Violence, addiction, recovery: An anthropological study of Mexico's anexos.
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ABSTRACT:
SUBMITTER: Garcia A
PROVIDER: S-EPMC5531188 | biostudies-other | 2016 Aug
REPOSITORIES: biostudies-other
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Project description:BackgroundRecovery, a primary goal of addiction treatment, goes beyond abstinence. Incorporating broad domains with key elements that vary across individuals, recovery is a difficult concept to measure. Most addiction-related quality measurement has emphasized process measures, which limits evaluation of treatment quality and long-term outcomes, whereas patient-reported outcomes are richer and nuanced. To address these gaps, this study developed and tested a patient-reported outcome measure for addiction recovery, named Response to Addiction Recovery (R2AR).MethodsA multi-stage mixed methods approach followed the Patient-Reported Outcomes Measurement Information System (PROMIS) measure development standard. People with lived experience (PWLE) of addiction, treatment providers, and other experts contributed to item distillation and iterative measure refinement. From an item bank of 356 unique items, 57 items were tested via survey and interviews, followed by focus groups and cognitive interviews.ResultsFace validity was demonstrated throughout. PWLE rated item importance higher and with greater variance than providers, yet both agreed that "There are more important things to me in my life than using substances" was the most important item. The final R2AR instrument has 19 items across 8 recovery domains, spanning early, active, and long-term recovery phases. Respondents assess agreement for each item as (1) a strength, and (2) importance to ongoing recovery.ConclusionR2AR allows PWLE to define what is important to their recovery. It is designed to support treatment planning as part of clinical workflows and to track recovery progress. Inclusion of PWLE and providers in the development process enhances its face validity. Including PWLE in the development of R2AR and using the tool to guide recovery planning emphasizes the importance of patient-centeredness in designing clinical tools and involving patients in their own care.
| S-EPMC10474628 | biostudies-literature
Project description:BACKGROUND:Few studies have explored longitudinal change in event-related brain responses during early recovery from addiction. Moreover, existing findings yield evidence of both increased and decreased signaling within reward and control centers over time. The current study explored reward- and control-related signals in a risky decision-making task and specifically investigated parametric modulations of the BOLD signal, rather than signal magnitude alone. It was hypothesized that risk-related signals during decision-making and outcome evaluation would reflect recovery and that change in specific signals would correspond with improved treatment outcomes. METHODS:Twenty-one substance dependent individuals were recruited upon enrollment in community-based substance use treatment programs, wherein they received treatment-as-usual. Participants completed functional neuroimaging assessments at baseline and 3-month follow-up while performing the Balloon Analogue Risk Task (BART). Risk- and reward-sensitive signals were identified using parametric modulators. Substance use was tracked throughout the 3-month study interval using the timeline follow-back procedure. RESULTS:Longitudinal contrasts of parametric modulators suggested improved formation of risk-informed outcome expectations at follow-up. Specifically, a greater response to high risk (low-likelihood) positive feedback was identified in caudal anterior cingulate cortex (ACC) and a greater response to low risk (low-likelihood) negative feedback was identified in caudal ACC and inferior frontal gyrus. In addition, attenuation of a ventromedial prefrontal cortex (vmPFC) "reward-seeking" signal (i.e., increasing response with greater reward) during risky decisions at follow-up was associated with less substance use during the study interval. CONCLUSIONS:Changes in risk- and reward-related signaling in ACC/vmPFC appear to reflect recovery and may support sobriety.
| S-EPMC5086261 | biostudies-literature
Project description:Background: Postpartum is a highly vulnerable time for women with opioid use disorder (OUD). Our primary objective was to identify patient and provider reported aspects of the pregnancy to postpartum transition that impact recovery progress for postpartum women receiving medication for opioid use disorder (MOUD). Methods: This qualitative study consisted of semi-structured interviews with postpartum women in OUD treatment (n = 12) and providers (n = 9) at an outpatient addiction clinic. Interviews were transcribed and analyzed using an editing style approach to report themes and quotes. Results: Patients and providers identified different themes that both promote and challenge recovery during the postpartum transition. These comprised of clinical factors, including MOUD, neonatal opioid withdrawal syndrome (NOWS) and pain associated with labor and delivery as well as psychosocial factors, such as role of a support system, mental health aspects of anxiety and depression causing mood changes, stigma and mistrust among healthcare providers and child welfare. Conclusions: Patients receiving MOUD and their providers identified multiple aspects unique to the postpartum transition that substantially strengthen and/or oppose OUD recovery. These aspects impacting recovery include factors specific to the receipt of MOUD treatment and those not specific to MOUD, yet tied to the postpartum state. Overall, these findings provide insight into areas for future research focused on identifying opportunities to promote recovery-oriented care for families affected by OUD.
