning gains and could be helped to reconstruct their traumatic experiences into a narrative with the use of illustrative material. Conclusions NET may be safe and effective to treat children with war related PTSD in the setting of refugee settlements in developing countries.

  8. Narrative Exposure Therapy as a treatment for child war survivors with posttraumatic stress disorder: two case reports and a pilot study in an African refugee settlement.

    Science.gov (United States)

    Onyut, Lamaro P; Neuner, Frank; Schauer, Elisabeth; Ertl, Verena; Odenwald, Michael; Schauer, Maggie; Elbert, Thomas

    2005-02-03

    Little data exists on the effectiveness of psychological interventions for children with posttraumatic stress disorder (PTSD) that has resulted from exposure to war or conflict-related violence, especially in non-industrialized countries. We created and evaluated the efficacy of KIDNET, a child-friendly version of Narrative Exposure Therapy (NET), as a short-term treatment for children. Six Somali children suffering from PTSD aged 12-17 years resident in a refugee settlement in Uganda were treated with four to six individual sessions of KIDNET by expert clinicians. Symptoms of PTSD and depression were assessed pre-treatment, post-treatment and at nine months follow-up using the CIDI Sections K and E. Important symptom reduction was evident immediately after treatment and treatment outcomes were sustained at the 9-month follow-up. All patients completed therapy, reported functioning gains and could be helped to reconstruct their traumatic experiences into a narrative with the use of illustrative material. NET may be safe and effective to treat children with war related PTSD in the setting of refugee settlements in developing countries.

  9. Narrative Exposure Therapy as a treatment for child war survivors with posttraumatic stress disorder: Two case reports and a pilot study in an African refugee settlement

    Science.gov (United States)

    Onyut, Lamaro P; Neuner, Frank; Schauer, Elisabeth; Ertl, Verena; Odenwald, Michael; Schauer, Maggie; Elbert, Thomas

    2005-01-01

    Background Little data exists on the effectiveness of psychological interventions for children with posttraumatic stress disorder (PTSD) that has resulted from exposure to war or conflict-related violence, especially in non-industrialized countries. We created and evaluated the efficacy of KIDNET, a child-friendly version of Narrative Exposure Therapy (NET), as a short-term treatment for children. Methods Six Somali children suffering from PTSD aged 12–17 years resident in a refugee settlement in Uganda were treated with four to six individual sessions of KIDNET by expert clinicians. Symptoms of PTSD and depression were assessed pre-treatment, post-treatment and at nine months follow-up using the CIDI Sections K and E. Results Important symptom reduction was evident immediately after treatment and treatment outcomes were sustained at the 9-month follow-up. All patients completed therapy, reported functioning gains and could be helped to reconstruct their traumatic experiences into a narrative with the use of illustrative material. Conclusions NET may be safe and effective to treat children with war related PTSD in the setting of refugee settlements in developing countries. PMID:15691374

  10. Caregiver recognition of childhood diarrhea, care seeking behaviors and home treatment practices in rural Burkina Faso: a cross-sectional survey.

    Directory of Open Access Journals (Sweden)

    Shelby E Wilson

    Full Text Available INTRODUCTION: To design effective national diarrhea control programs, including oral rehydration solution (ORS and therapeutic zinc supplementation, information is needed on local perceptions of illness, external care seeking behaviors, and home treatment practices. METHODS: A cross-sectional, community-based household survey was conducted in the Orodara Health District, Burkina Faso. Caregivers of 10,490 children <27 months were interviewed to assess child diarrhea prevalence and related care practices. Characteristics of households, caregivers, children, and reported illnesses were compared for those caregivers who did or did not recognize the presence of diarrhea, as defined according to clinical criteria (≥ 3 liquid or semi-liquid stools/day. Multiple logistic regression models were used to examine factors associated with illness recognition and treatment. RESULTS: Clinically defined diarrhea was present in 7.6% (95% CI: 7.1-8.1% of children during the 24 hours preceding the survey but recognized by only 55% of caregivers. Over half (55% of the caregivers of 1,067 children with a clinically defined diarrhea episode in the past 14 days sought care outside the home; 78% of those seeking care attended a public sector clinic. Care was sought and treatment provided more frequently for children with fever, vomiting, anorexia, longer illness duration, and those living closer to the health center; and care was sought more frequently for male children. 80% of children with recent diarrhea received some form of treatment; only 24% received ORS, whereas 14% received antibiotics. Zinc was not yet available in the study area. CONCLUSIONS: Caregivers frequently fail to recognize children's diarrhea, especially among younger infants and when illness signs are less severe. Treatment practices do not correspond with international recommendations in most cases, even when caregivers consult with formal health services. Child caregivers need additional

  11. Relationships of Childhood Adverse Experiences With Mental Health and Quality of Life at Treatment Start for Adult Refugees Traumatized by Pre-Flight Experiences of War and Human Rights Violations.

    Science.gov (United States)

    Opaas, Marianne; Varvin, Sverre

    2015-09-01

    Adverse and potentially traumatic experiences (PTEs) in childhood were examined among 54 adult refugee patients with pre-flight PTEs of war and human rights violations (HRVs) and related to mental health and quality of life at treatment start. Extent of childhood PTEs was more strongly related to mental health and quality of life than the extent of war and HRV experiences. Childhood PTEs were significantly related to arousal and avoidance symptoms of posttraumatic stress disorder (PTSD) and to quality of life, whereas pre-flight war and HRV experiences were significantly related to reexperiencing symptoms of PTSD only. Within childhood adversities, experiences of family violence and external violence, but not of loss and illness, were significantly related to increased mental health symptoms and reduced quality of life. These results point to the importance of taking childhood adverse experiences into account in research and treatment planning for adult refugees with war and HRVs trauma.

  12. Specters of War in Pyongyang: The Victorious Fatherland Liberation War Museum in North Korea

    Directory of Open Access Journals (Sweden)

    Suzy Kim

    2015-03-01

    Full Text Available While North Korea accused South Korea of starting a “civil war” (naeran during the Korean War, it has now moved away from such depictions to paint the war as an American war of imperialist aggression against Korea that was victoriously thwarted under the leadership of Kim Il Sung. In this regard, it may be more than a coincidence that the Victorious Fatherland Liberation War Museum in Pyongyang was built in the early 1970s, just as the Vietnam War drew to a close with a Vietnamese victory. This article examines the memorialization of the Korean War in North Korea at two pivotal historical points—the end of the Vietnam War in the 1970s and the end of the Cold War in the 1990s—with a particular focus on contemporary exhibitions at the war museum in Pyongyang. Rather than offering a simple comparison of divergent narratives about the war, the article seeks to illustrate that North Korea’s conception of history and its account of the war are staunchly modernist, with tragic consequences.

  13. The impact of voice disorders among teachers: vocal complaints, treatment-seeking behavior, knowledge of vocal care, and voice-related absenteeism.

    Science.gov (United States)

    Van Houtte, Evelyne; Claeys, Sofie; Wuyts, Floris; Van Lierde, Kristiane

    2011-09-01

    Teachers are at increased risk for developing voice disorders. Occupational risk factors have been extensively examined; however, little attention has been paid to the consequences of the vocal complaints. The objective of this study was to investigate the knowledge that teachers have about vocal care, treatment-seeking behavior, and voice-related absenteeism. The study group comprised 994 teachers and 290 controls whose jobs did not involve vocal effort. All participants completed a questionnaire inquiring about vocal complaints, treatment-seeking behavior, voice-related absenteeism, and knowledge about vocal care. Comparisons were made between teachers with and without vocal complaints and with the control group. Teachers reported significantly more voice problems than the control population (51.2% vs. 27.4%) (χ2=50.45, df=1, Pteachers reported significantly higher levels of voice disorders than their male colleagues (38% vs 13.2%, χ2=22.34, df=1, PTeachers (25.4%) sought medical care and eventually 20.6% had missed at least 1 day of work because of voice problems. Female teachers were significantly more likely to seek medical help (χ2=7.24, df=1, P=0.007) and to stay at home (χ2=7.10, df=1, P=0.008) in comparison with their male colleagues. Only 13.5% of all teachers received information during their education. Voice disorders have an impact on teachers' personal and professional life and imply a major financial burden for society. A substantial number of teachers needed medical help and was obligated to stay at home because of voice problems. This study strongly recommends the implementation of vocal education during the training of teacher students to prepare the vocal professional user. Copyright © 2011 The Voice Foundation. Published by Mosby, Inc. All rights reserved.

  14. Sleep quality in treatment-seeking veterans of Operations Enduring Freedom and Iraqi Freedom: the role of cognitive coping strategies and unit cohesion.

    Science.gov (United States)

    Pietrzak, Robert H; Morgan, Charles A; Southwick, Steven M

    2010-11-01

    Sleep difficulties are common in individuals exposed to stress or trauma, and maladaptive cognitive coping strategies, such as worry and fear of losing vigilance, as well as low social support, may further impair sleep quality. This study examined the severity and correlates of sleep difficulties in a sample of treatment-seeking veterans of Operations Enduring Freedom and Iraqi Freedom (OEF-OIF). A total of 167 OEF-OIF veterans seeking behavioral or primary care services completed a questionnaire containing measures of sleep quality, combat exposure, psychopathology, fear of loss of vigilance, cognitive coping strategies, and unit and postdeployment social support within 1 year of returning from deployment. Mean Pittsburgh Sleep Quality Inventory scores in the full sample were indicative of severely impaired sleep. Posttraumatic stress disorder (PTSD) was associated with increased sleep difficulties, most notably sleep disturbances, daytime dysfunction, and sleep quality. Hierarchical regression analysis in the full sample revealed that PTSD symptoms and scores on measures of worry and fear of loss of vigilance were positively associated with sleep difficulties and that scores on a measure of unit member support were negatively associated with sleep difficulties. Among veterans with PTSD, fear of loss of vigilance was positively associated with sleep difficulties and cognitive distraction and unit member support were negatively associated with sleep difficulties. Treatment-seeking OEF-OIF veterans report severe sleep difficulties, with more pronounced impairment in veterans with PTSD. The results of this study suggest that interventions to mitigate worry and fear of loss of vigilance and to enhance perceived unit member support may be helpful in reducing sleep difficulties following return from deployment in this population. Copyright © 2010 Elsevier Inc. All rights reserved.

  15. Self-rated psychopathic traits in a sample of treatment-seeking adolescent girls with internalizing and externalizing disorders: comparisons to girls in the community.

    Science.gov (United States)

    Oshukova, Svetlana; Kaltiala-Heino, Riittakerttu; Miettunen, Jouko; Marttila, Riikka; Aronen, Eeva T; Marttunen, Mauri; Kaivosoja, Matti; Lindberg, Nina

    2017-04-01

    Psychopathy research has thus far focused mostly on child, male, and delinquent samples, but the results are most likely non-generalizable to adolescent girls with mental health disorders. The present study aimed to compare self-rated psychopathic traits between female psychiatric outpatients and girls in the community, and to investigate how psychopathic traits relate to psychiatric disorders. The outpatient sample comprised 163 girls aged 15-17-years recruited from municipal mental health services. Psychiatric diagnoses were assessed based on the ICD-10 classification. The community sample comprised 355 girls from secondary, vocational, and high schools. The Youth Psychopathic trait Inventory (YPI) served as a self-assessment tool. Treatment-seeking girls exhibit a more impulsive and irresponsible lifestyle than do girls in the community. Girls with externalizing psychopathology, unlike those with an internalizing disorder, exhibit more deficient affective experience than do girls in the community. Psychopathic traits associate with having a psychiatric disorder, a depressive disorder, ADHD, and a conduct disorder. The psychiatric examination of treatment-seeking adolescent girls would likely benefit from screening for psychopathy and its underlying components.

  16. The impact of social support, unit cohesion, and trait resilience on PTSD in treatment-seeking military personnel with PTSD: The role of posttraumatic cognitions.

    Science.gov (United States)

    Zang, Yinyin; Gallagher, Thea; McLean, Carmen P; Tannahill, Hallie S; Yarvis, Jeffrey S; Foa, Edna B

    2017-03-01

    The personal resources of social support, unit cohesion, and trait resilience have been found to be associated with posttraumatic stress disorder (PTSD) severity among military personnel. However, the underlying mechanisms of these relationships are unclear. We hypothesized that negative posttraumatic cognitions, which are associated with PTSD, mediate the relationships between these personal resources and PTSD. The relationship between PTSD symptom severity and a latent factor comprised of social support, unit cohesion, and trait resilience was evaluated using cross-sectional data from 366 treatment-seeking active duty military personnel with PTSD following deployments to or near Iraq or Afghanistan. Structural equation modeling (SEM) was used to test whether posttraumatic cognitions mediated this relationship. The SEM model indicated that (1) a robust latent variable named personal resources (indicated by social support, unit cohesion, and trait resilience) was negatively associated with PTSD severity; (2) personal resources were negatively associated with negative posttraumatic cognitions; (3) negative posttraumatic cognitions fully mediated the association between personal resources and PTSD severity. The final SEM mediation model showed a highly satisfactory fit [χ2 (22) = 16.344, p = 0.798; χ2/df = 0.743; CFI = 1; RMSEA = 0.000]. These findings suggest that among active duty military personnel seeking treatment for PTSD, personal resources (social support, unit cohesion, and trait resilience) may mitigate PTSD severity by reducing negative posttraumatic cognitions. Copyright © 2016 Elsevier Ltd. All rights reserved.

  17. Factors Associated with the Failure to Seek HIV Care and Treatment Among HIV-Positive Women in a Northern Province of Vietnam

    DEFF Research Database (Denmark)

    Nguyen T., Nam; Bygbjerg, Ib Christian; Mogensen, Hanne Overgaard

    2010-01-01

    This cross-sectional survey examines the utilization of HIV care and treatment services after HIV diagnosis among women in Vietnam and describes factors that may be associated with failure in seeking services. From May 2007 to November 2007, we conducted structured interviews with 353 HIV...... participants had never attended HIV care and treatment services. Failure in seeking the services was associated with not being registered in the PAC (odds ratio [OR]: 3.0; 95% confidence interval [CI]: 1.4–6.4), not having a known HIV-positive family member (OR: 3.2; 95% CI: 1.2–8.3), not having disclosed HIV...... status (OR: 4.0; 95% CI: 2.0–8.1), and factors associated with the testing situation, whereby women who were tested by chance had a 4.0 times increased OR (95% CI: 1.4–11.7) and women who were tested in relation to antenatal care or delivery had 3.0 times increased OR (95% CI: 1.1–8.5) for failure...

