Patterns of childhood trauma and psychological distress among injecting heroin users in China.
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ABSTRACT:
SUBMITTER: Wang Z
PROVIDER: S-EPMC3012100 | biostudies-other | 2010 Dec
REPOSITORIES: biostudies-other
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Project description:OBJECTIVE:With an emphasis on betrayal trauma, this study used latent profile analysis to examine how childhood traumas co-occur and whether trauma patterns differentially predicted psychological distress. METHOD:A community sample of 806 adolescents and young adults participated. Youths reported their trauma histories, and lifetime DSM-IV disorders were assessed using a structured diagnostic interview. RESULTS:Latent profile analysis yielded 5 profiles: high betrayal trauma physical violence and emotional abuse (HBTPE), high betrayal trauma sexual and emotional abuse (HBTSE), low betrayal trauma (LBT), parent death (PD), and a no/low trauma profile. Logistic regression analyses compared youths in the no/low trauma profile to those in the trauma profiles. Youths in the HBTPE profile were more likely to have moderate/severe major depressive disorder (odds ratio [OR] = 2.92, 95% CI [1.16, 7.32]), posttraumatic stress disorder (OR = 4.33, 95% CI [1.34, 14.03]), and hallucinations (OR = 5.03, 95% CI [2.00, 12.67]); youths in the HBTSE and LBT profiles were more likely to experience hallucinations (OR = 3.19, 95% CI [1.21, 8.39] and OR = 3.20, 95% CI [1.01, 10.19], respectively); and youths in the PD profile were more likely to have moderate/severe depression (OR = 2.42, 95% CI [1.07, 5.43]). CONCLUSIONS:Specific trauma types co-occurred when considering type, level of betrayal, and frequency. The emergence of the 2 high betrayal trauma profiles, with differing symptom presentations, suggests that experiences of high betrayal traumas are not homogenous and specific trauma-focused interventions may be more appropriate for differing trauma profiles.
| S-EPMC4767667 | biostudies-literature
Project description:BackgroundThis study investigated longitudinal patterns of psychological distress in adult survivors of childhood cancer.MethodsParticipants included 4569 adult survivors in the Childhood Cancer Survivor Study Cohort (CCSS) who completed the Brief Symptom Inventory-18 on three occasions between 1994 and 2010. Longitudinal latent class analysis was used to identify discrete classes of psychological distress. Predictors of class membership were examined through logistic regression modelling with odds ratios (ORs) and 95% confidence intervals (CIs) reported.ResultsSurvivors were a median of 39 years of age and 30 years from diagnosis at the most recent follow-up. Most survivors reported few or no symptoms of distress over time, although subsets of survivors reported persistently elevated (depression: 8.9%; anxiety: 4.8%; somatisation: 7.2%) or significant increases in distress symptoms over the follow-up period (depression: 10.2%; anxiety: 11.8%; somatisation: 13.0%). Increasing distress symptoms were predicted by survivor perception of worsening physical health over time (depression: OR=3.3; 95% CI=2.4-4.5; anxiety: OR=3.0; 95% CI=2.2-4.0; somatisation: OR=5.3; 95% CI=3.9-7.4). Persistent distress symptoms were also predicted by survivor perception of worsening physical health over time, as well as by worsening pain and ending analgesic use.ConclusionSubgroups of adult survivors are at-risk for chronic distress or significant increases in distress decades following their original cancer diagnosis. Routine screening of psychological distress in adult survivors of childhood cancer is warranted, especially for survivors who experience physical health morbidities.
| S-EPMC3778287 | biostudies-literature
Project description:BackgroundStudies have identified differential substance use patterns by racial groups. One of the most commonly reported differences is a higher rate of injection drug use (IDU) among Non-Hispanic Whites compared to African Americans, but this is complicated by factors related to IDU (e.g., earlier drug-use initiation) that overlap with being White.ObjectiveWe explored differential substance use-patterns by racial groups within a sample of injection heroin users.MethodsSubstance-use data were collected from 373 not-in-treatment heroin users who endorsed any lifetime injection use (69.4% male). We examined differences in substance-use patterns (e.g., age of initiation, gateway adherence) by racial groups. Multiple t-tests with Bonferroni correction were conducted to understand which demographic and substance-use characteristics varied by racial groups.ResultsRelative to Non-Hispanic Whites, African Americans (45.8% of sample) were more likely to start using heroin earlier in their life, but also more likely to experience a longer delay between starting and regularly using heroin. We also identified differences in the degree of (injection) heroin-use consequences by racial groups. After correcting for multiple comparisons and controlling for age and gender, we observed differences for six substance-use and demographic characteristics by racial group. White participants were younger, started cocaine use earlier, and experienced more heroin-use consequences across two separate domains.ConclusionsAfter controlling for injection use, we observed differential substance-use characteristics by racial groups. The findings could be used to develop targeted prevention and harm-reduction strategies.