| S-EPMC8720325 | biostudies-literature
Project description:Problematic substance use and addiction is a growing crisis in the United States. As a result, identifying factors that effectively promote addiction recovery is, currently, of particular societal importance. Informed by evidence that-while addiction can be perpetuated by stress-related impulsivity and decreased self-regulation-perceived social support is protective against addiction, we test a model for addiction recovery as a form of posttraumatic growth (PTG), focused specifically on close relationships and personal strength-two domains of PTG. In an initial study, we found that perceived social support and impulsivity predicted number of relapses in individuals in a substance use disorder recovery program. Using experience sampling, we then observed that experiencing a stressful event predicted impulsive behavior. However, experiencing closeness with others-a domain of PTG-was directly associated with perceived social support, and both predicted positive emotional states, which were, in turn, inversely associated with experiencing a stressful event. Further, when experiencing a stressful event, personal strength-also a domain of PTG-was inversely associated with impulsive behavior and was predicted by both perceived social support and positive emotional states. Finally, in a follow-up experiment, we found that an ecological momentary intervention targeting perceived social support decreased impulsivity and increased self-regulation-an aspect of personal strength-in a dose-dependent fashion. Taken together, our findings: (1) support a PTG model for recovery; (2) provide evidence for processes by which close supportive relationships are protective against addiction and relapse; and (3) indicate that self-regulation is responsive to a short in-the-moment perceived social support intervention. We suggest that these findings support the theory that addiction is a social disease in the sense that close personal interactions and supportive relationships: (a) buffer against stress-related impulsivity, thereby protecting against addiction and relapse; and (b) increase personal strength, thereby decreasing the probability of impulsive-including addictive-behavior and promoting recovery.
| S-EPMC10881473 | biostudies-literature
Project description:IntroductionCurrent literature does not dispose from a widely accepted definition of recovery in alcohol use disorder (AUD), and most proposals originate from anglophone countries. This study introduces a pioneering consensus in Spain on the definition of recovery in AUD.MethodThe Delphi method was used. The expert panel, comprising 54 multidisciplinary professionals from the Community of Madrid.ResultsA high level of consensus (≥80% agreement) was reached for 45% of the items and majority (≥60%) for 84%. Recovery is understood as a dynamic, personalized, and voluntary process, potentially enduring throughout one's lifespan. It entails a transformative lifestyle shift aimed at achieving a significant improvement in overall quality of life, encompassing physical and mental health, interpersonal relationships, and environmental factors. The journey of recovery is marked by heightened psychological well-being, is characterized by empowerment, personal growth, existential purpose, and positive identity reconstruction. Recovery is supported by substance use management, requires proactive individual agency and involves both personal and societal responsibilities.ConclusionsThis study represents a milestone as it is the first consensus in the Community of Madrid on the meaning of recovery in AUD. The proposed definition of recovery could be a potential reference for similar regions within Spain or even for other countries with cultural similarities. The elucidation of a clear framework of recovery provides a solid basis for future research efforts and clinical interventions in the Spanish AUD landscape.
| S-EPMC11319745 | biostudies-literature
Project description:Introduction Internet-addiction (IA) is one of the most common non-chemical (or behavioral) addictions with genetic impact and substantial effects of psychological and personality characteristics, taking into account the childhood traumatic experience. Gene-environment interactions (GxE) may substantially impact on the risk of Internet-addiction (IA). Objectives Aim: to test the associations between the functional polymorphism rs6265 (Val66Met) in brain-derived neurotrophic factor (BDNF) gene, affecting BDNF function, and childhood traumatic experience and their GxE interactions with IA risk. Methods In total 456 participants were screened with Chinese Internet Addiction Scale (CIAS) to cut a cohort on two groups: IA (CIAS total score ≥ 65, n=100) and controls (CIAS total score less 64, n=356). The Adverse Childhood Experiences International Questionnaire (ACE-IQ) was used to assess childhood traumatic experience using its main domains: parents (P), family (F), abuse (A) and violence (V). BDNF Val158Met polymorphism was detected by RT-PCR. Results Logistic regression revealed associations of P scores with increased IA risk only after adjustment for sex and age (p=0.01, OR=1.166, 95%CI[1.038-1.309]) and V scores with decreased IA risk (p=0.000, OR=0.799, 95%CI [0,233;0,744] only before adjustment. No associations of F and A with IA risk were found. BDNF Val158Met per se was not associated with IA risk, but significant effect of interaction V score*BDNF rs6265 CC on IA risk in “protective” manner was revealed (р=0.039, OR=0.873, 95%CI[0.768-0.993]) in a model adjusted for sex and age. Conclusions Childhood violence experience interacts with BDNF Val158Met polymorphism and CC (ValVal) genotype may be possibly protective factor decreasing the internet addiction risk Disclosure This work was carried out with the financial support of the Russian Foundation for Basic Research: RFBR grant # 18-29-22079
| S-EPMC9566960 | biostudies-literature
Project description:BackgroundPeer recovery coaches (PRCs) have become a critical tool in addiction treatment in many areas of the world. Despite this fact, no identified research has examined the process or impact of PRC training. Furthermore, no scales were identified to measure trainee confidence in various PRC techniques. The goal of this article is to analyze the process and immediate impact of PRC training of twelve American Indians (AIs) in a culturally-specific program. We focus most specifically on trainee confidence levels.MethodsNo written consent was obtained and completion of the assessment was considered consent. Trainees completed self-assessments before and after the training. The self-assessment examined nine areas ranging from understanding the role of PRCs to knowledge of effective PRC techniques. Paired t-tests were used to assess for changes in individual trainee responses between the pre- and post-assessments.ResultsPre-training responses ranged from moderate to high. Questions with the lowest average confidence levels address PRC activities or specific techniques to facilitate recovery. All nine questions showed statistically significant mean improvements in the post-training self-assessments. Questions regarding specific PRC activities and techniques showed the greatest improvement. Questions relating to helping people more generally showed the smallest improvement. Average post-training responses fell within a very narrow range indicating relatively consistent confidence levels across skills. Analysis indicates participants were possibly over-confident in certain areas (i.e., maintaining boundaries). This small pilot represents an initial attempt to measure confidence levels of PRC trainees. The findings may inform future training by identifying certain areas where emphasis might be most helpful for trainees. In addition, it is hoped that this work will encourage more systematic analysis of the impact of PRC training on individuals.