  18. Seeking a way to promote the use of constructed wetlands for domestic wastewater treatment in developing countries.

    Science.gov (United States)

    Zurita, F; Belmont, M A; De Anda, J; White, J R

    2011-01-01

    The aim of this study was to evaluate the domestic wastewater treatment efficiency as well as the survivability of commercially valuable ornamental plants in subsurface flow wetlands (SSFW) for domestic wastewater (DWW) treatment in laboratory and pilot wetland studies. The laboratory scale study included five different species (Zantedeschia aethiopica, Strelitzia reginae, Anthurium andreanum, Canna hybrids and Hemmerocallis dumortieri) that were evaluated in horizontal flow subsurface treatment cells. All the plants survived during the 6-month experimental period demonstrating high wetland nutrient treatment efficiency. In order to validate and expand these preliminary results, a pilot-scale wetland study was carried out in SSFWs under two different flow regimes (horizontal and vertical flow). Four ornamental species were tested during a 1-year period: Zantedeschia aethiopica, Strelitzia reginae, Anthurium andreanum and Agapanthus africanus. The removal efficiencies were significantly higher in the vertical subsurface-flow constructed wetlands (VFCW) for all pollutants, except for nitrate (NO(3)-N), total nitrogen (TN) and total suspended solids (TSS). These results show that it is feasible to use select non-wetland plants with high market value in SSFWs without reducing the efficiency of the wastewater treatment system, although future work should continue in order to apply this technology in a large scale. The added value of floriculture in treatment wetlands can help to promote the use of constructed wetlands (CW) for domestic wastewater treatment in developing countries where economical resources are scarce and water pollution with DWW is common.

  19. Mapping heroin careers: utilising a standardised history-taking method to assess the speed of escalation of heroin using careers in a treatment-seeking cohort.

    Science.gov (United States)

    Best, David; Day, Ed; Cantillano, Vanessa; Gaston, Romina Lopez; Nambamali, Angela; Sweeting, Ruth; Keaney, Francis

    2008-03-01

    Although there has been increasing research attention to the concept of addiction careers and treatment careers, there are few standardised measures for assessing illicit drug using careers. A new instrument for mapping lifetime drug use history (LDUH) was used to assess transitions in the initial stages of heroin use careers among illicit drug users. 58 lifetime heroin users completed a one-off researcher-administered interview in treatment settings in two English cities, London and Birmingham, about their histories of drug use, drug treatment and other key life events. The sample reported initiating heroin use at a mean age of 21 years and escalated to daily use by 23 years. On average, there was a gap of nearly 8 years before seeking treatment and at the time of interview the cohort averaged one-third of their heroin careers in treatment. However, there was marked variability across the group, with three discernible groups identified based on use patterns. While one group (n = 21) showed consistent escalation in total quantity of heroin used across the first year, the second group had an intermittent pattern of use and the third group reported an unchanging monthly heroin use pattern. These groups differed in the time taken to initiate treatment and in the proportion of their heroin careers in active use. The instrument was acceptable to research participants and identified important variability in onset and escalation factors in heroin careers. The implications for therapeutic interventions and for clinical use of the instrument are discussed.

  20. Outcome of treatment seeking rural gamblers attending a nurse-led cognitive-behaviour therapy service: A pilot study

    Directory of Open Access Journals (Sweden)

    Barry Tolchard

    2016-03-01

    Conclusion: This study suggests that rural problem gamblers experience different levels of co-morbid anxiety and depression from their urban counterparts, but once in treatment appear to respond quicker. ACBT approach was found to be effective in treating rural gamblers and outcomes were maintained. Ensuring better availability and access to such treatment in rural areas is important. Nurses are in a position as the majority health professional in rural areas to provide such help.

  1. War games

    DEFF Research Database (Denmark)

    Kural, René

    2005-01-01

    Artiklen omhandler Imperial War Museum North tegnet af den polsk-amerikanske arkitekt Daniel Libeskind. Det er hans første projekt i Storbritannien og Englands femte krigsmuseum. Libeskind vand konkurrencen allerede i 1997, men først 5. juli 2002 kunne dørene slås op. Artiklen diskuterer om der e...

  2. Rutherford's war

    Science.gov (United States)

    Campbell, John

    2016-02-01

    Seagulls, sea lions and the comic-book hero Professor Radium were all recruited to fight the threat of submarines during the First World War. But as John Campbell explains, it was Ernest Rutherford who led the way a century ago in using acoustics to deter these deadly craft.

  3. Sketching War

    DEFF Research Database (Denmark)

    Engberg-Pedersen, Anders

    2014-01-01

    During the Napoleonic Wars the military croquis, or sketch map, played an important role in the spatial management of the various campaigns. Presumably, many of these sketch maps were destroyed or discarded after their immediate use. Those that survive have received little scholarly notice. Atten...

  4. Who seeks treatment for alcohol problems? Demography and alcohol-use characteristics of patients in taboo and non-taboo drinking groups attending professional alcohol services in Nepal.

    Science.gov (United States)

    Neupane, Sudan Prasad; Bramness, Jørgen G

    2014-12-01

    Only few individuals with alcohol problems seek help; those who do have not been described adequately. Here, we summarize the demographic and alcohol-related features of inpatients attending professional alcohol services in Nepal and examine differences between patients with and without social taboos about drinking. Fully structured interviews including the Composite International Diagnostic Interview and the Alcohol Use Disorder Identification Test were administered to 177 men and 21 women consecutively admitted to eight alcohol treatment centres in Kathmandu. Altogether, 164 patients (83%) had alcohol dependence and 24 patients (12%) had alcohol abuse. The sample had a mean age of 35.3 years (SD 10.1) with a time lag of 16.8 years (SD 9.8) from start of habitual drinking to first entry into treatment. Most (62%) were married, lived in urban areas (72%), had above-average income (57%), received adequate social support (71%), and belonged to social groups in which drinking is taboo (57%). Individuals in non-taboo group more often lived in urban areas, had lower socioeconomic status, more often reported parental problem drinking and started drinking at a younger age, whereas individuals in the taboo group more often had late onset, risky drinking, and waited longer before seeking treatment (P<0.05). Traditionally alcohol non-using castes and people with higher socioeconomic status over-represent professional alcohol services in Kathmandu. This, and high levels of hazardous and harmful alcohol use, indicate changing trends concerning social tolerance towards alcohol in Nepalese society in recent times and a heavy burden associated with alcohol disorders. Copyright © 2014 Elsevier B.V. All rights reserved.

  5. Treatment-seeking for selected reproductive health problems: behaviours of unmarried female adolescents in two low-performing areas of Bangladesh.

    Science.gov (United States)

    Kabir, Humayun; Saha, Nirod Chandra; Wirtz, Andrea L; Gazi, Rukhsana

    2014-07-17

    The reproductive health needs of unmarried adolescents in Bangladesh are largely unmet. This study aimed to explore treatment-seeking behaviour of unmarried female adolescents for selected reproductive health (RH) concerns in two low-performing areas of Bangladesh. As part of a large community based-project, a cross-sectional survey was conducted from November 2006 to March 2007. From each of two select study areas, 800 unmarried female adolescents aged 12-19 years were selected for participation by simple random sampling through household listing and were recruited into the study. Trained interviewers administered a structured questionnaire to participating female adolescents. Descriptive and bivariate analytic methods were used compare RH conditions and healthcare seeking behaviour of adolescents across urban and rural settings. Approximately 50% of the sample reported experiencing menstrual problems in the last year. The predominant problems reported by participants included: lower abdominal pain, back pain, irregular menstruation, and excessive bleeding during menstruation. Irrespective of study area, only 40% of the female adolescents with menstrual problems sought treatment from qualified physicians. Otherwise, utilization of healthcare facilities and care providers for reported problems varied significantly by rural and urban areas. Higher proportions of adolescents in the urban setting (15%) also reported recent symptoms of sexually transmitted infections (STIs), compared to those in the rural setting (9%; pseeking behaviours by unmarried female adolescents was low for menstrual problems. A vast majority of unmarried female adolescents practiced self-care for symptoms of STIs while only small proportions sought treatment from qualified physicians. These findings emphasize the need for offering relevant information on RH issues and introducing confidential adolescent-friendly reproductive healthcare facilities to enable unmarried female adolescents access to

  6. Reducing Adolescents' Perceived Barriers to Treatment and Increasing Help-Seeking Intentions: Effects of Classroom Presentations by General Practitioners

    Science.gov (United States)

    Wilson, Coralie Joy; Deane, Frank P.; Marshall, Kellie L.; Dalley, Andrew

    2008-01-01

    The "Building Bridges to General Practice" (BBGP) program is an outreach initiative. It aims to reduce young peoples' perceived knowledge- and belief-based barriers to engaging in treatment and to increase their behavioral intentions to consult a general medical practitioner (GP) for physical and psychological problems. By increasing…

  7. A high working memory load prior to memory retrieval reduces craving in non-treatment seeking problem drinkers

    NARCIS (Netherlands)

    Kaag, Anne Marije; Goudriaan, Anna E.; de Vries, Taco J.; Pattij, Tommy; Wiers, Reinout W.

    2017-01-01

    Reconsolidation-based interventions have been suggested to be a promising treatment strategy for substance use disorders. In this study, we aimed to investigate the effectiveness of a working memory intervention to interfere with the reconsolidation of alcohol-related memories in a sample of

  8. The Relationship Between Early Maladaptive Schemas, Depression, and Generalized Anxiety among Adults Seeking Residential Treatment for Substance Use Disorders.

    Science.gov (United States)

    Shorey, Ryan C; Elmquist, Joanna; Anderson, Scott; Stuart, Gregory L

    2015-01-01

    Previous research has shown that early maladaptive schemas (EMS) play an important role in substance use, depression, and anxiety. However, few studies have examined the role of EMS within the context of all three concurrently. The goal of this study was to determine the role of EMS in predicting symptoms of Major Depressive Disorder (MDD) and Generalized Anxiety Disorder (GAD) among adults in residential treatment for substance dependence. We used pre-existing patient records of adults diagnosed with a substance use disorder from a residential substance use treatment facility (N=122). The EMS domains of disconnection and rejection and impaired limits were associated with symptoms of MDD and the domain of impaired autonomy and performance was associated with symptoms of GAD, even after controlling for age, gender, years of education, alcohol use, drug use, and symptoms of MDD (when predicting GAD) and GAD (when predicting MDD). Findings suggest that EMS may play an important role in comorbid mental health problems among men and women in residential substance use treatment. Continued treatment outcome research is needed to examine whether modification of EMS results in improved mental health and substance use outcomes.

  9. Depressive Symptoms and Associated Clinical Characteristics in Outpatients Seeking Community-based Treatment for Alcohol and Drug Problems

    Science.gov (United States)

    Sanchez, Katherine; Walker, Robrina; Campbell, Aimee N. C.; Greer, Tracy L.; Hu, Mei-Chen; Grannemann, Bruce D.; Nunes, Edward V.; Trivedi, Madhukar H.

    2014-01-01

    Background Comorbid psychiatric and substance use disorders are common and associated with poorer treatment engagement, retention, and outcomes. This study examines the presence of depressive symptoms and the demographic and clinical correlates in a diverse sample of substance abuse treatment-seekers to better characterize patients with co-occurring depressive symptoms and substance use disorders and understand potential treatment needs. Methods Baseline data from a randomized clinical effectiveness trial of a computer-assisted, web-delivered psychosocial intervention were analyzed. Participants (N=507) were recruited from 10 geographically diverse outpatient drug treatment programs. Assessments included the self-report Patient Health Questionnaire, and measures of coping strategies, social functioning, physical health status, and substance use. Results One-fifth (21%; n=106) of the sample screened positive for depression; those screening positive for depression were significantly more likely to screen positive for anxiety (66.9%) and PTSD (42.9%). After controlling for anxiety and PTSD symptoms, presence of depressive symptoms remained significantly associated with fewer coping strategies (p = .001), greater impairment in social adjustment (p problem among substance abusers and, in this study, patients who screened positive for depression were more likely to have co-occurring symptoms of anxiety and PTSD. Additionally, the presence of depressive symptoms was associated with fewer coping strategies and poorer social adjustment. Coping skills are a significant predictor of addiction outcomes and it may be especially important to screen for and enhance coping among depressed patients. Evidence-based interventions that target coping skills and global functioning among substance abusers with depressive symptoms may be important adjuncts to usual treatment. PMID:25084694

  10. 'You are a man because you have children': experiences, reproductive health knowledge and treatment-seeking behaviour among men suffering from couple infertility in South Africa.

    Science.gov (United States)

    Dyer, S J; Abrahams, N; Mokoena, N E; van der Spuy, Z M

    2004-04-01

    In Africa, infertility traditionally has been viewed as a female problem. This study explores reproductive health knowledge, health-seeking behaviour and experiences related to involuntary childlessness in men suffering from couple infertility. Twenty-seven men from a diverse cultural urban community in South Africa participated in in-depth interviews at the time of their first visit to an infertility clinic in a tertiary referral centre. Men had little knowledge about the physiology of human fertility, causes of infertility and modern treatment options. Awareness of male factor infertility was, however, high. Most men appeared involved in the health-seeking process. Men described their emotional reactions to childlessness and the impact of infertility on marital stability, and many reported that infertile men suffered from stigmatization, verbal abuse and loss of social status. These findings improve our understanding of the reproductive health needs of men suffering from couple infertility in Africa. This understanding is essential for the effective integration of male partners into modern infertility management. The need for appropriate counselling of men and, most particularly, for education of the community is recognized.

  11. Psychological/verbal abuse and utilization of mental health care in perinatal women seeking treatment for depression.

    Science.gov (United States)

    Creech, Suzannah; Davis, Kristina; Howard, Margaret; Pearlstein, Teri; Zlotnick, Caron

    2012-10-01

    Research on psychological violence has suggested it is common among perinatal women and is predictive of later physical violence. Psychological violence is also a strong correlate of negative mental and physical health outcomes and may influence engagement in health services. Both physical and mental health care are of critical importance for perinatal women who may be especially vulnerable to psychological violence and its deleterious effects. This study examined the clinical records of 299 perinatal patients who received treatment in a psychiatric partial hospital program to determine whether there were differences in utilization of care between those women with and without current interpersonal psychological abuse. More women than expected who reported current psychological abuse left treatment early compared to those without such reports.