| S-EPMC7454016 | biostudies-literature
Project description:The harm associated with high-risk injected opiate use and the threat of the HIV epidemic among injecting drug users has become a worldwide problem. Twenty years ago, in the face of a rapid increase in mortality rates among injecting drug users and the upcoming threat of HIV, the first harm-reduction programs were implemented in the Western world. This paper is a literature review describing four forms of harm reduction currently in use in Europe, North America, and Australia. Each represents a reasonable counterapproach to the threat of increased prevalence of HIV among injecting drug users in transitional and developing countries. The paper attempts to explain the concepts behind the most commonly used types of harm reduction and provides a brief overview of the advantages and disadvantages of each and the reasons for their implementation. The main focus of the review is on the definition and the practical aspects of harm reduction; it includes a brief introduction of Chinese harm-reduction efforts and their implications.
| S-EPMC4002817 | biostudies-other
Project description:The objective of the study was to describe psychological features of abstinent heroin users undergoing rehabilitation in Saint Petersburg, Russia. Study subjects (n?=?197) were recruited prospectively at the time of their admission to rehabilitation between March 2010 and May 2011 at 7 inpatient opiate addiction rehabilitation centers in Saint-Petersburg and neighboring regions, Russia. The centers provided varying rehabilitation programs; 6 of them were religious centers. Socio-demographic information and self-reported HIV status were collected. Personality profiles and severity of drug-associated problems were estimated before and after rehabilitation using the Minnesota Multiphasic Personality Inventory 2 (MMPI-2), and the Addiction Severity Index (ASI).Thirty-three (17%) subjects dropped out before completing rehabilitation (non-completers). All subjects (completers and non-completers) had psychopathological personality profiles according to MMPI-2. These profiles were refractory to clinically significant improvement after rehabilitation, although some statistically significant changes toward improvement were observed. ASI scores showed statistically and clinically significant improvements after rehabilitation on all scales. Participants in longer-term versus shorter-term rehabilitation programs showed similar changes in their pre- and post-rehabilitation MMPI-2 and ASI scores. Our results suggest that unmet psychiatric needs should be addressed to potentially improve treatment completion in this population.
| S-EPMC6092806 | biostudies-other
Project description:The COVID-19 pandemic has a great impact on society as a whole. Yet the pandemic and associated mandatory lockdown in several countries may have increased the vulnerability of certain populations. The present study aimed to document the frequency of clinical level of psychological distress and COVID-19 related post-traumatic stress symptoms in youth during the first wave of the pandemic. The study more specifically explored the role of prior trauma and adverse life events as a vulnerability factor for negative outcomes. A sample of 4914 adolescents and young adults from the province of Quebec, Canada was recruited online through social networks during the first wave of COVID-19. Results revealed that 26.6% of youth displayed serious psychological distress and 20.3% probable PTSD symptoms. The number of past traumas and adversity experienced showed a dose-response relation with the prevalence of psychological distress and PTSD. After controlling for socio-demographic characteristics and COVID-19 related variables (exposure, fear, suspicion of having the infection), participants with a history of five traumas and more presented a two-fold risk of serious psychological distress and probable PTSD. Emotion dysregulation was also associated with an increased risk of symptoms while resilience was linked to a reduced risk of distress.
| S-EPMC9682866 | biostudies-literature
Project description:OBJECTIVE:Distress tolerance (DT; the perceived or actual ability to withstand negative internal states) has emerged as a promising transdiagnostic risk factor in clinically severe populations. However, little is known about etiological factors associated with the development of DT. We hypothesized that greater levels of childhood trauma would be associated with lower perceived and behavioral DT, beyond theoretically relevant covariates. METHOD:The current investigation evaluated several childhood trauma types (i.e., physical abuse, sexual abuse, emotional abuse, physical neglect, and emotional neglect) in relation to perceived (i.e., self-report) and behavioral DT in a sample of 87 trauma-exposed adults in acute-care psychiatric inpatient treatment. RESULTS:Results of hierarchical linear regression models indicated that greater childhood physical abuse and emotional neglect were significantly associated with higher perceived DT. Greater levels of emotional abuse were associated with lower perceived DT, and greater physical neglect was associated with lower behavioral DT. CONCLUSIONS:DT may be differentially influenced by different forms of childhood trauma. (PsycINFO Database Record
| S-EPMC5792367 | biostudies-literature
Project description:The number of poly-drug users who mix use heroin and synthetic drugs (SD) is increasing worldwide. The objective of this study is to measure the risk factors for being infected with hepatitis C (HCV), human immunodeficiency virus (HIV) and syphilis among SD-only users, heroin-only users and poly-drug users. A cross-sectional study was conducted in 2015 from a national HIV surveillance site in Southwest China, 447 poly-drug, 526 SD-only and 318 heroin-only users were recruited. Poly-drug users have higher drug-use frequency, higher rates of drug-sharing and unsafe sexual acts than other users (p < 0.05). About a third (36.7%) of poly-drug users experienced sexual arousal due to drug effects, which is higher than the rate among other drug users. Poly-drug users had the highest prevalence of HIV (10.5%) and syphilis (3.6%), but heroin-only users had the highest prevalence of HCV (66.0%) (all p < 0.05) among three groups. Logistic regression shows among poly-drug users, having sex following drug consumption and using drugs ≥1/day were the major risk factors for both HIV (Adjusted odds ratio (AOR) = 2.4, 95% CI [1.8-3.4]; 2.3, [1.6-3.1]) and syphilis infection (AOR = 4.1, [2.1-6.9]; 3.9, [1.8-5.4]). Elevated risk of both HIV and syphilis infection have been established among poly-drug users.