| S-EPMC7912601 | biostudies-literature
Project description:BackgroundThere is a need for studies that can highlight principles of addiction recovery. Because social relationships are involved in all change processes, understanding how social motivations affect the recovery process is vital to guide support programs.MethodsThe objective was to develop a model of recovery by examining addicted individuals' social motivations through longitudinal assessment of non-professional support dyads. A qualitative, longitudinal study design was used, combining focus groups and in-depth interviews with addicted individuals and their sponsors. Data were analyzed using the principles of grounded theory: open coding and memos for conceptual labelling, axial coding for category building, and selective coding for theory building. The setting was an addiction recovery social support program in Oslo, Norway. The informants included nine adults affected by addiction, six sponsors, and the program coordinator. The participants were addicted to either alcohol (2), benzodiazepines (1), pain killers (1) or polydrug-use (5). The sponsors were unpaid, and had no history of addiction problems.ResultsSupport perceived to be ineffective emerged in dyads with no operationalized goal, and high emotional availability with low degree of practical support. Support perceived to be effective was signified by the sponsor attending to power imbalance and the addict coming into position to help others and feel useful.ConclusionsThe findings appear best understood as a positive identity-model of recovery, indicated by the pursuit of skill building relevant to a non-drug using identity, and enabled by the on-going availability of instrumental support. This produced situations where role reversals were made possible, leading to increased self-esteem. Social support programs should be based on a positive identity-model of recovery that enable the building of a life-sustainable identity.
| S-EPMC3751355 | biostudies-literature
Project description:BackgroundThe health and well-being of students in recovery from substance use disorder are increasingly being recognized as a priority on college campuses. This scoping review maps the state of the existing literature evaluating collegiate recovery programming to highlight research gaps and inform policy.MethodWe conducted a systematic search of articles related to collegiate recovery programming published before August 2020. The 15 extracted study characteristics included publication type, study design, primary outcomes, reporting of behavioral addictions, mutual-help group attendance, sample demographic information, school size, ownership, and funding source.ResultsThe PRISMA-guided search strategy identified 357 articles for abstract review; of 113 articles retained for full-text review, 54 studies met criteria for inclusion. Primary outcomes were coded into four domains: clinical, recovery experience, program characterization, and stigma. Most (57%) used quantitative observational designs and 41% employed qualitative research designs. Government or foundation grants funded 11% of the studies.ConclusionThe domains identified offer a framework for healthcare providers, college administrators, and researchers to understand and improve programs, thereby better serving this vulnerable student group.
| S-EPMC8259809 | biostudies-literature
Project description:IntroductionThis study aims to estimate the prevalence of drug addiction among high-school students and its association with violence and school behavior. The present study provides baseline data focusing specifically on the extent of drug addiction and violence.MethodsA cross-sectional study design was used. The questionnaire covered students' demographic profiles, including age, gender, and academic branch, and statements related to violent behaviors and school-related factors. A urine sample was collected from each participant to test for drugs and was analyzed by Multi-Drug Rapid Test Cup.ResultsOut of 440 students, a total of 414 were included in this study. Positive drug use via urine sample was confirmed in 70 students (16.9%), with 80% being males. Violent behaviors were common, including used to write on the walls (118, 28.5%), had problems with teachers (107, 25.9%) or peers (267, 64.5%), or using abusive language with school staff (63, 15.2%). There were no significant associations between drug addiction and these violent behaviors (p > 0.05). Students who had no respect for the teachers were significantly more in the addicted group (31.4%) than the non-addicted group (14%) (p = 0.004).ConclusionHigh school should be identified as a critical period at risk for drug use and violent actions. This study points to the importance of early detection of drug addiction among vulnerable young people, enabling the development of educational programs to prevent abuse and dependence on substances.
| S-EPMC8209660 | biostudies-literature