  12. Predictors of Six-month Change in the Voice Handicap Index in a Treatment-seeking Population.

    Science.gov (United States)

    Moore, Jaime; Greenberg, Caprice; Thibeault, Susan L

    2017-01-01

    To evaluate predictors of longitudinal change in patient-perceived voice impact as determined by the Voice Handicap Index (VHI). Prospective, survey study. Patients consented to the University of Wisconsin Voice and Swallow Clinics Outcomes Database with voice, concerns with a baseline clinic visit from November 2012 to January 2014 were eligible for the study. The VHI was sent to patients 6 months post clinic visit to determine change in voice handicap from baseline. General health was screened using the 12-item Short Form Health Survey, using physical component summary and mental component summary scores. Predictor variables included treatment (medical and/or behavioral); dysphonia sub-diagnosis; grade, roughness, breathiness, asthenia, and strain rating; age; sex; socioeconomic factors; smoking history; and comorbidity score. Two hundred thirty-seven patients met study criteria and were followed longitudinally. Eighty-two patients returned 6-month surveys. The VHI was significantly correlated with mental component summary scores. Patients with a higher grade in baseline grade, roughness, breathiness, asthenia, and strain score were more likely to receive voice intervention (P = 0.04). Six-month improvement in VHI score was associated with both higher initial VHI score and higher educational level in both univariate (P < 0.01, P = 0.04) and multivariate analyses (P < 0.01, P = 0.02). Voice treatment (medical and/or behavioral) was not a significant factor for improvement in VHI score. Our results suggest that it is important to consider baseline self-perceived voice impact measures and educational level in setting expectations for voice treatment. Future studies examining the relationship between treatment patterns and voice-related patient outcomes are warranted. Copyright © 2017 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

  13. Seeking an oracle: using the Delphi process to develop practice guidelines for the treatment of endometriosis with Chinese herbal medicine.

    Science.gov (United States)

    Flower, Andrew; Lewith, George T; Little, Paul

    2007-11-01

    For most complementary and alternative medicine interventions, the absence of a high-quality evidence base to define good practice presents a serious problem for clinicians, educators, and researchers. The Delphi process may offer a pragmatic way to establish good practice guidelines until more rigorous forms of assessment can be undertaken. To use a modified Delphi to develop good practice guidelines for a feasibility study exploring the role of Chinese herbal medicine (CHM) in the treatment of endometriosis. To compare the outcomes from Delphi with data derived from a systematic review of the Chinese language database. An expert group was convened for a three-round Delphi that initially produced key statements relating to the CHM diagnosis and treatment of endometriosis (round 1) and then anonymously rated these on a 1-7 Likert scale (rounds 2 and 3). Statements with a median score of 5 and above were regarded as demonstrating positive group consensus. The differential diagnoses within Chinese Medicine and rating of the clinical value of individual herbs were then contrasted with comparable data from a review of Chinese language reports in the Chinese Biomedical Retrieval System (1978-2002), and China Academy of Traditional Chinese Medicine (1985-2002) databases and the Chinese TCM and magazine literature (1984-2004) databases. Consensus (good practice) guidelines for the CHM treatment of endometriosis relating to common diagnostic patterns, herb selection, dosage, and patient management were produced. The Delphi guidelines demonstrated a high degree of congruence with the information from the Chinese language databases. In the absence of rigorous evidence, Delphi offers a way to synthesize expert knowledge relating to diagnosis, patient management, and herbal selection in the treatment of endometriosis. The limitations of the expert group and the inability of Delphi to capture the subtle nuances of individualized clinical decision-making limit the usefulness of

  14. Utility of the Beck Depression Inventory to Screen for and Track Depression in Injection Drug Users Seeking Hepatitis C Treatment

    Science.gov (United States)

    Holtzheimer, Paul E.; Veitengruber, Jason; Wang, Chia C.; Krows, Meighan; Thiede, Hanne; Wald, Anna; Roy-Byrne, Peter

    2010-01-01

    Objective Treating acute HCV in injection drug users (IDUs) is complicated by a high prevalence of psychiatric comorbidities that may lead to increased risk for depressive complications of interferon treatment. Effective screening strategies are needed to help non-psychiatric clinicians identify depressive disorders. Methods Thirty IDUs with acute HCV completed the Beck Depression Inventory (BDI), underwent a psychiatric examination, and were randomized to 24 weeks of pegylated interferon treatment (IFA) or observation (OBS). Sensitivity, specificity, positive (PPV) and negative predictive values (NPV) of the BDI for diagnosing depression (with a cutoff >10) were calculated. The psychiatrist’s diagnosis was used as the gold standard. Depression severity was assessed over time with the BDI. Results Forty-seven percent of individuals met criteria for a depressive disorder. Sensitivity (91%) and NPV (92%) were high for the BDI; specificity (58%) and PPV (56%) were low. BDI worsened in 2 patients completing the study (one IFA, one OBS); two IFA patients were discontinued for possible depression-related complications. At baseline, subject-rated fatigue was associated with alanine aminotransferase (ALT) level. Conclusion The BDI is an adequate tool for ruling out depressive disorders in active IDUs with acute HCV, but specificity is low. Psychiatric consultation is recommended for all active IDUs being considered for acute HCV treatment. PMID:20633748

  15. Deconstructing the myth of Pasewalk: Why Adolf Hitler’s psychiatric treatment at the end of World War I bears no relevance

    Directory of Open Access Journals (Sweden)

    Jan Armbruster

    2016-06-01

    Full Text Available Abstract Background Even more than 70 years after the end of WW II, questions regarding the personality of dictator Adolf Hitler (1889-1945 remain unresolved. Among them, there is a focus on the problem of his state of mental health, in particular on the possible relevance of the medical treatment he received for a war injury at the military hospital of the small German town of Pasewalk in the last days of WW I. Some authors have come to postulate a profound change of his personality due either to a psychic trauma suffered or a hypnotic therapy he supposedly underwent for curing a hysterical blindness. Objectives The assumptions about Hitler’s war injury which rely on only two significant sources shall be assessed for their validity. Methods Existing historical sources and inferred hypotheses will be discussed in the light of alternative interpretations. Results The mentioned suppositions reveal their highly arbitrary character: neither a hysterical blindness of Hitler’s nor a hypnotic treatment at Pasewalk military hospital can be substantiated. Discussion Given the fact that Hitler’s medical sheet is most likely irrevocably lost, the authors plea for the acceptance of the limitations of historical research, even more so since the occurrences in Pasewalk lack any deeper importance for a historic assessment of Hitler’s personality.

  16. The Korean War and the post-war prisoners of war (POW) regime, 1945-1956

    OpenAIRE

    Wylie, Neville; Crossland, James

    2015-01-01

    This paper examines the framework for the treatment of prisoners of war that emerged after 1945. It focuses on one of the key elements of the post-war prisoner of war (POW) regime, the role of neutral bodies – state authorities acting as ‘protecting powers’ or humanitarian agencies such as the International Committee of the Red Cross – in supervising the implementation of the 1949 POW convention. It examines the importance of neutral supervision for the POW regime, and shows how the events of...

  17. Discrepancies Between Self-Reported Usual Sleep Duration and Objective Measures of Total Sleep Time in Treatment-Seeking Overweight and Obese Individuals.

    Science.gov (United States)

    O'Brien, Erin; Hart, Chantelle; Wing, Rena R

    2016-01-01

    To examine the agreement between actigraphy-estimated and self-reported sleep duration in obese individuals, we had 63 treatment seeking overweight/obese participants complete the Pittsburgh Sleep Quality Index (PSQI) and report sleep duration for weekends and weekdays, and compared their reports to 7 days of actigraphy. Actigraph total sleep time correlated r = .20-.31 with self-report and the absolute discrepancy averaged 51-54 minutes. Only 20 of the 32 subjects (62.5%) classified as short sleepers (sleep quality was associated with greater absolute discrepancy between actigraphy and self-report. The weak correlations between self-report and actigraph should be considered in future efforts to increase sleep duration to promote weight loss in obese individuals.

  18. Web-based brief personalized feedback intervention in a non-treatment seeking population of heavy drinkers, a randomized controlled trial

    DEFF Research Database (Denmark)

    Hansen, Anders Blædel Gottlieb; Becker, Ulrik; Søgaard Nielsen, Anette

    2010-01-01

    targeting heavy drinkers has not been tested. Objective: To examine whether a web-based personalized feedback intervention and web-based self-help material resulted in lowering of self-reported alcohol use in a non-treatment seeking population of heavy drinkers (defined as weekly alcohol consumption above...... randomized into a brief personalized feedback group (normative feedback) (n=476), a group receiving self-help material (information about health consequences of exceeding recommended drinking limits) (n=450), or a control group (no information) (n=455). Outcome measure was self-reported alcohol consumption......- and the personalized feedback group (2.6 standard drinks, P=0.01). In terms of feasibility, the success of the study was acceptable as 41% accepted participation and 70% were followed up. Discussion: We found no evidence that a brief personalized feedback intervention or self-help material could lead to a reduction...

  19. FREQUENCY OF HEPATITIS B AND C IN PATIENTS SEEKING TREATMENT AT THE DENTAL SECTION OF A TERTIARY CARE HOSPITAL.

    Science.gov (United States)

    Fayyaz, Muhammad; Ghous, Shah Mohammad; Fahimullah; Abbas, Irum; Ahmed, Nofil; Ahmed, Ans

    2015-01-01

    Hepatitis B and C are serious health problems and a major cause of liver disease worldwide. Like medical patients, dental patients are at increased risk of getting hepatitis B and C viral infection during various procedures. Keeping in view the rising incidence of hepatitis B and C in Pakistan, it was considered important to know about the frequency and distribution of HBV and HCV in patients undergoing various procedures during treatment in dentistry section. This study was based on the review of the records of the patients visiting the dental section of Ayub Teaching Hospital Abbottabad between April to December 2014. The,Secondary data of 3549 patients who visited the dental section for treatment during this period was used for this study. Male patients constituted 53.9% (1914) and female patients were 46.1% (1635) of total screened patients. Total infection with hepatitis B and C were found in 4.1% (147) of the screened patients. Out of these infections, hepatitis C was found in 66% (97) patients and hepatitis B in 32.7% (48), whereas 1.3% (2) of the patients had both the infections. Infection with hepatitis B and C viruses was detected in 39.5% (58) male patients and 60.5% (89) female patients. Alarmingly. high proportions of new 75.5% (111) cases of both the infections were detected during the nine month period. Due to high prevalence of HBV and HCV among patients coming for dental treatment, it is recommended that regular screening for HBV and HCV be performed on every patient before carrying out any procedure upon.

  20. Perceptions of Harm and Reasons for Misuse of Prescription Opioid Drugs and Reasons for Not Seeking Treatment for Physical or Emotional Pain Among a Sample of College Students.

    Science.gov (United States)

    Kenne, Deric R; Hamilton, Kelsey; Birmingham, Lauren; Oglesby, Willie H; Fischbein, Rebecca L; Delahanty, Douglas L

    2017-01-02

    Since the early 1990s, the United States has seen a significant increase in the prevalence of prescription opioid misuse. Despite benefits prescription opioids provide, misuse can be fatal. The current study was designed to investigate the prevalence of prescription opioid misuse, perceived harm of misuse, and reasons for misuse for physical or emotional pain instead of seeking professional medical or mental health treatment. Survey data were collected in the fall of 2013 via an online survey to a random sample of 668 students from a public Midwestern university. Lifetime prevalence of prescription opioid misuse was 9.5%. Misusers of prescription opioid drugs generally reported lower ratings of perceived harm as compared to individuals not reporting misuse of prescription opioid drugs. Primary reasons for misuse of prescription opioid drugs was to relieve pain (33.9%), "to feel good/get high" (23.2%) and experimentation (21.4%). Lifetime misuse of a prescription opioid drug for physical or emotional pain was reported by 8.1% and 2.2% of respondents, respectively. Primary reasons for misuse for physical pain included because pain was temporary, immediate relief was needed, and no health insurance/financial resources. Primary reasons for misuse for emotional pain included not wanting others to find out, embarrassment and fear. Conclusions/Importance: Reasons for misuse of prescription opioid drugs vary by type of prescription opioid drug. Reasons for not seeking treatment that ultimately lead to misuse, vary by type of pain being treated and may be important considerations in the effort to stem the misuse of prescription opioid drugs among college students.

  1. The Forgotten War: Korea.

    Science.gov (United States)

    Fleming, Dan B.; Kaufman, Burton I.

    1990-01-01

    Evaluates the coverage of the Korean War in 12 high school history textbooks. Lists the books, and reviews the coverage of each in the areas of: total coverage and illustrations; Korean war background; causes of the War; the Truman response; waging the War; the Truman-MacArthur controversy; and the results of the War. (GG)

  2. The Cardiovascular and Subjective Effects of Methamphetamine Combined with γ-vinyl-γ-aminobutyric acid (GVG) in Non-Treatment Seeking Methamphetamine-dependent Volunteers

    Science.gov (United States)

    De La Garza, Richard; Zorick, Todd; Heinzerling, Keith G.; Nusinowitz, Steve; London, Edythe D.; Shoptaw, Steven; Moody, David E.; Newton, Thomas F.