| S-EPMC5919913 | biostudies-literature
Project description:BackgroundUnanticipated severe injury to part of the musculoskeletal system, referred to as orthopedic trauma, can be debilitating. It can also be accompanied by equally debilitating psychological distress, but little is known about the effective interventions for psychological sequelae of orthopedic trauma.Questions/purposesWe sought to determine the effectiveness of interventions on psychological outcomes, such as post-traumatic stress disorder (PTSD), depression, and pain catastrophizing (feelings of helplessness, excessive rumination, and exaggerated description of pain), after major orthopedic trauma.MethodsUsing the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement as guidelines, we systematically searched Scopus, PubMed, and Google Scholar. Studies included for review were English-language interventional studies in an orthopedic trauma population that included assessment of post-injury psychological distress or disability as either a primary or secondary aim.ResultsTwelve studies were identified, including six randomized trials, three prospective cohort studies, and three retrospective cohort studies. Study sample sizes ranged from 48 to 569 patients, the mean age ranged from 29 to 52.8 years, and the percentage of male patients ranged from 38 to 90%. We examined four categories of interventions. Peer group treatment (one study) significantly reduced rates of depression but had low participation rates. Brief interventions to teach coping and self-efficacy skills (two studies) decreased depression, pain catastrophizing, and anxiety scores while increasing self-efficacy on short-term follow-up. Individualized counseling and rehabilitation (four studies) resulted in a consistent reduction in the risk of PTSD. Early amputation was found to result in lower rates of PSTD than limb salvage in US military personnel (four studies). One study examined surgeons' confidence in dealing with possible psychological distress; surgeons who participated in a program on collaborative care were significantly more confident that they could help their patients with such issues.ConclusionInterventional strategies, including group interventions, brief individual interventions, longitudinal counseling, and consideration of early amputation in selected populations have proved effective in reducing negative psychological sequelae of major orthopedic trauma. Further research that determines the effects of interventions in this population is needed.
| S-EPMC7534886 | biostudies-literature
Project description:OBJECTIVE:To explore HIV virological failure and drug resistance among injecting drug users (IDUs) receiving first-line antiretroviral treatment (ART) in China. DESIGN:A series of cross-sectional surveys from 2003 to 2012 from the Chinese National HIV Drug Resistance (HIVDR) Surveillance and Monitoring Network. SETTING:China. PARTICIPANTS:Data were analysed by the Chinese National (HIVDR) Surveillance and Monitoring Network from 2003 to 2012. Demographic, ART and laboratory data (CD4+ cell count, viral load and drug resistance) were included. Factors associated with virological failure were identified by logistic regression analysis. RESULTS:929 of the 8556 individuals in the Chinese HIVDR database were IDUs receiving first-line ART. For these 929 IDUs, the median duration of treatment was 14?months (IQR 6.0-17.8). 193 of the 929 IDUs (20.8%) experienced virological failure (HIV viral load ?1000 copies/mL). The prevalence of HIVDR among patients with virological failure was 38.9% (68/175). The proportion of patients with drug resistance to non-nucleoside reverse transcriptase inhibitor (NNRTIs), nucleoside reverse transcriptase inhibitor (NRTIs) and protease inhibitors (PIs) was 52.9%, 76.5% and 4.4%, respectively. Factors independently associated with virological failure include: ethnic minorities, junior high school education or less, farmers, self-reported missing doses in the past month, CD4 cell count at survey from 200 to 349 cells/mm(3) or from 0 to 199 cells/mm(3), and residence of Guangxi and Yunnan provinces. CONCLUSIONS:The proportion of virological failure was high among IDUs receiving first-line ART in China. However, better treatment outcomes were observed in Guangxi and Yunnan, which indicates the importance of ART education and adherence to intervention, especially for patients who are farmers, minorities or have a poor educational background.
| S-EPMC4202012 | biostudies-literature