    2009-01-01

    γ-Vinyl-γ-aminobutyric acid (GVG) elevates central nervous system γ-aminobutyric acid (GABA) levels by irreversibly inhibiting GABA transaminase. An open-label clinical trial in humans suggested that GVG may reduce cocaine and methamphetamine use. To test safety and to obtain preliminary data on efficacy of GVG for treating methamphetamine dependence, we conducted a double-blind, placebo-controlled, parallel groups study of GVG interaction with the cardiovascular and subjective effects produced by methamphetamine. Non-treatment seeking methamphetamine-dependent volunteers received either GVG (N=8) or placebo (N=9) by random assignment. GVG treatment was initiated at 1 g/day and increased to 5 g/day. After reaching the target dose of 5 g/day, participants received methamphetamine (15 + 30 mg, IV), and cardiovascular and subjective effects were assessed. No serious adverse events were noted, and the total number of adverse events was similar between the treatment groups. Considering the full time-course and peak effects independently, no significant differences were detected between the groups for systolic or diastolic blood pressures, or heart rate following methamphetamine exposure. Some methamphetamine-induced cardiovascular changes approached significance (p<0.10) and may warrant attention in future trials. Methamphetamine-induced subjective effects (“any drug effect”, “high”, “crave methamphetamine” were statistically similar between GVG and placebo treatment groups. Pharmacokinetic data indicate that GVG treatment did not alter methamphetamine or amphetamine plasma levels, and there was no association between methamphetamine or amphetamine plasma levels and peak cardiovascular effects. Taken together, the data indicate that GVG treatment is generally well tolerated but not efficacious in attenuating the positive subjective effects of methamphetamine in the laboratory. PMID:19698734

  3. The cardiovascular and subjective effects of methamphetamine combined with gamma-vinyl-gamma-aminobutyric acid (GVG) in non-treatment seeking methamphetamine-dependent volunteers.

    Science.gov (United States)

    De La Garza, Richard; Zorick, Todd; Heinzerling, Keith G; Nusinowitz, Steve; London, Edythe D; Shoptaw, Steven; Moody, David E; Newton, Thomas F

    2009-11-01

    Gamma-vinyl-gamma-aminobutyric acid (GVG) elevates central nervous system gamma-aminobutyric acid (GABA) levels by irreversibly inhibiting GABA transaminase. An open-label clinical trial in humans suggested that GVG may reduce cocaine and methamphetamine use. To test safety and to obtain preliminary data on efficacy of GVG for treating methamphetamine dependence, we conducted a double-blind, placebo-controlled, parallel group study of GVG interaction with the cardiovascular and subjective effects produced by methamphetamine. Non-treatment seeking methamphetamine-dependent volunteers received either GVG (N=8) or placebo (N=9) by random assignment. GVG treatment was initiated at 1 g/day and increased to 5 g/day. After reaching the target dose of 5 g/day, participants received methamphetamine (15+30 mg, IV), and cardiovascular and subjective effects were assessed. No serious adverse events were noted, and the total number of adverse events was similar between the treatment groups. Considering the full time course and peak effects independently, no significant differences were detected between the groups for systolic or diastolic blood pressures, or heart rate, following methamphetamine exposure. Some methamphetamine-induced cardiovascular changes approached significance (p<0.10) and may warrant attention in future trials. Methamphetamine-induced subjective effects ("any drug effect", "high", "crave methamphetamine") were statistically similar between GVG and placebo treatment groups. Pharmacokinetic data indicate that GVG treatment did not alter methamphetamine or amphetamine plasma levels, and there was no association between methamphetamine or amphetamine plasma levels and peak cardiovascular effects. Taken together, the data indicate that GVG treatment is generally well tolerated but not efficacious in attenuating the positive subjective effects of methamphetamine in the laboratory.

  4. Effect of Pathological Narcissism on Development of Early Maladaptive Schemas in Men Seeking Alcohol Use Disorders Treatment

    Directory of Open Access Journals (Sweden)

    Irem Anli

    2017-03-01

    Full Text Available We hypothesized that pathological narcissism of alcoholic individuals cause cognitive maladaptive schemas that lead to alcohol use disorders. We assessed the charts of 206 male patients with a diagnosis of alcohol use disorders according to DSM-5 that represent all male patients admitted into Bakirkoy Mental Health and Neurological Diseases Education and Research Hospital Alcohol and Drug Research, Treatment and Training Center (AMATEM during this period. The control group consisted of 102 male participants without any problems related to alcohol use or any other psychiatric diagnosis Data collection tools were Young Schema Qustionnaire and ndash;Short Form, Self Psychology Inventory and Sociodemographic Data Form. According to our results there is a statistically significant difference between alcohol use disorders and normal group in terms of pathological narcissism and early maladaptive schemas.. [Psikiyatride Guncel Yaklasimlar - Current Approaches in Psychiatry 2017; 9(1.000: 63-74

  5. Psychiatric Symptoms, Parental Attachment, and Reasons for Use as Correlates of Heavy Substance Use Among Treatment-Seeking Hispanic Adolescents.

    Science.gov (United States)

    Gattamorta, Karina A; Varela, Alberto; McCabe, Brian E; Mena, Maite P; Santisteban, Daniel A

    2017-02-23

    In early adolescence, Hispanics self-report higher drug use rates compared to White and African American peers. Among adolescent users, heavy users have more negative behavioral and health consequences. The purpose of this cross-sectional study is to examine whether psychiatric symptoms, parental attachment, and reasons for use predict heavy alcohol and illicit drug use (more than 10 times in the past three months) among Hispanic adolescents. This study examines baseline data from a study evaluating a family based substance abuse treatment program for Hispanic adolescents. Participants were 14-17 years old (N = 156, 44% female). Adolescent reports on the Diagnostic Interview Schedule for Children Predictive Scales measured psychiatric symptoms of major depressive disorder, attention deficit hyperactivity disorder, conduct disorder, and anxiety. The Personal Experiences Inventory measured type and amount of drug use, as well as perceived social and psychological benefits of drug use. The Inventory of Parent and Peer Attachment measured trust, communication, and alienation between adolescents and their mothers. Logistic regression identified correlates of heavy alcohol use and heavy illicit drug use among Hispanic adolescents. Higher social benefits were associated with increased likelihood of heavy alcohol use. Conduct disorder, higher levels of maternal attachment, lower levels of acculturation, and higher levels of psychological benefits of use were associated with an increased likelihood of heavy illicit drug use. These findings support the assumption that substance use treatment among Hispanic adolescents must be capable of addressing co-occurring psychiatric disorders, familial relationships, and the individual reasons/motivators to use.

  6. Factors associated with reported diarrhoea episodes and treatment-seeking in an urban slum of Kolkata, India.

    Science.gov (United States)

    Sur, Dipika; Manna, Byomkesh; Deb, Alok K; Deen, Jacqueline L; Danovaro-Holliday, M Carolina; von Seidlein, Lorenz; Clemens, John D; Bhattacharya, Sujit K

    2004-06-01

    In an urban slum in eastern Kolkata, India, reported diarrhoea rates, healthcare-use patterns, and factors associated with reported diarrhoea episodes were studied as a part of a diarrhoea-surveillance project. Data were collected through a structured interview during a census and healthcare-use survey of an urban slum population in Kolkata. Several variables were analyzed, including (a) individual demographics, such as age and educational level, (b) household characteristics, such as number of household members, religious affiliation of the household head, building material, expenditure, water supply and sanitation, and (c) behaviour, such as hand-washing after defecation and healthcare use. Of 57,099 study subjects, 428 (0.7%) reported a diarrhoea episode sometime during the four weeks preceding the interview. The strongest independent factors for reporting a history of diarrhoea were having another household member with diarrhoea (adjusted odds ratio [OR]=3.8; 95% confidence interval [CI] 3.3-4.4) and age less than 60 months (adjusted OR=3.7; 95% CI 3.0-4.7). The first choice of treatment by the 428 subjects was as follows: 151 (35%) had self- or parent-treatment, 150 (35%) consulted a private allopathic practitioner, 70 (16%) went directly to a pharmacy, 29 (7%) visited a hospital, 14 (3%) a homoeopathic practitioner, 2 (0.5%) an ayurvedic practitioner, and 12 (3%) other traditional healers. The choices varied significantly with the age of patients and their religion. The findings increase the understanding of the factors and healthcare-use patterns associated with diarrhoea episodes and may assist in developing public-health messages and infrastructure in Kolkata.

  7. Becoming a warring nation

    DEFF Research Database (Denmark)

    Daugbjerg, Mads; Sørensen, Birgitte Refslund

    2017-01-01

    This introduction sets the frame for the section’s four articles, all themed on contemporary developments in Denmark in the wake of the country’s involvement in the ‘coalition’ wars of recent decades. During this period, Danish governments have adopted a so-called ‘activist’ foreign policy, a key...... pacifism and a strong foreign policy tradition of non-involvement. We outline this Danish road from ‘adaptation’ to ‘activism’, arguing for a need for a critical, qualitatively based research focus on the social and cultural repercussions of this peculiar ‘military moment’ in Denmark. The four articles...... that make up the themed section are written on the basis of ethnographic case studies that seek to contribute to such a wider discussion....

  8. Post-cold war United Nations peacekeeping operations: a review of the case for a hybrid level 2+ medical treatment facility.

    Science.gov (United States)

    Johnson, Ralph Jay

    2015-01-01

    Post-Cold War, UN peacekeeping operations (UN PKOs) have become larger, more mobile, multi-faceted and conducted over vast areas of remote, rugged, and harsh geography. They have been increasingly involved in dangerous areas with ill-defined boundaries, simmering internecine armed conflict, and disregard on the part of some local parties for peacekeepers' security and role. Yet progressively there have been expectations of financial restraint and austerity. Additionally, UN PKOs have become more "robust," that is, engaged in preemptive, assertive operations. A statistically positive and significant relationship exists between missions' size, complexity, remoteness, and aggressive tenor and a higher probability of trauma or death, especially as a result of hostile actions or disease. Therefore, in the interest of "force protection" and optimizing operations, a key component of UN PKOs is health care and medical treatment. The expectation is that UN PKO medical support must conform to the general intent and structure of current UN PKOs to become more streamlined, portable, mobile, compartmentalized, and specialized, but also more varied and complex to address the medical aspects of these missions cost-efficiently. This article contends that establishing a hybrid level 2-a level 2 with level 3 modules and components (i.e., level 2+)-is a viable course of action when considering trends in the medical aspects of Post-Cold War UN PKOs. A level 2 medical treatment facility has the potential to provide needed forward mobile medical treatment, especially trauma care, for extended, complex, large-scale, and comprehensive UN PKOs. This is particularly the case for missions that include humanitarian outreach, preventive medicine, and psychiatry. The level 2 treatment facility is flexible enough to expand into a hybrid level 2+ with augmentation of modules based on changes in mission requirements and variation in medical aspects.

  9. Reconstructing Order: Post-War Reconstruction after the Taiping Civil War, 1864-1874

    OpenAIRE

    Heselton, Christopher Carlton

    2017-01-01

    In the aftermath of the tumultuous Taiping Civil War (1851-1864), Qing officials began imagining a reconstruction of Chinese post-war society through broad programs that resettled refugees, demobilized the army, and rebuilt temples, roads, and academies. This was an ambitious program and unprecedented in the annals of Chinese history, seeking to radically restore Chinese society through government intervention. At the center of their plans, was an administration, the Reconstruction Bureau, th...

  10. Aggression levels in treatment seeking inpatients with alcohol-related problems compared to levels in the general population in Hungary.

    Science.gov (United States)

    Gerevich, József; Bácskai, Erika; Czobor, Pál

    2007-08-01

    Association between aggression and heavy alcohol use is documented in the literature in various disparate samples and settings. Comparison of trait aggression levels using a uniform methodology across different samples is almost entirely lacking. This study compared trait aggression levels of treated inpatients with severe alcohol-related problems with those of a nationally representative sample of the general adult population using the same methodology. Results indicated that in the patient population the trait aggression levels were substantially higher than in the general population. Because several studies have demonstrated that aggressive personality traits are closely linked with violence after drinking alcohol, our results further highlight the importance of treatment programs in this at-risk population. From a methodological perspective, the higher trait aggression level of inpatients with alcohol-related problems compared with the general population supports the assumption that the underrepresentation of alcoholics in the population surveys may restrict the range in the severity of alcohol use and dependence, and may therefore produce severely biased results in such studies.

  11. The Influence of Parental Emotional Neglect on Assault Victims Seeking Treatment for Depressed Mood and Alcohol Misuse: A Pilot Study

    Directory of Open Access Journals (Sweden)

    Kylie A. Bailey

    2016-10-01

    Full Text Available This study explores the relationship between reported parental emotional neglect when a child, assault type experienced, posttraumatic stress symptoms (PTSS, depression, and alcohol consumption in treatment seekers for comorbid depressive symptoms and alcohol misuse. Participants (n = 220 with concurrent depression and alcohol misuse were recruited from the DAISI (Depression and Alcohol Integrated and Single-focussed Interventions project. Assault type and PTSS were retrospectively assessed by the Posttraumatic Stress Diagnostic Scale. The Measure of Parenting Style is a self-report measure that retrospectively assessed emotional neglect experienced as a child. An exploratory factor analysis using the tetrachoric correlation matrix (applying principal factor extraction with a varimax rotation identified the two assault factors of sexual assault (SA and physical assault (PA. A path analysis revealed that Maternal Emotional Neglect increased the impact of PTSS and depression. Paternal Emotional Neglect increased the impact of PA on PTSS and alcohol dependence symptoms. There appears to be differential effects of assault type and Maternal/Paternal emotional neglect on depression and alcohol misuse, suggesting that parenting roles serve distinct protective functions.

  12. Severity of depressive symptoms and accuracy of dietary reporting among obese women with major depressive disorder seeking weight loss treatment.

    Science.gov (United States)

    Whited, Matthew C; Schneider, Kristin L; Appelhans, Bradley M; Ma, Yunsheng; Waring, Molly E; DeBiasse, Michele A; Busch, Andrew M; Oleski, Jessica L; Merriam, Philip A; Olendzki, Barbara C; Crawford, Sybil L; Ockene, Ira S; Lemon, Stephenie C; Pagoto, Sherry L

    2014-01-01

    An elevation in symptoms of depression has previously been associated with greater accuracy of reported dietary intake, however this association has not been investigated among individuals with a diagnosis of major depressive disorder. The purpose of this study was to investigate reporting accuracy of dietary intake among a group of women with major depressive disorder in order to determine if reporting accuracy is similarly associated with depressive symptoms among depressed women. Reporting accuracy of dietary intake was calculated based on three 24-hour phone-delivered dietary recalls from the baseline phase of a randomized trial of weight loss treatment for 161 obese women with major depressive disorder. Regression models indicated that higher severity of depressive symptoms was associated with greater reporting accuracy, even when controlling for other factors traditionally associated with reporting accuracy (coefficient  =  0.01 95% CI = 0.01 - 0.02). Seventeen percent of the sample was classified as low energy reporters. Reporting accuracy of dietary intake increases along with depressive symptoms, even among individuals with major depressive disorder. These results suggest that any study investigating associations between diet quality and depression should also include an index of reporting accuracy of dietary intake as accuracy varies with the severity of depressive symptoms.

  13. Severity of Depressive Symptoms and Accuracy of Dietary Reporting among Obese Women with Major Depressive Disorder Seeking Weight Loss Treatment

    Science.gov (United States)

    Whited, Matthew C.; Schneider, Kristin L.; Appelhans, Bradley M.; Ma, Yunsheng; Waring, Molly E.; DeBiasse, Michele A.; Busch, Andrew M.; Oleski, Jessica L.; Merriam, Philip A.; Olendzki, Barbara C.; Crawford, Sybil L.; Ockene, Ira S.; Lemon, Stephenie C.; Pagoto, Sherry L.

    2014-01-01

    An elevation in symptoms of depression has previously been associated with greater accuracy of reported dietary intake, however this association has not been investigated among individuals with a diagnosis of major depressive disorder. The purpose of this study was to investigate reporting accuracy of dietary intake among a group of women with major depressive disorder in order to determine if reporting accuracy is similarly associated with depressive symptoms among depressed women. Reporting accuracy of dietary intake was calculated based on three 24-hour phone-delivered dietary recalls from the baseline phase of a randomized trial of weight loss treatment for 161 obese women with major depressive disorder. Regression models indicated that higher severity of depressive symptoms was associated with greater reporting accuracy, even when controlling for other factors traditionally associated with reporting accuracy (coefficient  =  0.01 95% CI = 0.01 – 0.02). Seventeen percent of the sample was classified as low energy reporters. Reporting accuracy of dietary intake increases along with depressive symptoms, even among individuals with major depressive disorder. These results suggest that any study investigating associations between diet quality and depression should also include an index of reporting accuracy of dietary intake as accuracy varies with the severity of depressive symptoms. PMID:24587338

  14. Sexual minorities seeking services.

    Science.gov (United States)

    Rogers, Tracey L; Emanuel, Kristen; Bradford, Judith

    2003-01-01

    SUMMARY Understanding the mental health needs of lesbian and bisexual (sexual minority) women is an integral part of designing and providing appropriate mental health services and treatment for them. In an effort to understand the mental health needs of sexual minority women who seek community treatment, a chart review was conducted of the 223 lesbian and bisexual women who presented for services between July 1, 1997 and December 31, 2000 at Fenway Community Health in Boston, MA. Data are based on clients' self-reports and clinician assessments of clients' presenting problem, relevant developmental history, prior mental health and substance abuse treatment, current reports of emotional/psychological symptoms, and areas of impaired functioning. Although substance abuse and suicidal ideation were commonly reported problems, other concerns were more frequently reported. High percentages of lesbians and bisexual women reported relationship concerns and lack of adequate social networks; rates of depression and anxiety based on clinicians' assessments were also high. Overall, lesbians and bisexual women did not differ in the issues they brought to treatment or level or types of impairment. Compared with previous community survey samples, however, study participants appeared to be healthier than general, non-clinical samples of self-identified lesbians, possibly reflecting the special characteristics of sexual minority women who seek treatment in specialized community sites such as the Fenway. Although patients who come to these sites may not represent the more general population of sexual minority women, community health centers known to serve lesbian, gay, bisexual and transgender (LGBT) individuals may be fruitful access points for studying the mental health status and treatment needs of sexual minority women.

  15. Information Seeking Within Organizations.

    Science.gov (United States)

    Morrison, Elizabeth Wolfe

    2002-01-01

    Reviews literature on employee feedback-seeking behavior and the literature on information seeking by organizational newcomers. Highlights the various motives that affect the decision of whether or not to seek information. Offers an integrated model of antecedents, dynamics, forms, and outcomes of employee information seeking. Concludes with…

  16. The Impact of a Community Awareness Strategy on Caregiver Treatment Seeking Behaviour and Use of Artemether-Lumefantrine for Febrile Children in Rural Kenya.

    Directory of Open Access Journals (Sweden)

    Beatrice Wasunna

    Full Text Available Access to prompt and effective treatment is the cornerstone for malaria control. Population Services International in collaboration with the Ministry of Health launched a malaria behaviour change communication intervention in Nyanza province, Kenya. The initiative aimed to improve: symptom recognition and prompt access to government health facilities for febrile children; effective treatment with the recommended first-line drug artemether-lumefantrine (AL in public health facilities and adherence to the AL regimen.Pre- and post-intervention cross-sectional household surveys were used to evaluate the impact of the intervention on prompt and correct use of AL for febrile children below five years of age. The primary outcome was the proportion of children below five years of age with fever in the last 14 days accessing AL within 48 hours of fever onset.There was an increase from 62.8% pre-intervention to 79.4% post-intervention (95% CI: 11.1, 22.1 in caregivers who reported seeking formal treatment promptly (on the same day, or next day for their febrile children. However, there was a decrease in the use of government health facilities in the post-intervention period. There was a small increase in the proportion of children accessing AL within 48 hours of fever onset [18.4% vs 23.5% (0.1-10.0].The findings of this evaluation demonstrate that interventions that target only one sector may have a limited impact on improvements in prompt and effective treatment where multiple sources of treatments are sought for febrile illness. Additionally, the context in which an intervention is implemented is likely to influence the process and outcomes.

  17. A Cross-sectional Study to Assess Disability and Its Correlates among Treatment Seeking Individuals with Alcohol Use Disorders.

    Science.gov (United States)

    Balhara, Yatan Pal Singh; Singh, Shalini; Modak, Tamonud; Sarkar, Siddharth

    2017-01-01

    Alcohol use is a major risk factor for global disease burden, and excessive use leads to disability in the individual. This study aimed to assess the disability and its correlates among individuals with alcohol use disorders (AUDs). In addition, it assessed the quality of life measures in this population group. A cross-sectional study on a sample (N = 62) from among treatment seekers for alcohol dependence. Diagnostic and Statistical Manual, Fifth Edition (DSM-5) criteria were used to assess disorder severity. The WHO Disability Assessment Schedule (WHODAS) 2.0 and World Health Organization Quality of Life-BREF were used to assess disability and quality of life, respectively. Descriptive statistics, correlation analysis, and linear regression analysis were used for comparative assessments. The level of statistical significance was kept at P disability in the domains of "participation in the society," "household and work-related activities" and "cognitive functioning." The quality of life measures indicate poor physical health, reduced work capacity, and cognitive dysfunction. A negative correlation was seen between the social dimensions of disability (getting along) and quality of life measures of psychological health (P = 0.026) and social relationships (P = 0.046), work domain of disability schedule and physical health score on quality of life evaluation (P = 0.001). Older age had greater impairment in the work domain (P = 0.040), and unemployment was associated with higher disability (P = 0.001). Unemployment and duration of alcohol use were the independent predictors of greater disability. Disability assessment using WHODAS 2.0 shows significant impairment in individuals with AUDs that is negatively correlated with quality of life measures.

  18. Intolerance of uncertainty and post-traumatic stress symptoms: An investigation within a treatment seeking trauma-exposed sample.

    Science.gov (United States)

    Oglesby, Mary E; Gibby, Brittany A; Mathes, Brittany M; Short, Nicole A; Schmidt, Norman B

    2017-01-01

    Intolerance of uncertainty (IU) has been associated with post-traumatic stress symptoms (PTSS) in the literature. However, no research to date has investigated the relationship between IU and PTSS within a clinical trauma-exposed sample, which is an important next step in the literature and crucial for the generalizability of these findings. Therefore, the current study hypothesized that IU would be related to increased PTSS within a clinical sample of trauma-exposed individuals. Further, we hypothesized that IU would be related to elevated PTSS after accounting for anxiety sensitivity (AS) and negative affect (NA), two known correlates of PTSS. Finally, we examined the relations between IU and the PTSS clusters (i.e., avoidance, emotional numbing, hyperarousal, and re-experiencing) while covarying for AS and NA. Participants included community adults (n=126) presenting at an outpatient clinic. All participants had previously experienced a traumatic event as defined by the DSM-5 PTSD Criterion A. Results revealed that IU was significantly associated with increased PTSS above and beyond AS and NA. Further, results indicated that IU was significantly related to the avoidance, hyperarousal, and emotional numbing PTSS clusters, even after covarying for AS and NA. IU was not significantly associated with the PTSS re-experiencing cluster once AS and NA were taken into account. Our results expand upon the extant literature by demonstrating that IU is associated with PTSS above and beyond AS and NA within a clinical trauma-exposed sample. These findings are discussed in terms of promising directions for future research and treatment strategies. Copyright © 2016 Elsevier Inc. All rights reserved.

  19. Suicidal ideation in treatment-seeking Veterans of Operations Enduring Freedom and Iraqi Freedom: the role of coping strategies, resilience, and social support.

    Science.gov (United States)

    Pietrzak, Robert H; Russo, Amanda R; Ling, Qi; Southwick, Steven M

    2011-06-01

    Recent epidemiologic studies have found an increased risk of suicide among Veterans of Operations Enduring Freedom and Iraqi Freedom (OEF-OIF) with psychiatric disorders. However, little is known about whether variables other than psychiatric conditions, such as coping strategies, resilience, and social support, may be related to suicidality in this population. A total of 167 OEF-OIF Veterans seeking behavioral or primary care services completed a survey containing measures of combat exposure, psychopathology, pain, psychological resilience, social support, and cognitive coping strategies. Thirty-six respondents (21.6%) reported contemplating suicide in the two weeks prior to completing the survey. Compared to suicide non-contemplators, suicide contemplators were older, and more likely to screen positive for depression and posttraumatic stress disorder (PTSD), and to report a deployment-related pain condition or complaint. They also scored higher on measures of worry, self-punishment, and cognitive-behavioral avoidance strategies, and lower on measures of psychological resilience and postdeployment social support. Multivariate analysis revealed that a positive depression screen, and higher scores on measures of self-punishment and cognitive-social avoidance coping were positively associated with suicidal ideation, while higher scores on measures of psychological resilience (i.e., positive acceptance of change) were negatively related to suicidal ideation. Moderator analysis revealed that a positive screen for depression or PTSD significantly diminished the protective effect of postdeployment social support on suicidal ideation. 1 in 5 treatment-seeking OEF-OIF Veterans may contemplate suicide. Interventions to reduce depressive symptoms, and maladaptive cognitive-behavioral coping strategies of self-punishment and cognitive social avoidance, and to bolster psychological resilience may help mitigate suicidality in this population. Published by Elsevier Ltd.

  20. Neuropsychological performance in treatment-seeking Operation Enduring Freedom/Operation Iraqi Freedom Veterans with a history of mild traumatic brain injury.

    Science.gov (United States)

    Jak, Amy J; Gregory, Amber; Orff, Henry J; Colón, Candice; Steele, Norma; Schiehser, Dawn M; Delano-Wood, Lisa; Jurick, Sarah M; Twamley, Elizabeth W

    2015-01-01

    Clinical neuropsychological presentation of treatment-seeking Veterans with a remote history of mild traumatic brain injury (mTBI) is widely variable. This manuscript seeks to better characterize cognitive concerns in the post-acute phase following mTBI and to identify the neuropsychological profiles of a large sample of clinically referred Operation Enduring Freedom/Operation Iraqi Freedom/Operation New Dawn (OEF/OIF/OND) Veterans with a history of mTBI and current cognitive complaints. We hypothesized that a minority of cases would exhibit valid and widespread neuropsychological deficits. Retrospective chart reviews of neuropsychological testing and mental health symptoms and diagnoses were conducted on 411 clinically referred OEF/OIF/OND Veterans with a history of mTBI. Groups were created based on scores on performance validity measures and based on overall neuropsychological performance. A total of 29.9% of the sample performed below normative expectations on at least one performance validity test (PVT). Of those Veterans performing adequately on PVTs, 60% performed within normal limits on virtually all neuropsychological measures administered, leaving only 40% performing below expectations on two or more measures. Mood and neurobehavioral symptoms were significantly elevated in Veterans performing below cutoff on PVTs compared to Veterans who performed within normative expectations or those with valid deficits. Neurobehavioral symptoms were significantly correlated with mental health symptom reports but not with injury variables. In summary, in a large sample of clinically referred Veterans with persistent cognitive complaints after mild TBI, a third demonstrated invalid clinical neuropsychological testing, and, of those performing at or above cutoff on PVTs, over half performed within normative expectations across most neuropsychological tests administered. Results highlight the importance of objective assessment of cognitive functioning in this population

  1. Teaching the Vietnam War: A Conference Report.

    Science.gov (United States)

    Winterstein, Stephen

    2000-01-01

    On May 6-7, 2000, the Foreign Policy Research Institute's (FPRI's) sixth History Institute convened with more than 40 high school and college history teachers to seek answers to the question: "How should we teach the history of the Vietnam War to our children today?" Not surprisingly, no simple answers were forthcoming. This conference…

  2. Explaining Violence in Sierra Leone's Civil War

    African Journals Online (AJOL)

    Explaining the violence of civil war is never a simple task for the scholar. In the case of the Sierra Leone, paradoxically, the task has in some ways been rendered more difficult by the sheer variety of compelling scholarship on the question. This paper seeks to identify the most useful of the explanations offered thus far, and ...

  3. Private Military Contractors, War Crimes and International ...

    African Journals Online (AJOL)

    This article adds to the literature on the subject by arguing that the elusiveness of PMCs' individual or corporate responsibility for war crimes presents one of the greatest challenges for international humanitarian law (IHL). This presents a dilemma for IHL, which seeks to address individual offences. The situation becomes ...

  4. Mental Health Literacy and Eating-Disordered Behavior: Beliefs of Adolescent Girls Concerning the Treatment of and Treatment-Seeking for Bulimia Nervosa

    Science.gov (United States)

    Mond, J. M.; Marks, P.; Hay, P. J.; Rodgers, B.; Kelly, C.; Owen, C.; Paxton, S. J.

    2007-01-01

    This research examined the "mental health literacy" of adolescents concerning eating-disordered behavior. A vignette describing a fictional 16-year old female meeting diagnostic criteria for bulimia nervosa was presented to 522 female high school students, followed by a series of questions concerning treatment of and treatment-seeking…

  5. Sensation seeking behavior among schizophrenics.

    Science.gov (United States)

    Farhady, Yadollah; Fadai, Farbod; Mazinani, Robabeh; Ashtari, Zabih; Alawijeh, Morteza

    2007-01-01

    To compare sensation seeking between schizophrenic patients (and clinical subtypes of schizophrenia) according to criteria of DSM-IV-TR; and a healthy control group. Two hypotheses were assumed: 1. Sensation seeking in the control group is higher than schizophrenic patients. 2. The levels of sensation seeking are different among clinical subtypes of schizophrenia. The sample comprised a study group of 69 schizophrenic inpatients at Raazy Psychiatric Center, Tehran, Iran in 2005 (10 males and 10 females for each of paranoid, undifferentiated and residual subtypes, and 9 males from disorganized subtype), and 50 randomly selected healthy people, the control group. To measure sensation seeking, the Zuckermann Sensation Seeking Scale, a 41-item questionnaire form, was used after evaluating its validity and reliability. After obtaining a weak or negative correlation, we omitted 9 questions, so that finally a 32-item questionnaire with highest reliability (Cronbach`s alpha = 0.64), remained and was utilized. We used descriptive statistical methods and calculation of statistical indices, and Student t-test for independent groups to evaluate the research hypotheses. The first hypothesis was confirmed at a 99% significance level. The second hypothesis was rejected at a 95% significance level. We found a definite correlation between schizophrenia and a low level of sensation seeking. Accordingly, and since sensation seeking (as a part of temperament) has a strong genetic component, a low level of sensation seeking is probably an existing feature of schizophrenia. Assessing sensation seeking in high-risk populations (children or the siblings of schizophrenics) could be a practical attempt at prevention or immediate treatment of schizophrenia.

  6. Treatment use, perceived need, and barriers to seeking treatment for substance abuse and mental health problems among older adults compared to younger adults.

    Science.gov (United States)

    Choi, Namkee G; DiNitto, Diana M; Marti, C Nathan

    2014-12-01

    This study examined age group differences in and correlates of treatment use and perceived treatment need for substance use disorders (SUD) and mental health (MH) problems as well as self-reported barriers to treatment among people 65+ years old vs. 26-34, 35-49, and 50-64 years old. Data are from the 2008 to 2012 National Survey on Drug Use and Health (NSDUH) (N = 96,966). Age group differences were examined using descriptive bivariate analyses and binary logistic regression analyses. The 65+ age group was least likely to use treatment and perceive treatment need, but the 50-64 age group was more similar to the younger age groups than the 65+ age group. Controlling for age, other predisposing, and enabling factors, alcohol and illicit drug dependence and comorbid SUD and MH problems increased the odds of SUD treatment use. Of MH problems, anxiety disorder had the largest odds for MH treatment use. Bivariate analyses showed that lack of readiness to stop using and cost/limited insurance were the most frequent barriers to SUD and MH treatment, respectively, among older adults, and they were less likely than younger age groups to report stigma/confidentiality concerns for MH treatment. Older adults will become a larger portion of the total U.S. population with SUD and/or MH problems. Healthcare providers should be alert to the need to help older adults with SUD and/or MH problems obtain treatment. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  7. Who Seeks Treatment When Medicine Opens the Door to Pathological Gambling Patients—Psychiatric Comorbidity and Heavy Predominance of Online Gambling

    Directory of Open Access Journals (Sweden)

    Anders Håkansson

    2017-11-01

    Full Text Available BackgroundFew studies have assessed treatment-seeking behavior and patient characteristics in pathological gambling focusing on psychiatric comorbidity, particularly in a setting of heavy exposure to online gambling. This study aimed to address patient characteristics in a novel health care-based treatment modality for pathological gambling, including potential associations between gambling types, psychiatric comorbidity, and gender.MethodsAll patients undergoing structured assessment between January 2016 and April 2017 were included (N = 106, and patient records were reviewed for cooccurring psychiatric disorders and types of problem games.ResultsEighty percent were men, and 58% received a psychiatric disorder apart from pathological gambling. Problematic gambling on online casino and online sports betting represented 84% of patients. Non-substance-related psychiatric comorbidity was significantly associated with female gender.ConclusionOnline gambling is more clearly predominating in this setting than in studies from other countries. High rates of comorbidity call for structured psychiatric assessment in problem gambling, with a particular focus on female patients with pathological gambling.

  8. The Perception of Threat from Emotions in Predicting Binge Eating Behaviours in People Who Are Obese and Seeking Treatment for Their Weight.

    Science.gov (United States)

    Fox, J R E; Msetfi, R M; Johnson, R S; Haigh, E

    2016-09-01

    The affect regulation theory suggests that people binge eat to regulate negative emotional states. In this study, we used a basic emotions perspective to consider the role of perceived threat of emotions, emotional suppression and reduced emotional expressiveness in predicting binge eating behaviours in people who are obese. Treatment-seeking participants with obesity (N = 51, body mass index range from 30.8 to 60.2 kg m -2 ) completed measures of 'perception of threat from emotion' as well as 'emotional expressiveness' and binge eating. The results demonstrated that perceived threat of sadness predicted binge eating (β = .55, p emotional expressiveness mediated the relationship between perceived threat of fear and binge eating (β = .25, 95%). These findings are contextualized within a theoretical perspective that suggests that individuals who binge eat are threatened by certain emotional states and they use binge eating to suppress certain, but not all, emotional states. Copyright © 2015 John Wiley & Sons, Ltd. Considering basic emotions within binge eating should be a part of a psychological assessment and treatment. This should consider how emotions could often be perceived as being threatening and their expression is limited. It is possible that the emotions of fear and sadness appear to be particularly threatening within binge eating/obese populations. Copyright © 2015 John Wiley & Sons, Ltd.

  9. Mental distress in treatment seeking young adults (18-25 years) with severe obesity compared with population controls of different body mass index levels: cohort study.

    Science.gov (United States)

    Dreber, H; Reynisdottir, S; Angelin, B; Tynelius, P; Rasmussen, F; Hemmingsson, E

    2017-02-01

    Young adults (18-25) with severe obesity constitute a challenging patient group, and there is limited evidence about their mental health status compared to population controls. Mental distress in treatment seeking young adults with severe obesity (n = 121, mean body mass index [BMI] = 39.8 kg m-2 ) was compared with matched (1:3 for age, gender and socioeconomic status) population controls of normal weight (n = 363, mean BMI = 22.4 kg m-2 ), as well as unmatched population controls with class I obesity (n = 105, mean BMI = 32.1 kg m-2 ) or severe obesity (n = 41, mean BMI = 39.7 kg m-2 ). Mental distress was measured by the General Health Questionnaire-12 (GHQ-12), and we quantified physician-diagnosed depression, present anxiety and suicide attempts. Poisson regression and linear regression analysis were used for analysing differences in mental distress between groups. Treatment seekers experienced more mental distress than normal weight controls as measured by continuous (adjusted mean: 3.9 vs. 2.2 points, P Treatment seekers also experienced more mental distress as measured by continuous GHQ-12 than controls with class I obesity (adjusted mean: 2.3 points) or severe obesity (adjusted mean: 2.1; both, P treatment seekers with severe obesity constitute a risk group for mental distress compared to population controls of different BMI levels. © 2017 World Obesity Federation.

  10. How Hugh Hampton Young's treatment of President Woodrow Wilson's urinary retention and urosepsis affected the resolution of World War I.

    Science.gov (United States)

    Fogg, Ryan; Kutikov, Alexander; Uzzo, Robert G; Canter, Daniel

    2011-09-01

    President Woodrow Wilson was never able to gain ratification of the Treaty of Versailles, the peace accord to end World War I. Before he could convince the American people of the importance of ratification, Wilson suffered a stroke followed by life threatening urinary sepsis due to urinary retention, and was treated by the father of modern urology, Hugh Hampton Young. The effects of these health problems are examined in the context of their implications on international affairs. Biographical sources and primary documentation of Wilson's physicians were reviewed to determine the effect of Wilson's stroke on his voiding habits. Hugh Hampton Young's evaluation and decision making is examined in depth. In the fall of 1919 President Wilson was recovering from a stroke. Shortly after the stroke his preexisting voiding dysfunction progressed to urinary retention from which urinary sepsis developed. Hugh Hampton Young advised on Wilson's case and counseled patience over surgery. The President began voiding spontaneously and recovered from sepsis. The illness left him severely weakened and unable to mount an aggressive campaign to persuade the U.S. Senate of the importance of ratifying the Treaty of Versailles. His personal physician, Admiral Cary T. Grayson, stated that the President was mentally never the same after the sepsis. Wilson's voiding dysfunction contributed to his inability to win approval for the Treaty of Versailles and the League of Nations. As a result, the United States returned to a policy of isolationism and Europe plunged into 2 decades of upheaval, leading to World War II. Copyright © 2011 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

  11. The effect of alternative graphical displays used to present the benefits of antibiotics for sore throat on decisions about whether to seek treatment: a randomized trial.

    Directory of Open Access Journals (Sweden)

    Cheryl L L Carling

    2009-08-01

    Full Text Available BACKGROUND: We conducted an Internet-based randomized trial comparing four graphical displays of the benefits of antibiotics for people with sore throat who must decide whether to go to the doctor to seek treatment. Our objective was to determine which display resulted in choices most consistent with participants' values. METHODS AND FINDINGS: This was the first of a series of televised trials undertaken in cooperation with the Norwegian Broadcasting Company. We recruited adult volunteers in Norway through a nationally televised weekly health program. Participants went to our Web site and rated the relative importance of the consequences of treatment using visual analogue scales (VAS. They viewed the graphical display (or no information to which they were randomized and were asked to decide whether to go to the doctor for an antibiotic prescription. We compared four presentations: face icons (happy/sad or a bar graph showing the proportion of people with symptoms on day three with and without treatment, a bar graph of the average duration of symptoms, and a bar graph of proportion with symptoms on both days three and seven. Before completing the study, all participants were shown all the displays and detailed patient information about the treatment of sore throat and were asked to decide again. We calculated a relative importance score (RIS by subtracting the VAS scores for the undesirable consequences of antibiotics from the VAS score for the benefit of symptom relief. We used logistic regression to determine the association between participants' RIS and their choice. 1,760 participants completed the study. There were statistically significant differences in the likelihood of choosing to go to the doctor in relation to different values (RIS. Of the four presentations, the bar graph of duration of symptoms resulted in decisions that were most consistent with the more fully informed second decision. Most participants also preferred this

  12. Sex differences in treatment-seeking behavior by education and marital status before and after admission to hospital. A register-based cohort study of the Danish population aged 50+

    DEFF Research Database (Denmark)

    Höhn, Andreas; Lindahl-Jacobsen, Rune; Rau, Roland

    A large body of previous research has shown that men tend to seek medical help less than women, which can lead to delays in diagnosis and treatment, and might explain a portion of the female advantage in survival. Using Danish register data, we identified all individuals aged 50+ who were admitted...... to hospital between 1999 and 2008. For this population, we identified all contacts with GPs between 1996 and 2011 to quantify the sex differences in treatment-seeking behavior within the 3-year periods before and after hospitalization, and to estimate the impact of the civil and educational status on the sex...

  13. Walk-ins seeking treatment at an emergency department or general practitioner out-of-hours service: a cross-sectional comparison.

    Science.gov (United States)

    Chmiel, Corinne; Huber, Carola A; Rosemann, Thomas; Zoller, Marco; Eichler, Klaus; Sidler, Patrick; Senn, Oliver

    2011-05-09

    Emergency Departments (ED) in Switzerland are faced with increasing numbers of patients seeking non-urgent treatment. The high rate of walks-ins with conditions that may be treated in primary care has led to suggestions that those patients would best cared for in a community setting rather than in a hospital. Efficient reorganisation of emergency care tailored to patients needs requires information on the patient populations using the various emergency services currently available. The aim of this study is to evaluate the differences between the characteristics of walk-in patients seeking treatment at an ED and those of patients who use traditional out-of-hours GP (General Practitioner) services provided by a GP-Cooperative (GP-C). In 2007 and 2009 data was collected covering all consecutive patient-doctor encounters at the ED of a hospital and all those occurring as a result of contacting a GP-C over two evaluation periods of one month each. Comparison was made between a GP-C and the ED of the Waid City Hospital in Zurich. Patient characteristics, time and source of referral, diagnostic interventions and mode of discharge were evaluated. Medical problems were classified according to the International Classification of Primary Care (ICPC-2). Patient characteristics were compared using non-parametric tests and multiple logistic regression analysis was applied to investigate independent determinants for contacting a GP-C or an ED. Overall a total of 2974 patient encounters were recorded. 1901 encounters were walk-ins and underwent further analysis (ED 1133, GP-C 768). Patients consulting the GP-C were significantly older (58.9 vs. 43.8 years), more often female (63.5 vs. 46.9%) and presented with non-injury related medical problems (93 vs. 55.6%) in comparison with patients at the ED. Independent determining factors for ED consultation were injury, male gender and younger age. Walk-in distribution in both settings was equal over a period of 24 hours and most common

  14. Understanding malaria treatment-seeking preferences within the public sector amongst mobile/migrant workers in a malaria elimination scenario: a mixed-methods study.

    Science.gov (United States)

    Win, Aung Ye Naung; Maung, Thae Maung; Wai, Khin Thet; Oo, Tin; Thi, Aung; Tipmontree, Rungrawee; Soonthornworasiri, Ngamphol; Kengganpanich, Mondha; Kaewkungwal, Jaranit

    2017-11-13

    Migration flows and the emerging resistance to artemisinin-based combination therapy in the Greater Mekong Sub-region (GMS) create programmatic challenges to meeting the AD 2030 malaria elimination target in Myanmar. The National Malaria Control Programme (NMCP) targeted migrant workers based mainly on the stability of their worksites (categories 1: permanent work-setting; categories 2 and 3: less stable work-settings). This study aims to assess the migration patterns, malaria treatment-seeking preferences, and challenges encountered by mobile/migrant workers at remote sites in a malaria-elimination setting. A mixed-methods explanatory sequential study retrospectively analysed the secondary data acquired through migrant mapping surveys (2013-2015) in six endemic regions (n = 9603). A multivariate logistic regression model was used to ascertain the contributing factors. A qualitative strand (2016-2017) was added by conducting five focus-group discussions (n = 50) and five in-depth interviews with migrant workers from less stable worksites in Shwegyin Township, Bago Region. The contiguous approach was used to integrate quantitative and qualitative findings. Among others, migrant workers from Bago Region were significantly more likely to report the duration of stay ≥ 12 months (63% vs. 49%) and high seasonal mobility (40% vs. 35%). Particularly in less stable settings, a very low proportion of migrant workers (17%) preferred to seek malaria treatment from the public sector and was significantly influenced by the worksite stability (adjusted OR = 1.4 and 2.3, respectively for categories 2 and 1); longer duration of stay (adjusted OR = 3.5); and adjusted OR < 2 for received malaria messages, knowledge of malaria symptoms and awareness of means of malaria diagnosis. Qualitative data further elucidated their preference for the informal healthcare sector, due to convenience, trust and good relations, and put migrant workers at risk of substandard care

  15. Walk-ins seeking treatment at an emergency department or general practitioner out-of-hours service: a cross-sectional comparison

    Directory of Open Access Journals (Sweden)

    Eichler Klaus

    2011-05-01

    Full Text Available Abstract Background Emergency Departments (ED in Switzerland are faced with increasing numbers of patients seeking non-urgent treatment. The high rate of walks-ins with conditions that may be treated in primary care has led to suggestions that those patients would best cared for in a community setting rather than in a hospital. Efficient reorganisation of emergency care tailored to patients needs requires information on the patient populations using the various emergency services currently available. The aim of this study is to evaluate the differences between the characteristics of walk-in patients seeking treatment at an ED and those of patients who use traditional out-of-hours GP (General Practitioner services provided by a GP-Cooperative (GP-C. Methods In 2007 and 2009 data was collected covering all consecutive patient-doctor encounters at the ED of a hospital and all those occurring as a result of contacting a GP-C over two evaluation periods of one month each. Comparison was made between a GP-C and the ED of the Waid City Hospital in Zurich. Patient characteristics, time and source of referral, diagnostic interventions and mode of discharge were evaluated. Medical problems were classified according to the International Classification of Primary Care (ICPC-2. Patient characteristics were compared using non-parametric tests and multiple logistic regression analysis was applied to investigate independent determinants for contacting a GP-C or an ED. Results Overall a total of 2974 patient encounters were recorded. 1901 encounters were walk-ins and underwent further analysis (ED 1133, GP-C 768. Patients consulting the GP-C were significantly older (58.9 vs. 43.8 years, more often female (63.5 vs. 46.9% and presented with non-injury related medical problems (93 vs. 55.6% in comparison with patients at the ED. Independent determining factors for ED consultation were injury, male gender and younger age. Walk-in distribution in both settings was

  16. Seeking New Treatments for Endometriosis

    Science.gov (United States)

    ... PFCs A specific ultraviolet filter (sunscreen) used in cosmetics High urine concentrations of chromium and copper Other ENDO data have recently shown that a history of infertility was associated with increased risk of ...

  17. Seeking New Treatments for Endometriosis

    Science.gov (United States)

    ... NICHD Research Information Find a Study More Information Preeclampsia and Eclampsia About NICHD Research Information Find a ... of the Director Director's Corner Office of Administrative Management (OAM) Office of Communications (OC) Office of Global ...

  18. American Orthopaedic Surgeons in World War I.

    Science.gov (United States)

    Green, David P; DeLee, Jesse C

    2017-04-05

    On April 6, 1917, the United States declared war on Germany and entered what was then called the Great War. Among the first officers sent to Europe were 21 orthopaedic surgeons in the so-called First Goldthwait Unit. Prior to the war, orthopaedics had been a nonoperative "strap-and-buckle" specialty that dealt primarily with infections, congenital abnormalities, and posttraumatic deformity. The Great War changed all of that forever, creating a new surgical specialty with emphasis on acute treatment, prevention of deformity, restoration of function, and rehabilitation.

  19. Children of Treatment-Seeking Depressed Mothers: A Comparison with the Sequenced Treatment Alternatives to Relieve Depression (STAR*D) Child Study

    Science.gov (United States)

    Batten, Lisa A.; Hernandez, Mariely; Pilowsky, Daniel J.; Stewart, Jonathan W.; Blier, Pierre; Flament, Martine F.; Poh, Ernest; Wickramaratne, Priya; Weissman, Myrna M.

    2012-01-01

    Objective: To estimate the prevalence of current psychiatric disorders among children and adolescents (collectively called children) of mothers entering treatment for depression; to examine maternal predictors of child psychopathology among children of depressed mothers; and to determine consistency of findings with a similar child study ancillary…

  20. Is body shame a significant mediator of the relationship between mindfulness skills and the quality of life of treatment-seeking children and adolescents with overweight and obesity?

    Science.gov (United States)

    Moreira, Helena; Canavarro, Maria Cristina

    2017-03-01

    This study aimed to examine (a) whether mindfulness skills were associated with higher quality of life through lower body shame for treatment-seeking children/adolescents with overweight and obesity and (b) whether this indirect effect was moderated by children/adolescents' age and gender. The sample included 153 children/adolescents with overweight/obesity followed in individual nutrition consultations. Participants completed self-report measures of mindfulness, body shame, and quality of life. Moderated mediation analyses showed that higher levels of mindfulness were associated with better perceived quality of life through lower body shame, but only among girls. For boys, higher levels of body shame did not translate into a poorer perception of quality of life, and the indirect effect of mindfulness on quality of life via lower body shame was not significant. These results suggest that body shame is an important mechanism to explain why mindfulness may help girls with overweight/obesity perceive a better quality of life. Copyright © 2016 Elsevier Ltd. All rights reserved.

  1. Types of gambling and levels of harm: A UK study to assess severity of presentation in a treatment-seeking population.

    Science.gov (United States)

    Ronzitti, Silvia; Soldini, Emiliano; Lutri, Vittorio; Smith, Neil; Clerici, Massimo; Bowden-Jones, Henrietta

    2016-09-01

    Background and aim Previous international research emphasized that some forms of gambling are more "addictive" than others. More recently, research has shown that we should shift our attention from the type of gambling activity to the level of involvement in a number of different gambling activities. The aim of our study was to verify whether a higher Problem Gambling Severity Index (PGSI) score was associated with particular gambling activities and evaluate the impact of involvement on gambling behavior. Methods A total of 736 treatment-seeking individuals with gambling disorder were assessed at the National Problem Gambling Clinic in London. First, the independent two-sample t-test and the Mann-Whitney test were used to verify if the PGSI score changed significantly according to the gambling activity at a bivariate level. Second, we conducted a cluster analysis and finally, we fitted a linear regression model in order to verify if some variables are useful to predict gambling addiction severity. Results The PGSI score was significantly higher for lower stakes gaming machine gamblers (1% significance level) and for fixed-odds betting terminal (FOBT) gamblers (5% significance level) at a bivariate level. Moreover, such finding was confirmed by cluster and linear regression analyses. Conclusions The results of this study indicated that gambling addiction severity was related to gambling involvement and, for a given level of gambling involvement, gambling addiction severity may vary according to gambling type, with a particularly significant increase for FOBT and gaming machine gambling.

  2. Prevalence and predictors of Axis I disorders in a large sample of treatment-seeking victims of sexual abuse and incest.

    Science.gov (United States)

    McElroy, Eoin; Shevlin, Mark; Elklit, Ask; Hyland, Philip; Murphy, Siobhan; Murphy, Jamie

    2016-01-01

    Childhood sexual abuse (CSA) is a common occurrence and a robust, yet non-specific, predictor of adult psychopathology. While many demographic and abuse factors have been shown to impact this relationship, their common and specific effects remain poorly understood. This study sought to assess the prevalence of Axis I disorders in a large sample of help-seeking victims of sexual trauma, and to examine the common and specific effects of demographic and abuse characteristics across these different diagnoses. The participants were attendees at four treatment centres in Denmark that provide psychological therapy for victims of CSA (N=434). Axis I disorders were assessed using the Millon Clinical Multiaxial Inventory-III (MCMI-III). Multivariate logistic regression analysis was used to examine the associations between CSA characteristics (age of onset, duration, number of abusers, number of abusive acts) and 10 adult clinical syndromes. There was significant variation in the prevalence of disorders and the abuse characteristics were differentially associated with the outcome variables. Having experienced sexual abuse from more than one perpetrator was the strongest predictor of psychopathology. The relationship between CSA and adult psychopathology is complex. Abuse characteristics have both unique and shared effects across different diagnoses.

  3. Prevalence and predictors of Axis I disorders in a large sample of treatment-seeking victims of sexual abuse and incest

    Directory of Open Access Journals (Sweden)

    Eoin McElroy

    2016-04-01

    Full Text Available Background: Childhood sexual abuse (CSA is a common occurrence and a robust, yet non-specific, predictor of adult psychopathology. While many demographic and abuse factors have been shown to impact this relationship, their common and specific effects remain poorly understood. Objective: This study sought to assess the prevalence of Axis I disorders in a large sample of help-seeking victims of sexual trauma, and to examine the common and specific effects of demographic and abuse characteristics across these different diagnoses. Method: The participants were attendees at four treatment centres in Denmark that provide psychological therapy for victims of CSA (N=434. Axis I disorders were assessed using the Millon Clinical Multiaxial Inventory-III (MCMI-III. Multivariate logistic regression analysis was used to examine the associations between CSA characteristics (age of onset, duration, number of abusers, number of abusive acts and 10 adult clinical syndromes. Results: There was significant variation in the prevalence of disorders and the abuse characteristics were differentially associated with the outcome variables. Having experienced sexual abuse from more than one perpetrator was the strongest predictor of psychopathology. Conclusions: The relationship between CSA and adult psychopathology is complex. Abuse characteristics have both unique and shared effects across different diagnoses.

  4. Weight bias internalization in treatment-seeking overweight adults: Psychometric validation and associations with self-esteem, body image, and mood symptoms.

    Science.gov (United States)

    Durso, Laura E; Latner, Janet D; Ciao, Anna C

    2016-04-01

    Internalized weight bias has been previously associated with impairments in eating behaviors, body image, and psychological functioning. The present study explored the psychological correlates and psychometric properties of the Weight Bias Internalization Scale (WBIS) among overweight adults enrolled in a behavioral weight loss program. Questionnaires assessing internalized weight bias, anti-fat attitudes, self-esteem, body image concern, and mood symptoms were administered to 90 obese or overweight men and women between the ages of 21 and 73. Reliability statistics suggested revisions to the WBIS. The resulting 9-item scale was shown to be positively associated with body image concern, depressive symptoms, and stress, and negatively associated with self-esteem. Multiple linear regression models demonstrated that WBIS scores were significant and independent predictors of body image concern, self-esteem, and depressive symptoms. These results support the use of the revised 9-item WBIS in treatment-seeking samples as a reliable and valid measure of internalized weight bias. Copyright © 2016. Published by Elsevier Ltd.

  5. History of sexual abuse and development of sexual risk behavior in low-income, urban African American girls seeking mental health treatment.

    Science.gov (United States)

    Wilson, Helen W; Emerson, Erin; Donenberg, Geri R; Pettineo, Laura

    2013-01-01

    This study examined relationships between sexual abuse and patterns of sexual risk-taking among low-income, urban African American adolescent girls seeking mental health treatment. Participants (N = 158) were 12- to 16-year-old African American girls recruited from outpatient mental health clinics serving urban, mostly low-socioeconomic status communities in Chicago, Illinois and followed for two years between 2003 and 2010. This study included self-reports of sexual abuse and four waves (T2-T5) of self-reported data on sexual experience and sexual risk-taking (number of partners, inconsistent condom use, and sex with a risky partner). Latent curve modeling was used to examine patterns of sexual behavior over the four time points with sexual abuse and mental health symptoms as covariates. Sexual abuse was significantly associated with T2 sexual experience, T2-T4 number of partners, T3 inconsistent condom use, and T2-T3 having a risky partner. These relationships decreased when mental health symptoms were controlled. This longitudinal study revealed a complex relationship between sexual abuse and sexual risk that would be missed if sexual risk were assessed at a single time point. Findings supported early intervention to delay onset of sexual risk behavior among low-income African American girls with mental health concerns and histories of sexual abuse.

  6. Residual injury, appearance-related concerns, symptoms of post-traumatic stress disorder, and depression within a treatment-seeking veteran sample.

    Science.gov (United States)

    Weaver, Terri L; Walter, Kristen H; Chard, Kathleen M; Bosch, Jeane

    2014-10-01

    This study explored the associations among injury-related appearance changes experienced during deployment/combat, symptom severity of post-traumatic stress disorder and depression, and body image distress within a treatment-seeking veteran population (n = 91). Thirty-three percent of the sample reported having an appearance-related residual injury experienced during combat or deployment (n = 30). A subsample, who completed the body image distress measure (n = 69), was divided into two groups: those with an appearance-related residual injury (n = 22) and those without an appearance-related residual injury (n = 47). Correlational analyses revealed significant, positive correlations between body image distress and depression symptom severity. Results also showed a trend relationship between body image distress and post-traumatic stress disorder symptom severity for those with an appearance-related residual injury although correlations were nonsignificant among these constructs for those without an appearance-related residual injury. Multiple regression analyses revealed that body image distress was a unique predictor of depression symptom severity, controlling for residual injury status. Implications of these findings for exploring the psychological impact of residual injury were discussed. Reprint & Copyright © 2014 Association of Military Surgeons of the U.S.

  7. Subjective and objective binge eating in relation to eating disorder symptomatology, depressive symptoms, and self-esteem among treatment-seeking adolescents with bulimia nervosa.

    Science.gov (United States)

    Fitzsimmons-Craft, Ellen E; Ciao, Anna C; Accurso, Erin C; Pisetsky, Emily M; Peterson, Carol B; Byrne, Catherine E; Le Grange, Daniel

    2014-07-01

    This study investigated the importance of the distinction between objective (OBE) and subjective binge eating (SBE) among 80 treatment-seeking adolescents with bulimia nervosa. We explored relationships among OBEs, SBEs, eating disorder (ED) symptomatology, depression, and self-esteem using two approaches. Group comparisons showed that OBE and SBE groups did not differ on ED symptoms or self-esteem; however, the SBE group had significantly greater depression. Examining continuous variables, OBEs (not SBEs) accounted for significant unique variance in global ED pathology, vomiting, and self-esteem. SBEs (not OBEs) accounted for significant unique variance in restraint and depression. Both OBEs and SBEs accounted for significant unique variance in eating concern; neither accounted for unique variance in weight/shape concern, laxative use, diuretic use, or driven exercise. Loss of control, rather than amount of food, may be most important in defining binge eating. Additionally, OBEs may indicate broader ED pathology, while SBEs may indicate restrictive/depressive symptomatology. Copyright © 2014 John Wiley & Sons, Ltd and Eating Disorders Association.

  8. Vietnam: Historians at War

    Science.gov (United States)

    Moyar, Mark

    2008-01-01

    Although the Vietnam War ended more than thirty years ago, historians remain as divided on what happened as the American people were during the war. Mark Moyar maps the ongoing battle between "orthodox" and "revisionist" Vietnam War historians: the first group, those who depict Vietnam as a bad war that the United States should…

  9. Abolishing Fees at Health Centers in the Context of Community Case Management of Malaria: What Effects on Treatment-Seeking Practices for Febrile Children in Rural Burkina Faso?

    Directory of Open Access Journals (Sweden)

    Thomas Druetz

    Full Text Available Burkina Faso started nationwide community case management of malaria (CCMm in 2010. In 2011, health center user fees for children under five were abolished in some districts.To assess the effects of concurrent implementation of CCMm and user fees abolition on treatment-seeking practices for febrile children.This is a natural experiment conducted in the districts of Kaya (CCMm plus user fees abolition and Zorgho (CCMm only. Registry data from 2005 to 2014 on visits for malaria were collected from all eight rural health centers in the study area. Annual household surveys were administered during malaria transmission season in 2011 and 2012 in 1,035 randomly selected rural households. Interrupted time series models were fitted for registry data and Fine and Gray's competing risks models for survey data.User fees abolition in Kaya significantly increased health center use by eligible children with malaria (incidence rate ratio for intercept change = 2.1, p <0.001. In 2011, in Kaya, likelihood of health center use for febrile children was three times higher and CHW use three times lower when caregivers knew services were free. Among the 421 children with fever in 2012, the delay before visiting a health center was significantly shorter in Kaya than in Zorgho (1.46 versus 1.79 days, p <0.05. Likelihood of visiting a health center on the first day of fever among households <2.5 km or <5 km from a health center was two and three times higher in Kaya than in Zorgho, respectively (p <0.001.User fees abolition reduced visit delay for febrile children living close to health centers. It also increased demand for and use of health center for children with malaria. Concurrently, demand for CHWs' services diminished. User fees abolition and CCMm should be coordinated to maximize prompt access to treatment in rural areas.

  10. Asymmetries in rent seeking

    NARCIS (Netherlands)

    Dari-Mattiacci, G.; Langlais, E.; Lovat, B.; Parisi, F.; Congleton, R.D.; Hillman, A.L.

    2015-01-01

    In rent-seeking contests, players are seldom identical to one another. In this chapter, we examine the rent-seeking literature that explores the effects of specific forms of asymmetry between contestants. We consider Tullock’s rent-seeking contests involving two players who differ in strength

  11. Collaborative information seeking

    DEFF Research Database (Denmark)

    Hertzum, Morten

    2008-01-01

    Since common ground is pivotal to collaboration, this paper proposes to define collaborative information seeking as the combined activity of information seeking and collaborative grounding. While information-seeking activities are necessary for collaborating actors to acquire new information......, the activities involved in information seeking are often performed by varying subgroups of actors. Consequently, collaborative grounding is necessary to share information among collaborating actors and, thereby, establish and maintain the common ground necessary for their collaborative work. By focusing...... on the collaborative level, collaborative information seeking aims to avoid both individual reductionism and group reductionism, while at the same time recognizing that only some information and understanding need be shared....

  12. A developmental-based motivational intervention to reduce alcohol and marijuana use among non-treatment-seeking young adults: a randomized controlled trial.

    Science.gov (United States)

    Stein, Michael D; Caviness, Celeste M; Morse, Emily F; Grimone, Kristin R; Audet, Daniel; Herman, Debra S; Moitra, Ethan; Anderson, Bradley J

    2017-09-02

    To test the hypothesis that among non-treatment-seeking emerging adults (EA) who both use marijuana and have alcohol binges, a brief, longitudinally delivered, developmentally based motivational intervention would show greater reductions in the use of these two substances compared with a health education control condition. Parallel, two-group, randomized controlled trial with follow-up interventions conducted at 1, 3, 6 and 9 months and final assessments at 12 and 15 months. Hospital-based research unit in the United States. Community-based 18-25-year-olds who reported at least monthly binge drinking and at least weekly marijuana use. Motivational intervention (EA-MI) focused primarily on themes of emerging adulthood (identity exploration, instability, self-focus, feeling in-between, a sense of possibilities) and the subjects' relationship to substance use (n = 110) compared with an attention-matched health education control condition (n = 116). The primary outcomes were days of binge alcohol, marijuana and dual use day as measured using the timeline follow-back method analysing the treatment by time interaction to determine relative differences in the rate of change between intervention arms. At baseline, the mean rate (days/30) of binge drinking was 5.23 (± 4.31) of marijuana use was 19.4 (± 10.0) and of dual (same day) use was 4.11 (± 4.13). Relative to baseline, there were reductions in the rate of binge alcohol use, marijuana use and days of combined binge alcohol and marijuana use (P < 0.001) at all follow-up assessments. However, the treatment × time interaction was not statistically significant for alcohol (P = 0.37), for marijuana (P = 0.07) or for dual use (P = 0.55). Averaged over all follow-ups, mean reductions in binge, marijuana and dual use days were 1.16, 1.45 and 1.08, respectively, in the health education arm, and 1.06, 1.69 and 0.96 in EA-MI. Bayes factors were < 0.01 for frequency of binge alcohol use and frequency of dual

  13. Patient reported delays in seeking treatment for Tuberculosis (TB among adult and pediatric TB patients and TB patients co-infected with HIV in Lima, Peru: a qualitative study

    Directory of Open Access Journals (Sweden)

    Valerie A Paz-Soldan

    2014-12-01

    Full Text Available Abstract: Tuberculosis (TB remains a significant public health challenge worldwide, and particularly in Peru with one of the highest incidence rates in Latin America. TB patient behavior has a direct influence on whether a patient will receive timely diagnosis and successful treatment of their illness. Objectives: The objective was to understand the complex factors that can impact TB patient health seeking behavior. Methods: In-depth interviews were conducted with adult and parents of pediatric patients receiving TB treatment (n=43, within that group a sub-group was also co-infected with HIV (n=11. Results: Almost all of the study participants recognized delays in seeking either their child’s or their own diagnosis of their TB symptoms. The principal reasons for treatment-seeking delays were lack of knowledge and confusion of tuberculosis symptoms, fear and embarrassment of receiving a TB diagnosis, and a patient tendency to self-medicate prior to seeking formal medical attention.Conclusions: Health promotion activities that target patient delays have the potential to improve individual patient outcomes and mitigate the spread of TB at a community level.

  14. Psychometric properties and construct validity of the brief Wisconsin inventory of smoking dependence motives in an Internet-based sample of treatment-seeking Hungarian smokers.

    Science.gov (United States)

    Vajer, Péter; Urbán, Róbert; Tombor, Ildikó; Stauder, Adrienne; Kalabay, László

    2011-04-01

    Both full and brief versions of the Wisconsin Inventory of Smoking Dependence are promising new measurement tools for studying tobacco dependence. We assessed the psychometric properties and construct validity of the Wisconsin Inventory of Smoking Dependence Motives (WISDM)-68 and WISDM-37. Participants were adult, treatment-seeking Hungarian daily smokers (N = 720) with Internet access who were also registered on a smoking cessation Web site. Using confirmatory factor analyses (CFAs), we tested the measurement models of both WISDM-68 and WISDM-37, internal consistency of subscales of WISDM-37, and gender invariance. We tested the associations between heaviness of smoking, tobacco dependence symptoms, smoking environment, and subscales of WISDM-37. Although the measurement model of WISDM-68 did not fit adequately, the measurement model of WISDM-37, including 11 correlating factors (affiliative attachment, automaticity, loss of control, cognitive enhancement, craving, cue exposure/associative processes, social/environmental goads, taste, tolerance, weight control, affective enhancement), satisfactorily represents the data. Latent structures are equal in both genders. Internal consistency of subscales of WISDM-37 ranges between 0.67 and 0.90. Tobacco dependence symptoms were significantly linked with all motives, heaviness of smoking was related significantly only to affiliative attachment, automaticity, loss of control, cognitive enhancement, craving, and tolerance, while tobacco dependence symptoms and gender were controlled. Gender was associated only with the weight control motive. Concurring with previous reports using other types of sample, WISDM-37 has sufficient psychometric properties and good construct validity to make it useful in measuring the multidimensional nature of tobacco dependence even in Internet-based research. Without precedent, gender equality of WISDM-37 is also supported.

  15. The relationship between parent feeding styles and general parenting with loss of control eating in treatment-seeking overweight and obese children.

    Science.gov (United States)

    Matheson, Brittany E; Camacho, Casandra; Peterson, Carol B; Rhee, Kyung E; Rydell, Sarah A; Zucker, Nancy L; Boutelle, Kerri N

    2015-11-01

    To examine differences in parent feeding behaviors and general parenting of overweight children with and without loss of control (LOC) eating. One-hundred-and-eighteen overweight and obese children (10.40 ± 1.35 years; 53% female; 52% Caucasian; BMI-z: 2.06 ± 0.39) and their parents (42.42 ± 6.20 years; 91% female; 70% Caucasian; BMI: 31.74 ± 6.96 kg/m(2) ) were seen at a baseline assessment visit for a behavioral intervention that targeted overeating. The Eating Disorder Examination, adapted for children (ChEDE) was administered to assess for LOC eating. Parents completed the Parental Feeding Styles Questionnaire (PFSQ) and the Child Feeding Questionnaire (CFQ) to assess parent feeding styles and behaviors. Children also completed a self-report measure of general parenting (Child Report of Parent Behavior Inventory, CRPBI-30). Forty-three children (36.40%) reported at least one LOC eating episode in the month prior to assessment. Parents who reported greater restriction and higher levels of pressure to eat were more likely to have children that reported LOC eating (ps Parents who utilized more instrumental feeding and prompting/encouragement to eat techniques were less likely to have children that reported LOC eating (ps parenting behaviors were unrelated to child LOC eating (ps > 0.05). Parent feeding styles and behaviors appear to be differentially and uniquely related to LOC eating in treatment-seeking overweight and obese children. Future research is needed to determine if implementing interventions that target parent feeding behaviors may reduce LOC eating, prevent full-syndrome eating disorders, and reduce weight gain in youth. © 2015 Wiley Periodicals, Inc.

  16. Patterns of Change in Weekend Drinking Cognitions Among Non–Treatment-Seeking Young Adults During Exposure to a 12-Week Text Message Intervention

    Science.gov (United States)

    Suffoletto, Brian; Chung, Tammy

    2016-01-01

    Objective: We sought to identify patterns of response (latent classes) to a text-message (short message service) intervention based on weekend drinking cognitions (e.g., drinking plans, commitment to a low consumption goal), and to examine how the latent classes differed in baseline characteristics and alcohol consumption outcomes. Method: We conducted a secondary analysis of 384 non–treatment seeking young adults with hazardous alcohol use randomly assigned to a 12-week short message service intervention. Responses to weekly short message service queries related to weekend drinking cognitions were categorized as (a) planned not to drink, (b) planned to drink but did not plan a heavy drinking episode (HDE), (c) planned to have an HDE but willing to limit alcohol consumption, (d) planned to have an HDE and not willing to limit alcohol consumption We used repeated-measures latent class analysis to identify distinct classes based on these categories and examined associations of the classes with baseline covariates and alcohol consumption outcomes through 6 months. Results: We identified the following three latent classes: planned not to drink (62%), willing to limit drinks (27%), and not willing to limit drinks (12%). The “not willing to limit drinks” class exhibited the least reductions in alcohol consumption and was more likely to include White individuals and those with higher baseline drinking severity. The “planned not to drink” class had the greatest reductions in alcohol consumption. Conclusions: Young adults who exhibited low likelihood of committing to goals to limit weekend drinking were less responsive to short message service intervention, suggesting the need for alternative interventions. PMID:27797693

  17. Prospective Assessment of Nocturnal Awakenings in a Case Series of Treatment-Seeking Chronic Insomnia Patients: A Pilot Study of Subjective and Objective Causes

    Science.gov (United States)

    Krakow, Barry; Romero, Edward; Ulibarri, Victor A.; Kikta, Shara

    2012-01-01

    assessment of nocturnal awakenings in a case series of treatment-seeking chronic insomnia patients: a pilot study of subjective and objective causes. SLEEP 2012;35(12):1685-1692. PMID:23204611

  18. Over-expression of CD8+ T-cell activation is associated with decreased CD4+ cells in patients seeking treatment of Alcohol Use Disorder.

    Science.gov (United States)

    Zuluaga, Paola; Sanvisens, Arantza; Martínez-Cáceres, Eva; Teniente, Aina; Tor, Jordi; Muga, Robert

    2017-11-01

    Harmful alcohol consumption may have an impact on the adaptive immune system through an imbalance in T cell subpopulations and changes in cell activation. We aimed to analyze profiles of CD4 and CD8T cell activation in patients with alcohol use disorder (AUD). We used a cross-sectional study with patients seeking treatment of the disorder. Blood samples for immunophenotyping were obtained at admission. Profiles of T cell activation were defined: (I) CD38+/HLA-DR+, (II) CD38+/HLA-DR-, (III) CD38-/HLA-DR+, (IV) CD38-/HLA-DR- and compared with healthy controls. We calculated a CD8+ T cell activation indicator (AI) that was defined as the quotient of non-activated cells (CD38-/HLA-DR-) and activated cells (CD38+/HLA-DR+). 60 patients were eligible (83%M); median age was 49 years [IQR: 44-54] and alcohol consumption was 145g/day [IQR: 90-205]. Mean±SD of CD38+/HLA-DR- was 50.3±50.6 cells/μL in patients and 33.5±24.5 cells/